Antifungal Therapy: New Advances in the Understanding and Treatment of Mycosis

Scorzoni, Liliana; de Paula e Silva, Ana C. A.; Marcos, Caroline M.; Assato, Patrícia A.; de Melo, Wanessa C. M. A.; de Oliveira, Haroldo C.; Costa-Orlandi, Caroline B.; Mendes-Giannini, Maria J. S.; Fusco-Almeida, Ana M.

doi:10.3389/fmicb.2017.00036

Cited by 418Antifungal resistance and susceptibilityFungal Plant Pathogen ControlFungal Infections and Studies

Antifungal Therapy: New Advances in the Understanding and Treatment of Mycosis

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Scorzoni, Liliana, de Paula e Silva, Ana C. A., Marcos, Caroline M., Assato, Patrícia A., de Melo, Wanessa C. M. A., de Oliveira, Haroldo C., Costa-Orlandi, Caroline B., Mendes-Giannini, Maria J. S. +1 more·2017·Frontiers in Microbiology

DOI 10.3389/fmicb.2017.00036PMC PMC5253656

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Abstract

The high rates of morbidity and mortality caused by fungal infections are associated with the current limited antifungal arsenal and the high toxicity of the compounds. Additionally, identifying novel drug targets is challenging because there are many similarities between fungal and human cells. The most common antifungal targets include fungal RNA synthesis and cell wall and membrane components, though new antifungal targets are being investigated. Nonetheless, fungi have developed resistance mechanisms, such as overexpression of efflux pump proteins and biofilm formation, emphasizing the importance of understanding these mechanisms. To address these problems, different approaches to preventing and treating fungal diseases are described in this review, with a focus on the resistance mechanisms of fungi, with the goal of developing efficient strategies to overcoming and preventing resistance as well as new advances in antifungal therapy. Due to the limited antifungal arsenal, researchers have sought to improve treatment via different approaches, and the synergistic effect obtained by the combination of antifungals contributes to reducing toxicity and could be an alternative for treatment. Another important issue is the development of new formulations for antifungal agents, and interest in nanoparticles as new types of carriers of antifungal drugs has increased. In addition, modifications to the chemical structures of traditional antifungals have improved their activity and pharmacokinetic parameters. Moreover, a different approach to preventing and treating fungal diseases is immunotherapy, which involves different mechanisms, such as vaccines, activation of the immune response and inducing the production of host antimicrobial molecules. Finally, the use of a mini-host has been encouraging for in vivo testing because these animal models demonstrate a good correlation with the mammalian model; they also increase the speediness of as well as facilitate the preliminary testing of new antifungal agents. In general, many years are required from discovery of a new antifungal to clinical use. However, the development of new antifungal strategies will reduce the therapeutic time and / or increase the quality of life of patients.

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Molecular Mechanisms of 5-Fluorocytosine Resistance in Yeasts and Filamentous Fungi
Delma, F. Z., Al-Hatmi, A. M. S., Brüggemann, R. J. M., Melchers, W. J. G., de Hoog, S., Verweij, P. E., & Buil, J. B. (2021) · Journal of Fungi · doi:10.3390/jof7110909 · Cited by 96 · see citing works
Synergistic and antagonistic drug interactions in the treatment of systemic fungal infections
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The two-component response regulator Ssk1 and the mitogen-activated protein kinase Hog1 control antifungal drug resistance and cell wall architecture of Candida auris
Shivarathri, R., Jenull, S., Stoiber, A., Chauhan, M., Mazumdar, R., Singh, A., Nogueira, F., Kuchler, K., Chowdhary, A., & Chauhan, N. (2020) · mSphere · doi:10.1128/msphere.00973-20 · Cited by 59 · see citing works
Multiresistant Fusarium Pathogens on Plants and Humans: Solutions in (from) the Antifungal Pipeline?
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Assessment of the in vitro and in vivo activity of atorvastatin against Candida albicans.
Ajdidi, A., Sheehan, G., Abu Elteen, K., & Kavanagh, K. (2019) · Journal of medical microbiology · doi:10.1099/jmm.0.001065 · Cited by 18 · see citing works

Authors: Scorzoni, L., de Paula e Silva, A. C. A., Marcos, C. M., Assato, P. A., de Melo, W. C. M. A., de Oliveira, H. C., Costa-Orlandi, C. B., Mendes-Giannini, M. J. S., & Fusco-Almeida, A. M.
Affiliations: Universidade Estadual Paulista (Unesp) (BR)
ORCID: Scorzoni, Liliana
Marcos, Caroline M.
Assato, Patrícia A.
Costa-Orlandi, Caroline B.
Venue: Frontiers in Microbiology
Publisher: Frontiers Media SA
Published: 2017-01-23
Volume: 08
Pages: 36-36
ISSN: 1664-302X (ISSN-L)
DOI: 10.3389/fmicb.2017.00036
PMC: PMC5253656
OpenAlex: W2581889147
Cited by: 418
References: 341
Citations by year: 2026: 13 · 2025: 26 · 2024: 52 · 2023: 55 · 2022: 59 · 2021: 63 · 2020: 62 · 2019: 51 · 2018: 29 · 2017: 8
FWCI: 6.30
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
Locations: Frontiers in Microbiology (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
UNESP Institutional Repository (São Paulo State University) (submittedVersion, other-oa)
Funders: Conselho Nacional de Desenvolvimento Científico e Tecnológico (150261/2016-0 (CC-O))
Fundação de Amparo à Pesquisa do Estado de São Paulo (2013/10917-9, 2015/03700-9, 2015/14023-8, 2016/17048-4)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords: antifungal therapy, fungal infection, antifungal resistance, efflux pumps, biofilm formation, combination antifungal therapy, antifungal toxicity, antifungal drug delivery, nanoparticles, structure-activity modification, immunotherapy, antifungal vaccines, antifungal drug development, in vivo animal models

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Antifungal Therapy: New Advances in the Understanding and Treatment of Mycosis

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