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Martin I, Hart A. Antifungal medicines in the terrestrial environment: Levels in biosolids from England and Wales. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 870:161999. [PMID: 36737009 DOI: 10.1016/j.scitotenv.2023.161999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
Antifungals are used widely in clinical and agricultural practice to control fungal growth, either treating or preventing infection. There are reports of increasing prevalence of resistance to antifungals in human pathogens and concern that their use in agriculture is driving clinical resistance in patients. While crop protection products are the most obvious source in agriculture, a further source may be biosolids from wastewater treatment. In the UK, these are applied to land to provide nutrients and improve soil structure for crops. In this study, biosolids from ten sites in England and one in Wales were analysed for clinical antifungals. Ketoconazole and miconazole were detected in all samples with a median concentration of 0.87 and 0.54 mg kg-1 dry weight (DW), respectively. Clotrimazole was detected at seven of eleven sites at a median level of 1.32 mg kg-1 DW and its absence at four others was considered treatment related. Two prescription-only and systemic medications, itraconazole and posaconazole, were frequently detected with median concentrations of 0.14 mg kg-1 DW and 0.09 mg kg-1 DW, respectively. The biosolid levels of itraconazole found in this study were two orders of magnitude higher than an indicative Predicted No Effect Concentration for resistance selection (PNEC-R) in soil. Neither fluconazole, griseofulvin, and voriconazole nor flucytosine and nystatin were found above the limit of detection of 0.01 or 0.1 mg kg-1 as received, respectively. The findings show that biosolids represent a viable pathway for antifungal agents to reach soil.
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Affiliation(s)
- Ian Martin
- Environment Agency, Horizon House, Deanery Road, Bristol BS1 5TL, United Kingdom of Great Britain and Northern Ireland.
| | - Alwyn Hart
- Environment Agency, Horizon House, Deanery Road, Bristol BS1 5TL, United Kingdom of Great Britain and Northern Ireland
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2
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Aljaffary M, Jang H, Alomeir N, Zeng Y, Alkhars N, Vasani S, Almulhim A, Wu TT, Quataert S, Bruno J, Lee A, Xiao J. Effects of Nystatin oral rinse on oral Candida species and Streptococcus mutans among healthy adults. Clin Oral Investig 2023:10.1007/s00784-023-04969-5. [PMID: 36964224 DOI: 10.1007/s00784-023-04969-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 03/19/2023] [Indexed: 03/26/2023]
Abstract
OBJECTIVES To examine the effect of Nystatin oral rinse on oral Candida species and Streptococcus mutans carriage. MATERIALS AND METHODS Twenty healthy adults with oral candidiasis participated in the single-arm clinical trial and received Nystatin oral rinse for 7 days, 4 applications/day, and 600,000 International Units/application. Demographic-socioeconomic-oral-medical conditions were obtained. Salivary and plaque Candida species and Streptococcus mutans were assessed at baseline and 1-week and 3-month follow-ups. Twenty-four salivary cytokines were assessed. Candida albicans isolates underwent Nystatin susceptibility test. RESULTS Half of participants (10/20) were free of salivary C. albicans after using Nystatin rinse. Salivary S. mutans was significantly reduced at 3-month follow-up (p < 0.05). Periodontal status reflected by bleeding-on-probing was significantly improved at 1-week and 3-month follow-ups (p < 0.05). Plaque accumulation was significantly reduced at 1-week follow-up (p < 0.05). Interestingly, the responses to Nystatin oral rinse were not associated with race, gender, age, oral hygiene practice, adherence to Nystatin rinse, or sweet consumption (p > 0.05). No C. albicans isolates were resistant to Nystatin. Furthermore, salivary cytokine eotaxin and fractalkine were significantly reduced at 3-month follow-up among participants who responded to Nystatin rinse (p < 0.05). CONCLUSIONS The study results indicate that oral antifungal treatment had an effect on S. mutans salivary carriage. Future clinical trials are warranted to comprehensively assess the impact of antifungal treatment on the oral flora other than S. mutans and Candida. CLINICAL RELEVANCE Due to the potential cariogenic role of oral Candida species, antifungal approaches shed new light on the prevention and management of dental caries from a fungal perspective.
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Affiliation(s)
- Mohammed Aljaffary
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hoonji Jang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
- Temple University, Philadelphia, PA, USA
| | - Nora Alomeir
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Yan Zeng
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Naemah Alkhars
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
- Faculty of Dentistry, Department of General Dental Practice, Kuwait University, Kuwait City, Kuwait
| | - Shruti Vasani
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Abdullah Almulhim
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Tong Tong Wu
- Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Sally Quataert
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA
| | - Jennifer Bruno
- Immunology and Microbiology, University of Rochester Medical Center, Rochester, NY, USA
| | - Aaron Lee
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
- Perinatal Oral Health, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, 14620, USA.
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Szymański M, Chmielewska S, Czyżewska U, Malinowska M, Tylicki A. Echinocandins - structure, mechanism of action and use in antifungal therapy. J Enzyme Inhib Med Chem 2022; 37:876-894. [PMID: 35296203 PMCID: PMC8933026 DOI: 10.1080/14756366.2022.2050224] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
With increasing number of immunocompromised patients as well as drug resistance in fungi, the risk of fatal fungal infections in humans increases as well. The action of echinocandins is based on the inhibition of β-(1,3)-d-glucan synthesis that builds the fungal cell wall. Caspofungin, micafungin, anidulafungin and rezafungin are semi-synthetic cyclic lipopeptides. Their specific chemical structure possess a potential to obtain novel derivatives with better pharmacological properties resulting in more effective treatment, especially in infections caused by Candida and Aspergillus species. In this review we summarise information about echinocandins with closer look on their chemical structure, mechanism of action, drug resistance and usage in clinical practice. We also introduce actual trends in modification of this antifungals as well as new methods of their administration, and additional use in viral and bacterial infections.
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Affiliation(s)
- Mateusz Szymański
- Department of Microbiology and Biotechnology, Laboratory of Cytobiochemistry, University of Bialystok, Bialystok, Poland
| | - Sandra Chmielewska
- Doctoral School of Exact and Natural Sciences, University of Bialystok, Bialystok, Poland
| | - Urszula Czyżewska
- Department of Microbiology and Biotechnology, Laboratory of Cytobiochemistry, University of Bialystok, Bialystok, Poland
| | - Marta Malinowska
- Department of Organic Chemistry, Laboratory of Natural Product Chemistry, University of Bialystok, Bialystok, Poland
| | - Adam Tylicki
- Department of Microbiology and Biotechnology, Laboratory of Cytobiochemistry, University of Bialystok, Bialystok, Poland
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McEvoy K, Normile TG, Poeta MD. Antifungal Drug Development: Targeting the Fungal Sphingolipid Pathway. J Fungi (Basel) 2020; 6:jof6030142. [PMID: 32825250 PMCID: PMC7559796 DOI: 10.3390/jof6030142] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/13/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023] Open
Abstract
Fungal infections are becoming more prevalent and problematic due to the continual rise of immune deficient patients as well as the progressive development of drug resistance towards currently available antifungal drugs. There has been a significant increase in the development of antifungal compounds with a similar mechanism of action of current drugs. In contrast, there has been very little progress in developing compounds inhibiting totally new fungal targets or/and fungal pathways. This review focuses on novel compounds recently discovered to target the fungal sphingolipids and their metabolizing enzymes.
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Affiliation(s)
- Kyle McEvoy
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, NY 11794, USA; (K.M.); (T.G.N.)
| | - Tyler G. Normile
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, NY 11794, USA; (K.M.); (T.G.N.)
| | - Maurizio Del Poeta
- Department of Microbiology and Immunology, Stony Brook University, Stony Brook, NY 11794, USA; (K.M.); (T.G.N.)
- Division of Infectious Diseases, School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
- Veterans Administration Medical Center, Northport, NY 11768, USA
- Correspondence: ; Tel.: +1-631-632-4024
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5
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Berzaghi R, Agócs A, Curto MA, Gulyás-Fekete G, Kocsis B, Ribas JC, Lóránd T. Novel Cell Wall Antifungals Reveal a Special Synergistic Activity in pbr1 Mutants Resistant to the Glucan Synthesis Antifungals Papulacandins and Echinocandins. Front Microbiol 2019; 10:1692. [PMID: 31428061 PMCID: PMC6689975 DOI: 10.3389/fmicb.2019.01692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 07/09/2019] [Indexed: 01/22/2023] Open
Abstract
A series of 4-(arylmethylene)-3-isochromanones have been prepared with base-catalyzed Knoevenagel condensation starting from 3-isochromanone and aromatic aldehydes. The outcome of the reaction- the isomeric composition of the products depends on the aromatic aldehyde applied. These reactions afforded mostly the more stable E-diastereoisomer, but some condensations resulted in the Z-diastereoisomer or mixture of the stereoisomers (1-16). The products showed antifungal effect against some pathogenic fungi. We wanted to extend this study and to synthesize a new generation of 4-(arylmethylene)-3-isochromanones. These condensations led mostly to E-diastereoisomers (17-30). The structure verifications were performed by FT IR, 1H and13C NMR methods. Both the 1-16 and the novel 17-30 compounds have been screened against the three yeast models, fission yeast Schizosaccharomyces pombe (wild-type, and pbr1-6 and pbr1-8 mutants resistant to specific cell wall synthesis inhibitors), budding yeast Saccharomyces cerevisiae (wild-type and pbr1-1) and pathogenic yeast Candida albicans (wild-type, ATCC 26555, 90028 and SC5314). Osmotic protection with sorbitol attenuated the in vivo inhibition in living cells suggesting a cell wall-specific antifungal effect. Moreover, the S. pombe wild-type and mutant strains were tested for their resistant or sensitive in vitro β(1,3)-glucan synthase (GS) activity. We found both in vivo in living cells and in vitro in the enzymatic GS assay a synergistic effect of higher sensitivity of the pbr1 mutants resistant to the specific GS inhibitors papulacandins and echinocandins. These results may provide new insights into new strategies of combined antifungal therapy of GS inhibitors directed against spontaneous mutants resistant to echinocandins.
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Affiliation(s)
- Rodrigo Berzaghi
- Instituto de Biología Funcional y Genómica, Consejo Superior de Investigaciones Científicas, Universidad de Salamanca, Salamanca, Spain
| | - Attila Agócs
- Department of Biochemistry and Medical Chemistry, University of Pécs Medical School, Pécs, Hungary
| | - María A. Curto
- Instituto de Biología Funcional y Genómica, Consejo Superior de Investigaciones Científicas, Universidad de Salamanca, Salamanca, Spain
| | - Gergely Gulyás-Fekete
- Department of Biochemistry and Medical Chemistry, University of Pécs Medical School, Pécs, Hungary
| | - Béla Kocsis
- Department of Medical Microbiology and Immunology, University of Pécs Medical School, Pécs, Hungary
| | - Juan C. Ribas
- Instituto de Biología Funcional y Genómica, Consejo Superior de Investigaciones Científicas, Universidad de Salamanca, Salamanca, Spain
| | - Tamás Lóránd
- Department of Biochemistry and Medical Chemistry, University of Pécs Medical School, Pécs, Hungary
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Abstract
Natural cyclic peptides are conformationally constrained notable biomolecules and reveal several drug-like properties such as high binding affinity, metabolic stability, target selectivity, bioavailability, low toxicity and flexibility. They have attracted a lot of attention as alternative sources of new drugs to traditional small molecules in drug discovery. Compared to classical medicines, cyclic peptides with a novel mechanism of action are attractive for their potential therapeutic applications particularly for cancer therapy and several diseases caused by resistant and non-resistant bacteria, virus, and fungi. Herein, we provide an overview of the naturally occurring biologically active cyclic peptide therapeutic landscape, including promising candidates, which are under trial in different stages for future and/or clinically used drugs against different diseases. This will certainly be an essential resource for upcoming and existing researchers and scientists within industry and academia in medicinal, bioorganic, and natural product chemistry.
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Affiliation(s)
- Smritilekha Bera
- School of Chemical Sciences, Central University of Gujarat, Gandhinagar - 382030, India
| | - Dhananjoy Mondal
- School of Chemical Sciences, Central University of Gujarat, Gandhinagar - 382030, India
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7
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The CWI Pathway: Regulation of the Transcriptional Adaptive Response to Cell Wall Stress in Yeast. J Fungi (Basel) 2017; 4:jof4010001. [PMID: 29371494 PMCID: PMC5872304 DOI: 10.3390/jof4010001] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 12/11/2017] [Accepted: 12/19/2017] [Indexed: 12/14/2022] Open
Abstract
Fungi are surrounded by an essential structure, the cell wall, which not only confers cell shape but also protects cells from environmental stress. As a consequence, yeast cells growing under cell wall damage conditions elicit rescue mechanisms to provide maintenance of cellular integrity and fungal survival. Through transcriptional reprogramming, yeast modulate the expression of genes important for cell wall biogenesis and remodeling, metabolism and energy generation, morphogenesis, signal transduction and stress. The yeast cell wall integrity (CWI) pathway, which is very well conserved in other fungi, is the key pathway for the regulation of this adaptive response. In this review, we summarize the current knowledge of the yeast transcriptional program elicited to counterbalance cell wall stress situations, the role of the CWI pathway in the regulation of this program and the importance of the transcriptional input received by other pathways. Modulation of this adaptive response through the CWI pathway by positive and negative transcriptional feedbacks is also discussed. Since all these regulatory mechanisms are well conserved in pathogenic fungi, improving our knowledge about them will have an impact in the developing of new antifungal therapies.
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8
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A novel connection between the Cell Wall Integrity and the PKA pathways regulates cell wall stress response in yeast. Sci Rep 2017; 7:5703. [PMID: 28720901 PMCID: PMC5515849 DOI: 10.1038/s41598-017-06001-9] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/13/2017] [Indexed: 12/22/2022] Open
Abstract
Fungal cells trigger adaptive mechanisms to survive in situations that compromise cell wall integrity. We show here that the global transcriptional response elicited by inhibition of the synthesis of β-1,3-glucan by caspofungin, encompasses a set of genes that are dependent on Slt2, the MAPK of the Cell Wall Integrity (CWI) pathway, and a broad group of genes regulated independently of Slt2. Genes negatively regulated by the cyclic AMP/Protein Kinase A (PKA) signaling pathway were overrepresented in the latter group. Moreover, cell wall stress mediated by inhibition of β-1,3-glucan synthesis, but not by other cell wall interfering compounds, negatively regulated PKA signaling as indicated by the nuclear localisation of Msn2, cellular glycogen accumulation, a decrease of intracellular cAMP levels and a severe decrease in both the activation of the small GTPase Ras2 and the phosphorylation of known substrates of PKA. All these effects relied on the plasma membrane-spanning sensor of the CWI pathway Wsc1. In addition, caspofungin induced a reduction in the cytosolic pH, which was dependent on the extracellular region of Wsc1. Therefore, alterations of the β-1,3-glucan network in the fungal cell wall, induce, through Wsc1, the activation of the CWI pathway and parallel inhibition of PKA signaling.
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9
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Novel alkylated azoles as potent antifungals. Eur J Med Chem 2017; 133:309-318. [PMID: 28395217 DOI: 10.1016/j.ejmech.2017.03.075] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/27/2017] [Accepted: 03/30/2017] [Indexed: 11/23/2022]
Abstract
Fluconazole (FLC) is the drug of choice when it comes to treat fungal infections such as invasive candidiasis in humans. However, the widespread use of FLC has resulted in the development of resistance to this drug in various fungal strains and, simultaneously has occasioned the need for new antifungal agents. Herein, we report the synthesis of 27 new FLC derivatives along with their antifungal activity against a panel of 13 clinically relevant fungal strains. We also explore their toxicity against mammalian cells, their hemolytic activity, as well as their mechanism of action. Overall, many of our FLC derivatives exhibited broad-spectrum antifungal activity and all compounds displayed an MIC value of <0.03 μg/mL against at least one of the fungal strains tested. We also found them to be less hemolytic and less cytotoxic to mammalian cells than the FDA approved antifungal agent amphotericin B. Finally, we demonstrated with our best derivative that the mechanism of action of our compounds is the inhibition of the sterol 14α-demethylase enzyme involved in ergosterol biosynthesis.
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10
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Aranda-Martinez A, Lopez-Moya F, Lopez-Llorca LV. Cell wall composition plays a key role on sensitivity of filamentous fungi to chitosan. J Basic Microbiol 2016; 56:1059-1070. [DOI: 10.1002/jobm.201500775] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/11/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Almudena Aranda-Martinez
- Laboratory of Plant Pathology, Department of Marine Sciences, Applied Biology, Multidisciplinary Institute for Environmental Studies Ramón Margalef; University of Alicante; Alicante Spain
| | - Federico Lopez-Moya
- Laboratory of Plant Pathology, Department of Marine Sciences, Applied Biology, Multidisciplinary Institute for Environmental Studies Ramón Margalef; University of Alicante; Alicante Spain
| | - Luis Vicente Lopez-Llorca
- Laboratory of Plant Pathology, Department of Marine Sciences, Applied Biology, Multidisciplinary Institute for Environmental Studies Ramón Margalef; University of Alicante; Alicante Spain
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11
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Gil-Alonso S, Jauregizar N, Ortega I, Eraso E, Suárez E, Quindós G. In vitro pharmacodynamic modelling of anidulafungin against Candida spp. Int J Antimicrob Agents 2016; 47:178-83. [DOI: 10.1016/j.ijantimicag.2015.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 12/10/2015] [Accepted: 12/16/2015] [Indexed: 01/12/2023]
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12
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James KM, MacDonald KW, Chanyi RM, Cadieux PA, Burton JP. Inhibition of Candida albicans biofilm formation and modulation of gene expression by probiotic cells and supernatant. J Med Microbiol 2016; 65:328-336. [PMID: 26847045 DOI: 10.1099/jmm.0.000226] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Oral candidiasis is a disease caused by opportunistic species of Candida that normally reside on human mucosal surfaces. The transition of Candida from budding yeast to filamentous hyphae allows for covalent attachment to oral epithelial cells, followed by biofilm formation, invasion and tissue damage. In this study, combinations of Lactobacillus plantarum SD5870, Lactobacillus helveticus CBS N116411 and Streptococcus salivarius DSM 14685 were assessed for their ability to inhibit the formation of and disrupt Candida albicans biofilms. Co-incubation with probiotic supernatants under hyphae-inducing conditions reduced C. albicans biofilm formation by >75 % in all treatment groups. Likewise, combinations of live probiotics reduced biofilm formation of C. albicans by >67 %. When live probiotics or their supernatants were overlaid on preformed C. albicans biofilms, biofilm size was reduced by >63 and >65 % respectively. Quantitative real-time PCR results indicated that the combined supernatants of SD5870 and CBS N116411 significantly reduced the expression of several C. albicans genes involved in the yeast-hyphae transition: ALS3 (adhesin/invasin) by 70 % (P < 0.0001), EFG1 (hyphae-specific gene activator) by 47 % (P = 0.0061), SAP5 (secreted protease) by 49 % (P < 0.0001) and HWP1 (hyphal wall protein critical to biofilm formation) by >99 % (P < 0.0001). These findings suggest the combination of L. plantarum SD5870, L. helveticus CBS N116411 and S. salivarius DSM 14685 is effective at both preventing the formation of and removing preformed C. albicans biofilms. Our novel results point to the downregulation of several Candida genes critical to the yeast-hyphae transition, biofilm formation, tissue invasion and cellular damage.
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Affiliation(s)
- K M James
- Fanshawe College, London, Ontario, Canada.,Integra Medical Inc., Stiller Center for Technology Commercialization, Western University Research Park, London, Ontario, Canada
| | - K W MacDonald
- Integra Medical Inc., Stiller Center for Technology Commercialization, Western University Research Park, London, Ontario, Canada
| | - R M Chanyi
- Fanshawe College, London, Ontario, Canada.,Integra Medical Inc., Stiller Center for Technology Commercialization, Western University Research Park, London, Ontario, Canada.,Department of Microbiology and Immunology, University of Western Ontario, London, Ontario, Canada
| | - P A Cadieux
- Fanshawe College, London, Ontario, Canada.,Department of Microbiology and Immunology, University of Western Ontario, London, Ontario, Canada.,Canadian Centre for Human Microbiome and Probiotics, Lawson Health Research Institute, London, Ontario, Canada
| | - J P Burton
- Canadian Centre for Human Microbiome and Probiotics, Lawson Health Research Institute, London, Ontario, Canada.,Department of Microbiology and Immunology, University of Western Ontario, London, Ontario, Canada.,Division of Urology, Department of Surgery, University of Western Ontario, London, Ontario, Canada
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13
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De Cremer K, Staes I, Delattin N, Cammue BPA, Thevissen K, De Brucker K. Combinatorial drug approaches to tackleCandida albicansbiofilms. Expert Rev Anti Infect Ther 2015; 13:973-84. [DOI: 10.1586/14787210.2015.1056162] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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14
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Kováčová K, Degani G, Stratilová E, Farkaš V, Popolo L. Catalytic properties of Phr family members of cell wall glucan remodeling enzymes: implications for the adaptation of Candida albicans to ambient pH. FEMS Yeast Res 2015; 15:fou011. [DOI: 10.1093/femsyr/fou011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Wang S, Wang Y, Liu W, Liu N, Zhang Y, Dong G, Liu Y, Li Z, He X, Miao Z, Yao J, Li J, Zhang W, Sheng C. Novel carboline derivatives as potent antifungal lead compounds: design, synthesis, and biological evaluation. ACS Med Chem Lett 2014; 5:506-11. [PMID: 24900870 DOI: 10.1021/ml400492t] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 02/13/2014] [Indexed: 11/30/2022] Open
Abstract
A series of novel antifungal carboline derivatives was designed and synthesized, which showed broad-spectrum antifungal activity. Particularly, compound C38 showed comparable in vitro antifungal activity to fluconazole without toxicity to human embryonic lung cells. It also exhibited good fungicidal activity against both fluconazole-sensitive and -resistant Candida albicans cells and had potent inhibition activity against Candida albicans biofilm formation and hyphal growth. Moreover, C38 showed good synergistic antifungal activity in combination with fluconazole (FLC) against FLC-resistant Candida species. Preliminary mechanism studies revealed that C38 might act by inhibiting the synthesis of fungal cell wall.
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Affiliation(s)
- Shengzheng Wang
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
| | - Yan Wang
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
| | - Wei Liu
- School
of Medicine, Tongji University, 1239 Siping Road, Shanghai 200092, People’s Republic of China
| | - Na Liu
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
| | - Yongqiang Zhang
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
| | - Guoqiang Dong
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
| | - Yang Liu
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
| | - Zhengang Li
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
| | - Xiaomeng He
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
| | - Zhenyuan Miao
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
| | - Jianzhong Yao
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
| | - Jian Li
- School
of Pharmacy, East China University of Science and Technology, Shanghai 200237, People’s Republic of China
| | - Wannian Zhang
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
| | - Chunquan Sheng
- School
of Pharmacy, Second Military Medical University, 325 Guohe Road, Shanghai 200433, People’s Republic of China
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16
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Pea F. Current pharmacological concepts for wise use of echinocandins in the treatment ofCandidainfections in septic critically ill patients. Expert Rev Anti Infect Ther 2014; 11:989-97. [DOI: 10.1586/14787210.2013.836058] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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17
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Reactive oxygen species-inducing antifungal agents and their activity against fungal biofilms. Future Med Chem 2014; 6:77-90. [DOI: 10.4155/fmc.13.189] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Invasive fungal infections are associated with very high mortality rates ranging from 20–90% for opportunistic fungal pathogens such as Candida albicans, Cryptococcus neoformans and Aspergillus fumigatus. Fungal resistance to antimycotic treatment can be genotypic (due to resistant strains) as well as phenotypic (due to more resistant fungal lifestyles, such as biofilms). With regard to the latter, biofilms are considered to be critical in the development of invasive fungal infections. However, there are only very few antimycotics, such as miconazole (azoles), echinocandins and liposomal formulations of amphotericin B (polyenes), which are also effective against fungal biofilms. Interestingly, these antimycotics all induce reactive oxygen species (ROS) in fungal (biofilm) cells. This review provides an overview of the different classes of antimycotics and novel antifungal compounds that induce ROS in fungal planktonic and biofilm cells. Moreover, different strategies to further enhance the antibiofilm activity of such ROS-inducing antimycotics will be discussed.
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Antifungal agents commonly used in the superficial and mucosal candidiasis treatment: mode of action and resistance development. Postepy Dermatol Alergol 2013; 30:293-301. [PMID: 24353489 PMCID: PMC3858657 DOI: 10.5114/pdia.2013.38358] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 04/16/2013] [Accepted: 06/23/2013] [Indexed: 12/02/2022] Open
Abstract
Recent progress in medical sciences and therapy resulted in an increased number of immunocompromised individuals. Candida albicans is the leading opportunistic fungal pathogen causing infections in humans, ranging from superficial mucosal lesions to disseminated or bloodstream candidiasis. Superficial candidiasis not always presents a risk to the life of the infected host, however it significantly lowers the quality of life. Superficial Candida infections are difficult to treat and their frequency of occurrence is currently rising. To implement successful treatment doctors should be up to date with better understanding of C. albicans resistance mechanisms. Despite high frequency of Candida infections there is a limited number of antimycotics available for therapy. This review focuses on current understanding of the mode of action and resistance mechanisms to conventional and emerging antifungal agents for treatment of superficial and mucosal candidiasis.
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Zambuzzi-Carvalho PF, Tomazett PK, Santos SC, Ferri PH, Borges CL, Martins WS, de Almeida Soares CM, Pereira M. Transcriptional profile of Paracoccidioides induced by oenothein B, a potential antifungal agent from the Brazilian Cerrado plant Eugenia uniflora. BMC Microbiol 2013; 13:227. [PMID: 24119145 PMCID: PMC3852496 DOI: 10.1186/1471-2180-13-227] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 10/01/2013] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The compound oenothein B (OenB), which is isolated from the leaves of Eugenia uniflora, a Brazilian Cerrado plant, interferes with Paracoccidioides yeast cell morphology and inhibits 1,3-β-D-glucan synthase (PbFKS1) transcript accumulation, which is involved in cell wall synthesis. In this work we examined the gene expression changes in Paracoccidioides yeast cells following OenB treatment in order to investigate the adaptive cellular responses to drug stress. RESULTS We constructed differential gene expression libraries using Representational Difference Analysis (RDA) of Paracoccidioides yeast cells treated with OenB for 90 and 180 min. Treatment for 90 min resulted in the identification of 463 up-regulated expressed sequences tags (ESTs) and 104 down-regulated ESTs. For the 180 min treatment 301 up-regulated ESTs and 143 down-regulated were identified. Genes involved in the cell wall biosynthesis, such as GLN1, KRE6 and FKS1, were found to be regulated by OenB. Infection experiments in macrophages corroborated the in vitro results. Fluorescence microscopy showed increased levels of chitin in cells treated with OenB. The carbohydrate polymer content of the cell wall of the fungus was also evaluated, and the results corroborated with the transcriptional data. Several other genes, such as those involved in a variety of important cellular processes (i.e., membrane maintenance, stress and virulence) were found to be up-regulated in response to OenB treatment. CONCLUSIONS The exposure of Paracoccidioides to OenB resulted in a complex altered gene expression profile. Some of the changes may represent specific adaptive responses to this compound in this important pathogenic fungus.
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Affiliation(s)
- Patrícia Fernanda Zambuzzi-Carvalho
- Departamento de Bioquímica e Biologia Molecular, Laboratório de Biologia Molecular, Instituto de Ciências Biológicas, ICBII, Campus II, Universidade Federal de Goiás, C.P. 131, 74001-970 Goiânia, GO, Brazil
| | - Patrícia Kott Tomazett
- Departamento de Bioquímica e Biologia Molecular, Laboratório de Biologia Molecular, Instituto de Ciências Biológicas, ICBII, Campus II, Universidade Federal de Goiás, C.P. 131, 74001-970 Goiânia, GO, Brazil
| | - Suzana Costa Santos
- Laboratório de Bioatividade Molecular, Instituto de Química, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Pedro Henrique Ferri
- Laboratório de Bioatividade Molecular, Instituto de Química, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Clayton Luiz Borges
- Departamento de Bioquímica e Biologia Molecular, Laboratório de Biologia Molecular, Instituto de Ciências Biológicas, ICBII, Campus II, Universidade Federal de Goiás, C.P. 131, 74001-970 Goiânia, GO, Brazil
| | | | - Célia Maria de Almeida Soares
- Departamento de Bioquímica e Biologia Molecular, Laboratório de Biologia Molecular, Instituto de Ciências Biológicas, ICBII, Campus II, Universidade Federal de Goiás, C.P. 131, 74001-970 Goiânia, GO, Brazil
| | - Maristela Pereira
- Departamento de Bioquímica e Biologia Molecular, Laboratório de Biologia Molecular, Instituto de Ciências Biológicas, ICBII, Campus II, Universidade Federal de Goiás, C.P. 131, 74001-970 Goiânia, GO, Brazil
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Rapid antifungal susceptibility testing by matrix-assisted laser desorption ionization-time of flight mass spectrometry analysis. J Clin Microbiol 2013; 51:2964-9. [PMID: 23824764 DOI: 10.1128/jcm.00903-13] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The widespread use of antifungal agents, which is likely to expand with their enhanced availability, has promoted the emergence of drug-resistant strains. Antifungal susceptibility testing (AFST) is now an essential procedure for guiding appropriate antifungal therapy. Recently, we developed a matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS)-based method that enables the detection of fungal isolates with reduced echinocandin susceptibility, relying on the proteome changes that are detectable after a 15-h exposure of fungal cells to serial drug concentrations. Here, we describe a simplified version of this approach that facilitates discrimination of the susceptible and resistant isolates of Candida albicans after a 3-h incubation in the presence of "breakpoint" level drug concentrations of the echinocandin caspofungin (CSF). Spectra at concentrations of 0 (null), 0.03 (intermediate), and 32 (maximal) μg/ml of CSF were used to create individual composite correlation index (CCI) matrices for 65 C. albicans isolates, including 13 fks1 mutants. Isolates are then classified as susceptible or resistant to CSF if the CCI values of spectra at 0.03 and 32 μg/ml are higher or lower, respectively, than the CCI values of spectra at 0.03 and 0 μg/ml. In this way, the drug resistance of C. albicans isolates to echinocandin antifungals can be quickly assessed. Furthermore, the isolate categorizations determined using MALDI-TOF MS-based AFST (ms-AFST) were consistent with the wild-type and mutant FKS1 genotypes and the AFST reference methodology. The ms-AFST approach may provide a rapid and reliable means of detecting emerging antifungal resistance and accelerating the initiation of appropriate antifungal treatment.
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Contreras-Hernández I, Mould-Quevedo J, Zendejas-Villanueva JL, Sánchez JAG, Mejía-Aranguré JM, Garduño-Espinosa J. Evaluación económica de antimicóticos en pacientes no neutropénicos con candidiasis invasiva en México. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/bf03320885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Echinocandins: production and applications. Appl Microbiol Biotechnol 2013; 97:3267-84. [PMID: 23463246 DOI: 10.1007/s00253-013-4761-9] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 02/06/2013] [Accepted: 02/07/2013] [Indexed: 10/27/2022]
Abstract
The first echinocandin-type antimycotic (echinocandin B) was discovered in the 1970s. It was followed by the isolation of more than 20 natural echinocandins. These cyclic lipo-hexapeptides are biosynthesized on non-ribosomal peptide synthase complexes by different ascomycota fungi. They have a unique mechanism of action; as non-competitive inhibitors of β-1,3-glucan synthase complex they target the fungal cell wall. Results of the structure-activity relationship experiments let us develop semisynthetic derivatives with improved properties. Three cyclic lipohiexapeptides (caspofungin, micafungin and anidulafungin) are currently approved for use in clinics. As they show good fungicidal (Candida spp.) or fungistatic (Aspergillus spp.) activity against the most important human pathogenic fungi including azole-resistant strains, they are an important addition to the antifungal armamentarium. Some evidence of acquired resistance against echinocandins has been detected among Candida glabrata strains in recent years, which enhanced the importance of data collected on the mechanism of acquired resistance developing against the echinocandins. In this review, we show the structural diversity of natural echinocandins, and we summarize the emerging data on their mode of action, biosynthesis and industrial production. Their clinical significance as well as the mechanism of natural and acquired resistance is also discussed.
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Pharmacological and Host Considerations Surrounding Dose Selection and Duration of Therapy with Echinocandins. CURRENT FUNGAL INFECTION REPORTS 2012. [DOI: 10.1007/s12281-012-0085-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Use of matrix-assisted laser desorption ionization-time of flight mass spectrometry for caspofungin susceptibility testing of Candida and Aspergillus species. J Clin Microbiol 2012; 50:2479-83. [PMID: 22535984 DOI: 10.1128/jcm.00224-12] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) was evaluated for testing susceptibility to caspofungin of wild-type and fks mutant isolates of Candida and Aspergillus. Complete essential agreement was observed with the CLSI reference method, with categorical agreement for 94.1% of the Candida isolates tested. Thus, MALDI-TOF MS is a reliable and accurate method to detect fungal isolates with reduced caspofungin susceptibility.
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Caira M, Posteraro B, Sanguinetti M, de Carolis E, Leone G, Pagano L. First case of breakthrough pneumonia due to Aspergillus nomius in a patient with acute myeloid leukemia. Med Mycol 2012; 50:746-50. [PMID: 22369623 DOI: 10.3109/13693786.2012.660507] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We report the first known case of a breakthrough pulmonary infection caused by Aspergillus nomius in an acute myeloid leukemia patient receiving caspofungin therapy. The isolate was identified using matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) and sequencing-based methods. The organism was found to be fully susceptible, in vitro, to echinocandin antifungal agents.
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Affiliation(s)
- Morena Caira
- Institute of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy.
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Rocha da Silva C, de Sousa Campos R, Adalgiza dos Santos Neta M, Rozellê Ferreira Ângelo M, Iury Ferreira Magalhães H, Coêlho Cavalcanti B, Odorico de Moraes M, Silveira Macedo D, Vitoriano Nobre Júnior H. Susceptibility to caspofungin of Candida spp. strains isolated in Ceará, Northeastern Brazil. J Mycol Med 2011. [DOI: 10.1016/j.mycmed.2011.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vale-Silva LA, Pinto P, Lopes V, Ramos H, Pinto E. Comparison of the Etest and a rapid flow cytometry-based method with the reference CLSI broth microdilution protocol M27-A3 for the echinocandin susceptibility testing of Candida spp. Eur J Clin Microbiol Infect Dis 2011; 31:941-6. [DOI: 10.1007/s10096-011-1390-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 08/18/2011] [Indexed: 10/17/2022]
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Montejo M, Quindós G. [Scientific evidence supporting the use of micafungin in the treatment of invasive candidiasis]. Enferm Infecc Microbiol Clin 2011; 29 Suppl 2:15-22. [PMID: 21420572 DOI: 10.1016/s0213-005x(11)70004-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Micafungin is a semisynthetic lipopeptide developed from Coleophoma empetri, which blocks the synthesis of β-1,3-D-glucan, an essential component of the fungal wall, though non-competitive inhibition of β-1,3-D-glucan synthetase. Micafungin is a dose-dependent candidacidal agent with excellent in vitro efficacy against most Candida spp. including species resistant to amphotericin B, such as Candida lusitaniae, several azoles, such as C. glabrata or C. krusei, and isolates not susceptible to other echinocandins. Moreover, this drug is active against Candida biofilms. Micafungin is a first-line drug for the treatment of candidemias and invasive candidiasis in adults and children (including neonates). This drug is approved for use in the treatment of invasive candidiasis and Candida esophagitis, as well as in the prophylaxis of Candida infections in hematopoietic stem cell transplant recipients or those at risk of prolonged neutropenia. Micafungin can be used both in the treatment and prevention of candidiasis in neonates, children, adolescents, adults, and the elderly, making it highly useful in patient groups in which the use of other antifungal drugs has not been authorized.
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Affiliation(s)
- Miguel Montejo
- Unidad de Enfermedades Infecciosas, Hospital Universitario de Cruces, Barakaldo, España.
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Abstract
The echinocandins are antifungal agents, which act by inhibiting the synthesis of β-(1,3)-D-glucan, an integral component of fungal cell walls. Caspofungin, the first approved echinocandin, demonstrates good in vitro and in vivo activity against a range of Candida species and is an alternative therapy for Aspergillus infections. Caspofungin provides an excellent safety profile and is therefore favoured in patients with moderately severe to severe illness, recent azole exposure and in those who are at high risk of infections due to Candida glabrata or Candida krusei. In vivo/in vitro resistance to caspofungin and breakthrough infections in patients receiving this agent have been reported for Candida and Aspergillus species. The types of pathogens and the frequency causing breakthrough mycoses are not well delineated. Caspofungin resistance resulting in clinical failure has been linked to mutations in the Fksp subunit of glucan synthase complex. European Committee for Antimicrobial Susceptibility Testing and Clinical and Laboratory Standards Institute need to improve the in vitro susceptibility testing methods to detect fks hot spot mutants. Caspofungin represents a significant advance in the care of patients with serious fungal infections.
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Affiliation(s)
- Astrid Mayr
- Department of Hygiene, Microbiology and Social Medicine, Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria
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Clinical breakpoints for the echinocandins and Candida revisited: Integration of molecular, clinical, and microbiological data to arrive at species-specific interpretive criteria. Drug Resist Updat 2011; 14:164-76. [DOI: 10.1016/j.drup.2011.01.004] [Citation(s) in RCA: 276] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 01/17/2011] [Accepted: 01/20/2011] [Indexed: 11/24/2022]
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Mayr A, Lass-Flörl C. Epidemiology and antifungal resistance in invasive Aspergillosis according to primary disease: review of the literature. Eur J Med Res 2011; 16:153-7. [PMID: 21486729 PMCID: PMC3352071 DOI: 10.1186/2047-783x-16-4-153] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 02/22/2011] [Indexed: 11/10/2022] Open
Abstract
Aspergilli, less susceptible to antifungals emerge and resistance to azoles have been found mainly in Aspergillus fumigatus; this has launched a new phase in handling aspergillosis. Resistant strains have currently been reported from Belgium, Canada, China, Denmark, France, Norway, Spain, Sweden, The Netherlands, UK and the USA. Centres in the UK (Manchester) and The Netherlands (Nijmegen) have described particularly high frequencies (15 and 10% respectively), and a significant increase in azole resistance in recent years. The reason of this high incidence may be due to long term azole therapy in patients with chronic aspergillosis in Manchester, and due to high use of agricultural azoles in Nijmegen. The primary underlying mechanism of resistance is as a result of alterations in the cyp51A target gene, with a variety of mutations found in clinical isolates and one genotype identified in the environmental (LH98). Reports on well documented in vitro and in vivo resistance to echinocandins are rare for Aspergillus species and resistance may be under-diagnosed as susceptibility testing is less frequently performed due to technical reasons.
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Affiliation(s)
| | - C Lass-Flörl
- Division of Hygiene and Medical Microbiology, Department of Hygiene, Microbiology and Social Medicine, Innsbruck Medical University, Innsbruck, Austria
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32
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Definitions and Epidemiology of Candida Species not Susceptible to Echinocandins. CURRENT FUNGAL INFECTION REPORTS 2011. [DOI: 10.1007/s12281-011-0053-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Teague SJ. Learning lessons from drugs that have recently entered the market. Drug Discov Today 2011; 16:398-411. [PMID: 21414418 DOI: 10.1016/j.drudis.2011.03.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Revised: 02/09/2011] [Accepted: 03/08/2011] [Indexed: 10/18/2022]
Abstract
Which projects in the drug discovery field are most likely to be successful? In this article, I provide guidelines for answering this question by examining recent drug market entrants in detail, in particular their route of administration, trial design, novelty, therapeutic target and toxicities. I identify targets, trials and organizations as the key issues that are currently leading to the poor productivity in the pharmaceutical industry. Here, I outline some solutions and reasons for optimism, and suggest that the key determinants for success in drug discovery can be defined by studying recently launched drugs.
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Affiliation(s)
- Simon J Teague
- Department of Medicinal Chemistry, AstraZeneca R&D Charnwood, Loughborough, Leicestershire LE11 5RH, UK.
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Williams D, Lewis M. Pathogenesis and treatment of oral candidosis. J Oral Microbiol 2011; 3. [PMID: 21547018 PMCID: PMC3087208 DOI: 10.3402/jom.v3i0.5771] [Citation(s) in RCA: 165] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 01/03/2011] [Accepted: 01/04/2011] [Indexed: 02/07/2023] Open
Abstract
Oral infections caused by yeast of the genus Candida and particularly Candida albicans (oral candidoses) have been recognised throughout recorded history. However, since the 1980s a clear surge of interest and associated research into these infections have occurred. This has largely been due to an increased incidence of oral candidosis over this period, primarily because of the escalation in HIV-infection and the AIDS epidemic. In addition, changes in medical practice leading to a greater use of invasive clinical procedures and a more widespread use of immunosuppressive therapies have also contributed to the problem. Whilst oral candidosis has previously been considered to be a disease mainly of the elderly and very young, its occurrence throughout the general population is now recognised. Candida are true ‘opportunistic pathogens’ and only instigate oral infection when there is an underlying predisposing condition in the host. Treatment of these infections has continued (and in some regards continues) to be problematic because of the potential toxicity of traditional antifungal agents against host cells. The problem has been compounded by the emergence of Candida species other than C. albicans that have inherent resistance against traditional antifungals. The aim of this review is to give the reader a contemporary overview of oral candidosis, the organisms involved, and the management strategies that are currently employed or could be utilised in the future.
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Martins IM, Cortés JCG, Muñoz J, Moreno MB, Ramos M, Clemente-Ramos JA, Durán A, Ribas JC. Differential activities of three families of specific beta(1,3)glucan synthase inhibitors in wild-type and resistant strains of fission yeast. J Biol Chem 2010; 286:3484-96. [PMID: 21115488 DOI: 10.1074/jbc.m110.174300] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Three specific β(1,3)glucan synthase (GS) inhibitor families, papulacandins, acidic terpenoids, and echinocandins, have been analyzed in Schizosaccharomyces pombe wild-type and papulacandin-resistant cells and GS activities. Papulacandin and enfumafungin produced similar in vivo effects, different from that of echinocandins. Also, papulacandin was the strongest in vitro GS inhibitor (IC(50) 10(3)-10(4)-fold lower than with enfumafungin or pneumocandin), but caspofungin was by far the most efficient antifungal because of the following. 1) It was the only drug that affected resistant cells (minimal inhibitory concentration close to that of the wild type). 2) It was a strong inhibitor of wild-type GS (IC(50) close to that of papulacandin). 3) It was the best inhibitor of mutant GS. Moreover, caspofungin showed a special effect for two GS inhibition activities, of high and low affinity, separated by 2 log orders, with no increase in inhibition. pbr1-8 and pbr1-6 resistances are due to single substitutions in the essential Bgs4 GS, located close to the resistance hot spot 1 region described in Saccharomyces and Candida Fks mutants. Bgs4(pbr)(1-8) contains the E700V change, four residues N-terminal from hot spot 1 defining a larger resistance hot spot 1-1 of 13 amino acids. Bgs4(pbr)(1-6) contains the W760S substitution, defining a new resistance hot spot 1-2. We observed spontaneous revertants of the spherical pbr1-6 phenotype and found that an additional A914V change is involved in the recovery of the wild-type cell shape, but it maintains the resistance phenotype. A better understanding of the mechanism of action of the antifungals available should help to improve their activity and to identify new antifungal targets.
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Affiliation(s)
- Ivone M Martins
- Instituto de Microbiología Bioquímica, Consejo Superior de Investigaciones Científicas/Universidad de Salamanca, 37007 Salamanca, Spain
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Schuermans C, van Bergen M, Coorevits L, Verhaegen J, Lagrou K, Surmont I, Jeurissen A. Breakthrough Saprochaete capitata infections in patients receiving echinocandins: case report and review of the literature. Med Mycol 2010; 49:414-8. [PMID: 21105848 DOI: 10.3109/13693786.2010.535179] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We report a rare case of a fatal Saprochaete capitata breakthrough infection in a patient with acute myeloid leukemia receiving empirical caspofungin therapy. S. capitata is an uncommon, yet emerging cause of invasive infections, especially in patients with haematological malignancies. Blood cultures from our patient yielded S. capitata which was found to be resistant, in vitro, to caspofungin. We consecutively reviewed all published cases of breakthrough infections caused by S. capitata in patients receiving echinocandins. S. capitata should be considered in those patients who remain febrile or who develop invasive mould infections while under echinocandin therapy.
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Affiliation(s)
- C Schuermans
- Department of Hematology, GZA St. Augustinus, Wilrijk, Belgium
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Echinocandin Antifungal Drug Resistance in Candida Species: A Cause for Concern? Curr Infect Dis Rep 2010; 12:437-43. [DOI: 10.1007/s11908-010-0131-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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