1
|
Petraitiene R, Petraitis V, Zaw MH, Hussain K, Ricart Arbona RJ, Roilides E, Walsh TJ. Combination of Systemic and Lock-Therapies with Micafungin Eradicate Catheter-Based Biofilms and Infections Caused by Candida albicans and Candida parapsilosis in Neutropenic Rabbit Models. J Fungi (Basel) 2024; 10:293. [PMID: 38667964 PMCID: PMC11050883 DOI: 10.3390/jof10040293] [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: 02/01/2024] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Vascular catheter-related infections, primarily caused by Candida albicans and Candida parapsilosis, pose significant challenges due to the formation of biofilms on catheters, leading to refractory disease and considerable morbidity. We studied the efficacy of micafungin in systemic and lock therapies to eliminate catheter-based biofilms and deep tissue infections in experimental central venous catheter (CVC)-related candidemia in neutropenic rabbits. Silastic CVCs in rabbits were inoculated with 1 × 103 CFU/mL of C. albicans or C. parapsilosis, establishing catheter-based biofilm, and subjected to various treatments. Neutropenic rabbits treated with a combination of lock therapy and systemic micafungin demonstrated the most significant reduction in fungal burden, from 5.0 × 104 to 1.8 × 102 CFU/mL of C. albicans and from 5.9 × 104 to 2.7 × 102 CFU/mL of C. parapsilosis (p ≤ 0.001), in the CVC after 24 h, with full clearance of blood cultures after 72 h from treatment initiation. The combination of lock and systemic micafungin therapy achieved eradication of C. albicans from all studied tissues (0.0 ± 0.0 log CFU/g) vs. untreated controls (liver 7.5 ± 0.22, spleen 8.3 ± 0.25, kidney 8.6 ± 0.07, cerebrum 6.3 ± 0.31, vena cava 6.6 ± 0.29, and CVC wash 2.3 ± 0.68 log CFU/g) (p ≤ 0.001). Rabbits treated with a combination of lock and systemic micafungin therapy demonstrated a ≥2 log reduction in C. parapsilosis in all treated tissues (p ≤ 0.05) except kidney. Serum (1→3)-β-D-glucan levels demonstrated significant decreases in response to treatment. The study demonstrates that combining systemic and lock therapies with micafungin effectively eradicates catheter-based biofilms and infections caused by C. albicans or C. parapsilosis, particularly in persistently neutropenic conditions, offering promising implications for managing vascular catheter-related candidemia and providing clinical benefits in cases where catheter removal is not feasible.
Collapse
Affiliation(s)
- Ruta Petraitiene
- Transplantation-Oncology Infectious Diseases Program, Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine of Cornell University, 1300 York Ave., New York, NY 10065, USA; (V.P.); (M.H.Z.); (K.H.)
| | - Vidmantas Petraitis
- Transplantation-Oncology Infectious Diseases Program, Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine of Cornell University, 1300 York Ave., New York, NY 10065, USA; (V.P.); (M.H.Z.); (K.H.)
| | - Myo H. Zaw
- Transplantation-Oncology Infectious Diseases Program, Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine of Cornell University, 1300 York Ave., New York, NY 10065, USA; (V.P.); (M.H.Z.); (K.H.)
- Sutter Health Memorial Medical Center, 1700 Coffee Rd., Modesto, CA 95355, USA
| | - Kaiser Hussain
- Transplantation-Oncology Infectious Diseases Program, Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine of Cornell University, 1300 York Ave., New York, NY 10065, USA; (V.P.); (M.H.Z.); (K.H.)
- Department of Radiology, Houston Methodist Hospital, Houston Radiology Associated, 6565 Fannin St. #268, Houston, TX 77030, USA
| | - Rodolfo J. Ricart Arbona
- Center for Comparative Medicine and Pathology, Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, 1275 York Ave., New York, NY 10021, USA
- Department of Genetic Medicine, Weill Cornell Medicine of Cornell University, 1300 York Ave., New York, NY 10065, USA
| | - Emanuel Roilides
- Hippokration Hospital, School of Medicine, Aristotle University, Konstantinoupoleos 49, GR-54642 Thessaloniki, Greece;
| | - Thomas J. Walsh
- Transplantation-Oncology Infectious Diseases Program, Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine of Cornell University, 1300 York Ave., New York, NY 10065, USA; (V.P.); (M.H.Z.); (K.H.)
- Center for Innovative Therapeutics and Diagnostics, Richmond, VA 23220, USA
| |
Collapse
|
2
|
Saputra H, Safaat M, Santoso P, Wakabayashi R, Goto M, Taira T, Kamiya N. Design of Protease-Responsive Antifungal Liposomal Formulation Decorated with a Lipid-Modified Chitin-Binding Domain. Int J Mol Sci 2024; 25:3567. [PMID: 38612381 PMCID: PMC11011847 DOI: 10.3390/ijms25073567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Candida albicans is a prevalent fungal pathogen that displays antibiotic resistance. The polyene antifungal amphotericin B (AmB) has been the gold standard because of its broad antifungal spectra, and its liposomal formulation, AmBisome, has been used widely and clinically in treating fungal infections. Herein, we explored enhancing the antifungal activity of AmBisome by integrating a small chitin-binding domain (LysM) of chitinase A derived from Pteris ryukyuensis. LysM conjugated with a lipid (LysM-lipid) was initially prepared through microbial transglutaminase (MTG)-mediated peptide tag-specific conjugation of LysM with a lipid-peptide substrate. The AmBisome formulation modified with LysM-lipid conjugates had a size distribution that was comparable to the native liposomes but an increased zeta potential, indicating that LysM-lipid conjugates were anchored to AmBisome. LysM-lipid-modified AmBisome exhibited long-term stability at 4 °C while retaining the capacity to bind chitin. Nevertheless, the antifungal efficacy of LysM-lipid-modified AmBisome against C. albicans was modest. We then redesigned a new LysM-lipid conjugate by introducing a peptide linker containing a thrombin digestion (TD) site at the C-terminus of LysM (LysM-TD linker-lipid), thereby facilitating the liberation of the LysM domain from AmBisome upon the addition of thrombin. This new AmBisome formulation anchored with LysM-TD linker-lipid exhibited superior performance in suppressing C. albicans growth in the presence of thrombin compared with the LysM-lipid formulation. These results provide a platform to design stimuli-responsive AmBisome formulations that respond to external environments and thus advance the treatment of pathogenic fungi infections.
Collapse
Affiliation(s)
- Hendra Saputra
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Fukuoka 819-0395, Japan; (H.S.); (M.S.); (P.S.); (R.W.); (M.G.)
| | - Muhammad Safaat
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Fukuoka 819-0395, Japan; (H.S.); (M.S.); (P.S.); (R.W.); (M.G.)
| | - Pugoh Santoso
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Fukuoka 819-0395, Japan; (H.S.); (M.S.); (P.S.); (R.W.); (M.G.)
| | - Rie Wakabayashi
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Fukuoka 819-0395, Japan; (H.S.); (M.S.); (P.S.); (R.W.); (M.G.)
| | - Masahiro Goto
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Fukuoka 819-0395, Japan; (H.S.); (M.S.); (P.S.); (R.W.); (M.G.)
- Division of Biotechnology, Center for Future Chemistry, Kyushu University, 744 Motooka, Fukuoka 819-0395, Japan
| | - Toki Taira
- Department of Bioscience and Biotechnology, Faculty of Agriculture, University of the Ryukyus, Nishihara-cho, Okinawa 903-0213, Japan;
| | - Noriho Kamiya
- Department of Applied Chemistry, Graduate School of Engineering, Kyushu University, 744 Motooka, Fukuoka 819-0395, Japan; (H.S.); (M.S.); (P.S.); (R.W.); (M.G.)
- Division of Biotechnology, Center for Future Chemistry, Kyushu University, 744 Motooka, Fukuoka 819-0395, Japan
| |
Collapse
|
3
|
Wijaya M, Halleyantoro R, Kalumpiu JF. Biofilm: The invisible culprit in catheter-induced candidemia. AIMS Microbiol 2023; 9:467-485. [PMID: 37649801 PMCID: PMC10462453 DOI: 10.3934/microbiol.2023025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/20/2023] [Accepted: 04/24/2023] [Indexed: 09/01/2023] Open
Abstract
Candidemia is the most common form of invasive fungal infection associated with several risk factors, and one of them is the use of medical devices, to which microbial biofilms can attach. Candidemia related to the use of peripheral intravascular and central venous catheters (CVC) is referred to as Candida catheter-related bloodstream infection, with more than 90% being related to CVC usage. The infection is associated with a higher morbidity and mortality rate than nosocomial bacterial infections. Candida spp. can protect themselves from the host immune system and antifungal drugs because of the biofilm structure, which is potentiated by the extracellular matrix (ECM). Candida albicans and Candida parapsilosis are the most pathogenic species often found to form biofilms associated with catheter usage. Biofilm formation of C. albicans includes four mechanisms: attachment, morphogenesis, maturation and dispersion. The biofilms formed between C. albicans and non-albicans spp. differ in ECM structure and composition and are associated with the persistence of colonization to infection for various catheter materials and antifungal resistance. Efforts to combat Candida spp. biofilm formation on catheters are still challenging because not all patients, especially those who are critically ill, can be recommended for catheter removal; also to be considered are the characteristics of the biofilm itself, which readily colonizes the permanent medical devices used. The limited choice and increasing systemic antifungal resistance also make treating it more difficult. Hence, alternative strategies have been developed to manage Candida biofilm. Current options for prevention or therapy in combination with systemic antifungal medications include lock therapy, catheter coating, natural peptide products and photodynamic inactivation.
Collapse
Affiliation(s)
- Meiliyana Wijaya
- Department of Parasitology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Ryan Halleyantoro
- Department of Parasitology, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | - Jane Florida Kalumpiu
- Department of Parasitology, Faculty of Medicine, Pelita Harapan University, Banten, Indonesia
| |
Collapse
|
4
|
Merdan O, Şişman AS, Aksoy SA, Kızıl S, Tüzemen NÜ, Yılmaz E, Ener B. Investigation of the Defective Growth Pattern and Multidrug Resistance in a Clinical Isolate of Candida glabrata Using Whole-Genome Sequencing and Computational Biology Applications. Microbiol Spectr 2022; 10:e0077622. [PMID: 35867406 PMCID: PMC9430859 DOI: 10.1128/spectrum.00776-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 06/16/2022] [Indexed: 11/20/2022] Open
Abstract
Candida glabrata is increasingly isolated from blood cultures, and multidrug-resistant isolates have important implications for therapy. This study describes a cholesterol-dependent clinical C. glabrata isolate (ML72254) that did not grow without blood (containing cholesterol) on routine mycological media and that showed azole and amphotericin B (AmB) resistance. Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) and whole-genome sequencing (WGS) were used for species identification. A modified Etest method (Mueller-Hinton agar supplemented with 5% sheep blood) was used for antifungal susceptibility testing. WGS data were processed via the Galaxy platform, and the genomic variations of ML72254 were retrieved. A computational biology workflow utilizing web-based applications (PROVEAN, AlphaFold Colab, and Missense3D) was constructed to predict possible deleterious effects of these missense variations on protein functions. The predictive ability of this workflow was tested with previously reported missense variations in ergosterol synthesis genes of C. glabrata. ML72254 was identified as C. glabrata sensu stricto with MALDI-TOF, and WGS confirmed this identification. The MICs of fluconazole, voriconazole, and amphotericin B were >256, >32, and >32 μg/mL, respectively. A novel frameshift mutation in the ERG1 gene (Pro314fs) and many missense variations were detected in the ergosterol synthesis genes. None of the missense variations in the ML72254 ergosterol synthesis genes were deleterious, and the Pro314fs mutation was identified as the causative molecular change for a cholesterol-dependent and multidrug-resistant phenotype. This study verified that web-based computational biology solutions can be powerful tools for examining the possible impacts of missense mutations in C. glabrata. IMPORTANCE In this study, a cholesterol-dependent C. glabrata clinical isolate that confers azole and AmB resistance was investigated using artificial intelligence (AI) technologies and cloud computing applications. This is the first of the known cholesterol-dependent C. glabrata isolate to be found in Turkey. Cholesterol-dependent C. glabrata isolates are rarely isolated in clinical samples; they can easily be overlooked during routine laboratory procedures. Microbiologists therefore need to be alert when discrepancies occur between microscopic examination and growth on routine media. In addition, because these isolates confer antifungal resistance, patient management requires extra care.
Collapse
Affiliation(s)
- Osman Merdan
- Department of Medical Microbiology, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkey
| | - Ayşe Sena Şişman
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkey
| | - Seçil Ak Aksoy
- İnegöl Vocational School, Bursa Uludağ University, Bursa, Turkey
| | - Samet Kızıl
- Department of Medical Microbiology, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkey
| | - Nazmiye Ülkü Tüzemen
- Department of Medical Microbiology, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkey
| | - Emel Yılmaz
- Department of Clinical Microbiology and Infectious Diseases, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkey
| | - Beyza Ener
- Department of Medical Microbiology, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkey
| |
Collapse
|
5
|
Gu F, Hu S, Wu Y, Wu C, Yang Y, Gu B, Du H. A SERS Platform for Rapid Detection of Drug Resistance of Non- Candida albicans Using Fe 3O 4@PEI and Triangular Silver Nanoplates. Int J Nanomedicine 2022; 17:3531-3541. [PMID: 35971445 PMCID: PMC9375581 DOI: 10.2147/ijn.s369591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/24/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose Candida infection has a high mortality rate, and the increasing prevalence of non-Candida albicans drug resistance in recent years poses a potential threat to human health. Non-Candida albicans has long culture cycles, and its firm cell walls making it difficult to isolate DNA for sequencing. Materials and Methods Fe3O4@PEI (PEI, polyvinyl imine) was mixed with clinical samples to form Fe3O4@PEI@non-Candida albicans and enriched them with magnets. Triangular silver nanoplates enhanced the surface-enhanced Raman scattering (SERS) signal. SERS was used to detect the fingerprint spectrum of non-Candida albicans. Then, orthogonal partial least squares discriminant analysis (OPLS-DA) was used to analyze the drug resistance of non-Candida albicans. Results SERS combined with OPLS-DA could well analyze the drug resistance of non-Candida albicans. Through 10-fold-cross validation, the accuracy of training and test data is greater than 99%, indicating that the model has good classification ability. We used SERS for the first time to detect the drug resistance of non-Candida albicans directly. Conclusion This approach can be utilized without causing damage to the cell wall and can be accomplished in as little as 90 minutes. It can provide timely guidance for the treatment of patients with good clinical application potential.
Collapse
Affiliation(s)
- Feng Gu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, People's Republic of China.,Department of Laboratory Medicine, Xuzhou Central Hospital, Xuzhou, 221000, People's Republic of China
| | - Shan Hu
- Department of Laboratory Medicine, Xuzhou Tumor Hospital, Xuzhou, 221005, People's Republic of China
| | - Yunjian Wu
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, 221004, People's Republic of China
| | - Changyu Wu
- School of Medical Imaging, Xuzhou Medical University, Xuzhou, 221004, People's Republic of China
| | - Ying Yang
- Department of Biotechnology, Beijing Institute of Radiation Medicine, Beijing Key Laboratory of New Molecular Diagnosis Technologies for Infectious Diseases, Beijing, 100850, People's Republic of China
| | - Bing Gu
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510000, People's Republic of China
| | - Hong Du
- Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, People's Republic of China
| |
Collapse
|
6
|
Haro-Reyes T, Díaz-Peralta L, Galván-Hernández A, Rodríguez-López A, Rodríguez-Fragoso L, Ortega-Blake I. Polyene Antibiotics Physical Chemistry and Their Effect on Lipid Membranes; Impacting Biological Processes and Medical Applications. MEMBRANES 2022; 12:membranes12070681. [PMID: 35877884 PMCID: PMC9316096 DOI: 10.3390/membranes12070681] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/21/2022] [Accepted: 06/23/2022] [Indexed: 01/27/2023]
Abstract
This review examined a collection of studies regarding the molecular properties of some polyene antibiotic molecules as well as their properties in solution and in particular environmental conditions. We also looked into the proposed mechanism of action of polyenes, where membrane properties play a crucial role. Given the interest in polyene antibiotics as therapeutic agents, we looked into alternative ways of reducing their collateral toxicity, including semi-synthesis of derivatives and new formulations. We follow with studies on the role of membrane structure and, finally, recent developments regarding the most important clinical applications of these compounds.
Collapse
Affiliation(s)
- Tammy Haro-Reyes
- Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Av. Universidad s/n, Col. Chamilpa, Cuernavaca 62210, Morelos, Mexico; (T.H.-R.); (L.D.-P.); (A.G.-H.)
| | - Lucero Díaz-Peralta
- Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Av. Universidad s/n, Col. Chamilpa, Cuernavaca 62210, Morelos, Mexico; (T.H.-R.); (L.D.-P.); (A.G.-H.)
| | - Arturo Galván-Hernández
- Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Av. Universidad s/n, Col. Chamilpa, Cuernavaca 62210, Morelos, Mexico; (T.H.-R.); (L.D.-P.); (A.G.-H.)
| | - Anahi Rodríguez-López
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Cuernavaca 62210, Morelos, Mexico; (A.R.-L.); (L.R.-F.)
| | - Lourdes Rodríguez-Fragoso
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Cuernavaca 62210, Morelos, Mexico; (A.R.-L.); (L.R.-F.)
| | - Iván Ortega-Blake
- Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, Av. Universidad s/n, Col. Chamilpa, Cuernavaca 62210, Morelos, Mexico; (T.H.-R.); (L.D.-P.); (A.G.-H.)
- Correspondence: ; Tel.: +52-77-7329-1762
| |
Collapse
|
7
|
Kovács R, Majoros L. Antifungal lock therapy: an eternal promise or an effective alternative therapeutic approach? Lett Appl Microbiol 2022; 74:851-862. [PMID: 35032330 PMCID: PMC9306927 DOI: 10.1111/lam.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/02/2022] [Accepted: 01/07/2022] [Indexed: 11/30/2022]
Abstract
Each year, millions of central venous catheter insertions are performed in intensive care units worldwide. The usage of these indwelling devices is associated with a high risk of bacterial and fungal colonization, leading to the development of microbial consortia, namely biofilms. These sessile structures provide fungal cells with resistance to the majority of antifungals, environmental stress and host immune responses. Based on different guidelines, colonized/infected catheters should be removed and changed immediately in the case of Candida‐related central line infections. However, catheter replacement is not feasible for all patient populations. An alternative therapeutic approach may be antifungal lock therapy, which has received high interest, especially in the last decade. This review summarizes the published Candida‐related in vitro, in vivo data and case studies in terms of antifungal lock therapy. The number of clinical studies remains limited and further studies are needed for safe implementation of the antifungal lock therapy into clinical practice.
Collapse
Affiliation(s)
- Renátó Kovács
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Hungary.,Faculty of Pharmacy, University of Debrecen, Hungary
| | - László Majoros
- Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Hungary
| |
Collapse
|
8
|
Sahu RK, Salem-Bekhit MM, Bhattacharjee B, Almoshari Y, Ikbal AMA, Alshamrani M, Bharali A, Salawi A, Widyowati R, Alshammari A, Elbagory I. Mucormycosis in Indian COVID-19 Patients: Insight into Its Patho-Genesis, Clinical Manifestation, and Management Strategies. Antibiotics (Basel) 2021; 10:1079. [PMID: 34572661 PMCID: PMC8468123 DOI: 10.3390/antibiotics10091079] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 12/21/2022] Open
Abstract
Mucormycosis in patients who have COVID-19 or who are otherwise immunocompromised has become a global problem, causing significant morbidity and mortality. Infection is debilitating and fatal, leading to loss of organs and emotional trauma. Radiographic manifestations are not specific, but diagnosis can be made through microscopic examination of materials collected from necrotic lesions. Treatment requires multidisciplinary expertise, as the fungus enters through the eyes and nose and may even reach the brain. Use of the many antifungal drugs available is limited by considerations of resistance and toxicity, but nanoparticles can overcome such limitations by reducing toxicity and increasing bioavailability. The lipid formulation of amphotericin-B (liposomal Am-B) is the first-line treatment for mucormycosis in COVID-19 patients, but its high cost and low availability have prompted a shift toward surgery, so that surgical debridement to remove all necrotic lesions remains the hallmark of effective treatment of mucormycosis in COVID-19. This review highlights the pathogenesis, clinical manifestation, and management of mucormycosis in patients who have COVID-19.
Collapse
Affiliation(s)
- Ram Kumar Sahu
- Department of Pharmaceutical Science, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia; (R.K.S.); (R.W.)
- Department of Pharmaceutical Science, Assam University (A Central University), Silchar 788011, India
| | - Mounir M. Salem-Bekhit
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
- Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Cairo 11884, Egypt
| | - Bedanta Bhattacharjee
- Department of Pharmaceutical Sciences, Faculty of Science and Engineering, Dibrugarh University, Dibrugarh 786004, India;
| | - Yosif Almoshari
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia; (Y.A.); (M.A.); (A.S.)
| | - Abu Md Ashif Ikbal
- Department of Pharmacy, Tripura University (A Central University), Suryamaninagar 799022, India
| | - Meshal Alshamrani
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia; (Y.A.); (M.A.); (A.S.)
| | - Alakesh Bharali
- Department of Pharmaceutics, Girijananda Chowdhury Institute of Pharmaceutical Sciences, Azara, Hatkhowapara, Guwahati 781017, India;
| | - Ahmad Salawi
- Department of Pharmaceutics, College of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia; (Y.A.); (M.A.); (A.S.)
| | - Retno Widyowati
- Department of Pharmaceutical Science, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia; (R.K.S.); (R.W.)
| | - Abdulrahman Alshammari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Ibrahim Elbagory
- College of Pharmacy, Northern Border University, Arar 1321, Saudi Arabia;
| |
Collapse
|
9
|
Wang X, Mohammad IS, Fan L, Zhao Z, Nurunnabi M, Sallam MA, Wu J, Chen Z, Yin L, He W. Delivery strategies of amphotericin B for invasive fungal infections. Acta Pharm Sin B 2021; 11:2585-2604. [PMID: 34522599 PMCID: PMC8424280 DOI: 10.1016/j.apsb.2021.04.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/18/2021] [Accepted: 03/15/2021] [Indexed: 12/11/2022] Open
Abstract
Invasive fungal infections (IFIs) represent a growing public concern for clinicians to manage in many medical settings, with substantial associated morbidities and mortalities. Among many current therapeutic options for the treatment of IFIs, amphotericin B (AmB) is the most frequently used drug. AmB is considered as a first-line drug in the clinic that has strong antifungal activity and less resistance. In this review, we summarized the most promising research efforts on nanocarriers for AmB delivery and highlighted their efficacy and safety for treating IFIs. We have also discussed the mechanism of actions of AmB, rationale for treating IFIs, and recent advances in formulating AmB for clinical use. Finally, this review discusses some practical considerations and provides recommendations for future studies in applying AmB for combating IFIs.
Collapse
Key Words
- ABCD, AmB colloidal dispersion
- AIDS, acquired immunodeficiency syndrome
- AP, antisolvent precipitation
- ARDS, acute respiratory distress syndrome
- AmB, amphotericin B
- AmB-GCPQ, AmB-encapsulated N-palmitoyl-N-methyl-N,N-dimethyl-N,N,N-trimethyl-6-O-glycol-chitosan nanoparticles
- AmB-IONP, AmB-loaded iron oxide nanoparticles
- AmB-PM, AmB-polymeric micelles
- AmB-SD, AmB sodium deoxycholate
- AmBd, AmB deoxycholate
- Amphotericin B
- Aspergillus fumigatus, A. fumigatus
- BBB, blood‒brain barrier
- BCS, biopharmaceutics classification system
- BDDE, butanediol diglycidyl ether
- BSA, bovine serum albumin
- BUN, blood urea nitrogen
- C. Albicans, Candida Albicans
- CFU, colony-forming unit
- CLSM, confocal laser scanning microscope
- CMC, carboxymethylated l-carrageenan
- CP, chitosan-polyethylenimine
- CS, chitosan
- Conjugates
- DDS, drug delivery systems
- DMPC, dimyristoyl phosphatidyl choline
- DMPG, dimyristoyl phosphatidylglycerole
- DMSA, dimercaptosuccinic acid
- Drug delivery
- GNPs, gelatin nanoparticles
- HPH, high-pressure homogenization
- HPMC, hydroxypropyl methylcellulose
- ICV, intensive care unit
- IFIs, invasive fungal infections
- Invasive fungal infections
- L-AmB, liposomal AmB
- LNA, linolenic acid
- MAA, methacrylic acid
- MFC, minimum fungicidal concentrations
- MIC, minimum inhibitory concentration
- MN, microneedles
- MOP, microneedle ocular patch
- MPEG-PCL, monomethoxy poly(ethylene glycol)-poly(epsilon-caprolactone)
- NEs, nanoemulsions
- NLC, nanostructured lipid carriers
- NPs, nanoparticles
- Nanoparticles
- P-407, poloxamer-407
- PAM, polyacrylamide
- PCL, polycaprolactone
- PDA, poly(glycolic acid)
- PDLLA, poly(d,l-lactic acid)
- PDLLGA, poly(d,l-lactic-co-glycolic acid)
- PEG, poly(ethylene glycol)
- PEG-DSPE, PEG-lipid poly(ethylene glycol)-distearoylphosphatidylethanolamine
- PEG-PBC, phenylboronic acid-functionalized polycarbonate/PEG
- PEG-PUC, urea-functionalized polycarbonate/PEG
- PGA-PPA, poly(l-lysine-b-l-phenylalanine) and poly(l-glutamic acid-b-l-phenylalanine)
- PLA, poly(lactic acid)
- PLGA, polyvinyl alcohol poly(lactic-co-glycolic acid)
- PLGA-PLH-PEG, PLGA-b-poly(l-histidine)-b-poly(ethylene glycol)
- PMMA, poly(methyl methacrylate)
- POR, porphyran
- PVA, poly(vinyl alcohol)
- PVP, polyvinylpyrrolidone
- Poor water-solubility
- RBCs, red blood cells
- RES, reticuloendothelial system
- ROS, reactive oxygen species
- SEM, scanning electron microscope
- SL-AmB, sophorolipid-AmB
- SLNs, solid lipid nanoparticles
- Topical administration
- Toxicity
- γ-CD, γ-cyclodextrin
- γ-PGA, γ-poly(gamma-glutamic acid
Collapse
Affiliation(s)
- Xiaochun Wang
- Department of Pharmaceutics, China Pharmaceutical University, Nanjing 211198, China
| | - Imran Shair Mohammad
- School of Pharmaceutical Sciences, Sun Yat-sen University, University Town, Guangzhou 510006, China
| | - Lifang Fan
- Jiangsu Aosaikang Pharmaceutical Co., Ltd., Nanjing 211112, China
| | - Zongmin Zhao
- School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA
| | - Md Nurunnabi
- Department of Pharmaceutical Sciences, School of Pharmacy, University of Texas at El Paso, El Paso, TX 79902, USA
| | - Marwa A. Sallam
- Department of Industrial Pharmacy, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt
| | - Jun Wu
- Department of Geriatric Cardiology, Jiangsu Provincial Key Laboratory of Geriatrics, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhongjian Chen
- Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai 200443, China
| | - Lifang Yin
- Department of Pharmaceutics, China Pharmaceutical University, Nanjing 211198, China
| | - Wei He
- Department of Pharmaceutics, China Pharmaceutical University, Nanjing 211198, China
| |
Collapse
|
10
|
In Vitro and In Vivo Antifungal Activity of AmBisome Compared to Conventional Amphotericin B and Fluconazole against Candida auris. Antimicrob Agents Chemother 2021; 65:AAC.00306-21. [PMID: 33846131 DOI: 10.1128/aac.00306-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/02/2021] [Indexed: 12/27/2022] Open
Abstract
Antifungal activity of AmBisome against Candida auris was determined in vitro and in vivo AmBisome showed MIC50 and MIC90 values of 1 and 2 μg/ml, respectively. Unlike conventional amphotericin B, significant in vivo efficacy was observed in the AmBisome 7.5 mg/kg treatment group in survival and reduction of kidney tissue fungal burden compared to the untreated group. Our data show that AmBisome has significant antifungal activity against C. auris infection in vitro and in vivo.
Collapse
|
11
|
Scorzoni L, Fuchs BB, Junqueira JC, Mylonakis E. Current and promising pharmacotherapeutic options for candidiasis. Expert Opin Pharmacother 2021; 22:867-887. [PMID: 33538201 DOI: 10.1080/14656566.2021.1873951] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Candida spp. are commensal yeasts capable of causing infections such as superficial, oral, vaginal, or systemic infections. Despite medical advances, the antifungal pharmacopeia remains limited and the development of alternative strategies is needed.Areas covered: We discuss available treatments for Candida spp. infections, highlighting advantages and limitations related to pharmacokinetics, cytotoxicity, and antimicrobial resistance. Moreover, we present new perspectives to improve the activity of the available antifungals, discussing their immunomodulatory potential and advances on drug delivery carriers. New therapeutic approaches are presented including recent synthesized antifungal compounds (Enchochleated-Amphotericin B, tetrazoles, rezafungin, enfumafungin, manogepix and arylamidine); drug repurposing using a diversity of antibacterial, antiviral and non-antimicrobial drugs; combination therapies with different compounds or photodynamic therapy; and innovations based on nano-particulate delivery systems.Expert opinion: With the lack of novel drugs, the available assets must be leveraged to their best advantage through modifications that enhance delivery, efficacy, and solubility. However, these efforts are met with continuous challenges presented by microbes in their infinite plight to resist and survive therapeutic drugs. The pharmacotherapeutic options in development need to focus on new antimicrobial targets. The success of each antimicrobial agent brings strategic insights to the next phased approach in treatingCandida spp. infections.
Collapse
Affiliation(s)
- Liliana Scorzoni
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University/UNESP, SP Brazil
| | - Beth Burgwyn Fuchs
- Division of Infectious Diseases, Rhode Island Hospital, Alpert Medical School, Brown University, Providence, RI USA
| | - Juliana Campos Junqueira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University/UNESP, SP Brazil
| | - Eleftherios Mylonakis
- Division of Infectious Diseases, Rhode Island Hospital, Alpert Medical School, Brown University, Providence, RI USA
| |
Collapse
|
12
|
Chatzimoschou A, Giampani A, Meis JF, Roilides E. Activities of nine antifungal agents against Candida auris biofilms. Mycoses 2020; 64:381-384. [PMID: 33270284 DOI: 10.1111/myc.13223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 11/21/2020] [Accepted: 11/26/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Candida auris is a newly described multidrug-resistant fungal pathogen associated with biofilm formation and severe infections with high mortality. OBJECTIVES To study the activities of fluconazole, itraconazole, posaconazole, voriconazole, deoxycholate and liposomal amphotericin B, anidulafungin, caspofungin and micafungin against C auris biofilms and planktonic cells. MATERIALS/METHODS C auris strains originating from 5 clades (South Asian, East Asian, African, South American and Iranian) were tested for biofilm production by safranin staining of the extracellular matrix polysaccharide structure as well as biofilm (BF) and planktonic (PLK) antifungal susceptibility to nine antifungal agents using the XTT reduction assay. RESULTS Candida auris isolates produced mature BF as compared to non-C auris control (Candida albicans and Candida parapsilosis) strains. Four C auris isolates exhibited relatively high MIC's for fluconazole (32-128 mg/L for PLK MIC and 128-1024 mg/L for BF MIC) as compared to the Iranian strain that had PLK and BF MIC's 0.5 and 16, respectively. Itraconazole, posaconazole and voriconazole had relatively low PLK MICs but high BF MICs. A similar pattern was observed with echinocandins; relatively low PLK MIC (0.06-4 mg/L) but quite high BF MICs (4-2048 mg/L). While all isolates exhibited relatively low PLK MICs (0.06-4 mg/L) for both amphotericin B formulations, liposomal amphotericin B showed higher MICs compared to deoxycholate amphotericin B against C auris BF. CONCLUSION Triazoles, echinocandins and liposomal amphotericin B appear to have less activity against C auris biofilms than deoxycholate amphotericin B. Our in vitro model provides evidence for intrinsic C auris biofilm resistance to antifungal agents.
Collapse
Affiliation(s)
- Athanasios Chatzimoschou
- Laboratory of Infectious Diseases, 3rd Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece.,Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands
| | - Athina Giampani
- Laboratory of Infectious Diseases, 3rd Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands.,Centre of Expertise in Mycology, Radboudumc/CWZ, Nijmegen, The Netherlands.,Bioprocess Engineering and Biotechnology Graduate Program, Federal University of Paraná, Curitiba, Brazil
| | - Emmanuel Roilides
- Laboratory of Infectious Diseases, 3rd Department of Pediatrics, Medical Faculty, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki, Greece
| |
Collapse
|
13
|
Reginatto P, Bergamo VZ, Berlitz SJ, Guerreiro ICK, de Andrade SF, Fuentefria AM. Rational selection of antifungal drugs to propose a new formulation strategy to control Candida biofilm formation on venous catheters. Braz J Microbiol 2020; 51:1037-1049. [PMID: 32077074 DOI: 10.1007/s42770-020-00242-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/06/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Infections associated with medical devices are often related to colonization by Candida spp. biofilm; in this way, numerous strategies have been developed and studied, mainly in order to prevent this type of fungal growth. AIM Considering the above, the main objective of the present study is to make a rational choice of the best antifungal therapy for the in vitro treatment of the biofilm on venous catheters, proposing an innovative formulation of a film-forming system to coat the surface in order to prevent the formation of biofilms. METHODOLOGY Anidulafungin, fluconazole, voriconazole, ketoconazole, amphotericin B, and the association of anidulafungin and amphotericin B were tested against biofilms of C. albicans, C. tropicalis, and C. parapsilosis strains in microtiter plates and in a polyurethane catheter. Besides, anidulafungin, amphotericin B, and the combination of both were incorporated in a film-forming system and were evaluated against biofilm. RESULTS The superior activity of anidulafungin was demonstrated in relation to the other antifungal agents. Although amphotericin B showed good activity, high concentrations were required. The combination showed a synergistic action, in solution and in the formulation, showing excellent results, with activity above 90%. CONCLUSION Due to the superiority of anidulafungin and the synergistic activity of the combination, these alternatives were the most promising options for use in a formulation proposal as a new strategy to combat the Candida spp. biofilm. These formulations demonstrated high in vitro performance in the prevention of biofilms, indicating that they are candidates with great potential for in vivo tests.
Collapse
Affiliation(s)
- Paula Reginatto
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. .,Laboratório de Micologia Aplicada, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Vanessa Zafanelli Bergamo
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Simone Jacobus Berlitz
- Programa de Pós-Graduação em Nanotecnologia Farmacêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Irene Clemes Kulkamp Guerreiro
- Programa de Pós-Graduação em Nanotecnologia Farmacêutica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Produção de Matéria-Prima, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Saulo Fernandes de Andrade
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Produção de Matéria-Prima, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alexandre Meneghello Fuentefria
- Programa de Pós-Graduação em Microbiologia Agrícola e do Ambiente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
14
|
Lack of efficacy of echinocandins against high metabolic activity biofilms of Candida parapsilosis clinical isolates. Braz J Microbiol 2020; 51:1129-1133. [PMID: 31898245 DOI: 10.1007/s42770-019-00219-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 12/17/2019] [Indexed: 12/12/2022] Open
Abstract
Candida parapsilosis produces biofilm, which colonizes catheters and other invasive medical devices that are manipulated by health care workers. In previous studies, C. parapsilosis in vitro biofilms have exhibited high resistance rates against conventional antifungals, but susceptibility to both echinocandins and lipid formulations of amphotericin B (lipid complex and liposomal). However, a recent study showed good activity of amphotericin B deoxycholate on the biomass of C. parapsilosis biofilms. Although moderate activity of echinocandins has been demonstrated against low metabolic activity biofilms of C. parapsilosis, few studies have analyzed the action of these drugs on high metabolic activity biofilms. Moreover, high biofilm-forming isolates have been associated with central venous catheter-related fungemia outbreaks and higher mortality rates. Therefore, it is relevant to verify the activity of the main antifungal drugs against high metabolic activity biofilms of C. parapsilosis. Our study aimed to evaluate the in vitro activity of amphotericin B deoxycholate, anidulafungin, caspofungin, and micafungin against high biofilm-forming and high metabolic activity clinical isolates of C. parapsilosis. Our results showed good activity of amphotericin B against C. parapsilosis biofilms, but none of the echinocandin drugs was effective. This suggests that amphotericin B deoxycholate may be a better choice than echinocandins for the treatment of biofilm-associated infections by C. parapsilosis, mainly in countries with insufficient health care resources to purchase lipid formulations of amphotericin B. These results warn of the possibility of persistent catheter-related candidemia caused by high biofilm-forming C. parapsilosis strains when treated with echinocandin drugs.
Collapse
|
15
|
Faustino C, Pinheiro L. Lipid Systems for the Delivery of Amphotericin B in Antifungal Therapy. Pharmaceutics 2020; 12:pharmaceutics12010029. [PMID: 31906268 PMCID: PMC7023008 DOI: 10.3390/pharmaceutics12010029] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 12/31/2022] Open
Abstract
Amphotericin B (AmB), a broad-spectrum polyene antibiotic in the clinic for more than fifty years, remains the gold standard in the treatment of life-threatening invasive fungal infections and visceral leishmaniasis. Due to its poor water solubility and membrane permeability, AmB is conventionally formulated with deoxycholate as a micellar suspension for intravenous administration, but severe infusion-related side effects and nephrotoxicity hamper its therapeutic potential. Lipid-based formulations, such as liposomal AmB, have been developed which significantly reduce the toxic side effects of the drug. However, their high cost and the need for parenteral administration limit their widespread use. Therefore, delivery systems that can retain or even enhance antimicrobial efficacy while simultaneously reducing AmB adverse events are an active area of research. Among those, lipid systems have been extensively investigated due to the high affinity of AmB for binding lipids. The development of a safe and cost-effective oral formulation able to improve drug accessibility would be a major breakthrough, and several lipid systems for the oral delivery of AmB are currently under development. This review summarizes recent advances in lipid-based systems for targeted delivery of AmB focusing on non-parenteral nanoparticulate formulations mainly investigated over the last five years and highlighting those that are currently in clinical trials.
Collapse
Affiliation(s)
| | - Lídia Pinheiro
- Correspondence: ; Tel.: +351-21-7946-400; Fax: +351-21-7946-470
| |
Collapse
|
16
|
Gowda DV, Afrasim M, Meenakshi SI, Manohar M, Hemalatha S, Siddaramaiah H, Sathishbabu P, Rizvi SMD, Hussain T, Kamal MA. A Paradigm Shift in the Development of Anti-Candida Drugs. Curr Top Med Chem 2019; 19:2610-2628. [PMID: 31663480 DOI: 10.2174/1568026619666191029145209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 04/27/2019] [Accepted: 09/26/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The considerable increase in the incidence of Candida infection in recent times has prompted the use of numerous antifungal agents, which has resulted in the development of resistance towards various antifungal agents. With rising Candida infections, the need for design and development of novel antifungal agents is in great demand. However, new therapeutic approaches are very essential in preventing the mortality rate and improving the patient outcome in those suffering from Candida infections. OBJECTIVE The present review objective is to describe the burden, types of Candidiasis, mechanism of action of antifungal agents and its resistance and the current novel approaches used to combat candidiasis. METHODS We have collected and analyzed 135 different peer-reviewed literature studies pertinent to candidiasis. In this review, we have compiled the major findings from these studies. RESULTS AND CONCLUSION The review describes the concerns related to candidiasis, its current treatment strategy, resistance mechanisms and imminent ways to tackle the problem. The review explored that natural plant extracts and essential oils could act as sources of newer therapeutic agents, however, the focus was on novel strategies, such as combinational therapy, new antibodies, utilization of photodynamic therapy and adaptive transfer primed immune cells with emphasis on the development of effective vaccination.
Collapse
Affiliation(s)
- D V Gowda
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru- 570015, India
| | - M Afrasim
- Department of Pharmaceutics, Hail University, Hail, Saudi Arabia
| | - S I Meenakshi
- Department of Prosthodontics and Crown & Bridge, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysuru-570015, India
| | - M Manohar
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru- 570015, India
| | - S Hemalatha
- Department of Anaesthesia, JSS Medical College & Hospital, JSS Academy of Higher Education and Research, Mysuru - 570004, India
| | - H Siddaramaiah
- Department of Polymer Science and Technology, Sri Jayachamarajendra College of Engineering, JSS Science and Technology University, Mysuru - 570006, India
| | - P Sathishbabu
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru- 570015, India
| | - S M Danish Rizvi
- Department of Pharmaceutics, Hail University, Hail, Saudi Arabia
| | - T Hussain
- Department of Pharmacology and Toxicology, University of Hail, Hail, Saudi Arabia
| | - M A Kamal
- King Fahd Medical Research Center, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia.,Enzymoics, 7 Peterlee Place, Hebersham, NSW 2770, Australia.,Novel Global Community Educational Foundation, Australia
| |
Collapse
|
17
|
Černáková L, Light C, Salehi B, Rogel-Castillo C, Victoriano M, Martorell M, Sharifi-Rad J, Martins N, Rodrigues CF. Novel Therapies for Biofilm-Based Candida spp. Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1214:93-123. [DOI: 10.1007/5584_2019_400] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|