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Gazolla PAR, de Aguiar AR, Costa MCA, Oliveira OV, Costa AV, da Silva CM, do Nascimento CJ, Junker J, Ferreira RS, de Oliveira FM, Vaz BG, do Carmo PHF, Santos DA, Ferreira MMC, Teixeira RR. Synthesis of vanillin derivatives with 1,2,3-triazole fragments and evaluation of their fungicide and fungistatic activities. Arch Pharm (Weinheim) 2023:e202200653. [PMID: 36922908 DOI: 10.1002/ardp.202200653] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 03/18/2023]
Abstract
Vanillin is the main component of natural vanilla extract and is responsible for its flavoring properties. Besides its well-known applications as an additive in food and cosmetics, it has also been reported that vanillin can inhibit fungi of clinical interest, such as Candida spp., Cryptococcus spp., Aspergillus spp., as well as dermatophytes. Thus, the present work approaches the synthesis of a series of vanillin derivatives with 1,2,3-triazole fragments and the evaluation of their antifungal activities against Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, Cryptococcus neoformans, Cryptococcus gattii, Trichophyton rubrum, and Trichophyton interdigitale strains. Twenty-two vanillin derivatives were obtained, with yields in the range of 60%-91%, from copper(I)-catalyzed alkyne-azide cycloaddition (CuAAC) click reaction between two terminal alkynes prepared from vanillin and different benzyl azides. In general, the evaluated compounds showed moderate activity against the microorganisms tested, with minimum inhibitory concentration (MIC) values ranging from 32 to >512 µg mL-1 . Except for compound 3b against the C. gattii R265 strain, all vanillin derivatives showed fungicidal activity for the yeasts tested. The predicted physicochemical and ADMET (absorption, distribution, metabolism, excretion, and toxicity) properties for the compounds indicated favorable profiles for drug development. In addition, a four-dimensional structure-activity relationship (4D-SAR) analysis was carried out and provided useful insights concerning the structures of the compounds and their biological profile. Finally, molecular docking calculations showed that all compounds bind favorably at the lanosterol 14α-demethylase enzyme active site with binding energies ranging from -9.1 to -12.2 kcal/mol.
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Affiliation(s)
- Poliana A R Gazolla
- Departamento de Química, Grupo de Síntese e Pesquisa de Compostos Bioativos (GSPCB), Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Alex R de Aguiar
- Departamento de Química, Grupo de Síntese e Pesquisa de Compostos Bioativos (GSPCB), Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Maria C A Costa
- Laboratório de Quimiometria Teórica e Aplicada (LQTA), Universidade Estadual de Campinas - Unicamp, São Paulo, Campinas, Brazil
| | - Osmair V Oliveira
- Instituto Federal de São Paulo - Campus Catanduva, São Paulo, Catanduva, Brazil
| | - Adilson V Costa
- Departamento de Química e Física, Universidade Federal do Espírito Santo, Alto Universitário, Alegre, Espírito Santo, Brazil
| | - Cleiton M da Silva
- Departmento de Química, ICEx, Universidade Federal de Minas Gerais, Campus Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - Claudia J do Nascimento
- Universidade Federal do Estado do Rio de Janeiro, Instituto de Biociências, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jochen Junker
- Fundação Oswaldo Cruz/CDTS, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafaela S Ferreira
- Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Campus Pampulha, Minas Gerais, Belo Horizonte, Brazil
| | - Fabrício M de Oliveira
- Instituto Federal de Minas Gerais (IFMG), Campus Ouro Branco, Ouro Branco, Minas Gerais, Brazil
| | - Boniek G Vaz
- Instituto de Química, Universidade Federal de Goiás, Campus Samambaia, Goiânia, Goiás, Brazil
| | - Paulo H F do Carmo
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Campus Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - Daniel A Santos
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Campus Pampulha, Belo Horizonte, Minas Gerais, Brazil
| | - Márcia M C Ferreira
- Laboratório de Quimiometria Teórica e Aplicada (LQTA), Universidade Estadual de Campinas - Unicamp, São Paulo, Campinas, Brazil
| | - Róbson R Teixeira
- Departamento de Química, Grupo de Síntese e Pesquisa de Compostos Bioativos (GSPCB), Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
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Hamdy R, Hamoda AM, Al-Khalifa M, Menon V, El-Awady R, Soliman SSM. Efficient selective targeting of Candida CYP51 by oxadiazole derivatives designed from plant cuminaldehyde. RSC Med Chem 2022; 13:1322-1340. [PMID: 36439981 PMCID: PMC9667785 DOI: 10.1039/d2md00196a] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/19/2022] [Indexed: 07/24/2023] Open
Abstract
Candida infection represents a global threat with associated high resistance and mortality rate. Azoles such as the triazole drug fluconazole are the frontline therapy against invasive fungal infections; however, the emerging multidrug-resistant strains limit their use. Therefore, a series of novel azole UOSO1-15 derivatives were developed based on a modified natural scaffold to combat the evolved resistance mechanism and to provide improved safety and target selectivity. The antifungal screening against C. albicans and C. auris showed that UOSO10 and 12-14 compounds were the most potent derivatives. Among them, UOSO13 exhibited superior potent activity with MIC50 values of 0.5 and 0.8 μg mL-1 against C. albicans and C. auris compared to 25 and 600 μg mL-1 for fluconazole, respectively. UOSO13 displayed significant CaCYP51 enzyme inhibition activity in a concentration-dependent manner with an IC50 10-fold that of fluconazole, while exhibiting no activity against human CYP50 enzyme or toxicity to human cells. Furthermore, UOSO13 caused a significant reduction of Candida ergosterol content by 70.3% compared to a 35.6% reduction by fluconazole. Homology modeling, molecular docking, and molecular dynamics simulations of C. auris CYP51 enzyme indicated the stability and superiority of UOSO13. ADME prediction indicated that UOSO13 fulfils the drug-likeness criteria with good physicochemical properties.
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Affiliation(s)
- Rania Hamdy
- Research Institute for Medical and Health Sciences, University of Sharjah P.O. Box 27272 Sharjah United Arab Emirates
- Faculty of Pharmacy, Zagazig University Zagazig Egypt
| | - Alshaimaa M Hamoda
- Research Institute for Medical and Health Sciences, University of Sharjah P.O. Box 27272 Sharjah United Arab Emirates
- College of Medicine, University of Sharjah P.O. Box 27272 Sharjah United Arab Emirate
- Department of Pharmacognosy, Faculty of Pharmacy, Assiut University Assiut-71526 Egypt
| | - Mariam Al-Khalifa
- Research Institute for Medical and Health Sciences, University of Sharjah P.O. Box 27272 Sharjah United Arab Emirates
| | - Varsha Menon
- Research Institute for Medical and Health Sciences, University of Sharjah P.O. Box 27272 Sharjah United Arab Emirates
| | - Raafat El-Awady
- Research Institute for Medical and Health Sciences, University of Sharjah P.O. Box 27272 Sharjah United Arab Emirates
- College of Pharmacy, University of Sharjah P.O. Box 27272 Sharjah United Arab Emirates +97165057472
| | - Sameh S M Soliman
- Research Institute for Medical and Health Sciences, University of Sharjah P.O. Box 27272 Sharjah United Arab Emirates
- College of Pharmacy, University of Sharjah P.O. Box 27272 Sharjah United Arab Emirates +97165057472
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Reducing the off-target endocrinologic adverse effects of azole antifungals – can it be done? Int J Antimicrob Agents 2022; 59:106587. [DOI: 10.1016/j.ijantimicag.2022.106587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/08/2022] [Accepted: 04/03/2022] [Indexed: 11/18/2022]
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Haroun M, Tratrat C, Kochkar H, Nair AB. CDATA[Recent Advances in the Development of 1,2,3-Triazole-containing Derivatives as Potential Antifungal Agents and Inhibitors of Lanoster ol 14α-Demethylase. Curr Top Med Chem 2021; 21:462-506. [PMID: 33319673 DOI: 10.2174/1568026621999201214232018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/12/2020] [Accepted: 11/03/2020] [Indexed: 11/22/2022]
Abstract
1,2,3-Triazole, a five-membered heterocyclic nucleus, is widely recognized as a key chromophore of great value in medicinal chemistry for delivering compounds possessing innumerable biological activities, including antimicrobial, antitubercular, antidiabetic, antiviral, antitumor, antioxidants, and anti-inflammatory activities. Mainly, in the past years, diverse conjugates carrying this biologically valuable core have been reported due to their attractive fungicidal potential and potent effects on various infective targets. Hence, hybridization of 1,2,3-triazole with other antimicrobial pharmacophores appears to be a judicious strategy to develop new effective anti-fungal candidates to combat the emergence of drug-sensitive and drug-resistant infectious diseases. Thus, the current review highlights the recent advances of this promising category of 1,2,3-triazole-containing hybrids incorporating diverse varieties of bioactive heterocycles such as conozole, coumarin, imidazole, benzimidazole, pyrazole, indole, oxindole, chromene, pyrane, quinazoline, chalcone, isoflavone, carbohydrates, and amides. It underlies their inhibition behavior against a wide array of infectious fungal species during 2015-2020.
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Affiliation(s)
- Michelyne Haroun
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Christophe Tratrat
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Hafedh Kochkar
- Department of Chemistry, College of Science, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Anroop B Nair
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
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Zveaghintseva M, Stingaci E, Pogrebnoi S, Smetanscaia A, Valica V, Uncu L, Ch. Kravtsov V, Melnic E, Petrou A, Glamočlija J, Soković M, Carazo A, Mladěnka P, Poroikov V, Geronikaki A, Macaev FZ. Chromenol Derivatives as Novel Antifungal Agents: Synthesis, In Silico and In Vitro Evaluation. Molecules 2021; 26:molecules26144304. [PMID: 34299579 PMCID: PMC8307147 DOI: 10.3390/molecules26144304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022] Open
Abstract
Herein we report the synthesis of some new 1H-1,2,4-triazole functionalized chromenols (3a-3n) via tandem reactions of 1-(alkyl/aryl)-2-(1H-1,2,4-triazole-1-yl) with salicylic aldehydes and the evaluation of their antifungal activity. In silico prediction of biological activity with computer program PASS indicate that the compounds have a high novelty compared to the known antifungal agents. We did not find any close analog among the over 580,000 pharmaceutical agents in the Cortellis Drug Discovery Intelligence database at the similarity cutoff of 70%. The evaluation of antifungal activity in vitro revealed that the highest activity was exhibited by compound 3k, followed by 3n. Their MIC values for different fungi were 22.1-184.2 and 71.3-199.8 µM, respectively. Twelve from fourteen tested compounds were more active than the reference drugs ketoconazole and bifonazole. The most sensitive fungus appeared to be Trichoderma viride, while Aspergillus fumigatus was the most resistant one. It was found that the presence of the 2-(tert-butyl)-2H-chromen-2-ol substituent on the 4th position of the triazole ring is very beneficial for antifungal activity. Molecular docking studies on C. albicans sterol 14α-demethylase (CYP51) and DNA topoisomerase IV were used to predict the mechanism of antifungal activities. According to the docking results, the inhibition of CYP51 is a putative mechanism of antifungal activity of the novel chromenol derivatives. We also showed that most active compounds have a low cytotoxicity, which allows us to consider them promising antifungal agents for the subsequent testing activity in in vivo assays.
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Affiliation(s)
- Marina Zveaghintseva
- Laboratory of Organic Synthesis, Institute of Chemistry, 3 Str. Academiei 3, MD-2028 Chișinău, Moldova; (M.Z.); (E.S.); (S.P.)
| | - Eugenia Stingaci
- Laboratory of Organic Synthesis, Institute of Chemistry, 3 Str. Academiei 3, MD-2028 Chișinău, Moldova; (M.Z.); (E.S.); (S.P.)
| | - Serghei Pogrebnoi
- Laboratory of Organic Synthesis, Institute of Chemistry, 3 Str. Academiei 3, MD-2028 Chișinău, Moldova; (M.Z.); (E.S.); (S.P.)
| | - Anastasia Smetanscaia
- Scientific Center for Drug Research, “Nicolae Testemițanu” State University of Medicine and Pharmacy, Bd. Stefan Cel Mare și Sfant 165, MD-2004 Chișinău, Moldova; (A.S.); (V.V.); (L.U.)
| | - Vladimir Valica
- Scientific Center for Drug Research, “Nicolae Testemițanu” State University of Medicine and Pharmacy, Bd. Stefan Cel Mare și Sfant 165, MD-2004 Chișinău, Moldova; (A.S.); (V.V.); (L.U.)
| | - Livia Uncu
- Scientific Center for Drug Research, “Nicolae Testemițanu” State University of Medicine and Pharmacy, Bd. Stefan Cel Mare și Sfant 165, MD-2004 Chișinău, Moldova; (A.S.); (V.V.); (L.U.)
| | - Victor Ch. Kravtsov
- Laboratory of Physical Methods of Solid State Investigation “Tadeusz Malinowski”, Institute of Applied Physics, Str. Academiei 5, MD-2028 Chișinău, Moldova; (V.C.K.); (E.M.)
| | - Elena Melnic
- Laboratory of Physical Methods of Solid State Investigation “Tadeusz Malinowski”, Institute of Applied Physics, Str. Academiei 5, MD-2028 Chișinău, Moldova; (V.C.K.); (E.M.)
| | - Anthi Petrou
- Department of Pharmacy, School of Health, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Jasmina Glamočlija
- Mycological Laboratory, Department of Plant Physiology, Institute for Biological Research “Siniša Stanković”, National Institute of Republic of Serbia, University of Belgrade, 11060 Beograd, Serbia; (J.G.); (M.S.)
| | - Marina Soković
- Mycological Laboratory, Department of Plant Physiology, Institute for Biological Research “Siniša Stanković”, National Institute of Republic of Serbia, University of Belgrade, 11060 Beograd, Serbia; (J.G.); (M.S.)
| | - Alejandro Carazo
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University, 500 05 Hradec Králové, Czech Republic; (A.C.); (P.M.)
| | - Přemysl Mladěnka
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Charles University, 500 05 Hradec Králové, Czech Republic; (A.C.); (P.M.)
| | - Vladimir Poroikov
- Laboratory of Structure-Function Based Drug Design, Institute of Biomedical Chemistry, Pogodinskaya Str. 10, Bldg. 8, 119121 Moscow, Russia;
| | - Athina Geronikaki
- Department of Pharmacy, School of Health, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
- Correspondence: (A.G.); (F.Z.M.); Tel.: +30-2310-99-76-16 (A.G.)
| | - Fliur Z. Macaev
- Laboratory of Organic Synthesis, Institute of Chemistry, 3 Str. Academiei 3, MD-2028 Chișinău, Moldova; (M.Z.); (E.S.); (S.P.)
- Scientific Center for Drug Research, “Nicolae Testemițanu” State University of Medicine and Pharmacy, Bd. Stefan Cel Mare și Sfant 165, MD-2004 Chișinău, Moldova; (A.S.); (V.V.); (L.U.)
- Correspondence: (A.G.); (F.Z.M.); Tel.: +30-2310-99-76-16 (A.G.)
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Tratrat C. 1,2,4-Triazole: A Privileged Scaffold for the Development of Potent Antifungal Agents - A Brief Review. Curr Top Med Chem 2021; 20:2235-2258. [PMID: 32621720 DOI: 10.2174/1568026620666200704140107] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/04/2020] [Accepted: 04/13/2020] [Indexed: 12/23/2022]
Abstract
Over the past decades, a tremendous rise in invasive fungal infection diseases attributed to the yeast Candida albicans in immunocompromised individuals poses a seriously challenging issue. Another concern is the emergence of multi-drug resistant pathogens to the existing medicines due to their overuse and misuse. It was recently reported that 25-55% of the mortality rate is caused by invasive infection. Despite a large variety of drugs being available to treat invasive candidiasis, only two of them contain a 1,2,4-triazole core, namely Fluconazole and itraconazole, which are efficient in treating infection induced by fungal Candida species. Moreover, long-term therapy associated with azole medications has led to an increase in azole resistance as well as a high risk of toxicity. Despite numerous outstanding achievements in antifungal drug discovery, development of novel, safer and potent antifungal agents while overcoming the resistance problem associated with the current drugs is becoming the main focus of medicinal chemists. Therefore, this review outlines the breakthroughs in medicinal chemistry research regarding 1,2,4- triazole-based derivatives as potential antifungal agents in the past decade. In addition, the structureactivity relationship of these compounds is also discussed.
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Affiliation(s)
- Christophe Tratrat
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
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Erum R, Samad F, Khan A, Kazmi SU. A comparative study on production of extracellular hydrolytic enzymes of Candida species isolated from patients with surgical site infection and from healthy individuals and their co-relation with antifungal drug resistance. BMC Microbiol 2020; 20:368. [PMID: 33272216 PMCID: PMC7713141 DOI: 10.1186/s12866-020-02045-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 11/17/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Surgical site infection (SSI) is a crucial dilemma of surgery. Patients with SSIs not only face difficulty in treatment but also bear extra cost with high mortality rate. Resistant strains of Candida have emerged as an important nosocomial pathogen. Proteinase and phospholipase are exo- enzymes of Candida species, have importance with respect to their contribution in diseases. This study focused on prevalence of Candida species in surgical wound, their resistance to antifungal drugs, co-relation of these resistance with virulence potential of Candida species and comparison of production level of exo-enzymes of Candida species isolated from patients with SSIs and healthy individuals to highlights their role in SSIs. RESULTS A total of (n = 555) swab samples were investigated. (n = 450) samples were collected from patients with SSIs and (n = 105) were collected from healthy individuals. Samples were subjected for the identification of Candida species which were subsequently investigated for antifungal susceptibility, MICs and enzymatic activity of Candida species. Out of 128 strains of Candida spp. isolated from SSIs, 54(42.18%) were identified as C. albicans followed by C. glabrata 32(25%), C. parapsilosis 17(13.28%), C. krusei 13(10.16%) and C. tropicalis 12(9.38%). C. albicans isolates showed 100% susceptibility to voriconazole and amphotericin B followed by itraconazole 98% and fluconazole 89%. Out of 6 fluconazole resistant C. albicans 5(83.33%) were able to produce phospholipase while out of 48 fluconazole-susceptible strains 17(35.42%) were found to be phospholipase producer. Out of 54 C. albicans isolated from surgical wound 46(85.18%) and 49(90.74%) were found to be phospholipase and proteinase producer respectively, whereas out of 20 C. albicans isolates from healthy subjects 14(70%) produce proteinase and 12(60%) produce phospholipase. There were significant statistical differences found between the level of enzyme production by C. albicans, in relation to both sites (P = 0.014). CONCLUSION Study revealed that prevalence of Candida species is high in SSIs. Phospholipase and proteinase activity were more pronounced in Candida Species from surgical wound in contrast to species from healthy individuals suggests these enzymes may have been responsible for the severity of infection in surgical wound patients.
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Affiliation(s)
- Rakhshanda Erum
- Department of Microbiology, University of Karachi, Karachi, 75270, Pakistan.
| | - Farkhunda Samad
- Department of Microbiology, University of Karachi, Karachi, 75270, Pakistan
| | - Adnan Khan
- Department of Microbiology, University of Karachi, Karachi, 75270, Pakistan
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Munkboel CH, Rasmussen TB, Elgaard C, Olesen MLK, Kretschmann AC, Styrishave B. The classic azole antifungal drugs are highly potent endocrine disruptors in vitro inhibiting steroidogenic CYP enzymes at concentrations lower than therapeutic Cmax. Toxicology 2019; 425:152247. [DOI: 10.1016/j.tox.2019.152247] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/12/2019] [Accepted: 07/18/2019] [Indexed: 01/08/2023]
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Divse JM, Mhaske SB, Charolkar CR, Sant DG, Tupe SG, Deshpande MV, Khedkar VM, Nawale LU, Sarkar D, Pore VS. Synthesis and biological evaluation of new fluconazole β-lactam conjugates linked via 1,2,3-triazole. NEW J CHEM 2017. [DOI: 10.1039/c6nj03117j] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Novel fluconazole conjugates with potent antifungal activity are reported here. They were also found to be non-hemolytic and non-cytotoxic.
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Affiliation(s)
- Jaisingh M. Divse
- Organic Chemistry Division
- CSIR-National Chemical Laboratory
- Pune 411008
- India
| | - Santosh B. Mhaske
- Organic Chemistry Division
- CSIR-National Chemical Laboratory
- Pune 411008
- India
| | | | - Duhita G. Sant
- Biochemical Sciences Division
- CSIR-National Chemical Laboratory
- Pune 411008
- India
| | - Santosh G. Tupe
- Biochemical Sciences Division
- CSIR-National Chemical Laboratory
- Pune 411008
- India
| | - Mukund V. Deshpande
- Biochemical Sciences Division
- CSIR-National Chemical Laboratory
- Pune 411008
- India
| | - Vijay M. Khedkar
- School of Health Sciences
- University of KwaZulu Natal
- Durban 4000
- South Africa
- Department of Pharmaceutical Chemistry
| | - Laxman U. Nawale
- Combichem-Bioresource Center
- Organic Chemistry Division
- CSIR-National Chemical Laboratory
- Pune 411008
- India
| | - Dhiman Sarkar
- Combichem-Bioresource Center
- Organic Chemistry Division
- CSIR-National Chemical Laboratory
- Pune 411008
- India
| | - Vandana S. Pore
- Organic Chemistry Division
- CSIR-National Chemical Laboratory
- Pune 411008
- India
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Decline in the Use of Surgical Biopsy for Diagnosis of Pulmonary Disease in Hematopoietic Cell Transplantation Recipients in an Era of Improved Diagnostics and Empirical Therapy. Biol Blood Marrow Transplant 2016; 22:2243-2249. [PMID: 27590103 PMCID: PMC7128129 DOI: 10.1016/j.bbmt.2016.08.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 08/22/2016] [Indexed: 11/22/2022]
Abstract
Use of biopsy for diagnosis of post-HCT lung disease has declined significantly. Improved testing and increased azole use are associated with this decrease. Less invasive methods have improved diagnostics for respiratory pathogens. We outline an algorithm for appropriate use of lung biopsy in these patients.
Historically, diagnosis of enigmatic pulmonary disease after hematopoietic cell transplantation (HCT) required lung biopsy, but recent advancements in diagnosis and therapy for respiratory infections have changed how clinicians approach pulmonary abnormalities. We examined temporal trends in the use of lung biopsy after HCT. We retrospectively reviewed patients who underwent their first allogeneic HCT at the Fred Hutchinson Cancer Research Center between the years 1993 to 1997, 2003 to 2007, and 2013 to 2015 and subsequently underwent surgical lung biopsy for any reason. Lung biopsy between cohorts were analyzed using a Cox proportional hazards model with death and relapse considered competing risks. Of 1418 patients, 52 (3.7%) underwent 54 post-HCT surgical lung biopsies during 1993 to 1997 compared with 24 (2.1%) and 25 biopsies in the 2003 to 2007 cohort; 2 cases of surgical lung biopsies out of 786 HCT recipients occurred during the 2013 to 2015 cohort (.25%). The median time to biopsy post-HCT was 71.5 days (IQR, 31 to 89) for the early cohort and 97 days (IQR, 42 to 124) for the late cohort, for an overall biopsy incidence of .15 and .075 per 1000 patient days in the first year after HCT, respectively. Patients in the 2003 to 2007 cohort were less likely to undergo a lung biopsy (adjusted HR, .50; 95% CI, .29 to .83; P = .008) when compared with patients in the early cohort, but more patients in the early cohort underwent lung biopsy without antecedent bronchoscopy (25/54 [46%] versus 3/25 [12%], P = .005). Although infections were a more common finding at biopsy in the early cohort (35/1418 versus 8/1148, P < .001), the number of biopsies demonstrating noninfectious lesions was similar between the two cohorts (19/1418 versus 17/1148, P = .76). Fungal infections were the major infectious etiology in both cohorts (32/35 [91%] versus 5/8 [63%], P = .07), but there was a significant reduction in the number of Aspergillus species found at biopsy between the cohorts (30/54 versus 1/25, P < .001). A similar percentage underwent biopsy with therapeutic intent for invasive fungal disease in the 2 cohorts (8/54 [15%] versus 4/25 [16%]). Surgical evaluation of lung disease in HCT recipients significantly declined over a span of 2 decades. The decline from the years 1993 to 1997 compared with 2003 to 2007 was because of a reduction in the number of biopsies for post-transplant infections due to aspergillosis, which is temporally related to improved diagnostic testing by minimally invasive means and the increased use of empiric therapy with extended-spectrum azoles. This practice of primary nonsurgical diagnostic and treatment approaches to pulmonary disease post-HCT have continued, shown by low numbers of surgical biopsies over the last 3 years.
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Pore VS, Agalave SG, Singh P, Shukla PK, Kumar V, Siddiqi MI. Design and synthesis of new fluconazole analogues. Org Biomol Chem 2015; 13:6551-61. [DOI: 10.1039/c5ob00590f] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The synthesis of new fluconazole analogues containing two different 1,2,3-triazole units and an amide group is described. All the compounds showed very high antifungal activity and no toxicity.
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Affiliation(s)
- Vandana S. Pore
- Organic Chemistry Division
- CSIR-National Chemical Laboratory
- Pune 411 008
- India
| | - Sandip G. Agalave
- Organic Chemistry Division
- CSIR-National Chemical Laboratory
- Pune 411 008
- India
| | - Pratiksha Singh
- Medical Mycology Lab
- Division of Fermentation Technology
- CSIR-Central Drug Research Institute
- Lucknow
- India
| | - Praveen K. Shukla
- Medical Mycology Lab
- Division of Fermentation Technology
- CSIR-Central Drug Research Institute
- Lucknow
- India
| | - Vikash Kumar
- Computational Bio & Bioinformatics Lab
- Division of Molecular & Structural Biology
- CSIR-Central Drug Research Institute
- Lucknow
- India
| | - Mohammad I. Siddiqi
- Computational Bio & Bioinformatics Lab
- Division of Molecular & Structural Biology
- CSIR-Central Drug Research Institute
- Lucknow
- India
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De Sarro A, La Camera E, Fera M. New and Investigational Triazole Agents for the Treatment of Invasive Fungal Infections. J Chemother 2013; 20:661-71. [DOI: 10.1179/joc.2008.20.6.661] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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13
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In vitro activity of a new oral glucan synthase inhibitor (MK-3118) tested against Aspergillus spp. by CLSI and EUCAST broth microdilution methods. Antimicrob Agents Chemother 2012; 57:1065-8. [PMID: 23229479 DOI: 10.1128/aac.01588-12] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
MK-3118, a glucan synthase inhibitor derived from enfumafungin, and comparator agents were tested against 71 Aspergillus spp., including itraconazole-resistant strains (MIC, ≥ 4 μg/ml), using CLSI and EUCAST reference broth microdilution methods. The CLSI 90% minimum effective concentration (MEC(90))/MIC(90) values (μg/ml) for MK-3118, amphotericin B, and caspofungin, respectively, were as follows: 0.12, 2, and 0.03 for Aspergillus flavus species complex (SC); 0.25, 2, and 0.06 for Aspergillus fumigatus SC; 0.12, 2, and 0.06 for Aspergillus terreus SC; and 0.06, 1, and 0.03 for Aspergillus niger SC. Essential agreement between the values found by CLSI and EUCAST (± 2 log(2) dilution steps) was 94.3%. MK-3118 was determined to be a potent agent regardless of the in vitro method applied, with excellent activity against contemporary wild-type and itraconazole-resistant strains of Aspergillus spp.
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In vitro susceptibility of environmental isolates of Exophiala dermatitidis to five antifungal drugs. Mycopathologia 2012; 175:455-61. [PMID: 23229615 DOI: 10.1007/s11046-012-9597-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 10/24/2012] [Indexed: 10/27/2022]
Abstract
Several dematiaceous fungi frequently isolated from nature are involved in cases of superficial lesions to lethal cerebral infections. Antifungal susceptibility data on environmental and clinical isolates are still sparse despite the advances in testing methods. The objective of this study was to examine the activities of 5-flucytosine, amphotericin B, itraconazole, voriconazole and terbinafine against environmental isolates of Exophiala strains by minimum inhibition concentration (MIC) determination. The strains were obtained from hydrocarbon-contaminated soil, ant cuticle and fungal pellets from the infrabuccal pocket of attine gynes. Broth microdilution assay using M38-A2 reference methodology for the five antifungal drugs and DNA sequencing for fungal identification were applied. Terbinafine was the most active drug against the tested strains. It was observed that amphotericin B was less effective, notably against Exophiala spinifera, also studied. High MICs of 5-flucytosine against Exophiala dermatitidis occurred. This finding highlights the relevance of studies on the antifungal resistance of these potential opportunistic species. Our results also contribute to a future improvement of the standard methods to access the drug efficacy currently applied to black fungi.
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Lima-Neto RG, Cavalcante NNM, Srivastava RM, Mendonça Junior FJB, Wanderley AG, Neves RP, dos Anjos JV. Synthesis of 1,2,3-triazole derivatives and in vitro antifungal evaluation on Candida strains. Molecules 2012; 17:5882-92. [PMID: 22592091 PMCID: PMC6268928 DOI: 10.3390/molecules17055882] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 05/03/2012] [Accepted: 05/05/2012] [Indexed: 11/23/2022] Open
Abstract
1,2,3-Triazoles have been extensively studied as compounds possessing important biological activities. In this work, we describe the synthesis of ten 2-(1-aryl-1H-1,2,3-triazol-4-yl)propan-2-ols via copper catalyzed azide alkyne cycloaddition (CuAAc or click chemistry). Next thein vitro antifungal activity of these ten compounds was evaluated using the microdilution broth method against 42 isolates of four different Candida species. Among all tested compounds, the halogen substituted triazole 2-[1-(4-chlorophenyl)-1H-(1,2,3)triazol-4-yl]propan-2-ol, revealed the best antifungal profile, showing that further modifications could be done in the structure to obtain a better drug candidate in the future.
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Affiliation(s)
- Reginaldo G. Lima-Neto
- de Micologia Médica, Centro de Ciências Biológicas, Universidade Federal de Pernambuco (UFPE), 50670-901, Recife, PE, Brazil
| | - Nery N. M. Cavalcante
- de Síntese Orgânica, Departamento de Química Fundamental, Universidade Federal de Pernambuco (UFPE), 50740-560, Recife, PE, Brazil
| | - Rajendra M. Srivastava
- de Síntese Orgânica, Departamento de Química Fundamental, Universidade Federal de Pernambuco (UFPE), 50740-560, Recife, PE, Brazil
| | - Francisco J. B. Mendonça Junior
- de Síntese e Vetorização de Substâncias Bioativas, Universidade Estadual da Paraíba (UEPB), 58058-420, João Pessoa, PB, Brazil
| | - Almir G. Wanderley
- de Farmacologia Pré-Clínica e Toxicologia de Produtos Bioativos, Departamento de Fisiologia e Farmacologia, Universidade Federal de Pernambuco (UFPE), 50670-901, Recife, PE, Brazil
| | - Rejane P. Neves
- de Micologia Médica, Centro de Ciências Biológicas, Universidade Federal de Pernambuco (UFPE), 50670-901, Recife, PE, Brazil
| | - Janaína V. dos Anjos
- de Síntese Orgânica, Departamento de Química Fundamental, Universidade Federal de Pernambuco (UFPE), 50740-560, Recife, PE, Brazil
- Author to whom correspondence should be addressed; ; Tel.: +55-81-2126-7411; Fax: +55-81-2126-8440
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Pore VS, Jagtap MA, Agalave SG, Pandey AK, Siddiqi MI, Kumar V, Shukla PK. Synthesis and antifungal activity of 1,5-disubstituted-1,2,3-triazole containing fluconazole analogues. MEDCHEMCOMM 2012. [DOI: 10.1039/c2md00205a] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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17
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Pfaller MA, Duncanson F, Messer SA, Moet GJ, Jones RN, Castanheira M. In vitro activity of a novel broad-spectrum antifungal, E1210, tested against Aspergillus spp. determined by CLSI and EUCAST broth microdilution methods. Antimicrob Agents Chemother 2011; 55:5155-8. [PMID: 21844312 PMCID: PMC3194992 DOI: 10.1128/aac.00570-11] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 07/25/2011] [Indexed: 02/01/2023] Open
Abstract
E1210 is a first-in-class broad-spectrum antifungal that suppresses hyphal growth by inhibiting fungal glycophosphatidylinositol (GPI) biosynthesis. In the present study, we extend these findings by examining the activity of E1210 and comparator antifungal agents against Aspergillus spp. by using the methods of the Clinical and Laboratory Standards Institute (CLSI) and the European Committee for Antimicrobial Susceptibility Testing (EUCAST) to test wild-type (WT) as well as amphotericin B (AMB)-resistant (-R) and azole-R strains (as determined by CLSI methods). Seventy-eight clinical isolates of Aspergillus were tested including 20 isolates of Aspergillus flavus species complex (SC), 22 of A. fumigatus SC, 13 of A. niger SC, and 23 of A. terreus SC. The collection included 15 AMB-R (MIC, ≥ 2 μg/ml) isolates of A. terreus SC and 10 itraconazole-R (MIC, ≥ 4 μg/ml) isolates of A. fumigatus SC (7 isolates), A. niger SC (2 isolates), and A. terreus SC (1 isolate). Comparator antifungal agents included anidulafungin, caspofungin, amphotericin B, itraconazole, posaconzole, and voriconazole. Both CLSI and EUCAST methods were highly concordant for E1210 and all comparators. The essential agreement (EA; ± 2 log(2) dilution steps) was 100% for all comparisons with the exception of posaconazole versus A. terreus SC (EA = 91.3%). The minimum effective concentration (MEC)/MIC(90) values (μg/ml) for E1210, anidulafungin, caspofungin, itraconazole, posaconazole, and voriconazole, respectively, were as follows for each species: for A. flavus SC, 0.03, ≤ 0.008, 0.12, 1, 1, and 1; for A. fumigatus SC, 0.06, 0.015, 0.12, >8, 1, and 4; for A. niger SC, 0.015, 0.03, 0.12, 4, 1, and 2; and for A. terreus SC, 0.06, 0.015, 0.12, 1, 0.5, and 1. E1210 was very active against AMB-R strains of A. terreus SC (MEC range, 0.015 to 0.06 μg/ml) and itraconazole-R strains of A. fumigatus SC (MEC range, 0.03 to 0.12 μg/ml), A. niger SC (MEC, 0.008 μg/ml), and A. terreus SC (MEC, 0.015 μg/ml). In conclusion, E1210 was a very potent and broad-spectrum antifungal agent regardless of in vitro method applied, with excellent activity against AMB-R and itraconazole-R strains of Aspergillus spp.
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Affiliation(s)
| | | | | | | | - Ronald N. Jones
- JMI Laboratories, North Liberty, Iowa 52317
- Tufts University School of Medicine, Boston, Massachusetts 02111
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In Vitro Activities of New Triazole Antifungal Agents, Posaconazole and Voriconazole, Against Oral Candida Isolates from Patients Suffering from Denture Stomatitis. Mycopathologia 2011; 173:35-46. [DOI: 10.1007/s11046-011-9460-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 08/03/2011] [Indexed: 11/27/2022]
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19
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Clinical breakpoints for voriconazole and Candida spp. revisited: review of microbiologic, molecular, pharmacodynamic, and clinical data as they pertain to the development of species-specific interpretive criteria. Diagn Microbiol Infect Dis 2011; 70:330-43. [DOI: 10.1016/j.diagmicrobio.2011.03.002] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Revised: 02/21/2011] [Accepted: 03/07/2011] [Indexed: 11/23/2022]
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20
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Ekhato IV, Rinehart JK. Carbon-14-and carbon-13-labeled phosphoric acid [2-4-(4-cyanophenyl)-thiazol-2-yl]-(2,4-difluorophenyl)-1-[1,2,4]triazol-4-yl-methylpropoxymethyl] monoester dilysine salt, a prodrug of ravuconazole. J Labelled Comp Radiopharm 2011. [DOI: 10.1002/jlcr.1879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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21
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Comparison of the broth microdilution (BMD) method of the European Committee on Antimicrobial Susceptibility Testing with the 24-hour CLSI BMD method for testing susceptibility of Candida species to fluconazole, posaconazole, and voriconazole by use of epidemiological cutoff values. J Clin Microbiol 2011; 49:845-50. [PMID: 21227994 DOI: 10.1128/jcm.02441-10] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The antifungal broth microdilution (BMD) method of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) was compared with CLSI BMD method M27-A3 for fluconazole, posaconazole, and voriconazole susceptibility testing of 1,056 isolates of Candida. The isolates were obtained in 2009 from more than 60 centers worldwide and included 560 isolates of C. albicans, 175 of C. glabrata, 162 of C. parapsilosis, 124 of C. tropicalis, and 35 of C. krusei. The overall essential agreement (EA) between EUCAST and CLSI results ranged from 96.9% (voriconazole) to 98.6% (fluconazole). The categorical agreement (CA) between methods and species of Candida was assessed using previously determined epidemiological cutoff values (ECVs). The ECVs (expressed as μg/ml) for fluconazole, posaconazole, and voriconazole, respectively, were as follows: 0.12, 0.06, and 0.03 for C. albicans; 32, 2, and 0.5 for C. glabrata; 2, 0.25, and 0.12 for C. parapsilosis; 2, 0.12, and 0.06 for C. tropicalis; 64, 0.5, and 0.5 for C. krusei. Excellent CA was observed for all comparisons between the EUCAST and CLSI results for fluconazole, posaconazole, and voriconazole, respectively, for each species: 98.9%, 93.6%, and 98.6% for C. albicans; 96.0%, 98.9%, and 93.7% for C. glabrata; 90.8%, 98.1%, and 98.1% for C. parapsilosis; 99.2%, 99.2%, and 96.8% for C. tropicalis; 97.1%, 97.1%, and 97.1% for C. krusei. We demonstrate high levels of EA and CA between the CLSI and EUCAST BMD methods for testing of triazoles against Candida when the MICs were determined after 24 h and ECVs were used to differentiate wild-type (WT) from non-WT strains. These results provide additional data in favor of the harmonization of these two methods.
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22
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Comparison of the broth microdilution methods of the European Committee on Antimicrobial Susceptibility Testing and the Clinical and Laboratory Standards Institute for testing itraconazole, posaconazole, and voriconazole against Aspergillus isolates. J Clin Microbiol 2011; 49:1110-2. [PMID: 21209166 DOI: 10.1128/jcm.02432-10] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We compared EUCAST and CLSI antifungal susceptibility testing methods for itraconazole, posaconazole, and voriconazole by testing 245 Aspergillus clinical isolates. The essential agreement (EA) between methods was excellent: 100% (itraconazole), 98.4% (posaconazole), and 99.6% (voriconazole) assessing EA at ±2 dilutions and 99.6% (itraconazole), 87.7% (posaconazole), and 96.3% (voriconazole) at ±1 dilution.
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23
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Guan Z, Chai X, Yu S, Hu H, Jiang Y, Meng Q, Wu Q. Synthesis, Molecular Docking, and Biological Evaluation of Novel Triazole Derivatives as Antifungal Agents. Chem Biol Drug Des 2010; 76:496-504. [DOI: 10.1111/j.1747-0285.2010.01038.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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24
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Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: a 10.5-year analysis of susceptibilities of Candida Species to fluconazole and voriconazole as determined by CLSI standardized disk diffusion. J Clin Microbiol 2010; 48:1366-77. [PMID: 20164282 DOI: 10.1128/jcm.02117-09] [Citation(s) in RCA: 442] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Fluconazole in vitro susceptibility test results for 256,882 isolates of Candida spp. were collected from 142 sites in 41 countries from June 1997 to December 2007. Data were collected for 197,619 isolates tested with voriconazole from 2001 to 2007. A total of 31 different species of Candida were isolated. Increased rates of isolation of the common non-albicans species C. glabrata (10.2% to 11.7%), C. tropicalis (5.4% to 8.0%), and C. parapsilosis (4.8% to 5.6%) were noted when the time periods 1997 to 2000 and 2005 to 2007 were compared. Investigators tested clinical isolates of Candida spp. by the CLSI M44-A disk diffusion method. Overall, 90.2% of Candida isolates tested were susceptible (S) to fluconazole; however, 13 of 31 species identified exhibited decreased susceptibility (<75% S), similar to that seen with the resistant (R) species C. glabrata and C. krusei. Among 197,619 isolates of Candida spp. tested against voriconazole, 95.0% were S and 3% were R. About 30% of fluconazole-R isolates of C. albicans, C. glabrata, C. tropicalis, C. rugosa, C. lipolytica, C. pelliculosa, C. apicola, C. haemulonii, C. humicola, C. lambica, and C. ciferrii remained S to voriconazole. An increase in fluconazole resistance over time was seen with C. parapsilosis, C. guilliermondii, C. lusitaniae, C. sake, and C. pelliculosa. Among the emerging fluconazole-R species were C. guilliermondii (11.4% R), C. inconspicua (53.2% R), C. rugosa (41.8% R), and C. norvegensis (40.7% R). The rates of isolation of C. rugosa, C. inconspicua, and C. norvegensis increased by 5- to 10-fold over the 10.5-year study period. C. guilliermondii and C. rugosa were most prominent in Latin America, whereas C. inconspicua and C. norvegensis were most common in Eastern European countries. This survey identifies several less-common species of Candida with decreased susceptibility to azoles. These organisms may pose a future threat to optimal antifungal therapy and underscore the importance of prompt and accurate species identification and antifungal susceptibility testing.
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Activity of MGCD290, a Hos2 histone deacetylase inhibitor, in combination with azole antifungals against opportunistic fungal pathogens. J Clin Microbiol 2009; 47:3797-804. [PMID: 19794038 DOI: 10.1128/jcm.00618-09] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report on the in vitro activity of the Hos2 fungal histone deacetylase (HDAC) inhibitor MGCD290 (MethylGene, Inc.) in combination with azoles against azole-resistant yeasts and molds. Susceptibility testing was performed by the CLSI M27-A3 and M38-A2 broth microdilution methods. Testing of the combinations (MGCD290 in combination with fluconazole, posaconazole, or voriconazole) was performed by the checkerboard method. The fractional inhibitory concentrations were determined and were defined as <0.5 for synergy, >or=0.5 but <4 for indifference, and >or=4 for antagonism. Ninety-one isolates were tested, as follows: 30 Candida isolates, 10 Aspergillus isolates, 15 isolates of the Zygomycetes order, 10 Cryptococcus neoformans isolates, 8 Rhodotorula isolates, 8 Fusarium isolates, 5 Trichosporon isolates, and 5 Scedosporium isolates. MGCD290 showed modest activity when it was used alone (MICs, 1 to 8 microg/ml) and was mostly active against azole-resistant yeasts, but the MICs against molds were high (16 to >32 microg/ml). MGCD290 was synergistic with fluconazole against 55 (60%) of the 91 isolates, with posaconazole against 46 (51%) of the 91 isolates, and with voriconazole against 48 (53%) of the 91 isolates. Synergy between fluconazole and MGCD290 was observed against 26/30 (87%) Candida isolates. All 23 of the 91 Candida isolates that were not fluconazole susceptible demonstrated a reduced fluconazole MIC that crossed an interpretive breakpoint (e.g., resistant [MIC, >or=64 microg/ml] to susceptible [MIC, <or=8 microg/ml]) when fluconazole was combined with MGCD290 at 0.12 to 4 microg/ml. The activity of fluconazole plus MGCD290 was also synergistic against 6/10 Aspergillus isolates. Posaconazole plus MGCD290 demonstrated synergy against 14/15 Zygomycetes (9 Rhizopus isolates and 5 Mucor isolates). Voriconazole plus MGCD290 demonstrated synergy against six of eight Fusarium isolates. Thus, MGCD290 demonstrated in vitro synergy with azoles against the majority of clinical isolates tested, including many azole-resistant isolates and genera inherently resistant to azoles (e.g., Mucor and Fusarium). Further evaluation of fungal HDAC inhibitor-azole combinations is indicated.
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Pesti J, Chen CK, Spangler L, DelMonte AJ, Benoit S, Berglund D, Bien J, Brodfuehrer P, Chan Y, Corbett E, Costello C, DeMena P, Discordia RP, Doubleday W, Gao Z, Gingras S, Grosso J, Haas O, Kacsur D, Lai C, Leung S, Miller M, Muslehiddinoglu J, Nguyen N, Qiu J, Olzog M, Reiff E, Thoraval D, Totleben M, Vanyo D, Vemishetti P, Wasylak J, Wei C. The Process Development of Ravuconazole: An Efficient Multikilogram Scale Preparation of an Antifungal Agent. Org Process Res Dev 2009. [DOI: 10.1021/op900065c] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jaan Pesti
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Chien-Kuang Chen
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Lori Spangler
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Albert J. DelMonte
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Serge Benoit
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Derek Berglund
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Jeffrey Bien
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Paul Brodfuehrer
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Yeung Chan
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Elisabeth Corbett
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Carrie Costello
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Paul DeMena
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Robert P. Discordia
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Wendel Doubleday
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Zhinong Gao
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Stephane Gingras
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - John Grosso
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Oscar Haas
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - David Kacsur
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Chiajen Lai
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Simon Leung
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Melanie Miller
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Jale Muslehiddinoglu
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Nina Nguyen
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Jun Qiu
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Martina Olzog
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Emily Reiff
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Dominique Thoraval
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Michael Totleben
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Dale Vanyo
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Purushotham Vemishetti
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - John Wasylak
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
| | - Chenkou Wei
- Process Research and Development, Bristol-Myers Squibb Pharmaceutical Co., One Squibb Drive, P.O. Box 191, New Brunswick, New Jersey, 08903-0191, U.S.A
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27
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Aher NG, Pore VS, Mishra NN, Kumar A, Shukla PK, Sharma A, Bhat MK. Synthesis and antifungal activity of 1,2,3-triazole containing fluconazole analogues. Bioorg Med Chem Lett 2009; 19:759-63. [PMID: 19110424 DOI: 10.1016/j.bmcl.2008.12.026] [Citation(s) in RCA: 225] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Revised: 11/10/2008] [Accepted: 12/05/2008] [Indexed: 11/19/2022]
Affiliation(s)
- Nilkanth G Aher
- Organic Chemistry Division, National Chemical Laboratory, Pune 411 008, India
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28
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Results from the ARTEMIS DISK Global Antifungal Surveillance Study, 1997 to 2007: 10.5-year analysis of susceptibilities of noncandidal yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing. J Clin Microbiol 2008; 47:117-23. [PMID: 19005141 DOI: 10.1128/jcm.01747-08] [Citation(s) in RCA: 134] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Fluconazole in vitro susceptibility test results determined by the CLSI M44-A disk diffusion method for 11,240 isolates of noncandidal yeasts were collected from 134 study sites in 40 countries from June 1997 through December 2007. Data were collected for 8,717 yeast isolates tested with voriconazole from 2001 through 2007. A total of 22 different species/organism groups were isolated, of which Cryptococcus neoformans was the most common (31.2% of all isolates). Overall, Cryptococcus (32.9%), Saccharomyces (11.7%), Trichosporon (10.6%), and Rhodotorula (4.1%) were the most commonly identified genera. The overall percentages of isolates in each category (susceptible, susceptible dose dependent, and resistant) were 78.0%, 9.5%, and 12.5% and 92.7%, 2.3%, and 5.0% for fluconazole and voriconazole, respectively. Less than 30% of fluconazole-resistant isolates of Cryptococcus spp., Cryptococcus albidus, Cryptococcus laurentii, Trichosporon beigelii/Trichosporon cutaneum, Rhodotorula spp., Rhodotorula rubra/Rhodotorula mucilaginosa, and Rhodotorula glutinis remained susceptible to voriconazole. Emerging resistance to fluconazole was documented among isolates of C. neoformans from the Asia-Pacific, Africa/Middle East, and Latin American regions but not among isolates from Europe or North America. This survey documents the continuing broad spectrum of activity of voriconazole against opportunistic yeast pathogens but identifies several of the less common species with decreased azole susceptibility. These organisms may pose a future threat to optimal antifungal therapy and emphasize the importance of prompt and accurate species identification.
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29
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Brown TA, Grooters AM, Hosgood GL. In vitro susceptibility ofPythium insidiosumand aLagenidiumsp to itraconazole, posaconazole, voriconazole, terbinafine, caspofungin, and mefenoxam. Am J Vet Res 2008; 69:1463-8. [DOI: 10.2460/ajvr.69.11.1463] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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30
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Chevreuil F, Landreau A, Seraphin D, Larcher G, Bouchara JP, Richomme P. Synthesis of new 1-[2-Azido-2-(2,4-dichlorophenyl)ethyl]-1H/-imidazoles and in vitro evaluation of their antifungal activity. J Enzyme Inhib Med Chem 2008; 23:617-22. [PMID: 18821251 DOI: 10.1080/14756360802205133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
New 1-[2-azido-2-(2,4-dichlorophenyl)ethyl]-1H/-imidazole were synthesized by nucleophilic substitution of various tertiary alcohols with azide anion in presence of boron trifluoride-diethyl etherate. Their antifungal activity was evaluated against Candida albicans, Candida glabrata, Aspergillus fumigatus and an azole-resistant petite mutant of C. glabrata. Preliminary SAR results are discussed.
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Affiliation(s)
- Francis Chevreuil
- EA 921, Laboratoire SONAS, UFR des Sciences Pharmaceutiques et Ingenierie de la Sante, Angers, France
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31
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Fungal vaccines: real progress from real challenges. THE LANCET. INFECTIOUS DISEASES 2008; 8:114-24. [DOI: 10.1016/s1473-3099(08)70016-1] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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32
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Arechavala AI, Bianchi MH, Robles AM, Santiso G, Negroni R. Identificación y sensibilidad frente a fluconazol y albaconazol de 100 cepas de levaduras aisladas de flujo vaginal. Rev Iberoam Micol 2007; 24:305-8. [DOI: 10.1016/s1130-1406(07)70061-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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33
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Sun QY, Zhang WN, Xu JM, Cao YB, Wu QY, Zhang DZ, Liu CM, Yu SC, Jiang YY. Synthesis and evaluation of novel 1-(1H-1,2,4-triazol-1-yl)-2-(2,4-difluorophenyl)-3-[(4-substitutedphenyl)-piperazin-1-yl]-propan-2-ols as antifungal agents. Eur J Med Chem 2007; 42:1151-7. [PMID: 17184885 DOI: 10.1016/j.ejmech.2006.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2006] [Revised: 10/31/2006] [Accepted: 11/13/2006] [Indexed: 10/23/2022]
Abstract
A series of 1-(1H-1,2,4-triazol-1-yl)-2-(2,4-difluorophenyl)-3-[(4-substitutedphenyl)-piperazin-1-yl]-propan-2-ols have been designed and synthesized on the basis of the structure-activity relationships and antimycotic mechanism of azole antifungal agents. Their structures were confirmed by elemental analysis, IR, MS, (1)H NMR and (13)C NMR. Results of preliminary antifungal tests against six human pathogenic fungi (Candida albicans, Candida parapsilosis, Cryptococcus neoformans, Candida tropicalis, inherently fluconazole-resistant Candida krusei, Candida glabrata) in vitro showed that all title compounds exhibited activity against fungi tested to some extent except against C. tropicalis. Compound 5b showed higher activity against C. albicans, C. parapsilosis and C. krusei than fluconazole, and its MIC values were determined to be 0.5microg/mL, 1microg/mL and 4microg/mL, respectively. Compound 5k showed higher activities against Torulopsis glabrata than fluconazole (with the MIC value of 2microg/mL). Compounds 5a, 5c, 5f, 5g, 5i exhibited higher activities against C. parapsilosis than fluconazole (with the MIC values of 2microg/mL, 2microg/mL, 2microg/mL, 1microg/mL and 2microg/mL, respectively).
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Affiliation(s)
- Qing-Yan Sun
- Department of Organic Chemistry, College of Pharmacy, Second Military Medical University, Guohe Road 325, Shanghai 200433, People's Republic of China
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34
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Abstract
Invasive fungal infections are important causes of morbidity and mortality in critically ill non neutropenic patients. For many years, amphotericin B and flucytosine have been the only available antifungal agents for invasive fungal infections. Fortunately, the antifungal armamentarium has increased during the past two decades with the addition of several new agents. In addition to itraconazole and fluconazole, lipid formulations of amphotericin B, voriconazole, and caspofungin have been recently licensed. These various antifungal agents differ in their pharmacokinetic and pharmacodynamic profile.
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Affiliation(s)
- Mercedes Catalán
- Servicio de Medicina Intensiva, Unidad Polivalente, Hospital Universitario 12 de Octubre, Avenida de Córdoba s/n, 28041 Madrid, Spain.
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35
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Pfaller MA, Diekema DJ, Gibbs DL, Newell VA, Meis JF, Gould IM, Fu W, Colombo AL, Rodriguez-Noriega E. Results from the ARTEMIS DISK Global Antifungal Surveillance study, 1997 to 2005: an 8.5-year analysis of susceptibilities of Candida species and other yeast species to fluconazole and voriconazole determined by CLSI standardized disk diffusion testing. J Clin Microbiol 2007; 45:1735-45. [PMID: 17442797 PMCID: PMC1933070 DOI: 10.1128/jcm.00409-07] [Citation(s) in RCA: 247] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Fluconazole in vitro susceptibility test results for 205,329 yeasts were collected from 134 study sites in 40 countries from June 1997 through December 2005. Data were collected for 147,776 yeast isolates tested with voriconazole from 2001 through 2005. All investigators tested clinical yeast isolates by the CLSI M44-A disk diffusion method. Test plates were automatically read and results recorded with a BIOMIC image analysis system. Species, drug, zone diameter, susceptibility category, and quality control results were collected quarterly. Duplicate (same patient, same species, and same susceptible-resistant biotype profile during any 7-day period) and uncontrolled test results were not analyzed. Overall, 90.1% of all Candida isolates tested were susceptible (S) to fluconazole; however, 10 of the 22 species identified exhibited decreased susceptibility (<75% S) on the order of that seen with the resistant (R) species C. glabrata and C. krusei. Among 137,487 isolates of Candida spp. tested against voriconazole, 94.8% were S and 3.1% were R. Less than 30% of fluconazole-resistant isolates of C. albicans, C. glabrata, C. tropicalis, and C. rugosa remained S to voriconazole. The non-Candida yeasts (8,821 isolates) were generally less susceptible to fluconazole than Candida spp. but, aside from Rhodotorula spp., remained susceptible to voriconazole. This survey demonstrates the broad spectrum of these azoles against the most common opportunistic yeast pathogens but identifies several less common yeast species with decreased susceptibility to antifungal agents. These organisms may pose a future threat to optimal antifungal therapy and emphasize the importance of prompt and accurate species identification.
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Affiliation(s)
- M A Pfaller
- Department of Pathology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
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36
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Pfaller MA, Diekema DJ. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev 2007; 20:133-63. [PMID: 17223626 PMCID: PMC1797637 DOI: 10.1128/cmr.00029-06] [Citation(s) in RCA: 2771] [Impact Index Per Article: 163.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Invasive candidiasis (IC) is a leading cause of mycosis-associated mortality in the United States. We examined data from the National Center for Health Statistics and reviewed recent literature in order to update the epidemiology of IC. IC-associated mortality has remained stable, at approximately 0.4 deaths per 100,000 population, since 1997, while mortality associated with invasive aspergillosis has continued to decline. Candida albicans remains the predominant cause of IC, accounting for over half of all cases, but Candida glabrata has emerged as the second most common cause of IC in the United States, and several less common Candida species may be emerging, some of which can exhibit resistance to triazoles and/or amphotericin B. Crude and attributable rates of mortality due to IC remain unacceptably high and unchanged for the past 2 decades. Nonpharmacologic preventive strategies should be emphasized, including hand hygiene; appropriate use, placement, and care of central venous catheters; and prudent use of antimicrobial therapy. Given that delays in appropriate antifungal therapy are associated with increased mortality, improved use of early empirical, preemptive, and prophylactic therapies should also help reduce IC-associated mortality. Several studies have now identified important variables that can be used to predict risk of IC and to help guide preventive strategies such as antifungal prophylaxis and early empirical therapy. However, improved non-culture-based diagnostics are needed to expand the potential for preemptive (or early directed) therapy. Further research to improve diagnostic, preventive, and therapeutic strategies is necessary to reduce the considerable morbidity and mortality associated with IC.
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Affiliation(s)
- M A Pfaller
- Medical Microbiology Division, C606 GH, Department of Pathology, University of Iowa College of Medicine, Iowa City, IA 52242, USA.
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37
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Sun QY, Xu JM, Cao YB, Zhang WN, Wu QY, Zhang DZ, Zhang J, Zhao HQ, Jiang YY. Synthesis of novel triazole derivatives as inhibitors of cytochrome P450 14alpha-demethylase (CYP51). Eur J Med Chem 2007; 42:1226-33. [PMID: 17335940 DOI: 10.1016/j.ejmech.2007.01.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Revised: 01/08/2007] [Accepted: 01/09/2007] [Indexed: 11/26/2022]
Abstract
A series of 1-(1H-1,2,4-triazol-1-yl)-2-(2,4-difluorophenyl)-3-[(4-substitutedphenyl)-piperazin-1-yl]-propan-2-ols have been designed and synthesized on the basis of the structure-activity relationships and antimycotic mechanism of azole antifungal agents. Their structures were confirmed by elemental analysis, IR, MS and (1)H NMR. Results of preliminary antifungal tests against eight human pathogenic fungi (Candida albicans, Candida parapsilosis, Candida tropicalis, Cryptococcus neoformans, Aspergillus fumigatus, Trichophyton rubrum, Fonsecaea compacta, and Microsporum gypseum) in vitro showed that all title compounds exhibited activity against fungi tested to some extent. Among the compounds tested, all compounds showed higher activity against C. albicans than fluconazole in vitro. Compounds 3, 6-8, 28, 29, and 32 exhibited the same activities against C. albicans as voriconazole (with the MIC value of 0.0152microg/mL). Compounds 3, 6, and 7 showed higher activity against C. parapsilosis than all five positive controls.
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Affiliation(s)
- Qing-Yan Sun
- Department of Organic Chemistry, College of Pharmacy, Second Military Medical University, Guohe Road 325, Shanghai 200433, People's Republic of China.
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38
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Maschmeyer G, Haas A. Voriconazole: a broad spectrum triazole for the treatment of serious and invasive fungal infections. Future Microbiol 2006; 1:365-85. [PMID: 17661629 DOI: 10.2217/17460913.1.4.365] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
For many years, serious systemic fungal infections have been treated with amphotericin B or narrow-spectrum azole antifungals. These treatments have been effective in many patients, but are associated with tolerability or pharmacokinetic concerns, or suboptimal antifungal activity in some patient groups. Voriconazole is a second-generation triazole with an extended spectrum of activity offering the potential to treat life-threatening fungal infections. The drug is available for intravenous or oral administration and has been shown to be effective in invasive aspergillosis, fluconazole-susceptible and -resistant candidiasis, and infections caused by various other fungal pathogens, including some formerly refractory organisms. Voriconazole is generally well tolerated with transient visual disturbances, liver enzyme abnormalities and skin rashes being the most common adverse events reported, but these rarely lead to treatment discontinuation.
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Affiliation(s)
- Georg Maschmeyer
- Klinikum Ernst von Bergmann, Department of Hematology & Oncology, Potsdam, Germany.
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39
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Paul S, Marty FM, Colson YL. Treatment of Cavitary Pulmonary Zygomycosis With Surgical Resection and Posaconazole. Ann Thorac Surg 2006; 82:338-40. [PMID: 16798251 DOI: 10.1016/j.athoracsur.2005.09.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2005] [Revised: 08/19/2005] [Accepted: 09/01/2005] [Indexed: 11/16/2022]
Abstract
We describe a 57-year-old woman with acute lymphoblastic leukemia who had a cavitary lesion develop in the right upper lobe caused by Cunninghamella bertholletiae, a zygomycete. The infection was resistant to both high-dose liposomal amphotericin B and voriconazole. The current report demonstrates successful treatment, even in the setting of subsequent bone marrow transplantation and immunosuppression, using a combination of surgical resection and posaconazole therapy.
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Affiliation(s)
- Subroto Paul
- Division of Thoracic Surgery, and Department of Surgery, Brigham & Women's Hospital, Boston, Massachusetts 02115, USA
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40
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Aperis G, Mylonakis E. Newer triazole antifungal agents: pharmacology, spectrum, clinical efficacy and limitations. Expert Opin Investig Drugs 2006; 15:579-602. [PMID: 16732713 DOI: 10.1517/13543784.15.6.579] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
New triazole antifungals (voriconazole, posaconazole, ravuconazole and albaconazole) have been developed to meet the increasing need for new antifungals, and address the rising incidence of invasive fungal infections and the emergence of fungal resistance. This report describes the spectrum of activity of the newer-generation triazoles based on data from in vitro, animal and clinical studies. The authors discuss the use of these agents in combination with other antifungals, the extent of cross-resistance, their toxicity profile and pharmacokinetic properties. A total of two agents are currently available: voriconazole (which is becoming a primary treatment for the management of invasive aspergillosis) and posaconazole (which demonstrates a broad antifungal spectrum). A further two agents, albaconazole and ravuconazole, are undergoing early clinical evaluation and their future is uncertain. For all newer triazoles, concerns about emerging drug-resistant fungi and the incidence and management of breakthrough infections will dictate their role in antifungal prophylaxis and treatment.
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Affiliation(s)
- George Aperis
- Harvard Medical School, Massachusetts General Hospital, Division of Infectious Diseases, 55 Fruit Street, Boston, MA 02114-2696, USA
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41
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Wolff M, Bouadma L, Mourvillier B. Apport des nouveaux azolés dans la prise en charge des infections fongiques. Therapie 2006; 61:227-33. [PMID: 16989123 DOI: 10.2515/therapie:2006039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Azoles have maintained a key role in the treatment of invasive fungal infections which have a growing importance, especially in immunocompromised patients. Because of its good activity and safety, fluconazole has becoming the treatment of choice for invasive candidiasis, except those caused by Candida glabrata and C. krusei. In contrast, itraconazole which is active against Aspergillus sp has limited use for the treatment of invasive mould infections due to the high variability of its bioavailibility. Voriconazole is active against a broad range of fungal pathogens including Aspergillus sp and other molds, except Zygomycetes. Voriconazole is used as first-line therapy for invasive aspergillosis and for infections caused by Fusarium and Scedosporium. It is available in both oral and intravenous administration. Posaconazole has similar in vitro activity but currently only the oral form is available. Its main indication is refractory aspergillosis or intolerance to previous treatment. Posaconzole will be very useful for long-term therapy of zygomycetes infections.
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Affiliation(s)
- Michel Wolff
- Service de Réanimation Médicale et des Maladies Infectieuses, Hôpital Bichat-Claude-Bernard, AP-HP, France.
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42
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Torres HA, Hachem RY, Chemaly RF, Kontoyiannis DP, Raad II. Posaconazole: a broad-spectrum triazole antifungal. THE LANCET. INFECTIOUS DISEASES 2005; 5:775-85. [PMID: 16310149 DOI: 10.1016/s1473-3099(05)70297-8] [Citation(s) in RCA: 194] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Posaconazale is a new triazole drug being investigated in phase III clinical trials for the treatment and prevention of invasive fungal infections. In-vitro and in-vivo studies showed that posaconazole has broad-spectrum activity against most Candida species, Cryptococcus neoformans, Aspergillus species, Fusarium species, zygomycetes, and endemic fungi. Posaconazole is given orally two to four times daily. This triazole is widely distributed in the body, metabolised mainly by the liver, and is well tolerated, even in long-term courses. Adverse events are generally mild and include headache and gastrointestinal complaints. Posaconazole has shown promising clinical efficacy against life-threatening fungal infections that are often refractory to the currently available antifungal therapies-eg, invasive aspergillosis, fusariosis, and the emerging zygomycosis.
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Affiliation(s)
- Harrys A Torres
- Department of Infectious Diseases, Infection Control and Employee Health, University of Texas M D Anderson Cancer Center, Houston, Texas 77030-4009, USA
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