Department of Molecular Genetics, University of Toronto, 661 University Avenue, Toronto, Ontario M5G 1M1, Canada.
Chem Rev. 2021 Mar 24;121(6):3390-3411. doi: 10.1021/acs.chemrev.0c00199. Epub 2020 May 22.
Fungal infections are a major contributor to infectious disease-related deaths across the globe. species are among the most common causes of invasive mycotic disease, with reigning as the leading cause of invasive candidiasis. Given that fungi are eukaryotes like their human host, the number of unique molecular targets that can be exploited for antifungal development remains limited. Currently, there are only three major classes of drugs approved for the treatment of invasive mycoses, and the efficacy of these agents is compromised by the development of drug resistance in pathogen populations. Notably, the emergence of additional drug-resistant species, such as and , further threatens the limited armamentarium of antifungals available to treat these serious infections. Here, we describe our current arsenal of antifungals and elaborate on the resistance mechanisms species possess that render them recalcitrant to therapeutic intervention. Finally, we highlight some of the most promising therapeutic strategies that may help combat antifungal resistance, including combination therapy, targeting fungal-virulence traits, and modulating host immunity. Overall, a thorough understanding of the mechanistic principles governing antifungal drug resistance is fundamental for the development of novel therapeutics to combat current and emerging fungal threats.
真菌感染是全球传染性疾病相关死亡的主要原因之一。真菌是最常见的侵袭性真菌病病原体之一,其中念珠菌属是侵袭性念珠菌病的主要病原体。由于真菌与人类宿主一样是真核生物,因此可用于抗真菌药物开发的独特分子靶标数量仍然有限。目前,仅有三类主要药物被批准用于治疗侵袭性真菌感染,而这些药物的疗效受到病原体种群耐药性的影响。值得注意的是,额外的耐药物种的出现,如近平滑念珠菌和热带念珠菌,进一步威胁到现有有限的抗真菌药物来治疗这些严重感染。在这里,我们描述了我们现有的抗真菌药物,并详细阐述了 物种具有的耐药机制,这些机制使它们对抗真菌治疗具有抗性。最后,我们强调了一些最有前途的治疗策略,这些策略可能有助于对抗抗真菌药物耐药性,包括联合治疗、针对真菌毒力特征以及调节宿主免疫。总的来说,深入了解抗真菌药物耐药性的机制原则对于开发新型治疗方法来应对当前和新出现的真菌威胁至关重要。