Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.
Clin Microbiol Rev. 2024 Mar 14;37(1):e0014223. doi: 10.1128/cmr.00142-23. Epub 2024 Jan 31.
Over recent decades, the global burden of fungal disease has expanded dramatically. It is estimated that fungal disease kills approximately 1.5 million individuals annually; however, the true worldwide burden of fungal infection is thought to be higher due to existing gaps in diagnostics and clinical understanding of mycotic disease. The development of resistance to antifungals across diverse pathogenic fungal genera is an increasingly common and devastating phenomenon due to the dearth of available antifungal classes. These factors necessitate a coordinated response by researchers, clinicians, public health agencies, and the pharmaceutical industry to develop new antifungal strategies, as the burden of fungal disease continues to grow. This review provides a comprehensive overview of the new antifungal therapeutics currently in clinical trials, highlighting their spectra of activity and progress toward clinical implementation. We also profile up-and-coming intracellular proteins and pathways primed for the development of novel antifungals targeting their activity. Ultimately, we aim to emphasize the importance of increased investment into antifungal therapeutics in the current continually evolving landscape of infectious disease.
近几十年来,全球真菌感染负担显著增加。据估计,每年有大约 150 万人死于真菌感染;然而,由于在真菌感染的诊断和临床认识方面存在差距,真菌病的全球实际负担被认为更高。由于可用的抗真菌药物种类有限,不同致病性真菌属对抗真菌药物的耐药性发展是一种日益常见且具有破坏性的现象。这些因素需要研究人员、临床医生、公共卫生机构和制药行业做出协调一致的反应,以制定新的抗真菌策略,因为真菌感染的负担仍在继续增加。本综述全面概述了目前处于临床试验阶段的新型抗真菌疗法,重点介绍了它们的活性谱和向临床应用的进展。我们还介绍了新兴的细胞内蛋白质和途径,这些蛋白质和途径有望成为针对其活性的新型抗真菌药物的开发目标。最终,我们旨在强调在当前不断发展的传染病领域,增加对抗真菌疗法的投资的重要性。