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An insight into new strategies to combat antifungal drug resistance

Authors Zheng YH, Ma YY, Ding Y, Chen XQ, Gao GX

Received 30 August 2018

Accepted for publication 9 October 2018

Published 5 November 2018 Volume 2018:12 Pages 3807—3816

DOI https://doi.org/10.2147/DDDT.S185833

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Anastasios Lymperopoulos


Yan-Hua Zheng,1 Yue-Yun Ma,2 Yi Ding,3 Xie-Qun Chen,1 Guang-Xun Gao1

1Department of Hematology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China; 2Department of Clinical Laboratory Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China; 3Department of Pharmacy, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China

Abstract: Invasive fungal infections especially in immunocompromised patients represent a dominating cause of mortality. The most commonly used antifungal agents can be divided into three broad categories, including triazoles, echinocandins and polyenes. Antifungal resistance is on the increase, posing a growing threat to the stewardship of immunocompromised patients with fungal infections. The paucity of currently available antifungals leads to the rapid emergence of drug resistance and thus aggravates the refractoriness of invasive fungal infections. Therefore, deep exploration into mechanisms of drug resistance and search for new antifungal targets are required. This review highlights the therapeutic strategies targeting Hsp90, calcineurin, trehalose biosynthesis and sphingolipids biosynthesis, in an attempt to provide clinical evidence for overcoming drug resistance and to form the rationale for combination therapy of conventional antifungals and agents with novel mechanisms of action. What’s more, this review also gives a concise introduction of three new-fashioned antifungals, including carboxymethyl chitosan, silver nanoparticles and chromogranin A-N46.

Keywords: carboxymethyl chitosan, chromogranin A-N46, Hsp90, calcineurin, trehalose, sphingolipids

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