Potential Microbiological Effects of Higher Dosing of Echinocandins.

Details

Serval ID
serval:BIB_22C6BC6AF51B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Potential Microbiological Effects of Higher Dosing of Echinocandins.
Journal
Clinical infectious diseases
Author(s)
Steinbach W.J., Lamoth F., Juvvadi P.R.
ISSN
1537-6591 (Electronic)
ISSN-L
1058-4838
Publication state
Published
Issued date
01/12/2015
Peer-reviewed
Oui
Volume
61 Suppl 6
Pages
S669-77
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
The antifungal "paradoxical effect" has been described as the reversal of growth inhibition at high doses of echinocandins, most usually caspofungin. This microbiological effect appears to be a cellular compensatory response to cell wall damage, resulting in alteration of cell wall content and structure as well as fungal morphology and growth. In vitro studies demonstrate this reproducible effect in a certain percentage of fungal isolates, but animal model and clinical studies are less consistent. The calcineurin and Hsp90 cell signaling pathways appear to play a major role in regulating these cellular and structural changes. Regardless of the clinical relevance of this paradoxical growth effect, understanding the specific actions of echinocandins is paramount to optimizing their use at either standard or higher dosing schemes, as well as developing future improvements in our antifungal arsenal.
Keywords
Animals, Antifungal Agents/administration & dosage, Antifungal Agents/adverse effects, Antifungal Agents/pharmacology, Antifungal Agents/therapeutic use, Aspergillosis/drug therapy, Aspergillosis/microbiology, Aspergillus/drug effects, Aspergillus/growth & development, Aspergillus/metabolism, Calcineurin/metabolism, Candida/drug effects, Candida/genetics, Candida/growth & development, Candidiasis/drug therapy, Candidiasis/microbiology, Caspofungin, Cell Wall/drug effects, Cell Wall/metabolism, Clinical Trials as Topic, Disease Models, Animal, Dose-Response Relationship, Drug, Drug Tolerance, Echinocandins/administration & dosage, Echinocandins/adverse effects, Echinocandins/pharmacology, Fungal Proteins/metabolism, HSP90 Heat-Shock Proteins/metabolism, Humans, Lipopeptides, Hsp90, calcineurin, cell wall, echinocandin, paradoxical effect
Pubmed
Web of science
Open Access
Yes
Create date
03/10/2019 16:36
Last modification date
04/10/2019 5:26
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