Echinocandins for the Treatment of Invasive Aspergillosis: from Laboratory to Bedside.
Details
Serval ID
serval:BIB_5956AF923F85
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Echinocandins for the Treatment of Invasive Aspergillosis: from Laboratory to Bedside.
Journal
Antimicrobial agents and chemotherapy
ISSN
1098-6596 (Electronic)
ISSN-L
0066-4804
Publication state
Published
Issued date
08/2019
Peer-reviewed
Oui
Volume
63
Number
8
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: epublish
Publication Status: epublish
Abstract
Echinocandins (caspofungin, micafungin, anidulafungin), targeting β-1,3-glucan synthesis of the cell wall, represent one of the three currently available antifungal drug classes for the treatment of invasive fungal infections. Despite their limited antifungal activity against Aspergillus spp., echinocandins are considered an alternative option for the treatment of invasive aspergillosis (IA). This drug class exhibits several advantages, such as excellent tolerability and its potential for synergistic interactions with some other antifungals. The objective of this review is to discuss the in vitro and clinical efficacy of echinocandins against Aspergillus spp., considering the complex interactions between the drug, the mold, and the host. The antifungal effect of echinocandins is not limited to direct inhibition of hyphal growth but also induces an immunomodulatory effect on the host's response. Moreover, Aspergillus spp. have developed important adaptive mechanisms of tolerance to survive and overcome the action of echinocandins, such as paradoxical growth at increased concentrations. This stress response can be abolished by several compounds that potentiate the activity of echinocandins, such as drugs targeting the heat shock protein 90 (Hsp90)-calcineurin axis, opening perspectives for adjuvant therapies. Finally, the present and future places of echinocandins as prophylaxis, monotherapy, or combination therapy of IA are discussed in view of the emergence of pan-azole resistance among Aspergillus fumigatus isolates, the occurrence of breakthrough IA, and the advent of new long-lasting echinocandins (rezafungin) or other β-1,3-glucan synthase inhibitors (ibrexafungerp).
Keywords
Antifungal Agents/pharmacology, Antifungal Agents/therapeutic use, Aspergillosis/drug therapy, Aspergillus fumigatus/drug effects, Echinocandins/pharmacology, Echinocandins/therapeutic use, HSP90 Heat-Shock Proteins/metabolism, Host-Pathogen Interactions/drug effects, Humans, Invasive Fungal Infections/drug therapy, Aspergillus, anidulafungin, calcineurin, caspofungin, heat shock protein 90, ibrexafungerp, micafungin, paradoxical effect, rezafungin
Pubmed
Web of science
Open Access
Yes
Create date
14/06/2019 16:01
Last modification date
07/07/2020 5:20