Antifungal Drug Resistance: Molecular Mechanisms in Candida albicans and Beyond Article Swipe
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· 2020
· Open Access
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· DOI: https://doi.org/10.1021/acs.chemrev.0c00199
· OA: W3026958586
Fungal infections are a major contributor to infectious disease-related deaths across the globe. <i>Candida</i> species are among the most common causes of invasive mycotic disease, with <i>Candida albicans</i> 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 <i>Candida auris</i> and <i>Candida glabrata</i>, 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 <i>Candida</i> 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.