新型抗真菌联合治疗侵袭性曲霉病。
Newer combination antifungal therapies for invasive aspergillosis.
机构信息
Department of Pediatrics, Division of Pediatric Infectious Diseases, Duke University, Durham, NC 27710, USA.
出版信息
Med Mycol. 2011 Apr;49 Suppl 1(0 1):S77-81. doi: 10.3109/13693786.2010.499374. Epub 2010 Jul 7.
Abstract
Optimal therapy for invasive aspergillosis is unknown, and many clinicians have attempted to utilize a combination antifungal approach to improve outcomes. However, while numerous in vitro studies, animal models, and clinical reports suggest the possibility that combination antifungal therapy might offer improved results, there is no definitive accepted strategy. The currently available antifungals used in various combination approaches have not demonstrated clear improvement over monotherapy. The current classes of drugs targeting the cell wall and cell membrane may need adjunctive agents focused on separate cellular pathways, such as cell stress response or cellular signaling, to maximize efficacy. The calcineurin and the Hsp90 pathways are two such untouched arenas in which targeted manipulation may lead to great advances against aspergillosis.
摘要
侵袭性曲霉病的最佳治疗方法尚不清楚，许多临床医生试图采用联合抗真菌方法来改善预后。然而，虽然许多体外研究、动物模型和临床报告表明联合抗真菌治疗可能提供更好的结果，但目前还没有明确的公认策略。在各种联合方法中使用的现有抗真菌药物并没有显示出比单药治疗有明显的改善。目前针对细胞壁和细胞膜的药物类别可能需要针对单独的细胞途径（如细胞应激反应或细胞信号传导）的辅助药物，以最大限度地提高疗效。钙调神经磷酸酶和热休克蛋白 90 途径是两个这样的未被触及的领域，靶向操作可能会在对抗曲霉病方面取得重大进展。
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