Krysan Damian J
Department of Microbiology/Immunology, University of Rochester, School of Medicine and Dentistry, Rochester, NY 14642, United States; Department of Pediatrics, University of Rochester, School of Medicine and Dentistry, Rochester, NY 14642, United States.
Fungal Genet Biol. 2015 May;78:93-8. doi: 10.1016/j.fgb.2014.12.001. Epub 2014 Dec 13.
Cryptococcosis is one of the most important fungal infections of humans. It primarily, but not exclusively, afflicts people with compromised immune function. Cryptococcosis is most commonly caused by Cryptococcus neoformans var. grubii with C. neoformans var. neoformans and C. gatti also contributing to the disease. Cryptococcosis is primarily manifested as meningoencephalitis although pneumonia occurs frequently as well. Globally, the burden of disease is highest among those living with HIV/AIDS and is one of the most common causes of death in this patient population. Cryptococcal meningitisis almost invariably fatal if untreated. The current gold standard therapy is amphotericin B combined with 5-flucytosine. Unfortunately, this therapy has significant toxicity and is not widely available in resource-limited regions. Fluconazole, which is associated with poorer outcomes, is frequently as an alternative. Here, I present the characteristics of an ideal anti-cryptococcal agent and review recent progress toward identifying both novel and repurposed drugs as potential new therapies.
隐球菌病是人类最重要的真菌感染之一。它主要（但并非仅仅）侵袭免疫功能受损的人群。隐球菌病最常见的病因是新型隐球菌格鲁比变种，新型隐球菌新型变种和格特隐球菌也可导致该病。隐球菌病主要表现为脑膜脑炎，不过肺炎也时常发生。在全球范围内，艾滋病病毒/艾滋病患者群体的疾病负担最重，且是该患者群体最常见的死亡原因之一。未经治疗的隐球菌性脑膜炎几乎必定致命。当前的金标准疗法是两性霉素B联合5-氟胞嘧啶。不幸的是，这种疗法具有显著毒性，且在资源有限的地区无法广泛获取。氟康唑的治疗效果较差，但常被用作替代药物。在此，我介绍理想抗隐球菌药物的特性，并综述在鉴定新型和重新利用药物作为潜在新疗法方面的最新进展。
