真菌的耐药性和耐受性。
Drug resistance and tolerance in fungi.
机构信息
School of Molecular Cell Biology & Biotechnology, George S. Wise Faculty of Life Sciences, Tel Aviv University, Ramat Aviv, Israel.
Department of Pediatrics and Microbiology/Immunology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
出版信息
Nat Rev Microbiol. 2020 Jun;18(6):319-331. doi: 10.1038/s41579-019-0322-2. Epub 2020 Feb 11.
Abstract
Systemic fungal infections pose a serious clinical problem. Treatment options are limited, and antifungal drug resistance is increasing. In addition, a substantial proportion of patients do not respond to therapy despite being infected with fungi that are susceptible to the drug. The discordance between overall treatment outcome and low levels of clinical resistance may be attributable to antifungal drug tolerance. In this Review, we define and distinguish resistance and tolerance and discuss the current understanding of the molecular, genetic and physiological mechanisms that contribute to those phenomena. Distinguishing tolerance from resistance might provide important insights into the reasons for treatment failure in some settings.
摘要
系统性真菌感染是一个严重的临床问题。治疗选择有限，且抗真菌药物耐药性日益增加。此外，尽管患者感染的真菌对药物敏感，仍有相当一部分患者对治疗无反应。总体治疗结果与临床低耐药率之间的差异可能归因于抗真菌药物耐受性。在这篇综述中，我们定义并区分了耐药性和耐受性，并讨论了目前对抗真菌药物耐药性和耐受性的分子、遗传和生理机制的理解。区分耐受性和耐药性可能为某些情况下治疗失败的原因提供重要的见解。
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