Vicente Francisca, Reyes Fernando, Genilloud Olga
Fundación MEDINA, Avda Conocimiento 34, 18016 Granada, Spain.
Nat Prod Rep. 2024 Dec 11;41(12):1835-1845. doi: 10.1039/d4np00044g.
Covering: up to 2024Fungal pathogens are a major threat to public health, with emerging resistance to all three classes of antifungals that are currently available and increased incidence of invasive fungal infections among hospitalized patients. Ibrexafungerp is a semi-synthetic analog of enfumafungin and the first antifungal agent approved in more than 20 years since the launch of caspofungin, the first of echinocandins. This new drug approval was made possible after a long arduous journey lasting 25 years by dedicated and talented medicinal chemists from two companies that undertook tedious atom-by-atom chemical modification of the natural product enfumafungin, a glycosylated fernane-type triterpenoid isolated from the fungus . This highlight will cover the discovery of enfumafungin, its biosynthesis and the characterisation of its antifungal profile and mode of action that led to the development of ibrexafungerp. We will discuss the challenges encountered during this long preclinical program and the clinical trial validation of this first-in-class oral antifungal approved to treat vulvovaginal candidiasis with an enormous therapeutic potential to treat future major threatening drug-resistant fungal pathogens.
截至2024年
真菌病原体是对公共卫生的重大威胁,对目前可用的所有三类抗真菌药物都出现了耐药性,并且住院患者侵袭性真菌感染的发病率有所增加。艾伯康唑是恩夫马芬净的半合成类似物,是自棘白菌素类的首个药物卡泊芬净上市20多年来首个获批的抗真菌药物。来自两家公司的敬业且有才华的药物化学家经过长达25年的漫长艰苦历程,对天然产物恩夫马芬净进行了繁琐的逐个原子化学修饰后,才实现了这种新药的获批。恩夫马芬净是一种从真菌中分离出的糖基化蕨烷型三萜。本综述将涵盖恩夫马芬净的发现、其生物合成以及其抗真菌谱和作用方式的表征,这些促成了艾伯康唑的研发。我们将讨论在这个漫长的临床前项目中遇到的挑战,以及这种一流口服抗真菌药物治疗外阴阴道念珠菌病的临床试验验证情况,该药物具有治疗未来主要威胁性耐药真菌病原体的巨大治疗潜力。