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棘白菌素的耐受性和异质性耐药:概念问题、临床意义及未解决的问题

Tolerance and heteroresistance to echinocandins in : conceptual issues, clinical implications, and outstanding questions.

作者信息

Shor Erika, Perlin David S, Kontoyiannis Dimitrios P

机构信息

Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, New Jersey, USA.

Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, New Jersey, USA.

出版信息

mSphere. 2025 May 27;10(5):e0016125. doi: 10.1128/msphere.00161-25. Epub 2025 Apr 16.

Abstract

is a significant public health threat due to its environmental persistence and multidrug resistance, with echinocandins being the preferred treatment. However, in addition to resistance, echinocandin tolerance and heteroresistance may contribute to treatment challenges. Echinocandin tolerance involves reduced drug-mediated killing, while heteroresistance is the ability of a small cell subset to grow at high drug concentrations. These phenomena may facilitate the emergence of full resistance and complicate clinical outcomes. The clinical significance of these mechanisms remains unclear, with limited data correlating them with treatment failures. Research is needed to understand their mechanisms and impact, develop streamlined and robust methods to detect them in clinical settings, and explore mitigation strategies. The pathogen's range of drug adaptations demands innovative approaches like spatial transcriptomics to dissect these complex responses and improve patient outcomes.

摘要

由于其环境持久性和多重耐药性,它是一个重大的公共卫生威胁,棘白菌素是首选治疗药物。然而,除了耐药性之外,棘白菌素耐受性和异质性耐药可能会给治疗带来挑战。棘白菌素耐受性涉及药物介导的杀伤作用降低,而异质性耐药是一小部分细胞亚群在高药物浓度下生长的能力。这些现象可能会促进完全耐药的出现并使临床结果复杂化。这些机制的临床意义仍不清楚,将它们与治疗失败相关联的数据有限。需要开展研究来了解它们的机制和影响,开发简化且可靠的方法在临床环境中检测它们,并探索缓解策略。病原体的药物适应范围需要像空间转录组学这样的创新方法来剖析这些复杂反应并改善患者预后。

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本文引用的文献

1
CO potentiates echinocandin efficacy during invasive candidiasis therapy via dephosphorylation of Hsp90 by Ptc2 in condensates.
Proc Natl Acad Sci U S A. 2025 Feb 11;122(6):e2417721122. doi: 10.1073/pnas.2417721122. Epub 2025 Feb 5.
3
Highly multiplexed spatial transcriptomics in bacteria.
Science. 2025 Jan 24;387(6732):eadr0932. doi: 10.1126/science.adr0932.
4
Candida albicans Recovered From Persistent Candidemia Exhibits Enhanced Virulence Traits.
J Infect Dis. 2025 Apr 15;231(4):e803-e812. doi: 10.1093/infdis/jiae631.
5
Acquired amphotericin B resistance leads to fitness trade-offs that can be mitigated by compensatory evolution in Candida auris.
Nat Microbiol. 2024 Dec;9(12):3304-3320. doi: 10.1038/s41564-024-01854-z. Epub 2024 Nov 20.
6
Cell aggregation mediated by deletion in modulates fungal colonization and host immune responses in the skin.
mSphere. 2024 Nov 21;9(11):e0073424. doi: 10.1128/msphere.00734-24. Epub 2024 Oct 30.
8
Step-wise evolution of azole resistance through copy number variation followed by KSR1 loss of heterozygosity in Candida albicans.
PLoS Pathog. 2024 Aug 30;20(8):e1012497. doi: 10.1371/journal.ppat.1012497. eCollection 2024 Aug.
9
Antifungal heteroresistance causes prophylaxis failure and facilitates breakthrough Candida parapsilosis infections.
Nat Med. 2024 Nov;30(11):3163-3172. doi: 10.1038/s41591-024-03183-4. Epub 2024 Aug 2.
10
Innate immune response to Candida auris.
Curr Opin Microbiol. 2024 Aug;80:102510. doi: 10.1016/j.mib.2024.102510. Epub 2024 Jul 3.

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