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对抗耐药性的创新抗真菌策略:最新进展与临床意义

Innovative antifungal strategies to combat drug-resistant : recent advances and clinical implications.

作者信息

Du Wei, Wang Qihui, Zhao Min

机构信息

National Clinical Research Center for Laboratory Medicine, Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China.

Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, China.

出版信息

Front Cell Infect Microbiol. 2025 Jul 31;15:1641373. doi: 10.3389/fcimb.2025.1641373. eCollection 2025.

Abstract

is an invasive fungal pathogen recognized globally as a significant health threat due to its marked resistance to multiple classes of antifungal agents, including azoles, echinocandins, and polyenes. The associated high morbidity and mortality rates present considerable public health challenges. Research efforts have largely focused on understanding the molecular mechanisms of antifungal resistance and developing alternative therapies to counteract this issue. This review summarizes current advances in the identification of natural antifungal compounds, the development of novel synthetic agents, biological antifungals, nanotechnology-based approaches, combination therapies, and photodynamic treatments. Notably, several synthetic compounds such as rezafungin and fosmanogepix are in clinical trials for infections. Biological antifungals, including monoclonal antibodies, vaccines, and peptides, have shown the capacity to enhance host immune responses and reduce mortality in murine models. Combination therapies have proven particularly valuable for overcoming resistance by exploiting synergistic effects and broadening antimicrobial coverage. Despite these promising developments, majority of studies have been conducted , with a relative lack of or human research. Therefore, further investigation is needed to validate the efficacy and safety of these alternative antifungal strategies for the treatment of drug-resistant infections.

摘要

是一种侵袭性真菌病原体,由于其对包括唑类、棘白菌素类和多烯类在内的多种抗真菌药物具有显著抗性,在全球范围内被公认为是对健康的重大威胁。相关的高发病率和死亡率带来了相当大的公共卫生挑战。研究工作主要集中在了解抗真菌耐药性的分子机制以及开发替代疗法来应对这一问题。本综述总结了在天然抗真菌化合物的鉴定、新型合成药物的开发、生物抗真菌剂、基于纳米技术的方法、联合疗法和光动力治疗方面的当前进展。值得注意的是,几种合成化合物,如瑞扎芬净和福沙那韦,正在进行针对感染的临床试验。生物抗真菌剂,包括单克隆抗体、疫苗和肽,已显示出在小鼠模型中增强宿主免疫反应和降低死亡率的能力。联合疗法已被证明对于通过利用协同效应和扩大抗菌谱来克服耐药性特别有价值。尽管有这些有前景的进展,但大多数研究是在……进行的,相对缺乏……或人体研究。因此,需要进一步研究来验证这些替代抗真菌策略治疗耐药……感染的有效性和安全性。

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