Goldman R C, Frost D J, Capobianco J O, Kadam S, Rasmussen R R, Abad-Zapatero C
Dept. 47M, Abbott Laboratories, Abbott Park, IL 60064-3500, USA.
Infect Agents Dis. 1995 Dec;4(4):228-47.
The incidence of severe, life-threatening fungal infections has increased dramatically over the last decade. Unfortunately, in practice the arsenal of antifungal drugs is limited to flucytosine, a few approved azoles, and polyenes, mainly amphotericin B. This situation is rather precarious in view of the extended spectrum of fungi causing severe disease in immunocompromised patients, development of resistance to some of the currently used agents, and the minimal fungicidal activity of the azoles. Although lagging behind the need for new antifungal agents, the study of fungal biochemistry, physiology, and genetics has undergone a resurgence to new heights of activity, thus providing a framework on which to build drug discovery programs in several new areas, two of which will be discussed in detail: the biology of Candida albicans secreted aspartyl protease with respect to inhibitor discovery, evaluation, and possible clinical utility; and the fungal cell wall beta-glucans with respect to the mechanism and regulation of synthesis and target sites for drug inhibition.
在过去十年中,严重的、危及生命的真菌感染的发生率急剧上升。不幸的是,在实际应用中,抗真菌药物的种类仅限于氟胞嘧啶、几种已获批的唑类药物以及多烯类药物,主要是两性霉素B。鉴于导致免疫功能低下患者发生严重疾病的真菌谱不断扩大、对一些当前使用药物产生耐药性以及唑类药物的最低杀菌活性,这种情况相当不稳定。尽管对新型抗真菌药物的需求滞后,但真菌生物化学、生理学和遗传学的研究已再度兴起,达到了新的活跃高度,从而为在几个新领域开展药物研发项目提供了一个框架,其中两个领域将详细讨论:白色念珠菌分泌天冬氨酸蛋白酶的生物学特性,涉及抑制剂的发现、评估及可能的临床应用;以及真菌细胞壁β-葡聚糖,涉及合成机制、调控以及药物抑制的靶点。