Reactive oxygen species-inducing antifungal agents and their activity against fungal biofilms

Future Med Chem. 2014 Jan;6(1):77-90. doi: 10.4155/fmc.13.189.

Abstract

Invasive fungal infections are associated with very high mortality rates ranging from 20-90% for opportunistic fungal pathogens such as Candida albicans, Cryptococcus neoformans and Aspergillus fumigatus. Fungal resistance to antimycotic treatment can be genotypic (due to resistant strains) as well as phenotypic (due to more resistant fungal lifestyles, such as biofilms). With regard to the latter, biofilms are considered to be critical in the development of invasive fungal infections. However, there are only very few antimycotics, such as miconazole (azoles), echinocandins and liposomal formulations of amphotericin B (polyenes), which are also effective against fungal biofilms. Interestingly, these antimycotics all induce reactive oxygen species (ROS) in fungal (biofilm) cells. This review provides an overview of the different classes of antimycotics and novel antifungal compounds that induce ROS in fungal planktonic and biofilm cells. Moreover, different strategies to further enhance the antibiofilm activity of such ROS-inducing antimycotics will be discussed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antifungal Agents* / chemistry
  • Antifungal Agents* / pharmacology
  • Azoles / chemistry
  • Azoles / pharmacology
  • Biofilms / drug effects*
  • Drug Resistance, Fungal / drug effects
  • Echinocandins / chemistry
  • Echinocandins / pharmacology
  • Fungi / drug effects*
  • Polyenes / chemistry
  • Polyenes / pharmacology
  • Reactive Oxygen Species / metabolism*

Substances

  • Antifungal Agents
  • Azoles
  • Echinocandins
  • Polyenes
  • Reactive Oxygen Species