Amphotericin B and Other Polyenes-Discovery, Clinical Use, Mode of Action and Drug Resistance.
Amphotericin B and Other Polyenes-Discovery, Clinical Use, Mode of Action and Drug Resistance.
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DOI：
10.3390/jof6040321
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发表时间：
2020-11-27
期刊：
影响因子：
--
通讯作者：
Van Dijck P
中科院分区：
文献类型：
--
作者：
Carolus H;Pierson S;Lagrou K;Van Dijck P
虽然多烯是市场上第一种广谱抗真菌药物，但70年后，它们仍然是治疗各种真菌感染的黄金标准。两性霉素B等多烯类化合物的形象存在争议。它们是最广泛的抗真菌药物类别，耐药发展仍然相对罕见，杀真菌性能广泛。然而，它们具有显著的宿主毒性，限制了它们的使用。近年来，多烯的作用方式得到了修订，新的耐药机制被发现，多烯耐药物种如念珠菌（Candida auris）也进入了研究领域。本文简要介绍了多烯的历史和临床应用，并重点介绍了多烯的作用方式、迄今为止发现的耐药机制的多样性以及多烯耐药发展的最新趋势。
Although polyenes were the first broad spectrum antifungal drugs on the market, after 70 years they are still the gold standard to treat a variety of fungal infections. Polyenes such as amphotericin B have a controversial image. They are the antifungal drug class with the broadest spectrum, resistance development is still relatively rare and fungicidal properties are extensive. Yet, they come with a significant host toxicity that limits their use. Relatively recently, the mode of action of polyenes has been revised, new mechanisms of drug resistance were discovered and emergent polyene resistant species such as Candida auris entered the picture. This review provides a short description of the history and clinical use of polyenes, and focusses on the ongoing debate concerning their mode of action, the diversity of resistance mechanisms discovered to date and the most recent trends in polyene resistance development.
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