Target- and prodrug-based design for fungal diseases and cancer-associated fungal infections

Adv Drug Deliv Rev. 2023 Jun:197:114819. doi: 10.1016/j.addr.2023.114819. Epub 2023 Apr 4.

Abstract

Invasive fungal infections (IFIs) are emerging as a serious threat to public health and are associated with high incidence and mortality. IFIs also represent a frequent complication in patients with cancer who are undergoing chemotherapy. However, effective and safe antifungal agents remain limited, and the development of severe drug resistance further undermines the efficacy of antifungal therapy. Therefore, there is an urgent need for novel antifungal agents to treat life-threatening fungal diseases, especially those with new mode of action, favorable pharmacokinetic profiles, and anti-resistance activity. In this review, we summarize new antifungal targets and target-based inhibitor design, with a focus on their antifungal activity, selectivity, and mechanism. We also illustrate the prodrug design strategy used to improve the physicochemical and pharmacokinetic profiles of antifungal agents. Dual-targeting antifungal agents offer a new strategy for the treatment of resistant infections and cancer-associated fungal infections.

Keywords: Antifungal; Drug resistance; Dual-targeting drug; Prodrugs; Virulence factors.

Publication types

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

MeSH terms

  • Antifungal Agents / pharmacology
  • Antifungal Agents / therapeutic use
  • Humans
  • Mycoses* / drug therapy
  • Neoplasms* / complications
  • Neoplasms* / drug therapy
  • Prodrugs* / therapeutic use

Substances

  • Antifungal Agents
  • Prodrugs