Pharmacological management of paracoccidioidomycosis

Area of Science:

• Mycology
• Infectious Diseases
• Immunology

Background:

• Paracoccidioidomycosis is a systemic mycosis endemic to Latin America.
• It is characterized by chronicity and severe disseminated forms in both healthy and immunocompromised individuals, particularly those with HIV co-infection, leading to high mortality rates (30-45%).
• Current treatments, including azoles and sulfa derivatives, require long durations, especially for severe forms, and novel alternatives are sought.

Purpose of the Study:

• To address the challenge of finding new treatment alternatives for severe forms of paracoccidioidomycosis.
• To explore novel therapeutic strategies beyond existing drug classes.

Main Methods:

• Review of existing controlled studies and case reports on azolic and sulfa derivative treatments.
• Identification of potential new therapeutic avenues, including new drug classes, combinations, and immunomodulatory agents.

Main Results:

• Fast-acting azolic and sulfa derivatives show utility for milder forms of paracoccidioidomycosis.
• Longer treatment durations are necessary for severe forms using current therapies.
• The study highlights the ongoing challenge in treating severe paracoccidioidomycosis.

Conclusions:

• Novel treatments for severe paracoccidioidomycosis are urgently needed.
• Potential new treatments may involve new drug classes, drug combinations, or immune response modulators.
• A peptide derived from the 43-kDa Paracoccidioides brasiliensis glycoprotein is identified as a potential immunomodulatory agent.