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Updated: Feb 2, 2026

Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
Published on: December 28, 2017
An insight into new strategies to combat antifungal drug resistance
Yan-Hua Zheng1, Yue-Yun Ma2, Yi Ding3
1Department of Hematology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China, gaoguangxun@fmmu.edu.cn; xiequnchen@fmmu.edu.cn.
Abstract:
Invasive fungal infections especially in immunocompromised patients represent a dominating cause of mortality. The most commonly used antifungal agents can be divided into three broad categories, including triazoles, echinocandins and polyenes. Antifungal resistance is on the increase, posing a growing threat to the stewardship of immunocompromised patients with fungal infections. The paucity of currently available antifungals leads to the rapid emergence of drug resistance and thus aggravates the refractoriness of invasive fungal infections. Therefore, deep exploration into mechanisms of drug resistance and search for new antifungal targets are required. This review highlights the therapeutic strategies targeting Hsp90, calcineurin, trehalose biosynthesis and sphingolipids biosynthesis, in an attempt to provide clinical evidence for overcoming drug resistance and to form the rationale for combination therapy of conventional antifungals and agents with novel mechanisms of action. What's more, this review also gives a concise introduction of three new-fashioned antifungals, including carboxymethyl chitosan, silver nanoparticles and chromogranin A-N46.
Insights
Antifungal drug resistance is increasing, threatening immunocompromised patients. This review explores new therapeutic targets and novel antifungal agents to combat rising resistance and improve treatment outcomes.
Area of Science:
- Mycology
- Infectious Diseases
- Pharmacology
Background:
- Invasive fungal infections (IFIs) are a major cause of mortality, particularly in immunocompromised individuals.
- Current antifungal drugs (triazoles, echinocandins, polyenes) face increasing resistance, limiting treatment efficacy.
- The limited arsenal of antifungals exacerbates drug resistance and treatment refractoriness.
Purpose of the Study:
- To explore novel therapeutic strategies and targets for overcoming antifungal drug resistance.
- To provide clinical evidence for combination therapy using conventional and novel antifungal agents.
- To introduce emerging antifungal agents with new mechanisms of action.
Main Methods:
- Review of current literature on antifungal drug resistance mechanisms.
- Highlighting therapeutic strategies targeting heat shock protein 90 (Hsp90), calcineurin, trehalose biosynthesis, and sphingolipid biosynthesis.
- Introduction of novel antifungal agents like carboxymethyl chitosan, silver nanoparticles, and chromogranin A-N46.
Main Results:
- Identification of key molecular targets (Hsp90, calcineurin, etc.) for novel antifungal therapies.
- Rationale for combining existing antifungals with agents that have novel mechanisms of action.
- Overview of promising new antifungal compounds with potential clinical applications.
Conclusions:
- Targeting specific pathways like Hsp90 and calcineurin offers potential to overcome drug resistance.
- Combination therapies hold promise for enhancing efficacy against invasive fungal infections.
- Novel antifungals such as carboxymethyl chitosan, silver nanoparticles, and chromogranin A-N46 represent future therapeutic avenues.
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