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Fluconazole-Resistant Vulvovaginal Candidosis: An Update on Current Management.
Pharmaceutics
December 2024
Femicare, Clinical Research for Women, 3300 Tienen, Belgium.
Currently, the rising prevalence of resistant species, particularly , as well as non-albicans isolates such as and , represent challenges in their management. In this review, we aimed to explore the current management of fluconazole-resistant vulvovaginal candidiasis (FRVVC). Identified studies focused on alternative antifungal therapies, including boric acid, nystatin, and newer agents like oteseconazole and ibrexafungerp.
View Article and Find Full Text PDFModulation of -Induced Immune Response in Vaginal Epithelial Cells by Garcinoic Acid.
Microorganisms
November 2024
Department of Medicine and Surgery, Medical Microbiology Section, University of Perugia, 06123 Perugia, Italy.
Vulvovaginal candidiasis (VVC) is a prevalent women's infection characterized by excessive inflammation and damage of the vaginal epithelium that, in its recurrent form (RVVC), causes more than three symptomatic episodes per year, impacting nearly 8% of women globally. Current antifungal treatments alleviate symptoms but often fail to restore the inflammatory homeostasis of mucosal tissue and prevent recurrences. α-Tocopherol (α-TOH) and garcinoic acid (GA), a vitamin E metabolite, with immunomodulatory properties, were investigated for the first time in vaginal epithelial cells exposed to infection to assess their effects on inflammatory signaling parameters important to restore cellular homeostasis.
View Article and Find Full Text PDFNeutrophil Extracellular Traps Capture the human pathogen, Candida albicans, in blood and Delay Hyphal Transformation.
J Leukoc Biol
January 2025
Center for Engineering in Medicine and Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA.
In tissues, neutrophils neutralize Candida albicans through phagocytosis and delay C. albicans hyphae growth by deploying neutrophil extracellular traps (NETs). However, in the bloodstream, the dynamic interactions between NETs and C.
View Article and Find Full Text PDFRefractory fungal infection: Three case reports highlighting good practice.
Med Mycol Case Rep
December 2024
Public Health Wales Mycology Reference Laboratory, University Hospital of Wales, Heath Park Way, CF14 4XW, Cardiff, United Kingdom.
Refractory invasive fungal disease is a significant clinical problem, with high morbidity, mortality and costs. The complex causes of refractory infection include breakthrough infection due to antifungal resistance (both innate and acquired), suboptimal therapy and impaired immune responses in critically ill or immunocompromised patients. This case series details three reports on the identification and management of refractory fungal infections, two cases of azole resistance and one case of resistant candidiasis, highlighting the importance of accurate diagnosis, monitoring, implementation of biomarkers (serological markers, PCR), antifungal susceptibility testing and antifungal stewardship to optimise management and minimise risks of emergence of drug resistance.
View Article and Find Full Text PDFLanosterol 14α-Demethylase (CYP51)/Heat Shock Protein 90 (Hsp90) Dual Inhibitors for the Treatment of Invasive Candidiasis.
J Med Chem
January 2025
The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University (Naval Medical University), 325 Guohe Road, Shanghai 200433, China.
Invasive candidiasis has attracted global attention with a high incidence and mortality. Current antifungal drugs are limited by unfavorable therapeutic efficacy, significant hepatorenal toxicity, and the development of drug resistance. Herein, we designed the first generation of lanosterol 14α-demethylase (CYP51)/heat shock protein 90 (Hsp90) dual inhibitors on the basis of antifungal synergism.
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