Can nonsteroidal anti-inflammatory drugs (NSAIDs) be repurposed for fungal infection?

Naunyn Schmiedebergs Arch Pharmacol

Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.

Published: January 2024

AI Article Synopsis

  • NSAIDs are commonly used to treat pain and inflammation, but recent research shows they also have antifungal properties against various fungal strains like Candida and Aspergillus.
  • These drugs can inhibit biofilm formation and the transformation of yeast into a more harmful form, likely through mechanisms involving prostaglandin E2.
  • Combining NSAIDs with traditional antifungal medications may improve treatment effectiveness, tackle drug-resistant strains, and lower toxicity for patients.

Article Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are an important class of anti-inflammatory drugs widely used for the treatment of musculoskeletal disorders, mild-to-moderate pain, and fever. This review aimed to explain the functional role and possible mechanisms of the antifungal effects of NSAIDs alone or in combination with antifungal drugs in vitro and in vivo. Several studies reported that NSAIDs such as aspirin, ibuprofen, diclofenac, indomethacin, ketorolac, celecoxib, flurbiprofen, and nimesulide had antifungal activities in vitro, either fungistatic or fungicidal, against different strains of Candida, Aspergillus, Cryptococcus, Microsporum, and Trichophyton species. These drugs inhibited biofilm adhesion and development, and yeast-to-hypha conversion which may be related to a prostaglandin E2 (PGE2)/PGEx-dependent mechanism. Modulating PGE2 levels by NSAIDs during fungal infection can be introduced as a possible mechanism to overcome. In addition, some important mechanisms of the antifungal activities of NSAIDs and their new derivatives on fungi and host immune responses are summarized. Overall, we believe that using NSAIDs along with classical antifungal drugs has the potential to be investigated as a novel therapeutic strategy in clinical studies. Furthermore, combination therapy can help manage resistant strains, increase the efficacy of antifungal drugs, and reduce toxicity.

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Source
http://dx.doi.org/10.1007/s00210-023-02651-xDOI Listing

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