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ABSTRACT
Introduction
Some of the fungi have become pathogenic to humans, and these opportunistic pathogens are able to cause severe systemic mycoses.
Areas covered
The number of antifungals for systemic administration is limited and resistance to these drugs is common. This review summarizes various approaches to the discovery and development of new antifungals, provides an overview of important molecules in basic research and compounds in clinical trials, and focuses on drug repurposing strategy, while providing an overview of drugs of other indications that have been tested in vitro for their antifungal activity for possible expansion of antifungal drugs and/or support of existing antimycotics.
Expert opinion
Despite the limitations of the research of new antifungals by manufacturers, in addition to innovated molecules based on clinically used drugs, several completely new small entities with unique mechanisms of actions have been identified. The identification of new molecular targets that offer alternatives for the development of new unique selective antifungal highly effective agents has been an important outcome of repurposing of non-antifungal drugs to antifungal drug. Also, given the advances in monoclonal antibodies and their application to immunosuppressed patients, it may seem possible to predict a more optimistic future for antifungal therapy than has been the case in recent decades.
Article highlights
The number of pathogens is growing, drug resistance is increasing, and new opportunistic fungal pathogens resistant to any therapy are attacking humans.
A wide variety of approaches have been applied to the development of new systemically administered antifungals for the treatment of invasive fungal infections.
Repurposing of non-antifungal drugs to antifungals and design of new antifungals based on the structures of repurposed drugs are performed.
New molecular targets on/in the fungal cell suitable for targeting newly developed drugs are identified.
The process of antifungal drug discovery and development needs to be reassessed and interactions between industry and academia need to be optimized.
This box summarizes key points contained in the article.
Declaration of interest
The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer disclosures
A reviewer on this manuscript has disclosed that they own shares in Sano Chemicals, who are developing an antifungal. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose.