Review Article
Antifungal Resistance and New Strategies to Control Fungal Infections
Table 2
Nature, target, mode of action, and fungal resistance mechanisms of the major antifungal drugs used in human therapy.
| Antifungal agent | Mode of action and cellular target | Mechanism of resistance |
| polyenes | binding to ergosterol | absence of ergosterol (loss of function mutation in ERG3 or ERG6) | decrease of ergosterol content in cells |
| azoles | inhibition of cytochrome p450 function: 14α-lanosterol demethylase (ERG11) sterol desaturase (ERG5) | efflux mediated by multidrug transporters | decrease of affinity in Erg11p by mutations | upregulation of ERG11 | | alterations in the ergosterol biosynthetic pathway |
| allylamines | inhibition of squalene epoxidase (ERG1) | unknown |
| morpholines | inhibition of sterol reductase (ERG24) and the isomerase (ERG2) | unknown |
| 5-fluorocytosine | inhibition of nucleic acids synthesis | defect in cytosine permease | deficiency or lack of enzymes implicated in the metabolism of 5-FC | deregulation of the pyrimidine biosynthetic pathway |
| echinocandins | inhibition of β-1,3 glucan synthase (FKS1&2) | alteration of affinity of echinocandins for β(1,3)-glucan synthase |
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