Antifungal Therapy for Systemic Mycosis and the Nanobiotechnology Era: Improving Efficacy, Biodistribution and Toxicity.

Ana C O Souza,Andre C Amaral

doi:10.3389/fmicb.2017.00336

Abstract

Fungal diseases have been emerging as an important public health problem worldwide with the increase in host predisposition factors due to immunological dysregulations, immunosuppressive and/or anticancer therapy. Antifungal therapy for systemic mycosis is limited, most of times expensive and causes important toxic effects. Nanotechnology has become an interesting strategy to improve efficacy of traditional antifungal drugs, which allows lower toxicity, better biodistribution, and drug targeting, with promising results in vitro and in vivo. In this review, we provide a discussion about conventional antifungal and nanoantifungal therapies for systemic mycosis.

Highlights

Fungal diseases have arisen as an important public health problem worldwide, having a great impact in human morbidity and mortality, specially among immunocompromised individuals (Denning and Hope, 2010; Shapiro et al, 2011; Caffrey and Obar, 2016; Prasad et al, 2016)
Antifungal activity in vitro of Amphotericin B lipid nanoparticles against C. albicans and A. fumigatus was better than the commercialized formulations and in vivo administration for the treatment of murine systemic aspergilloma was more effective than that of Ambisome R
In a very interesting approach, Tang et al (2015a) developed specialized pH-responsive Amphotericin B PLGA nanoparticles conjugated with poly(L-histidine) and polyethylene glycol (PEG) that had high affinity for fungal cell wall elements under acidic conditions and were further modified for increased targeting efficacy with anti-C. albicans antibody (Tang et al, 2015a)

Summary

Introduction

Fungal diseases have arisen as an important public health problem worldwide, having a great impact in human morbidity and mortality, specially among immunocompromised individuals (Denning and Hope, 2010; Shapiro et al, 2011; Caffrey and Obar, 2016; Prasad et al, 2016). Drug delivery systems containing nanoparticles have been object of intense investigation for the past decades, becoming an efficient strategy to increase drug bioavailability, reduce toxicity and enhance antifungal potency (Vyas and Gupta, 2006; Amaral and Felipe, 2013; de Sá et al, 2015; Stiufiuc et al, 2015). Together with the higher biosafety, it was reported that antifungal effectiveness of Amphotericin B lipid formulations may be reduced in comparison to that of free drug (Andes et al, 2006; Burgess et al, 2013).

Results

Conclusion