Abstract
Agricultural industry uses pesticides to optimize food production for the growing human population. A major issue for crops is fungal phytopathogens, which are treated mainly with azole fungicides. Azoles are also the main medical treatment in the management of Aspergillus diseases caused by ubiquitous fungi, such as Aspergillus fumigatus. However, epidemiological research demonstrated an increasing prevalence of azole-resistant strains in A. fumigatus. The main resistance mechanism is a combination of alterations in the gene cyp51A (TR34/L98H). Surprisingly, this mutation is not only found in patients receiving long-term azole therapy for chronic aspergillosis but also in azole naïve patients. This suggests an environmental route of resistance through the exposure of azole fungicides in agriculture. In this review, we report data from several studies that strongly suggest that agricultural azoles are responsible for medical treatment failure in azole-naïve patients in clinical settings.
Highlights
Agriculture undergoes many challenges comprising pests, diseases and abiotic stresses, which drastically decrease crop yield (Ricroch et al, 2016)
Azole resistance has emerged in azole-naive patients. This observation may be explained by a second route of resistance development through environmental exposure of A. fumigatus to azole fungicides used in the field
We will focus on the clinical use of azoles to treat patients affected with A. fumigatus, and we will present some studies in favor of a link between azole resistance due to antifungal use in agriculture and its side effects on human health
Summary
Agriculture undergoes many challenges comprising pests, diseases and abiotic stresses, which drastically decrease crop yield (Ricroch et al, 2016). This observation may be explained by a second route of resistance development through environmental exposure of A. fumigatus to azole fungicides used in the field This leads to our main question: «Does the massive use of azoles in agricultural practice lead to antifungal resistance among human pathogens, impairing medical treatment?». To address this problem, this review was organized according to the following topics: In the first part, we will discuss the use of different azoles in agricultural settings and their mode of action against plant fungal pathogens. We will focus on the clinical use of azoles to treat patients affected with A. fumigatus, and we will present some studies in favor of a link between azole resistance due to antifungal use in agriculture and its side effects on human health
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