Although candidaemia is the most common manifestation of invasive candidiasis, extensive visceral invasion with Candida can occur in all organs. The eyes, brain, liver, spleen, and kidneys are the most commonly affected . Candidiasis is the fourth most common cause of nosocomial bloodstream infections in Brazil and the U.S.A., with a mortality rate of approximately 40% [1, 2]. A progressive increase
in the number and severity of candidiasis over the past two decades has been observed worldwide, especially in immunocompromised patients and also in patients hospitalised with serious underlying diseases, during immunosuppressive therapy, or parenteral nutrition, as well as among patients exposed to invasive medical procedures.
selleck chemicals FK228 clinical trial Yeasts of Candida albicans are the most frequently implicated in cases of invasive candidiasis infections. However, nowadays Candida non-albicans (CNA) species such as Candida glabrata, Candida krusei, and Candida parapsilosis have increased in importance and number among fungal infections . Currently, the mainstay of chemotherapy employed for the treatment of fungal infections comprises drugs that affect the function or biosynthesis of membrane sterols . The polyenes (such as amphotericin B) were the first antifungal class used to treat invasive fungal infections. The primary mechanism of amphotericin B is its binding to the signature 24-alkyl sterols present in fungal cell membranes, leading to a perturbation of the membrane selective permeability and, consequently, loss of the cellular content. Despite the specific fungicidal effect of polyenes, they display significant toxicity to mammalian cells . Another important antifungal class comprises
the azoles, such as ketoconazole, fluconazole (FLC), itraconazole (ITC), posaconazole, and voriconazole, which are the compounds most frequently used today, and whose Anacetrapib specific target is the cytochrome P-450-dependent C14α-demethylase, a key enzyme of the ergosterol biosynthesis pathway . Although azoles are one of the main classes of drugs used in the treatment of fungal infections, these drugs present several problems such as their fungistatic rather than fungicidal activity, variable drug bioavailability, lack of intravenous preparations, large number of drug-drug interactions, development of resistance, and potential cross-resistance between different azoles . During the last two decades, some studies have described a new class of antifungals called azasterols, which are inhibitors of the Δ24(25)-sterol methyltransferase (24-SMT), another key enzyme of the ergosterol biosynthesis pathway, which is absent in the mammalian host cells [6–8]. This enzyme catalyses the S-adenosylmethionine-mediated incorporation of methyl groups at position 24 in sterols, which is an essential step for the biosynthesis of fungal sterols [6, 8].