Regulation of ERG3, ERG6, and ERG11 genes in antifungal-resistant isolates of candida parapsilosis

Background: Candida parapsilosis is one of the five common strains of yeasts involved in invasive candidiasis. The expression analysis of sterol biosynthesis pathway genes, which are associated with resistance, can assist the better understanding of antifungal resistance mechanisms

Methods: The antifungal susceptibility of 120 clinical C. parapsilosis isolates was examined. The changes in the gene expression related to resistance were analyzed

Results: Eight strains were resistant to fluconazole [FLC], itraconazole [ITC], and amphotericin B [AMB]. The regulation variations included increased mRNA levels of ERG3, ERG6, and ERG11 and decreased mRNA levels of ERG3 and ERG6 in response to FLC. ERG11 mRNA level increases in response to ITC and AMB

Conclusion: The mechanism of resistance to azoles in C. parapsilosis is very similar to C. Albicans. This feature may help to design new treatment strategy for candidiasis

Papel do colesterol exógeno nos mecanismos de adaptação de Leishmania spp a condições de estresse metabólico e farmacológico / Role of exogenous cholesterol in Leishmania spp adaptation mechanisms to conditions of metabolic and pharmacological stress

Os tripanossomatídeos não sintetizam o colesterol e sim esteróis com o esqueleto ergostano, porém um percentual significativo de colesterol exógeno é encontrado em todas as espécies de Leishmania, sugerindo um papel biológico para esta molécula. Esta tese tem como objetivo estudar a importância do uso de colesterol para Leishmania spp. em várias situações, avaliando o potencial deste sistema como um possível alvo farmacológico. A atividade dos inibidores de biossíntese de ergosterol associado com inibidores de transporte de colesterol derivado de LDL, foi avaliada em promastigotas e amastigotas intracelulares. A associação entre LBqT01 e cetoconazol, miconazol ou terbinafina mostrou sinergia. A associação entre a imipramina ou progesterona e cetoconazol ou terbinafina indicaram um efeito aditivo. O cetoconazol e miconazol demonstraram uma diminuição de até duas vezes o valor de IC50 nas formas amastigotas, quando combinado com os inibidores de transporte de colesterol. Foi observado também alteração da biossíntese de ergosterol após tratamento dos parasitos com os inibidores de transporte de colesterol, demonstrado por CG/MS. A combinação de LBqT01 e cetoconazol mostrou ser mais ativa in vivo do que cada fármaco individualmente. Estudamos também o mecanismo de resistência desses inibidores, avaliando a modulação de enzimas da via de biossíntese de esteróis e a utilização de colesterol exógeno pelos parasitos. Promastigotas de Leishmania amazonensis, Leishmania braziliensis e Leishmania guyanensis foram cultivadas com concentrações crescentes de sinvastatina, terbinafina e miconazol. Estes inibidores mostraram um índice de resistência de 2,5 - 8 vezes. A resistência cruzada também foi avaliada, com estes inibidores e fármacos de referência (miltefosina, anfotericina B e antimônio trivalente)...

The trypanosomes do not synthesize cholesterol sterols but with ergostane skeleton, buta significant percentage of exogenous cholesterol is found in all species of Leishmania,suggesting a biological role for this molecule. This work aims to study the importanceof use cholesterol to Leishmania spp. in several cases, evaluating the potential of thesystem as a possible drug target. The activity of the inhibitors of ergosterol biosynthesisinhibitors associated with transport of LDL cholesterol derivative was evaluated inintracellular amastigotes and promastigotes. The association between LBqT01 andketoconazole, miconazole or terbinafine showed synergy. The association betweenimipramine or progesterone, and ketoconazole, or terbinafine indicated an additiveeffect. The ketoconazole and miconazole showed a reduction of up to twice the IC50value in amastigotes when combined with the inhibitors of cholesterol transport. Changeof ergosterol biosynthesis of parasites after treatment with inhibitors of cholesteroltransport as demonstrated by GC/MS was also observed. The combination of LBqT01and ketoconazole was more active in vivo than either drug individually. We also studiedthe mechanism of resistance of these inhibitors by evaluating the modulation ofenzymes of the sterol biosynthesis pathway and use of exogenous cholesterol byparasites. Promastigotes of Leishmania amazonensis, Leishmania braziliensis andLeishmania guyanensis were cultured with increasing concentrations of simvastatin,terbinafine and miconazole. These inhibitors showed resistance index from 2.5 to 8times. Cross-resistance was evaluated with these inhibitors and reference drugs(miltefosine, amphotericin B and trivalent antimony)...

Ergosterol biosynthesis and drug development for Chagas disease

This article presents an overview of the currently available drugs nifurtimox (NFX) and benznidazole (BZN) used against Trypanosoma cruzi, the aetiological agent of Chagas disease; herein we discuss their limitations along with potential alternatives with a focus on ergosterol biosynthesis inhibitors (EBI). These compounds are currently the most advanced candidates for new anti-T. cruzi agents given that they block de novo production of 24-alkyl-sterols, which are essential for parasite survival and cannot be replaced by a host's own cholesterol. Among these compounds, new triazole derivatives that inhibit the parasite's C14± sterol demethylase are the most promising, as they have been shown to have curative activity in murine models of acute and chronic Chagas disease and are active against NFX and BZN-resistant T. cruzi strains; among this class of compounds, posaconazole (Schering-Plough Research Institute) and ravuconazole (Eisai Company) are poised for clinical trials in Chagas disease patients in the short term. Other T. cruzi-specific EBI, with in vitro and in vivo potency, include squalene synthase, lanosterol synthase and squalene epoxidase-inhibitors as well as compounds with dual mechanisms of action (ergosterol biosynthesis inhibition and free radical generation), but they are less advanced in their development process. The main putative advantages of EBI over currently available therapies include their higher potency and selectivity in both acute and chronic infections, activity against NFX and BZN-resistant T. cruzi strains, and much better tolerability and safety profiles. Limitations may include complexity and cost of manufacture of the new compounds. As for any new drug, such compounds will require extensive clinical testing before being introduced for clinical use, and the complexity of such studies, particularly in chronic patients, will be compounded by the current limitations in the verification of true parasitological...

Estudo clinico com o uso do itraconazol em Tinha crural, Tinha do corpo e Tinha do pe interdigital / Clinical study with itraconazole in the treatment of Tinea cruris, Tinea corporis and tinea pedis interdigital

Os autores estudaram 31 pacientes portadores de tinhas crural, do corpo e do pe interdigital, tratados com 100 mg de itraconazol, administrados junto com o almoco, durante 15 dias. Foram realizadas 3 avaliacoes clinicas e micologicas: no pre-tratamento, no final do tratamento e 2 semanas apos o tratamento. O itraconazol mostrou-se eficaz para o tratamento das dermatofitoses estudadas, na dose empregada, com 100 por cento de cura micologica. Em relacao a evolucao clinica, houve diminuicao estatistica significante (teste de Friedman-p < 0.001) dos sinais e sintomas avaliados. Nao foi observada ocorrencia de efeitos colaterais