Review Article Cytochromes P450 in fungi

Summary. The article gives an overview on the history of the discovery of P450 cytochromes and on their occurrence in nature, especially on their interactions with metabolic pathways in fungi. The significance of the P450 cytochromes in the ergosterol synthesis as well as in the inhibitory mechanisms caused by imidazole and triazole antimycotics is described is detail. Zusammenfassung. Der Artikel gibt eine Übersicht über die Entdeckungsgeschichte der P450-Cytochrome und ihr Vorkommen in der Natur. Insbesondere wird eingegangen auf das Vorkommen der P450-Cytochrome in Pilzen und ihre Interaktionen mit Stoffwechselprozessen der Pilzzellen. Die Bedeutung der P450-Cytochrome für die Ergosterol-Synthese der Pilze und für deren Hemmechanismen durch Imidazol- und Triazol-Antimykotika wird im Detail dargestellt.     

2007-2017年南京鼓楼医院抗真菌药物不良反应分析

目的 分析南京鼓楼医院抗真菌药物不良反应（ADR）发生的特点和规律,为临床合理用药提供参考。方法 收集南京鼓楼医院2007年9月—2017年9月上报国家药品不良反应监测中心的149例有效的抗真菌药物ADR报告,分别从患者的性别、年龄、给药途径、药物剂型、合并用药、累及器官系统分布及临床表现、ADR的转归情况等进行统计分析。结果 抗真菌药物所致的ADR患者男女比例为1∶1.22;60岁以上发生率最高（46例,30.87%）。引发ADR的主要给药途径为静脉滴注（98例,65.77%）。ADR报告涉及7种药物剂型,其中以粉针剂为主,占总剂型的34.23%。吡咯类的不良反应占88.59%,其中主要以伏立康唑为主,构成比为36.24%。未合并用药者为113例,占75.84%。所致ADR主要累及中枢及外周神经系统（49例,28.99%）,其次为皮肤及其附件（34例,20.12%）等。ADR的转归以痊愈和好转为主。结论 抗真菌药物发生ADR与多种因素相关,应严格控制药物的不合理使用,减少ADR发生。     

Monthly Update Oncologic,Endocrine & Metabolic: Prevention of immune dysfunction by dehydroepiandrosterone in ageing,chronic AIDS and leukaemia patients

Serious fungal infections are increasingly common in immunocompromised patients and existing antifungals do not completely satisfy the medical need. The latter have either considerable toxicity, e.g., amphotericin, which is, however, less toxic in lipid formulations, or have limited activity, e.g., azoles. Cell wall acting antifungals are inherently selective and fungicidal; two classes of compounds - nikkomycin Z targeted at chitin synthase, and echinocandin LY 303366 and pneumocandin L-743,872 targeted at α-1,3-glucan synthase - are currently in clinical development.     

Updated guidelines for managing fungal diseases in hematology patients

Many prospective open or comparative studies have been published over the last few years on antifungals. As invasive fungal disease remains an important cause of morbidity and mortality in high-risk hematology patients, the correct use of antifungal drugs, either as prophylaxis, empirical treatment in neutropenic patients or for therapy of overt disease, is of the utmost importance. Several international or national groups, including the Infectious Diseases Society of America and the European Conference on Infections in Leukaemia, have elaborated practice guidelines to improve the correct usage of antifungals. This article summarizes these guidelines, which have very similar recommendations, and comments on their evidence base.     

抗真菌药物研究进展

综述了近年抗真菌药物研究的进展,包括抗真菌抗生素与合成抗菌药, 也概述了开发中的新药。     

唑类抗真菌药的合成评述

对唑类抗真菌代表性药物酮康唑、特康唑、伊曲康唑、泊沙康唑、氟康唑和伏立康唑的主要合成方法进行了评述。     

Clinical and microbiological efficacy of chlorine dioxide in the management of chronic atrophic candidiasis: an open study

OBJECTIVE: To assess the clinical and microbiological efficacy of chlorine dioxide (ClO2) as a topical antiseptic for the treatment of chronic atrophic candidiasis in geriatric patients. PARTICIPANTS: Thirty patients with chronic atrophic candidiasis. METHODS: Patients were instructed to rinse the mouth with 0.8% ClO2 mouth rinse (DioxiDent) twice daily for one minute and to soak their dentures overnight in the ClO2 for 10 days. Patients were evaluated both clinically and microbiologically at baseline and after 10 days, and any significant side effects were recorded. The clinical appearance of the oral soft tissues was scored on a scale of 0-3 (0 indicating no clinical signs, 1 indicating involvement of < 25% of the palatal mucosa, 2 indicating involvement of 25-50% of the palatal mucosa, and 3 indicating marked erythema involving > 50% of the palatal mucosa). Microbiological testing was undertaken to determine the number of colony forming units (CFUs) of Candida albicans. RESULTS: ClO2 significantly improved the clinical appearance and microbial count (p < 0.001) after treatment, without significant side effects. Results showed marked improvement in the clinical appearance of the tissues after 10 days, with total resolution in the majority of cases. The total CFU/ml ranged from 15,000-53,000 at baseline and was reduced to < or = 500 after 10 days of treatment (p < 0.001). The mean clinical score was 2.50 at baseline, and was reduced to 0.17 after 10 days of treatment (p < 0.001). CONCLUSIONS: Within the limitations of this pilot study, the effectiveness of topical chlorine dioxide (0.8%) in the management of chronic atrophic candidiasis was demonstrated. ClO2 provided a safe and clinically effective option in the management of chronic atrophic candidiasis.