Review

Rise and fall of Caspofungin: the current status of Caspofungin as a treatment for Cryptococcus neoformans infection

Department of Biochemistry & Molecular Biology, Federal University of Ceará, Fortaleza, CE, 60451-970, Brazil

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Ana CM Costa

Department of Biochemistry & Molecular Biology, Federal University of Ceará, Fortaleza, CE, 60451-970, Brazil

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Nilton AS Neto

University of Brasília, Post-Graduation in Molecular Pathology, Darcy Ribeiro Campus, Brasília, DF, 70910-900, Brazil

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Daiane MS Brito

Department of Biochemistry & Molecular Biology, Federal University of Ceará, Fortaleza, CE, 60451-970, Brazil

Drug Research & Development Center, Department of Physiology & Pharmacology, Federal University of Ceará, Fortaleza, CE, 60430-275, Brazil

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Cleverson DT Freitas

Department of Biochemistry & Molecular Biology, Federal University of Ceará, Fortaleza, CE, 60451-970, Brazil

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João MM Neto

Department of Biochemistry & Molecular Biology, Federal University of Ceará, Fortaleza, CE, 60451-970, Brazil

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Felipe P Mesquita

Drug Research & Development Center, Department of Physiology & Pharmacology, Federal University of Ceará, Fortaleza, CE, 60430-275, Brazil

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Pedro FN Souza

*Author for correspondence: Tel.: +55 853 366 9816;

E-mail Address: pedrofilhobio@gmail.com

https://orcid.org/0000-0003-2524-4434

Drug Research & Development Center, Department of Physiology & Pharmacology, Federal University of Ceará, Fortaleza, CE, 60430-275, Brazil

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Published Online:18 Mar 2024https://doi.org/10.2217/fmb-2023-0236

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Abstract

Antifungal infections are becoming a major concern to human health due to antimicrobial resistance. Echinocandins have been promising agents against resistant fungal infections, primarily caspofungin, which has a more effective mechanism of action than azoles and polyenes. However, fungi such as Cryptococcus neoformans appear to be inheritably resistant to these drugs, which is concerning due to the high clinical importance of C. neoformans. In this review, we review the history of C. neoformans and the treatments used to treat antifungals over the years, focusing on caspofungin, while highlighting the C. neoformans problem and possible explanations for its inherent resistance.

Plain language summary

Caspofungin is a drug used to treat several types of fungal infections. Resistance to caspofungin is a huge problem, especially in those that are immunocompromised. It is important to understand the history of caspofungin discovery, its clinical applications and its mechanism of action, as well as if a new drug target could be used overcome resistance. This review may perform guide new studies combining caspofungin with other drugs and indicate new potential targets for caspofungin.

Keywords:

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History

Received 25 October 2023

Accepted 12 December 2023

Published online 18 March 2024

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Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/fmb-2023-0236

Author contributions

TKB Aguiar, ACM Costa, NAS Neto, DMS Brito, CDT Freitas, JMM Neto, FP Mesquita and PFN Souza performed the conception, and the study design was written and approved the final version for submission.

Financial disclosure

PFN Souza is thankful for the senior researcher grant from CNPq at process number 305003/2022-4. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Competing interests disclosure

The authors have no competing interests or relevant affiliations with any organization or entity with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Writing disclosure

No writing assistance was utilized in the production of this manuscript.

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