Cargando…

Could the Lung Be a Gateway for Amphotericin B to Attack the Army of Fungi?

Fungal diseases are a significant cause of morbidity and mortality worldwide, primarily affecting immunocompromised patients. Aspergillus, Pneumocystis, and Cryptococcus are opportunistic fungi and may cause severe lung disease. They can develop mechanisms to evade the host immune system and coloniz...

Descripción completa

Detalles Bibliográficos
Autores principales: de Carvalho Patricio, Beatriz Ferreira, da Silva Lopes Pereira, Juliana Oliveira, Sarcinelli, Michelle Alvares, de Moraes, Bianca Portugal Tavares, Rocha, Helvécio Vinicius Antunes, Gonçalves-de-Albuquerque, Cassiano Felippe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9784761/
https://www.ncbi.nlm.nih.gov/pubmed/36559201
http://dx.doi.org/10.3390/pharmaceutics14122707
_version_ 1784857887068127232
author de Carvalho Patricio, Beatriz Ferreira
da Silva Lopes Pereira, Juliana Oliveira
Sarcinelli, Michelle Alvares
de Moraes, Bianca Portugal Tavares
Rocha, Helvécio Vinicius Antunes
Gonçalves-de-Albuquerque, Cassiano Felippe
author_facet de Carvalho Patricio, Beatriz Ferreira
da Silva Lopes Pereira, Juliana Oliveira
Sarcinelli, Michelle Alvares
de Moraes, Bianca Portugal Tavares
Rocha, Helvécio Vinicius Antunes
Gonçalves-de-Albuquerque, Cassiano Felippe
author_sort de Carvalho Patricio, Beatriz Ferreira
collection PubMed
description Fungal diseases are a significant cause of morbidity and mortality worldwide, primarily affecting immunocompromised patients. Aspergillus, Pneumocystis, and Cryptococcus are opportunistic fungi and may cause severe lung disease. They can develop mechanisms to evade the host immune system and colonize or cause lung disease. Current fungal infection treatments constitute a few classes of antifungal drugs with significant fungi resistance development. Amphotericin B (AmB) has a broad-spectrum antifungal effect with a low incidence of resistance. However, AmB is a highly lipophilic antifungal with low solubility and permeability and is unstable in light, heat, and oxygen. Due to the difficulty of achieving adequate concentrations of AmB in the lung by intravenous administration and seeking to minimize adverse effects, nebulized AmB has been used. The pulmonary pathway has advantages such as its rapid onset of action, low metabolic activity at the site of action, ability to avoid first-pass hepatic metabolism, lower risk of adverse effects, and thin thickness of the alveolar epithelium. This paper presented different strategies for pulmonary AmB delivery, detailing the potential of nanoformulation and hoping to foster research in the field. Our finds indicate that despite an optimistic scenario for the pulmonary formulation of AmB based on the encouraging results discussed here, there is still no product registration on the FDA nor any clinical trial undergoing ClinicalTrial.gov.
format Online
Article
Text
id pubmed-9784761
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-97847612022-12-24 Could the Lung Be a Gateway for Amphotericin B to Attack the Army of Fungi? de Carvalho Patricio, Beatriz Ferreira da Silva Lopes Pereira, Juliana Oliveira Sarcinelli, Michelle Alvares de Moraes, Bianca Portugal Tavares Rocha, Helvécio Vinicius Antunes Gonçalves-de-Albuquerque, Cassiano Felippe Pharmaceutics Review Fungal diseases are a significant cause of morbidity and mortality worldwide, primarily affecting immunocompromised patients. Aspergillus, Pneumocystis, and Cryptococcus are opportunistic fungi and may cause severe lung disease. They can develop mechanisms to evade the host immune system and colonize or cause lung disease. Current fungal infection treatments constitute a few classes of antifungal drugs with significant fungi resistance development. Amphotericin B (AmB) has a broad-spectrum antifungal effect with a low incidence of resistance. However, AmB is a highly lipophilic antifungal with low solubility and permeability and is unstable in light, heat, and oxygen. Due to the difficulty of achieving adequate concentrations of AmB in the lung by intravenous administration and seeking to minimize adverse effects, nebulized AmB has been used. The pulmonary pathway has advantages such as its rapid onset of action, low metabolic activity at the site of action, ability to avoid first-pass hepatic metabolism, lower risk of adverse effects, and thin thickness of the alveolar epithelium. This paper presented different strategies for pulmonary AmB delivery, detailing the potential of nanoformulation and hoping to foster research in the field. Our finds indicate that despite an optimistic scenario for the pulmonary formulation of AmB based on the encouraging results discussed here, there is still no product registration on the FDA nor any clinical trial undergoing ClinicalTrial.gov. MDPI 2022-12-03 /pmc/articles/PMC9784761/ /pubmed/36559201 http://dx.doi.org/10.3390/pharmaceutics14122707 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
de Carvalho Patricio, Beatriz Ferreira
da Silva Lopes Pereira, Juliana Oliveira
Sarcinelli, Michelle Alvares
de Moraes, Bianca Portugal Tavares
Rocha, Helvécio Vinicius Antunes
Gonçalves-de-Albuquerque, Cassiano Felippe
Could the Lung Be a Gateway for Amphotericin B to Attack the Army of Fungi?
title Could the Lung Be a Gateway for Amphotericin B to Attack the Army of Fungi?
title_full Could the Lung Be a Gateway for Amphotericin B to Attack the Army of Fungi?
title_fullStr Could the Lung Be a Gateway for Amphotericin B to Attack the Army of Fungi?
title_full_unstemmed Could the Lung Be a Gateway for Amphotericin B to Attack the Army of Fungi?
title_short Could the Lung Be a Gateway for Amphotericin B to Attack the Army of Fungi?
title_sort could the lung be a gateway for amphotericin b to attack the army of fungi?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9784761/
https://www.ncbi.nlm.nih.gov/pubmed/36559201
http://dx.doi.org/10.3390/pharmaceutics14122707
work_keys_str_mv AT decarvalhopatriciobeatrizferreira couldthelungbeagatewayforamphotericinbtoattackthearmyoffungi
AT dasilvalopespereirajulianaoliveira couldthelungbeagatewayforamphotericinbtoattackthearmyoffungi
AT sarcinellimichellealvares couldthelungbeagatewayforamphotericinbtoattackthearmyoffungi
AT demoraesbiancaportugaltavares couldthelungbeagatewayforamphotericinbtoattackthearmyoffungi
AT rochahelvecioviniciusantunes couldthelungbeagatewayforamphotericinbtoattackthearmyoffungi
AT goncalvesdealbuquerquecassianofelippe couldthelungbeagatewayforamphotericinbtoattackthearmyoffungi