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A growing menace: Novel antifungals essential to tackle antifungal resistance

Incident cases of invasive fungal infections are expected to escalate in the coming years, in part, due to the impact of climate change.

Agar plate culture of C. albicans. Image by Dr. William Kaplan / CDC (Public Domain)
Agar plate culture of C. albicans. Image by Dr. William Kaplan / CDC (Public Domain)

Fungal infections are an often-underestimated health burden globally. Many fungal pathogens, as Digital Journal has previously reported, represent a major threat to public health and several are becoming increasingly common and resistant to treatment.

This has led the firm GlobalData to emphasise the urgency of tackling the challenge, as communicated to Digital Journal. Anaelle Tannen, Infectious Disease Analyst at GlobalData, states: “Fungal diseases are often presumed to be more bothersome than serious, and many individuals are unaware of the impact that these mycoses can have on human health. However, as the burden of invasive fungal infections is increasing globally, there is a pressing need to improve awareness and understanding of these infections.”

It is estimated there were over three million incident cases of invasive fungal infections across Australia, Brazil, Canada, China, France, Germany, India, Italy, Japan, Mexico, Russia, South Africa, South Korea, Spain, U.K., and U.S. in 2022. Of these, aspergillosis, candidiasis, cryptococcosis, and pneumocystis pneumonia were the major contributors of infection.

Fungi are also major food spoilers and contaminants in healthcare and pharmaceutical settings.

Incident cases of invasive fungal infections are also expected to escalate in the coming years, in part, due to the impact of climate change. For example, with increasing global temperatures, some fungi may expand their habitats to encompass new warmer regions, such as Cryptococcus deuterogattii which has emerged in the temperate regions of western Canada and the Pacific northwest of North America in recent years.

Furthermore, medical advances over recent decades have led to a global increase in the number of immunocompromised individuals, such as organ transplant recipients or those living with or HIV, with these patients being much more susceptible to invasive fungal infections.

Considering these patterns, Tannen adds: “Antifungal resistance is also a major problem, as some fungi no longer respond to any antifungal treatments, which contributes to high rates of morbidity and mortality associated with invasive fungal infections. In order to combat the growing resistance to existing drugs, it is essential that new therapeutic candidates in development utilize novel mechanisms of action.”

According to GlobalData, there are over 170 antifungal agents in the pipeline. Whilst many of these are based on established mechanisms of actions, there are some that utilize more novel approaches, such as Pfizer’s fosmanogepix (a GPI anchored wall transfer protein 1 (PfGWT1) inhibitor) in Phase II development for candidiasis.

This agent is also in development for other fungal infections including Phase I development for coccidioidomycosis.

Tannen concludes: “It is hoped that advances with novel antifungal therapies in development will help to address the major unmet need of limited treatment options within this market.”

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Written By

Dr. Tim Sandle is Digital Journal's Editor-at-Large for science news. Tim specializes in science, technology, environmental, business, and health journalism. He is additionally a practising microbiologist; and an author. He is also interested in history, politics and current affairs.

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