In a Perspective published in the journal Science today (27 March), Manchester academics Professor David Denning and Dr Mike Bromley, highlight the problems for doctors: poor responses, antifungal resistance, drug interactions and toxicity to many of the existing drugs.
Last week the US Food and Drug Administration approved a new azole antifungal, isavuconazole, from Basilea. The academics welcome this , but state that many of the existing problems such as resistance and poor responses to therapy in some patients will not be addressed. Completely new classes of antifungal drugs are required, say Denning and Bromley.
Professor Denning, who is a Professor of Infectious Diseases in Global Health at The University of Manchester, said: “In our clinics, we have large numbers of untreatable patients going downhill, and current therapy is ineffective or impossible to take for some patients. Many are really desperate and some die years earlier than they should through lack of treatment.”
Dr Mike Bromley, Lecturer at the Manchester Fungal Infection Group, also at The University of Manchester, is trying to identify new antifungals and define how they work on fungal cells. He declared: “New antifungals are tough to find, partly because the human cell machinery is quite similar in fungi, so killing a fungal cell without damaging a human cell is tricky. We have several promising leads however, which we are working on as fast as resources allow.”
The authors point out the very low numbers of funded positions in this area in the UK and USA (few grants awarded), which greatly impedes research in the area. High resistance rates in Candida and Aspergillus are very concerning.
On the plus side, several new development opportunities have opened up, such as chronic pulmonary aspergillosis ( which affects three million people) and fungal asthma (five to twenty million people), which combined with better diagnostics, will allow new clinical development pathways and very large commercial opportunities.
The full opinion piece can be read here (a subscription may be required).