Four new drugs may help fight the growing threat of fatal fungi

Science | AAAS | 10/22/2019 | Staff
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NICE, FRANCE—Martin Hoenigl, a specialist in fungal infections at the University of California, San Diego, sees half a dozen patients a year infected with a rare mold called Lomentospora prolificans that is resistant to all available antifungals. Doctors use combinations of two or three drugs in high doses to try to stop the infection, but usually to no avail. “Most of these patients die,” Hoenigl says.

That may be about to change. Hoenigl just started to enroll patients in a phase II trial of a new drug called olorofim that holds promise against Lomentospora. It is one of several compounds now in trials that could give doctors much-needed new tools against these intractable infections. “We have got several drugs with new mechanisms of action and they look really good,” says Tom Chiller, who heads the mycotic diseases branch at the U.S. Centers for Disease Control and Prevention in Atlanta. “It’s exciting times,” Hoenigl says.

Millions - Species - Earth - Dozen - Cause

Of the millions of fungal species on Earth, only a few dozen regularly cause human disease; fungi don’t grow well at mammals’ high body temperature, and a healthy human immune system is adept at dealing with the ones that do. But the HIV/AIDS epidemic and modern medical interventions such as chemotherapy and transplantation have led to a growing number of people with compromised or suppressed immune systems whose bodies can be overrun by a fungal invader. Symptoms vary widely depending on which organs are affected; a lung infection, for example, can lead to shortness of breath and cough. An estimated 1.5 million people die worldwide every year of invasive mycoses.

New drugs have been slow in coming because research funding has been scarce and investors prefer drugs against chronic diseases that patients take for life over ones that cure an infection. “There’s not a huge incentive, there’s not a...
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