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Antifungal pipeline:Is there light at the end of the tunnel?

World Journal of Clinical Cases 2024年第16期12卷 2686-2691页

作者： georgios schinas Nikolaos Spernovasilis Karolina Akinosoglou Department of Medicine University of PatrasPatras 26504Greece Department of Infectious Diseases German Oncology CenterLimassol 4108Cyprus

The misuse and overuse of classic antifungals have accelerated the development of resistance mechanisms,diminishing the efficacy of established therapeutic pathways and necessitating a shift towards alternative *** this pressing need for new treatments,the antifungal drug pipeline has been largely stagnant for the past three decades,primarily due to the high risks and costs associated with antifungal drug development,compounded by uncertain market *** research durations,special patient populations and rigorous regulatory demands pose significant barriers to bringing novel antifungal agents to *** response,the“push-pull”incentive model has emerged as a vital strategy to invigorate the pipeline and encourage *** editorial critically examines the current clinical landscape and spotlights emerging antifungal agents,such as Fosmanogepix,Ibrexafungerp,and Olorofim,while also unraveling the multifaceted challenges faced in new antifungal drug *** generation of novel antifungals offers a beacon of hope in the battle against antimicrobial resistance,but it is premature to declare them as definitive *** future role hinges on thorough clinical validation,costeffectiveness assessments,and continuous post-marketing *** through strategic implementation and integration with market strategies we can transform the landscape of antifungal development,addressing both the resistance crisis and the treatment challenges.

关键词： Antifungals Resistance Fosmanogepix Ibrexafungerp Olorofim

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Immune-mediated liver injury following COVID-19 vaccination

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World Journal of Virology 2023年第2期12卷 100-108页

作者： georgios schinas Eleni Polyzou Vasiliki Dimakopoulou Stamatia Tsoupra Charalambos Gogos Karolina Akinosoglou Department of Medicine University of PatrasPatras 26504Greece Department of Internal Medicine University of PatrasPatras 26504Greece

Liver injury secondary to vaccination is a rare adverse event that has recently come under attention thanks to the continuous pharmacovigilance following the widespread implementation of coronavirus disease 2019(COVID-19)vaccination *** three most widely distributed severe acute respiratory syndrome coronavirus 2 vaccine formulations,e.g.,BNT162b2,mRNA-1273,and ChAdOx1-S,can induce liver injury that may involve immune-mediated pathways and result in autoimmune hepatitis-like presentation that may require therapeutic intervention in the form of corticosteroid *** mechanisms have been proposed in an attempt to highlight immune checkpoint inhibition and thus establish causality with *** autoimmune features of such a reaction also prompt an in-depth investigation of the newly employed vaccine *** vaccine delivery platforms,e.g.,mRNA-containing lipid nanoparticles and adenoviral vectors,contribute to the inflammatory background that leads to an exaggerated immune response,while patterns of molecular mimicry between the spike(S)protein and prominent liver antigens may account for the autoimmune *** mediators triggered by vaccination or vaccine ingredients per se,including autoreactive antibodies,cytokines,and cytotoxic T-cell populations,may inflict hepatocellular damage through wellestablished *** aim to review available data associated with immunemediated liver injury associated with COVID-19 vaccination and elucidate potential mechanisms underlying its pathogenesis.

关键词： Adverse effects COVID-19 vaccines mRNA vaccine Autoimmune Hepatitis Chemical and Drug Induced Liver Injury Autoimmunity

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