Fungal echinocandin resistance

Fungal Genet Biol. 2010 Feb;47(2):117-26. doi: 10.1016/j.fgb.2009.09.003. Epub 2009 Sep 19.


The echinocandins are the newest class of antifungal agents in the clinical armory. These secondary metabolites are non-competitive inhibitors of the synthesis of beta-(1,3)-glucan, a major structural component of the fungal cell wall. Recent work has shown that spontaneous mutations can arise in two hot spot regions of Fks1 the target protein of echinocandins that reduce the enzyme's sensitivity to the drug. However, other strains have been isolated in which the sequence of FKS1 is unaltered yet the fungus has decreased sensitivity to echinocandins. In addition it has been shown that echinocandin-treatment can induce cell wall salvage mechanisms that result in the compensatory upregulation of chitin synthesis in the cell wall. This salvage mechanism strengthens cell walls damaged by exposure to echinocandins. Therefore, fungal resistance to echinocandins can arise due to the selection of either stable mutational or reversible physiological alterations that decrease susceptibility to these antifungal agents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antifungal Agents / pharmacology*
  • Antifungal Agents / therapeutic use
  • Aspergillus fumigatus / drug effects*
  • Aspergillus fumigatus / genetics
  • Aspergillus fumigatus / metabolism*
  • Biofilms
  • Candida albicans / drug effects*
  • Candida albicans / genetics
  • Candida albicans / growth & development
  • Candida albicans / metabolism*
  • Cell Wall / drug effects
  • Cell Wall / metabolism
  • Drug Resistance, Fungal / genetics
  • Drug Resistance, Fungal / physiology*
  • Echinocandins / pharmacology*
  • Echinocandins / therapeutic use
  • Genome, Fungal / genetics
  • Humans
  • Models, Biological
  • Mycoses / drug therapy
  • Mycoses / immunology


  • Antifungal Agents
  • Echinocandins