Discovery of BRD4-HDAC Dual Inhibitors with Improved Fungal Selectivity and Potent Synergistic Antifungal Activity against Fluconazole-Resistant Candida albicans

J Med Chem. 2023 Apr 27;66(8):5950-5964. doi: 10.1021/acs.jmedchem.3c00165. Epub 2023 Apr 10.

Abstract

Over the past several decades, invasive fungal infections, especially candidiasis, have caused dramatic morbidity and mortality due to ineffective antifungal drugs and severe drug resistance. Herein, new BRD4-histone deacetylase (HDAC) inhibitors were designed to restore the susceptibility of Candida albicans (C. albicans) to fluconazole (FLC). Interestingly, several compounds showed excellent selectivity against fungal HDACs. In particular, compound B2 showed excellent synergistic effect with FLC against resistant C. albicans (FICI = 0.063) with high selectivity against fungal HDACs (SI = 1653) and low cytotoxicity. Compound B2 effectively synergized with FLC and prevented biofilm formation and morphological transition in resistant C. albicans, potentiating the antifungal activity of FLC in vivo and significantly reducing kidney fungal loads. Thus, this drug combination is promising in the treatment of resistant C. albicans infections.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antifungal Agents* / pharmacology
  • Candida albicans
  • Candidiasis* / drug therapy
  • Cell Cycle Proteins
  • Drug Resistance, Fungal
  • Drug Synergism
  • Fluconazole / pharmacology
  • Histone Deacetylase Inhibitors / pharmacology
  • Humans
  • Microbial Sensitivity Tests
  • Nuclear Proteins
  • Transcription Factors

Substances

  • Antifungal Agents
  • Fluconazole
  • Nuclear Proteins
  • Histone Deacetylase Inhibitors
  • Transcription Factors
  • BRD4 protein, human
  • Cell Cycle Proteins