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- Title
An oxindole efflux inhibitor potentiates azoles and impairs virulence in the fungal pathogen Candida auris.
- Authors
Iyer, Kali R.; Camara, Kaddy; Daniel-Ivad, Martin; Trilles, Richard; Pimentel-Elardo, Sheila M.; Fossen, Jen L.; Marchillo, Karen; Liu, Zhongle; Singh, Shakti; Muñoz, José F.; Kim, Sang Hu; Porco, John A.; Cuomo, Christina A.; Williams, Noelle S.; Ibrahim, Ashraf S.; Edwards, John E.; Andes, David R.; Nodwell, Justin R.; Brown, Lauren E.; Whitesell, Luke
- Abstract
Candida auris is an emerging fungal pathogen that exhibits resistance to multiple drugs, including the most commonly prescribed antifungal, fluconazole. Here, we use a combinatorial screening approach to identify a bis-benzodioxolylindolinone (azoffluxin) that synergizes with fluconazole against C. auris. Azoffluxin enhances fluconazole activity through the inhibition of efflux pump Cdr1, thus increasing intracellular fluconazole levels. This activity is conserved across most C. auris clades, with the exception of clade III. Azoffluxin also inhibits efflux in highly azole-resistant strains of Candida albicans, another human fungal pathogen, increasing their susceptibility to fluconazole. Furthermore, azoffluxin enhances fluconazole activity in mice infected with C. auris, reducing fungal burden. Our findings suggest that pharmacologically targeting Cdr1 in combination with azoles may be an effective strategy to control infection caused by azole-resistant isolates of C. auris. The fungal pathogen Candida auris is resistant to multiple drugs including the common antifungal fluconazole. Here, Iyer et al. identify a compound that potentiates fluconazole activity against C. auris in vitro and in vivo by inhibiting a major efflux pump and thus increasing intracellular fluconazole accumulation.
- Subjects
FUNGAL virulence; AZOLES; INFECTION control; CANDIDA; CANDIDA albicans; ANTIFUNGAL agents
- Publication
Nature Communications, 2020, Vol 11, Issue 1, p1
- ISSN
2041-1723
- Publication type
Article
- DOI
10.1038/s41467-020-20183-3