Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! By
Is There a Difference in the Expression Levels of Genes Responsible for Fluconazole Resistance in Candida Albicans Isolated From People With Different Underlying Diseases? a Systematic Review Publisher



A Hoseinnejad AKBAR ; M Maheronnaghsh MEHRNOUSH ; Mt Armaki Mojtaba TAGHIZADEH ; J Jafarzadeh JALAL ; M Fatahinia MAHNAZ
Authors

Source: Current Medical Mycology Published:2024


Abstract

Background and Purpose: Fluconazole is one of the primary antifungal agents in the treatment of candidiasis. However, long-term treatment and indiscriminate use of drugs from the azole family have created resistant isolates. Candida albicans cells can develop resistance to fluconazole through various mechanisms. The present study aimed to investigate the expression of genes involved in fluconazole resistance in C. albicans in people with different underlying diseases. Materials and Methods: Databases, such as PubMed, Scopus, and Web of Science were used to collect studies evaluating the expression levels of key C. albicans genes associated with fluconazole resistance from 1997 to 2024. Finally, 25 out of the 1,096 extracted studies were selected based on the inclusion and exclusion criteria. Results: This systematic review identified the genes encoding the ATP-binding cassette membrane pump (CDR1, CDR2) and the genes encoding the major facilitator superfamily pumps (MDR1), as well as the ERG11 gene, are the most important effective genes in creating resistance of C. albicans to fluconazole. Based on the studies conducted since 1995, the CDR1 gene has the highest gene expression among the genes involved in resistance, followed by ERG11, MDR1, and CDR2, respectively. Conclusion: Comprehensive information about the activity of the genes and more studies on the genes involved in resistance, could provide valuable insights for further studies, prevent the occurrence of resistance to fluconazole and other azoles, and provide suitable treatments. The disease, as well as the dosage and duration of the antifungal therapy, may play an important role in determining the type of resistance mechanism of C. albicans. Therefore, further evaluation of the role of these genes in fluconazole-resistant species, along with their related gene products, is necessary. © 2025 Elsevier B.V., All rights reserved.
Related Docs
View other Related Docs
1. Detection of Erg11 Point Mutations in Iranian Fluconazole-Resistant Candida Albicans Isolates, Current Medical Mycology (2019)
2. Regulation of Erg3, Erg6, and Erg11 Genes in Antifungal-Resistant Isolates of Candida Parapsilosis, Iranian Biomedical Journal (2017)
3. The Evaluation of the Overexpression of the Erg-11, Mdr-1, Cdr-1, and Cdr-2 Genes in Fluconazole-Resistant Candida Albicans Isolated From Ahvazian Cancer Patients With Oral Candidiasis, Journal of Clinical Laboratory Analysis (2022)
Experts (# of related papers)
View all Related Experts
Seyed Hossein Mirhendi Esfahani (9)
Rasoul Mohammadi (8)
Other Related Docs
4. Overview on the Infections Related to Rare Candida Species, Pathogens (2022)
5. In Vitro Activity of Juglone (5-Hydroxy-1,4-Naphthoquinone) Against Both Fluconazole-Resistant and Susceptible Candida Isolates; [Actividad in Vitro De Juglona (5-Hidroxi-1,4-Naftoquinona) Contra Aislamientos De Candida Resistentes Y Sensibles a Fluconazol], Revista Iberoamericana de Micologia (2022)
6. In-Vivo Efficiency of the Novel Azole Compounds (Attaf-1 and Attaf-2) Against Systemic Candidiasis in a Murine Model, Journal of Medical Mycology (2023)
7. Caspofungin-Non-Susceptible Candida Orthopsilosis Isolated From Onychomycosis in Iran, Iranian Journal of Public Health (2017)
8. Amino Acid Substitutions in Erg11p of Azole-Resistant Candida Glabrata: Possible Effective Substitutions and Homology Modelling, Journal of Global Antimicrobial Resistance (2016)
9. Confirmation of Fifth Candida Auris Clade by Whole Genome Sequencing, Emerging Microbes and Infections (2022)
10. Differentiation of Candida Albicans Complex Species Isolated From Invasive and Non-Invasive Infections Using Hwp1 Gene Size Polymorphism, Current Medical Mycology (2021)
11. In Vitro Activities of Five Antifungal Drugs Against Opportunistic Agents of Aspergillus Nigri Complex, Mycopathologia (2016)
12. Antifungal Effect of Echinophora Platyloba Essence Against the Candida Species Isolated From Vulvovaginal Candidiasis, Compared With Fluconazole, Journal of Isfahan Medical School (2014)
13. Multicenter Study of Susceptibility of Aspergillus Species Isolated From Iranian University Hospitals to Seven Antifungal Agents, Microbiology Spectrum (2022)
14. Antifungal Effect of Atorvastatin in Comparison With Fluconazole on Candida Species Isolated From Patients Undergoing Head‑And‑Neck Radiotherapy, Dental Research Journal (2024)
15. Molecular Identification and Antifungal Susceptibility Profiles of Candida Dubliniensis and Candida Africana Isolated From Vulvovaginal Candidiasis: A Single-Centre Experience in Iran, Mycoses (2021)
16. Antifungal Susceptibility Analysis of Clinical Isolates of Candida Parapsilosis in Iran, Iranian Journal of Public Health (2016)
17. In Vitro Activities of Luliconazole, Lanoconazole, and Efinaconazole Compared With Those of Five Antifungal Drugs Against Melanized Fungi and Relatives, Antimicrobial Agents and Chemotherapy (2017)
18. Comparison of Proteinase Activity, Hemolysin Production, and Adherence Ability of Candida Albicans Isolates Obtained From Gastroesophageal Lesions and Urinary Tract Infections, Journal of Research in Medical Sciences (2022)
19. Epidemiology, Species Distribution, Antifungal Susceptibility, and Outcome of Candidemia in Intensive Care Units in Isfahan, Iran, Current Medical Mycology (2022)
20. Species Distribution and Antifungal Susceptibility Profile of Candida Isolates From Blood and Other Normally Sterile Foci From Pediatric Icu Patients in Tehran, Iran, Medical Mycology (2020)