Pharmacodynamics of ATI-2307 in a rabbit model of cryptococcal meningoencephalitis.

Giamberardino, Charles D, Tenor, Jennifer L, Toffaletti, Dena L, Palmucci, Julia R, Schell, Wiley, Boua, Jane-Valeriane K, Marius, Choiselle, Stott, Katharine E ORCID: 0000-0001-7079-7957, Steele, Shelby L, Hope, William ORCID: 0000-0001-6187-878X
et al (show 2 more authors) (2023) Pharmacodynamics of ATI-2307 in a rabbit model of cryptococcal meningoencephalitis. Antimicrobial agents and chemotherapy, 67 (10). e0081823-e0081823.

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Cryptococcal meningoencephalitis (CM) is a devastating fungal disease with high morbidity and mortality. The current regimen that is standard-of-care involves a combination of three different drugs administered for up to one year. There is a critical need for new therapies due to both toxicity and inadequate fungicidal activity of the currently available antifungal drugs. ATI-2307 is a novel aryl amidine that disrupts the mitochondrial membrane potential and inhibits the respiratory chain complexes of fungi-it thus represents a new mechanism for direct antifungal action. Furthermore, ATI-2307 selectively targets fungal mitochondria via a fungal-specific transporter that is not present in mammalian cells. It has very potent <i>in vitro</i> anticryptococcal activity. In this study, the efficacy of ATI-2307 was tested in a rabbit model of CM. ATI-2307 demonstrated significant fungicidal activity at dosages between 1 and 2 mg/kg/d, and these results were superior to fluconazole and similar to amphotericin B treatment. When ATI-2307 was combined with fluconazole, the antifungal effect was greater than either therapy alone. While ATI-2307 has potent anticryptococcal activity in the subarachnoid space, its ability to reduce yeasts in the brain parenchyma was relatively less over the same study period. This new drug, with its unique mechanism of fungicidal action and ability to positively interact with an azole, has demonstrated sufficient anticryptococcal potential in this experimental setting to be further evaluated in clinical studies.

Item Type: Article
Uncontrolled Keywords: Animals, Mammals, Rabbits, Cryptococcus neoformans, Meningitis, Cryptococcal, Meningoencephalitis, Fluconazole, Antifungal Agents
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 01 Feb 2024 11:25
Last Modified: 01 Feb 2024 11:25
DOI: 10.1128/aac.00818-23
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