Combined Effect of Platelets and Anidulafungin against Aspergillus fumigatus Infections

Abstract

Invasive aspergillosis (IA) is one of the major causes of morbidity and mortality in severely immunocompromised patients. Despite the existence of antifungal treatment IA mortality rate remains extremely high and may reach up to 80%. Previous studies have suggested important role of platelets in antifungal host defence. In vitro data show that platelets are able to attenuate germination, hyphal elongation and viability of Aspergillus fumigatus. Interaction of platelets with Aspergillus fumigatus induces differential expressions of fungal genes associated with stress response regulation, cellular transport and metabolism. A new class of antifungals, echinocandins (caspofungin, micafungin and anidulafungin), have entered the market. Anidulafungin displays strong antifungal activity against Candida and Aspergillus species and has very few side effects due to its specific inhibiting effect on the fungal cell wall synthesis. Anidulafungin is currently licensed for the treatment of adult patients with invasive candidiasis. Clinical significance of anidulafungin for IA treatment has to be further evaluated. Recently published studies have shown that efficiency of antifungal substances can be enhanced when combined with platelets. In this review we discuss the literature on the potential combined effect of platelets and anidulafungin against Aspergillus fumigatus infections.