Fungal fatal attraction: a mechanistic review on targeting liposomal amphotericin B (AmBisome^®) to the fungal membrane

Abstract

Liposomal amphotericin B (AmBisome^®) is a lipid-based nanotherapeutic that is used successfully worldwide to treat a broad range of life-threatening invasive fungal infections. In subtropical regions, AmBisome is emerging as the treatment of choice for human parasitic protozoan pathogens such as those from the genus Leishmania. The key to the remarkable efficacy of AmBisome is attributed to its liposome based formulation to deliver a potent drug at high dosage with significantly reduced toxicity in patients with immunocompromised systems. In spite of the rising frequency of AmBisome usage globally, the mechanisms underlying its ability to target to the sites of infection remain largely unknown. This review provides an overview of the current mechanistic understanding of AmBisome, discusses potential challenges and opportunities for the development of clinically effective, refractory resistant antifungal agents.

Keywords:

• Amphotericin
• targeting
• fungal resistance
• liposomes
• drug delivery
• Candida
• ergosterol
• biofilm

Acknowledgements

The author thanks Professor Neil A. R. Gow from the College of Life Sciences and Medicine, University of Aberdeen, for the research of gold-labelled liposomes in C. albicans mutants and Tarquinus H. Bunch for providing the illustrations.

Disclosure statement

The author reports no conflict of interest. The author alone is responsible for the content and writing of the article.