Fig 1 Mechanism of action of different classes of antifungals. AmB is Amphotericin B; cAmB is the encochleated form of Amphotericin B; L-AmB is liposomal Amphotericin B.
Fig 2 Pharmacokinetic profile of liposomal amphotericin B
Fig 3 Amphotericin B (AmB) activity and fungal resistance mechanisms. The upper panel shows AmB’s dual action:pore formation via ergosterol binding and oligomerization, and the “sterol sponge” mechanism, which sequesters ergosterol from membranes. Mitochondria-associated oxidative stress also contributes to fungal killing. The lower panel summarizes key resistance strategies: (i) ergosterol pathway alterations, generating sterols with reduced AmB affinity; (ii) enhanced oxidative stress defenses, including increased catalase activity with a consequent reduction in oxidative stress response; and (iii) biofilm formation, limiting drug penetration
Fig 4 Recommendations for L-AmB therapy in resistant and refractory fungal infections.
Current opinion on the potential role of liposomal amphotericin B in underexplored clinical scenarios
Angelino and colleagues in CMR
*supported by unrestricted grant from Gilead, who make Ambisome®️
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