Echinocandins

What are Echinocandins?

Echinocandins are a class of antifungal drugs that target the fungal cell wall. They are lipopeptide molecules that noncompetitively inhibit (1,3) beta-d-glucan synthase enzyme. This enzyme forms glucan, a major component of the fungal cell wall therefore by inhibiting its synthesis fungal cell walls are damaged.

The echinocandins have a unique mechanism of action, inhibiting beta-(1,3)-D-glucan synthase, an enzyme that is necessary for the synthesis of an essential component of the cell wall of several fungi. The echinocandins display fungistatic activity against Aspergillus spp.

No significant differences in clinical response between echinocandins and amphotericin B. In subgroup analysis, clinical responses were similar between micafungin or caspofungin and amphotericin B. Risk of discontinuing treatment due to adverse effects significantly lower with echinocandins than with amphotericin B.

Caspofungin is a medication within the echinocandins class designed to enhance the management of a spectrum of medical conditions.

The three major groups of antifungal agents in clinical use, azoles, polyenes, and allylamine/thiocarbamates, all owe their antifungal activities to inhibition of synthesis of or direct interaction with ergosterol.

The echinocandins are the only agents that target the fungal cell wall by inhibiting the synthesis of β-1,3-D-glucan polymers. This leads to instability of the cell and eventual cell lysis. Since mammalian cells do not have cell walls, this is a very effective target and avoids direct human cell toxicity.