ReviewJournal of microbiology (Seoul, Korea)2016
The development of fluconazole resistance in Candida albicans - an example of microevolution of a fungal pathogen.
Review in Journal of microbiology (Seoul, Korea), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it, 116 citations in OpenAlex.
- Global prevalence and trends of fluconazole resistance in non-albicans Candida species: a systematic review and meta-analysis.BMC infectious diseases · 2026Pooled it
- Morphotype-specific susceptibility toMicrobiology spectrum · 2026Article
- Therapeutic Effects and Mechanisms of Sodium New Houttuyfonate in a Murine Model of Intra-AbdominalInternational journal of molecular sciences · 2026Article
- Genomic Analysis Reveals Diversified and Stress-Responsive Transport Repertoire inJournal of fungi (Basel, Switzerland) · 2026Article
- Amphibian-Derived Peptide Analog TB_KKG6K: A Powerful Drug Candidate AgainstJournal of fungi (Basel, Switzerland) · 2025Article
- Adaptation of Candida albicans to specific host environments by gain-of-function mutations in transcription factors.PLoS pathogens · 2024Review
- Cluster analysis allowed to identify antifungal drugs that retain efficacy againstFrontiers in oral health · 2024Article
- Microevolution during Chronic Infection May LeadDermatology research and practice · 2024Article
- Assessing the In Vitro Potential of Glatiramer Acetate (CopaxoneJournal of fungi (Basel, Switzerland) · 2023Article
- Synergistic Effect of the Combination of Deferoxamine and FluconazoleAntimicrobial agents and chemotherapy · 2022Article
- The Risk Factors and Mechanisms of Azole Resistance ofJournal of fungi (Basel, Switzerland) · 2022Article
- Genomic Variation-Mediating Fluconazole Resistance in Yeast.Biomolecules · 2022Review
- Article
- Antifungal Exposure and Resistance Development: Defining Minimal Selective Antifungal Concentrations and Testing Methodologies.Frontiers in fungal biology · 2022Article
- A New Variant of Mutational and Polymorphic Signatures in theInfection and drug resistance · 2022Article
- Article
- Hinokitiol chelates intracellular iron to retard fungal growth by disturbing mitochondrial respiration.Journal of advanced research · 2021Article
- Antimicrobial Photodynamic Therapy: Latest Developments with a Focus on Combinatory Strategies.Pharmaceutics · 2021Review
- Etoposide and Camptothecin Reduce Growth, Viability, the Generation ofIndian journal of microbiology · 2021Article
- Systematic truncations of chromosome 4 and their responses to antifungals in Candida albicans.Journal, genetic engineering & biotechnology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The yeast Candida albicans is a member of the microbiota in the gastrointestinal and urogenital tracts of most healthy persons, but it can also cause symptomatic infections, especially in immunocompromised patients. During the life-long association with its human host, C. albicans generates genetically altered variants that are better adapted to changes in their environment. A prime example of this microevolution is the development of resistance to the commonly used drug fluconazole, which inhibits ergosterol biosynthesis, during antimycotic therapy. Fluconazole resistance can be caused by mutations in the drug target, by changes in the sterol biosynthesis pathway, and by gain-of-function mutations in transcription factors that result in the constitutive upregulation of ergosterol biosynthesis genes and multidrug efflux pumps. Fluconazole also induces genomic rearrangements that result in gene amplification and loss of heterozygosity for resistance mutations, which further increases drug resistance. These genome alterations may affect extended chromosomal regions and have additional phenotypic consequences. A striking case is the loss of heterozygosity for the mating type locus MTL in many fluconazole-resistant clinical isolates, which allows the cells to switch to the mating-competent opaque phenotype. This, in turn, raises the possibility that sexual recombination between different variants of an originally clonal, drug-susceptible population may contribute to the generation of highly fluconazole-resistant strains with multiple resistance mechanisms. The gain-of-function mutations in transcription factors, which result in deregulated gene expression, also cause reduced fitness. In spite of this, many clinical isolates that contain such mutations do not exhibit fitness defects, indicating that they have overcome the costs of drug resistance with further evolution by still unknown mechanisms.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.