Document Type : Reviews
Authors
1
1-Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 2-Student Research Committee, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
2
Department of Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3
Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
4
Department of Medical Mycology, School of Medicine, Babol University of Medical Sciences, Babol,Iran
5
Infectious and Tropical Diseases Research Center, Health Research Institute and b- Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
10.22034/cmm.2025.345313.1589
Abstract
Background and Purpose: Fluconazole is considered one of the main antifungal drugs for treating candidiasis. Despite this, long-term treatment and indiscriminate use of azole family drugs have created isolates resistant to these azoles. Candida albicans cells can develop resistance to fluconazole through various mechanisms. The present study has tried to investigate the expression of each gene effective in the resistance of C. albicans in people with different underlying diseases.
Methods: The databases as PubMed, Scopus, and Web of Science were used to collect all studies evaluating the expression level of the main genes of C. albicans resistance to fluconazole from 1997 to 2024. Finally, among the 1096 studies extracted, 25 studies were selected based on the inclusion and exclusion criteria.
Results: in this systematic review, the genes encoding the ABS membrane pump (CDR1, CDR2) and the genes encoding the MFS pumps (MDR1), as well as the ERG11 gene, are the most important effective genes in creating resistance of C. albicans to fluconazole. Based on the studies conducted since 1995, the CDR1 gene has the highest gene expression among the genes involved in resistance, followed by ERG11, MDR1, and CDR2, respectively.
Conclusion: Comprehensive information about the activity of the genes and more studies on the genes involved in resistance, can give a good direction to further studies, prevent the occurrence of resistance to fluconazole and other azoles, and provide suitable treatments. Disease, as well as the dosage and duration of the antifungal, may play an important role in determining the type of resistance mechanism of C. albicans. Therefore, further evaluation of the role of these genes in fluconazole-resistant species as well as their related gene products seems necessary.
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