关键词: Azole antifungal drug Cranio-facial defects Skeletal malformations Teratogenicity Voriconazole

Mesh : Animals Voriconazole / toxicity Female Antifungal Agents / toxicity Pregnancy Mice Abnormalities, Drug-Induced / etiology Teratogens / toxicity Male Litter Size / drug effects Triazoles / toxicity

来  源:   DOI:10.1016/j.reprotox.2024.108681

Abstract:
Antifungals are a class of drugs that target the treatment of invasive fungal infections. This includes polyenes, triazoles, and echinocadins. Among these, azoles are being extensively used nowadays. Triazoles have become standard for the azoles and have replaced amphotericin B as the first line of defence for fungal infections. With the increased cases of fungal infection, which affect a majority of the population at different stages and situations, one such section of the population is pregnant females. The rate and susceptibility of fungal infections are particularly higher in pregnant females, as the immunity of the mother is highly compromised. Systemic fungal infections like invasive aspergillosis, esophageal candidiasis, and candidemia are being treated with new age triazole antifungals like voriconazole. Prolonged and high concentrations of this drug are associated with various developmental anomalies. With this aim, teratogenic studies were performed on pregnant female mice during gestation and the weaning/lactation period to observe the effects of voriconazole at different dosages (8 mg/kg b.w., 10 mg/kg b.w., and 20 mg/kg b.w.). Pregnant dams were subjected to 20 mg/kg b.w. Voriconazole had a small litter size and a high number of resorptions. Craniofacial defects in the form of reduced ossification and widely open sutures, the presence of the 14th rib, asymmetry in the sternebrae, and the absence of ossified distal phalanges were some of the skeletal anomalies which were significant in the foetus and pups subjected to both 10 mg/kg b.w. and 20 mg/kg b.w. doses of voriconazole.
摘要:
抗真菌剂是一类靶向治疗侵袭性真菌感染的药物。这包括多烯,三唑类,和棘豆苷.其中,现在唑类药物被广泛使用。三唑已成为唑类的标准药物,并已取代两性霉素B成为真菌感染的第一道防线。随着真菌感染病例的增加,在不同的阶段和情况下影响大多数人口,人口中的一个这样的部分是怀孕的女性。孕妇中真菌感染的发生率和易感性尤其高,因为母亲的免疫力受到很大损害。系统性真菌感染如侵袭性曲霉病,食管念珠菌病,念珠菌菌血症正在接受新时代的三唑类抗真菌药物如伏立康唑治疗。长时间和高浓度的这种药物与各种发育异常有关。为了这个目标,在妊娠和断奶/哺乳期对怀孕的雌性小鼠进行致畸研究,以观察伏立康唑在不同剂量(8mg/kgb.w.,10mg/kgb.w.,和20mg/kgb.w.)。怀孕的水坝受到20mg/kgb.w.伏立康唑的产仔数小,吸收次数多。骨化减少和广泛开放的缝合线形式的颅面缺损,第14根肋骨的存在,Sternebrae的不对称,并且没有骨化的远端指骨是一些骨骼异常,在接受10mg/kgb.w.和20mg/kgb.w.剂量的伏立康唑的胎儿和幼崽中都很明显。
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