Combined treatment: antifungal drugs with antibodies, cytokines or drugs

To improve present results with antifungal drugs, modulation of the host im mune response is being explored. Human phagocytes of various lineages work cooperatively in vitro with antifungal drugs to inhibit or kill fungal path ogens, and this activity is augmented by several recombinant cytokines. Mon oclonal antibodies against the cryptococcal capsule have been shown to act as an adjunct in enhancing the outcome of cryptococcosis in animal models. This approach is now being pursued in systematic clinical trials. In experi mental candidiasis, several manipulations of the immune system, via adminis tration of cytokines, gene deletion or antibodies to cytokines, have been s hown to significantly affect survival and fungal clearance in vivo. This ap proach has already been demonstrated to be of benefit with recombinant huma n granulocyte-colony stimulating factor adjunct therapy of human candidiasi s. Combining antifungal drugs of different classes may enhance their therap eutic effect.