総論 7 クリプトコックス症と抗真菌薬
V. クリプトコックス症に無効な抗真菌薬（MCFG, CPFG）
キャンディン系薬はクリプトコックスに対して抗真菌効果を持たない．クリプトコックスはβ-D-グルカン合成酵素を有 し，また細胞壁にβ-D-グルカンを含んでいる52)．クリプトコッカスのβ-D-グルカン合成酵素活性は
in vitro
においてキャン ディン系薬により阻害されることが証明されている53)．キャンディン耐性のメカニズムとして,（１）細胞内への薬剤取り込 みの阻害,（２）薬剤排出ポンプの増加などが想定されるが53,54)，細胞膜エルゴステロール合成経路中の酵素の遺伝⼦破壊によ りキャンディン系薬への感受性が⾼まることから，本菌がキャンディン系薬の取り込みを阻害することにより耐性を保持して いることが推定されている54)．⽂献
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