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Background & objectives: the interaction of albumin- the most important plasma protein- with various drugs leads to variations in the pharmacokinetics of drugs. Since interaction of different pharmaceuticals with albumin is determinant in the estimation of dose and prediction of drug-drug and drug-food interferences, studying the binding ability of different drugs with albumin is an active area of research.
Methods: Docking studies were performed by Lamarckian Genetic Algorithm of AutoDock 4.2 program. The three-dimensional structures of albumin were obtained from Brookhaven protein data bank (2BXD & 2BXF; www.rcsb.org). Pre-processing of molecules was done using AM1 method and AutoDock Tools 1.5.4 software. AM1 optimization method was performed using Polak-Ribiere (conjugate gradient) algorithm with termination condition as RMS gradient of 0.1 Kcal/Å mol. Schematic representation of drug-albumin complexes were obtained by Ligplot.
Results: Oxiconazole and fenticonazole were top-ranked drugs in binding to site 1 (subdomain IIA) and 2 (subdomain IIIA) of albumin, respectively (∆G_b -9.01 and -9.89 kcal.mol^-1). Leu238 and Ala291 were the key residues of site 1 due to hydrophobic contacts with all of the antifungals, while Ile388, Asn391 and Leu430 were the key residues of site 2. A few structure binding relationship rules could be extracted from the binding pattern of antifungal drugs.
Conclusion: It was found that antifungal agents might have higher affinity toward site 2 of albumin rather than site 1. Estimated high albumin affinities of antifungals provided the possibility of drug-drug or drug-food interactions. It seemed that hydrophobic contacts were more significant in binding antifungals to albumin.
 

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Candida albicans is the most common cause of invasive candidiasis, but in recent years the incidence of infections caused by other species such as Candida Kruzei, Candida glabrata, Candida tropicalis, Candida parapsilosis and Candida lusitania has increased. In the last decade, the treatment methods for invasive candidiasis have changed completely, and a successful treatment depends on the timely start of treatment, the selection of an effective drug, and the lack of resistance of the fungus to that particular drug. On the other hand, the widespread use of immunosuppressive drugs as well as organ transplants has all caused widespread problems in the treatment of invasive candidiasis. Together, these observations highlight a rationale for the immediate development of new immunotherapy methods to enhance antifungal therapy in immunocompromised hosts. The past decade has seen great advances in our understanding of fungal immunobiology, leading to a number of new molecular and cellular immunotherapy methods for invasive fungal infections. Therefore, the aim of this study was to review the common and new antifungal drugs in the treatment of invasive candidiasis and to discuss the role of immunotherapy in better prevention and control of the disease.