Aspergillosis: A comprehensive review of pathogenesis, drug resistance, and emerging therapeutics

Amanpreet Singh^a, Jeewanjot Singh ^b, Sandeep Kumar^c

^aDepartment of pharmaceutics, Amar Shaheed Baba Ajit Singh Jujhar Singh Memorial College of Pharmacy, Bela, Ropar, Punjab, India

^b Department of pharmacology, Amar Shaheed Baba Ajit Singh Jujhar Singh Memorial College of Pharmacy, Bela, Ropar, Punjab, India

^cDepartment of pharmaceutics, Amar Shaheed Baba Ajit Singh Jujhar Singh Memorial College of Pharmacy, Bela, Ropar, Punjab, India

Aspergillosis stands as a primary opportunistic fungal infection which mainly results from Aspergillus fumigatus events that have gained more importance because of its multiple infection patterns and developing antifungal resistance. Healthcare providers identify two main ends of the aspergillosis spectrum which include allergic responses and invasive systemic infections that affect mainly immunocompromised subjects. This review presents a detailed summary for understanding the epidemiology of aspergillosis along with its risk factors as well as pathogenesis and host immune response and diagnostic difficulties. The analysis puts significant weight on increasing azole and echinocandin resistance that has become worse because of agricultural and environmental azole exposure and the development of multidrug-resistant strains. The mechanisms of action and restrictions together with resistance profiles differentiate different antifungal treatments like azoles and echinocandins in addition to polyenes from each other. The potential therapeutic benefits of using combination therapy with drug delivery targeting systems and developing new antifungal agents including rezafungin and ibrexafungerp are assessed. The review emphasizes relevant interactions between drugs when used together with food elements which affect antifungal safety and effectiveness specifically in patients with complex healthcare needs. The review analyzes newly developed diagnostic methods including PCR-based tests and biomarkers for their capability of improving fast and precise detection. The review presents immunomodulatory therapies as well as host-directed strategies which represent a set of emerging approaches. The clinical presentation of aspergillosis varies widely which case studies help doctors to understand better. Comprehensive management of aspergillosis necessitates cooperative medical care and precise medicinal interventions alongside continuous diagnostics improvements to achieve solutions for the worldwide health issue.