Psychogenetic, genetic and epigenetic mechanisms in Candida auris: Role in drug resistance

In recent years, we are facing the challenge of drug resistance emergence in fungi. The availability of limited antifungals and development of multi-drug resistance in fungal pathogens has become a serious concern in the past years in the health sector. Although several cellular, molecular, and genetic mechanisms have been proposed to explain the drug resistance mechanism in fungi, but a complete understanding of the molecular and genetic mechanisms is still lacking. Besides the genetic mechanism, epigenetic mechanisms are pivotal in the fungal lifecycle and disease biology. However, very little is understood about the role of epigenetic mechanisms in the emergence of multi-drug resistance in fungi, especially in Candida auris (C. auris). The current narrative review summaries the clinical characteristics, genomic organization, and molecular/ge-netic/epigenetic mechanisms underlying the emergence of drug resistance in C. auris. A very few studies have attempted to evaluate the role of epigenetic mechanisms in C. auris. Furthermore, advanced genetic tools such as the CRISP-Cas9 system can be utilized to elucidate the epigenetic mechanisms and their role in the emergence of multi-drug resistance in C. auris.(c) 2022 The Authors. Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/li-censes/by-nc-nd/4.0/).

Automated summary

In recent years, the emergence of drug resistance in fungi, particularly in Candida auris (C. auris), has become a serious concern due to limited antifungal options and the development of multi-drug resistance. While several cellular, molecular, and genetic mechanisms have been proposed to explain drug resistance, a complete understanding is still lacking, especially regarding the role of epigenetic mechanisms. This narrative review explores the clinical characteristics, genomic organization, and molecular/genetic/epigenetic mechanisms underlying drug resistance in C. auris, highlighting the potential of advanced genetic tools like the CRISPR-Cas9 system to elucidate epigenetic mechanisms.