Treatment of life-threatening cryptococcal
meningitis (CM) is highly
challenging due to the limited efficacy of the available antifungal
drugs. Antidepressant sertraline (SER) has been proposed to be a potential
antifungal agent for CM. However, clinical studies indicated that
SER failed to achieve the expected therapeutic effects. Herein, novel
SER derivatives were designed by scaffold hopping, and they showed
improved anticryptococcal activity both in vitro and in vivo. In particular, compound D16 was identified
as a promising anti-CM agent with a new antifungal mode of action.
It acted by blocking the biosynthesis of ergosterol through the inhibition
of Δ5,6-desaturase. This study provides a new target
and a drug-like candidate for CM treatment.