The widespread and irrational use of azole antifungal
agents has
led to an increase of azole-resistant Candida albicans strains with an urgent need for combination drug therapy, enhancing
the treatment efficacy. Here, we report the discovery of a first-in-class
pyrazole-isoxazole, namely, 5b, that showed remarkable
growth inhibition against the C. albicans ATCC 10231 strain in combination with voriconazole, acting as a
downregulator of ERG 11 (Cyp51) gene expression with
a significant reduction of the yeast-to-hypha morphological transition.
Furthermore, C. albicans CYP51 enzyme
assay and in-depth molecular docking studies unveiled the unique ability
of the combination of 5b and voriconazole to completely
fill the CYP51 binding sites. In vivo studies using
a Galleria mellonella model confirmed the previously in vitro observed synergistic effect of 5b with
voriconazole. Also considering its biocompatibility in a cellular
model of human keratinocytes, these results indicate that 5b represents a promising compound for a further optimization campaign.