Current
therapies against
invasive pulmonary aspergillosis (IPA) have a limited cure rate. Given that a delay in treatment initiation may be fatal, a new drug with rapid-onset and potent fungicidal activity is needed. The novel cyclic hexapeptide
ASP2397 (currently known as VL-2397) exhibited antifungal activity against Aspergillus fumigatus (including
azole-sensitive and
azole-resistant isolates), A. terreus, and A. flavus at an MIC range of 1 to 4 μg/ml in human serum. Time-kill curve experiments showed that
ASP2397 reduced germinated conidia of A. fumigatus by more than 1 log10 CFU within 6 h. In addition,
ASP2397 inhibited hyphal elongation from germinated conidia of A. fumigatus, A. terreus, and A. flavus more rapidly than
voriconazole. Under conditions of
delayed treatment initiation in an IPA mouse model,
ASP2397 had efficacy superior to that of
posaconazole, with 100% survival and over 1 log10 CFU/g reduction in lung fungal burden. Histopathological investigation of lungs also showed that
ASP2397 markedly suppressed
disease progression. To clarify its mechanism of action, we generated a UV-induced mutant of A. fumigatus with low susceptibility to
ASP2397. The mutant had a point mutation in the
siderophore transporter gene sit1, which is absent in mammalian cells. These findings suggest that
ASP2397 may improve clinical treatment options for IPA.