The therapeutic potential of phage-based antifungal treatment: strategies, mechanisms, and prospects

Human fungal infections are increasingly being recognized as a significant global health threat. The burden of fungal diseases is escalating, primarily due to the rising number of at-risk individuals, compounded by the limited availability of antifungal therapies that are both effective and minimally toxic. Phages, viruses that specifically infect and kill bacteria, have long been investigated for their therapeutic potential. However, despite their success in bacteriology, the applications of phages in antifungal therapy are under active research. Particularly, phages could be used to treat fungal infections by engineering them to express fungal antigens on their surfaces, and this would trigger specific immune responses, such as activating Th1 and Th17 responses or inducing the production of neutralizing antibodies. Phages could also be combined with photodynamic inactivation (PDI) or antimicrobials to enhance treatment efficiency. Meanwhile, phages can exert direct antifungal effects by depleting iron, a crucial nutrient for fungal growth. This paper provides a comprehensive review of the phage-based antifungal treatment.