{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:27:09Z","timestamp":1777922829033,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2017,1,12]],"date-time":"2017-01-12T00:00:00Z","timestamp":1484179200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2017,9,1]]},"abstract":"<jats:p>\n                    In our earlier\n                    <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">in vivo<\/jats:italic>\n                    studies, synergistic effects were observed when itraconazole or voriconazole were combined with tetrandrine (TET) against\n                    <jats:italic toggle=\"yes\">Aspergillus fumigatus<\/jats:italic>\n                    , and the synergistic mechanism was related to inhibition of the drug efflux pump. Posaconazole (PCZ) is a broad-spectrum triazole antifungal agent used for the treatment of diverse fungal infections, including aspergillosis and candidiasis. Herein, the antifungal effects of TET are further investigated\n                    <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">in vivo<\/jats:italic>\n                    alone or combined with PCZ against 20 clinical isolates of\n                    <jats:italic toggle=\"yes\">A. fumigatus.<\/jats:italic>\n                    We found that the minimal inhibitory concentrations (MICs) of PCZ were decreased one- to twofold and three- to fivefold across a series of concentration gradients\n                    <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                    in presence of TET. Time-killing curves revealed that the synergy was dependent on TET and PCZ concentrations as well as incubation time. The combination could further downregulate the expression of\n                    <jats:italic toggle=\"yes\">MDR2<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">MDR3<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">MDR4<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">ATRF<\/jats:italic>\n                    in PCZ-resistant strain, however, it has subtle effects on TET-synergized mechanism. In addition, TET in combination with PCZ significantly prolonged mice survival time and reduced kidney and brain tissue burdens\n                    <jats:italic toggle=\"yes\">in vivo<\/jats:italic>\n                    . Our data\n                    <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">in vivo<\/jats:italic>\n                    demonstrate that TET is an effective synergist with azoles against\n                    <jats:italic toggle=\"yes\">A. fumigates.<\/jats:italic>\n                  <\/jats:p>","DOI":"10.1089\/mdr.2016.0217","type":"journal-article","created":{"date-parts":[[2017,1,12]],"date-time":"2017-01-12T12:20:14Z","timestamp":1484223614000},"page":"674-681","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Synergistic Effects of Tetrandrine with Posaconazole Against\n                    <i>Aspergillus fumigatus<\/i>"],"prefix":"10.1177","volume":"23","author":[{"given":"Shui-Xiu","family":"Li","sequence":"first","affiliation":[{"name":"Jinan University","place":["People's Republic of China"]},{"name":"Jinan University","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan-Jun","family":"Song","sequence":"additional","affiliation":[{"name":"Jinan University","place":["People's Republic of China"]},{"name":"Jinan University","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Jiang","sequence":"additional","affiliation":[{"name":"Jinan University","place":["People's Republic of China"]},{"name":"Jinan University","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya-Jing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Jinan University","place":["People's Republic of China"]},{"name":"Jinan University","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Guo","sequence":"additional","affiliation":[{"name":"Jinan University","place":["People's Republic of China"]},{"name":"Jinan University","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong-Mei","family":"Li","sequence":"additional","affiliation":[{"name":"Georgetown University Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun-Ju","family":"Zhu","sequence":"additional","affiliation":[{"name":"Jinan University","place":["People's Republic of China"]},{"name":"Jinan University","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Jinan University","place":["People's Republic of China"]},{"name":"Jinan University","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,1,12]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-014-0722-7"},{"key":"e_1_3_4_3_2","first-page":"1","article-title":"Pharmacokinetics and safety of posaconazole delayed-release tablets for invasive fungal infections","volume":"8","author":"Wiederhold N.P.","year":"2016","unstructured":"Wiederhold N.P. 2016. Pharmacokinetics and safety of posaconazole delayed-release tablets for invasive fungal infections. Clin. Pharmacol., 8:1\u20138.","journal-title":"Clin. Pharmacol."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkv177"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1185973"},{"key":"e_1_3_4_6_2","first-page":"454","article-title":"In vitro study of the synergistic effect of tetrandrine and fluconazole against Candida albicans","volume":"39","author":"Li F.","year":"2006","unstructured":"Li F., , Zhang H., , and Shan K.. 2006. In vitro study of the synergistic effect of tetrandrine and fluconazole against Candida albicans. Chin. J. Dermatol., 39:454\u2013456.","journal-title":"Chin. J. 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