Which class of antifungal agents primarily works by inhibiting cell wall synthesis?

Echinocandins are a class of antifungal agents that primarily target the synthesis of the fungal cell wall, specifically by inhibiting the enzyme chitin synthase. This enzyme is crucial for the synthesis of glucan, a major component of the cell wall in many fungi. By disrupting this process, echinocandins compromise the structural integrity of the fungal cell wall, leading to cell lysis and ultimately fungal cell death.

This mechanism of action is particularly effective against certain types of fungi such as Candida and Aspergillus species, which rely heavily on their cell walls for maintaining shape and withstanding osmotic pressure. Echinocandins differ from other antifungal classes, such as azoles, polyenes, and allylamines, which target different components of the fungal cell. Azoles inhibit ergosterol synthesis, which is essential for cell membrane integrity, polyenes bind to ergosterol in the membrane leading to cell leakage, and allylamines also target ergosterol synthesis but via a different enzymatic pathway. Thus, the unique mechanism of action of echinocandins makes them particularly valuable in treating fungal infections where cell wall synthesis is a critical vulnerability.