Reversal of Fluconazole Resistance in Multidrug Efflux-Resistant Fungi by the Dysidea arenaria Sponge Sterol 9α,11α-Epoxycholest-7-ene-3β,5α,6α,19-tetrol 6-Acetate

Abstract
The sponge sterol 9α,11α-epoxycholest-7-ene-3β,5α,6α,19-tetrol 6-acetate (ECTA) (1) is the first marine natural product to reverse fluconazole resistance mediated by a Candida albicans MDR efflux pump. The IC50 of fluconazole is decreased from 300 to 8.5 μM (35-fold enhancement) when combined with 1 (3.8 μM). A revised C-6 configuration of 1 is established.

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