Antifungal peptides for biofilm disruption: Mechanisms, design strategies, and translational outlook.

Invasive fungal infections in intensive care units are a serious concern, especially when they are associated with biofilm formation. These infections often lead to high mortality because biofilms make the fungi more resistant to antifungal drugs and harder for the immune system to clear. Pathogens such as Candida auris, Candida albicans, and Aspergillus fumigatus are particularly problematic, as they are known to develop multidrug resistance and cause persistent infections in critically ill patients. These biofilms often show a much higher tolerance to standard antifungal drugs and can escape the host body's immune defenses. This makes the infections they cause more persistent and very difficult to treat in clinical practice. Antifungal peptides (AFPs), whether derived from natural host-defense molecules or designed through rational engineering, are emerging as promising options for tackling fungal biofilms. They act through several mechanisms, such as disrupting the fungal cell membrane, blocking early adhesion and morphogenesis, and weakening the extracellular matrix. Importantly, they may also work in synergy with existing antifungal drugs, making treatment more effective. Recent progress in peptide engineering and delivery methods, such as nanocarriers and hydrogel-based systems has enhanced the stability, selectivity, and ability of peptides to target fungal biofilms in experimental models. At the same time, there are important challenges that remain, including their tendency to break down due to proteolytic enzymes, possible cytotoxic effects, difficulties in large scale manufacturing, and regulatory hurdles linked to peptide-based therapies. Overall, AFPs represent a promising and fast developing area of research, but their use in clinical practice is limited. More studies are needed to confirm their safety, effectiveness and practical feasibility for managing biofilm-associated fungal infections.