Liu, s. | bioRxiv Science

bioRxiv2026

Repurposing the Antiviral Agent Pibrentasvir: In Vitro Synergistic Effects in Combination with Different Azole Antifungal Agents

ObjectiveTo investigate the combined effects of multiple drugs and provide more therapeutic options for invasive fungal infections, this study evaluated the in vitro susceptibility of Aspergillus spp., Candida auris, Cryptococcus neoformans, and Exophiala dermatitidis to pibrentasvir (PIB) in combination with itraconazole (ITR), voriconazole (VOR), posaconazole (POS), or fluconazole (FLU). MethodsAccording to the M27-A3 and M38-A2 guidelines established by the Clinical and Laboratory Standards Institute (CLSI), the in vitro antifungal activities of PIB combined with ITR, VOR, POS, or FLU against 78 clinical isolates, including Aspergillus spp., E. dermatitidis, C. auris, and C. neoformans, were determined. The minimum inhibitory concentrations (MICs) and fractional inhibitory concentration indices (FICIs) were calculated to evaluate the synergistic effects. ResultsPIB alone exhibited no antifungal activity. Significant synergistic effects were observed when PIB was combined with azole antifungal agents. The PIB-POS combination showed synergistic effects against Aspergillus spp. (27/41, 65.90%), C. auris (9/10, 90.00%), C. neoformans (2/9, 22.20%), and E. dermatitidis (11/18, 61.11%). The PIB-ITR combination also showed synergistic effects against Aspergillus spp. (18/41, 43.9%), C. auris (9/10, 90.0%), C. neoformans (2/9, 22.2%), and E. dermatitidis (10/18, 55.5%). Synergistic effects were less frequently observed with the PIB-VOR or PIB-FLU combinations, and no antagonistic effects were observed. ConclusionThis study demonstrates that PIB acts as an azole sensitizer, with the strongest synergistic effects observed when combined with POS or ITR, providing a new research direction for combination therapy against invasive fungal infections.

microbiology↗

bioRxiv2025

Drift and isolation drive genomic erosion and island speciation in a lineage of macaques

Allopatric speciation, especially on large islands and archipelagos, is a significant driver of evolutionary diversification, as geographic isolation fosters the independent evolution of populations1,2. In these isolated populations, lineage sorting and genetic drift dominate, accelerating allele fixation and reducing shared genetic variation3,4. Here, we investigated how sea-level transgression during the Early Holocene triggered rapid speciation in large vertebrates by studying macaques isolated on Dangan Island (DGD), located just 30 km from present-day Hong Kong. Whole-genome sequencing revealed that [~]10,000 years of isolation drove the macaques evolution into a distinct species, as indicated by pronounced genomic divergence (mean Fst > = 0.462 vs. mainland), 1.94 million lineage-specific variants, and complete ancestral differentiation with no evidence of post-isolation gene flow. A severe demographic collapse (effective population size, Ne {approx} 40) led to substantial genomic erosion (65.8% loss of genetic diversity). Paradoxically, this also enhanced resilience through drift-mediated genetic triage. Increased homozygosity exposed and purged lethal recessive alleles in lipid metabolism pathways (68% reduction in genetic load), while simultaneously fixing mildly deleterious variants--such as a splice-site mutation in SKAP2--thereby generating a form of genomic "burden" alongside rapid immune adaptation via 251 fixed missense mutations. These findings demonstrate that island isolation can drive vertebrate speciation within a few thousand years, with genetic drift playing a dominant role in shaping genomic architecture. Accordingly, conservation strategies should prioritize monitoring loss-of-function (LoF) variants in essential pathways and prescreening for deleterious allele combinations between donors and recipients prior to implementing genetic rescue in small, drift-sensitive populations.

genomics↗