Advances in the Diagnosis and Management of Invasive Fungal Disease

Formanek, Perry; Dilling, Daniel F.

doi:10.1016/j.chest.2019.06.032

Cited by 22 publications

(26 citation statements)

References 29 publications

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“…The clinical manifestations are non-specific, usually requiring a degree of suspicion for early recognition and prompt antifungal treatment [195]. According to the International Society for Heart and Lung Transplantation, IFIs are defined as the presence of fungus in the respiratory secretions including sputum or bronchoalveolar lavage (BL) detected by PCR, biomarkers or cultures in the presence of symptoms, radiological and endobronchial changes or signs of histological changes indicative of tissue invasion by fungi [195][196][197]. The invasive fungal infections cooperative group (IFICG) of the European Organisation for Research and Treatment for Cancer (EORTC) and Mycology Study Group (MSG) of the National Institute of Allergy and Infectious Diseases (NIAID) have published standard classifications of IFIs for research purposes.…”

Section: Diagnostic Methods Based On Properties Of the Fungal Cellmentioning

confidence: 99%

“…The invasive fungal infections cooperative group (IFICG) of the European Organisation for Research and Treatment for Cancer (EORTC) and Mycology Study Group (MSG) of the National Institute of Allergy and Infectious Diseases (NIAID) have published standard classifications of IFIs for research purposes. These classifications apply possible, probable and proven to the patient evaluation data based on a combination of host factors, clinical presentations, microbiological and biomarker indications [195,197,198]. The standard diagnostic tools used in the clinical setting to diagnose IFIs are summarised in Table 3.…”

Section: Diagnostic Methods Based On Properties Of the Fungal Cellmentioning

confidence: 99%

“…To date, more comprehensive reviews are available that provide details on the most relevant and applicable diagnostic techniques currently used in the clinical settings [199][200][201][202][203][204]. [195,197,199,205,[213][214][215]…”

Section: Diagnostic Methods Based On Properties Of the Fungal Cellmentioning

confidence: 99%

“…Currently, therapeutic strategies to combat complicated infections as well as innate, emerging resistance in fungal pathogens include adjunctive therapies and new antifungal drugs [233]. Adjunctive therapies functions by interfering with resistance mechanisms or modifying drug activity [197]. Examples of the former include efflux pump inhibitors, which increase intracellular antifungal concentration, and histone deacetylase inhibitors, which are used in combination with azoles to inhibit fungal growth [197,[234][235][236].…”

Section: Antifungal Treatment and Iron Chelation Therapymentioning

confidence: 99%

“…Adjunctive therapies functions by interfering with resistance mechanisms or modifying drug activity [197]. Examples of the former include efflux pump inhibitors, which increase intracellular antifungal concentration, and histone deacetylase inhibitors, which are used in combination with azoles to inhibit fungal growth [197,[234][235][236]. Compounds that modify antifungal activity usually act synergistically by altering the fungal stress response mechanisms [237][238][239][240].…”

Section: Antifungal Treatment and Iron Chelation Therapymentioning

confidence: 99%

See 4 more Smart Citations

Iron Assimilation during Emerging Infections Caused by Opportunistic Fungi with emphasis on Mucorales and the Development of Antifungal Resistance

Stanford

Voigt

2020

Genes

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Iron is a key transition metal required by most microorganisms and is prominently utilised in the transfer of electrons during metabolic reactions. The acquisition of iron is essential and becomes a crucial pathogenic event for opportunistic fungi. Iron is not readily available in the natural environment as it exists in its insoluble ferric form, i.e., in oxides and hydroxides. During infection, the host iron is bound to proteins such as transferrin, ferritin, and haemoglobin. As such, access to iron is one of the major hurdles that fungal pathogens must overcome in an immunocompromised host. Thus, these opportunistic fungi utilise three major iron acquisition systems to overcome this limiting factor for growth and proliferation. To date, numerous iron acquisition pathways have been fully characterised, with key components of these systems having major roles in virulence. Most recently, proteins involved in these pathways have been linked to the development of antifungal resistance. Here, we provide a detailed review of our current knowledge of iron acquisition in opportunistic fungi, and the role iron may have on the development of resistance to antifungals with emphasis on species of the fungal basal lineage order Mucorales, the causative agents of mucormycosis.

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