Coccidioidomycosis—A Fungal Disease of the Americas

Hector, Richard F.; Laniado-Laborı́n, Rafael

doi:10.1371/journal.pmed.0020002

Cited by 144 publications

(104 citation statements)

References 20 publications

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“…There are no clinical studies comparing combination therapy to single drug therapy, and since amphotericin B adds considerable potential for toxicity, the benefits of combination therapy would need to be substantial to justify combination therapy. However, if nikkomycin Z becomes available in the future, combination therapy with azoles should be explored given the synergy or additive effects demonstrated in animal models (205,206).…”

Section: Advances In Antifungal Therapy For Coccidioidomycosismentioning

confidence: 99%

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

et al. 2013

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SUMMARY Coccidioidomycosis is the endemic mycosis caused by the fungal pathogens Coccidioides immitis and C. posadasii . This review is a summary of the recent advances that have been made in the understanding of this pathogen, including its mycology, genetics, and niche in the environment. Updates on the epidemiology of the organism emphasize that it is a continuing, significant problem in areas of endemicity. For a variety of reasons, the number of reported coccidioidal infections has increased dramatically over the past decade. While continual improvements in the fields of organ transplantation and management of autoimmune disorders and patients with HIV have led to dilemmas with concurrent infection with coccidioidomycosis, they have also led to advances in the understanding of the human immune response to infection. There have been some advances in therapeutics with the increased use of newer azoles. Lastly, there is an overview of the ongoing search for a preventative vaccine.

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Section: Advances In Antifungal Therapy For Coccidioidomycosismentioning

confidence: 99%

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

et al. 2013

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“…Approximately 20 million persons live in counties within West Texas, New Mexico, Arizona, and Southern California which are major regions of endemicity for this respiratory disease. It is estimated that up to 100,000 new cases of human primary coccidioidal infection occur each year in the United States (20), accounting for millions of dollars in health care costs. Vaccination against coccidioidomycosis has been argued to be a cost-effective intervention and a feasible endeavor, since natural infection almost always confers lifelong immunity to reinfection (3,6,46).…”

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confidence: 99%

Evaluation of Two Homologous Proline-Rich Proteins of Coccidioides posadasii as Candidate Vaccines against Coccidioidomycosis

2007

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Evaluation of the protective efficacy of recombinant T-cell-reactive proteins of Coccidioides posadasii in a murine model of coccidioidomycosis has led to the discovery of potential vaccines against this respiratory disease. A recombinant proline-rich antigen (rAg2/Pra) has been reported to be a leading vaccine candidate. However, contradictory results exist on the protection afforded by this antigen. Subcutaneous vaccination of either C57BL/6 or BALB/c mice with rAg2/Pra plus adjuvant followed by intraperitoneal challenge with C. posadasii resulted in a significant reduction of the fungal burden at 12 to 14 days postchallenge compared to that in nonvaccinated animals. Use of the same vaccination protocol followed by intranasal (i.n.) challenge of C57BL/6 mice with an equal number of organisms culminated in chronic pulmonary infection or death over a 90-day period. Early studies of Ag2/Pra suggested that it is a component of an immunogenic complex. We reveal in this study that C. posadasii produces a homolog of the reported proline-rich antigen, designated Prp2, which shows 69% protein sequence identity and 86% similarity to Ag2/Pra. Protection against i.n. challenge of C57BL/6 mice was evaluated by vaccination with the single bacterially expressed homolog, rAg2/Pra, or rPrp2 in combination with rAg2/Pra, each in the presence of the same adjuvant. The combined vaccine provided significantly better protection than either of the single recombinant protein vaccines. Results of enzyme-linked immunospot assays of the immunized mice revealed that the two proline-rich homologs contain unique T-cell epitopes. In combination, the recombinant proteins stimulate a more heterogeneous and protective T-cell repertoire than the monovalent vaccines.

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“…This may be reflective of a niche environment since incidences of fungal genera will vary among regions based on the "true" microbial community, or it could be a product of the sampling method, agar selected, incubation time, and identification methods. For example, the most well-known human pathogens associated with desert dust storms and dust exposure originating from dried bird faces are Coccidioides immitis and Histoplasma capsulatum, respectively, yet these have been found only in the [35], Africa [37] Potent allergen related disease III Ulocladium (11.1%) Saudi Arabia [8], Taiwan [35] No reports IV Aspergillus (10.9%) Saudi Arabia [8,9], Taiwan [36], Africa [37], Mali [38], Mid Atlantic [39], Israel [40] Aspergillosis (Pulmonary allergic and colonizing), Number of different allergen related diseases in the immunocompromised person V Alternaria (8.6%) Saudi Arabia [8], Turkey [30], Taiwan [36], Africa [37], Mali [38], Mid Atlantic [39], Israel [40] Potent allergen (common causative agent of extrinsic asthma) VI Penicillium (7.3%) Saudi Arabia [8], Turkey [30], Taiwan [36], Mid Atlantic [39] Potent allergen related disease VII Curvularia (6.8%) Taiwan [35] Allergen-related disease Americas [22,23] and none of these pathogens were reported in this study's findings. This reaffirms that desert environments harbor diverse mycological communities and with this there are regional variations.…”

Section: Discussionmentioning

confidence: 99%

A study of airborne fungal allergens in sandstorm dust in Al-Zulfi, Central region of Saudi Arabia

Vijayakumar¹,

Aboody²,

Alturaiki³

et al. 2017

J Environ Occup Sci

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Background: The impact of sandstorm dust events on local air quality and public health are becoming a greater concern in the Kingdom of Saudi Arabia. Among sandstorm dust particles, airborne fungal spores cause serious respiratory ailments to those who are exposed to the dust. Although the study of dust storm material has attracted research interest, little work has been carried out in Saudi Arabia and no major study has been conducted in the Al-Zulfi, Riyadh province region. Hence, the aim of the study was to investigate airborne fungal allergen concentrations in sandstorm dust in the Al-Zulfi city, Saudi Arabia. Materials and Methods: During the study period, 12 sandstorm dust samples and 3 control samples were collected from various locations (educational campus, people gathering, and recreational places) by gravitational plate exposure method using Sabouraud dextrose agar. Following incubation, the fungal colonies were identified by microscopic and morphological identification. Results: A total of 2590 fungal isolates were identified among 36 exposures of sandstorm dust samples. From the samples dematiaceous fungi and hyaline fungi were observed, divided 56.2%, 43.8%, respectively. The incidences of predominant fungal genera were Fusarium (21%), Cladosporium (15.8%), Ulocladium (11.1%), Aspergillus (10.9%), and Alternaria (8.6%). Conclusion: Our observations infer that some of the most important allergenic fungal spores are predominantly observed in sandstorm dust samples and incidences of dematiaceous fungi are higher than hyaline fungi. This study highlights the need for precautionary safety measures to protect the public against sandstorm dust exposures.

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Coccidioidomycosis—A Fungal Disease of the Americas

Abstract: Coccidioidomycosis was first recognized as a serious disease over 100 years ago, but the disease remains an enigma and often goes undiagnosed, even in endemic areas

Cited by 144 publications

References 20 publications

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

Recent Advances in Our Understanding of the Environmental, Epidemiological, Immunological, and Clinical Dimensions of Coccidioidomycosis

Evaluation of Two Homologous Proline-Rich Proteins of Coccidioides posadasii as Candidate Vaccines against Coccidioidomycosis

A study of airborne fungal allergens in sandstorm dust in Al-Zulfi, Central region of Saudi Arabia

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