Cryptococcus and Cryptococcosis in the Twenty-First Century

Poeta, Maurizio Del; Chaturvedi, Vishnu

doi:10.1007/s11046-012-9544-9

Cited by 3 publications

(2 citation statements)

References 21 publications

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“…In developing countries, fungal infections affect not only immunocompromised but also immunocompetent healthy individuals in region of endemic mycoses (Brown et al, 2012), with Cryptococcus species (spp.) representing the major human fungal pathogen (Del Poeta and Chaturvedi, 2012). The main fungal pathogens affecting humans comprise those ubiquitously present in the environmental fungi, Aspergillus fumigatus , Cryptoccocus neoformans and more recently Cryptoccocus gatii , Histoplasma capsulatum , Coccidoides posadasii, Pneumocystis jirovecii and the commensal P. jiroveci or the Candida spp.…”

Section: Introductionmentioning

confidence: 99%

Fungal pathogens—a sweet and sour treat for toll-like receptors

Bourgeois¹,

Kuchler²

2012

Front. Cell. Inf. Microbio.

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Hundred-thousands of fungal species are present in our environment, including normal colonizers that constitute part of the human microbiota. The homeostasis of host-fungus interactions encompasses efficient fungal sensing, tolerance at mucosal surfaces, as well as antifungal defenses. Decrease in host immune fitness or increase in fungal burden may favor pathologies, ranging from superficial mucocutaneous diseases to invasive life-threatening fungal infections. Toll-like receptors (TLRs) are essential players in this balance, due to their ability to control both inflammatory and anti-inflammatory processes upon recognition of fungal-specific pathogen-associated molecular patterns (PAMPs). Certain members of the TLR family participate to the initial recognition of fungal PAMPs on the cell surface, as well as inside phagosomes of innate immune cells. Active signaling cascades in phagocytes ultimately enable fungus clearance and the release of cytokines that shape and instruct other innate immune cells and the adaptive immune system. Some TLRs cooperate with other pattern recognition receptors (PRRs) (e.g., C-type lectins and Galectins), thus allowing for a tailored immune response. The spatio-temporal and physiological contributions of individual TLRs in fungal infections remains ill-defined, although in humans, TLR gene polymorphisms have been linked to increased susceptibility to fungal infections. This review focuses entirely on the role of TLRs that control the host susceptibility to environmental fungi (e.g., Aspergillus, Cryptoccocus, and Coccidoides), as well as to the most frequent human fungal pathogens represented by the commensal Candida species. The emerging roles of TLRs in modulating host tolerance to fungi, and the strategies that evolved in some of these fungi to evade or use TLR recognition to their advantage will also be discussed, as well as their potential suitability as targets in vaccine therapies.

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Section: Introductionmentioning

confidence: 99%

Fungal pathogens—a sweet and sour treat for toll-like receptors

Bourgeois¹,

Kuchler²

2012

Front. Cell. Inf. Microbio.

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“…Características das amostras de Cryptococcus spp. isolados de pacientes atendidos no HCU,[2004][2005][2006][2007][2008][2009][2010][2011][2012][2013] Susceptibilidade in vitro aos antifúngicos pelas metodologias de disco difusão em ágar e microdiluição em caldo dos isolados de Cryptococcus neoformans de pacientes atendidos no HCU,[2004][2005][2006][2007][2008][2009][2010][2011][2012][2013] Distribuição por faixa etária e sexo dos pacientes acometidos pela Criptococose e atendidos no HCU,[2004][2005][2006][2007][2008][2009][2010][2011][2012][2013] Frequência das manifestações clínicas de pacientes com Criptococose atendidos no HCU, 2004-2013 46%) pacientes apresentaram infecção por outros microorganismos, sendo que destes, nove foram isolados da corrente sanguínea. meningoencefalite (p=0,001).…”

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Caracterização de amostras de Cryptococcus neoformans e aspectos clínicos e epidemiológicos da criptococose de pacientes do Hospital de Clínicas de Uberlândia

Aguiar¹

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Cryptococcus is a yeast-like fungus, capsuled, which has the ability to infect and cause disease in a wide variety of hosts; is the causative agent of cryptococcosis, systemic disease, subacute or chronic, occurring before the AIDS epidemic was sporadic and usually associated with patients with low cellular immunity. Two species are the main pathogenic to humans: C. neoformans and C. gattii; generally C. neoformans cause disease in immunocompromised individuals, manifested as a disease in immunocompetent individuals generally have as C. gattii agent. The laboratory diagnosis of cryptococcosis is usually performed by microbiological examinations (direct and culture research) in various clinical specimens and also by serological methods (latex reaction). Molecular techniques may also be used, but still have limited application in clinical diagnostics. Treatment is with amphotericin B in the induction phase and with fluconazole in the phases of consolidation and maintenance. The objectives of this study were to investigate the phenotypic and molecular characteristics and determine the antifungal susceptibility of Cryptococcus neoformans isolated from samples from patients treated at Uberlândia Clinical Hospital in the 2004-2013 period; and also examine the demographic characteristics of the patients. The phenotypic characteristics have been studied through the use of conventional biochemical tests, such as melanin production and urease and sensitivity to canavanine; to have the molecular characteristics, conventional PCR reactions and research have been used in the URA-5 gene by PCR-RFLP. The antifungal susceptibility was performed either by disk diffusion technique and the dilution technique broth through VITEK ® 2 system. The demographic characteristics of patients suffering from cryptococcosis were studied by analyzing the records. Between 41 samples were stored Cryptococcus identified as C. neoformans. During molecular analysis it was found that 40 were C. neoformans var. grubii (VNI) and one was C. gattii (VGI). All strains were mating type . All isolates were susceptible to antifungals front tested by automated method of broth microdilution (Vitek ® 2, Biomerieux). Patients affected by cryptococcosis were mostly men 31-40 years old, coming from urban areas. The meningoencephalitis was the predominant form of the disease; most were immunocompromised, AIDS being the predominant underlying disease. Most of them receive appropriate treatment according to the proposed guidelines; however, 58% of patients progressed to death.

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First Molecular Typing of Cryptococcemia-Causing Cryptococcus in Central-West Brazil

et al. 2013

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Molecular epidemiology studies on cryptococcemia are limited. This study aimed to describe the clinical features of patients with bloodstream infections by Cryptococcus sp. in a public tertiary hospital in Mato Grosso do Sul, as well as identify the fungus' molecular type and determine its antifungal susceptibility. Molecular typing was performed using URA5 restriction fragment length polymorphism PCR, and antifungal susceptibility was determined by microdilution method standardized by the Clinical and Laboratory Standards Institute. Over 14 years, 48 patients were diagnosed with cryptococcemia. The majority (72.9 %) was male with a median age of 40 years; 81.3 % of the patients had HIV/AIDS and 72.9 % died. Cryptococcus neoformans was the most commonly isolated species (97.9 %). Molecular analysis identified the genotypes C. neoformans VNI (93.7 %), C. neoformans VNII (4.2 %), and Cryptococcus gattii VGII (2.1 %). In vitro, these fungi were not resistant to fluconazole, itraconazole, voriconazole, and amphotericin B. This is the first description of the molecular types of cryptococcemia agents in central-west Brazil. Its high lethality, especially in HIV-negative patients, suggests that early diagnosis and prompt antifungal therapy are crucial for a good clinical outcome.

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Cryptococcus and Cryptococcosis in the Twenty-First Century

Cited by 3 publications

References 21 publications

Fungal pathogens—a sweet and sour treat for toll-like receptors

Fungal pathogens—a sweet and sour treat for toll-like receptors

Caracterização de amostras de Cryptococcus neoformans e aspectos clínicos e epidemiológicos da criptococose de pacientes do Hospital de Clínicas de Uberlândia

First Molecular Typing of Cryptococcemia-Causing Cryptococcus in Central-West Brazil

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