Cryptococcus neoformans, a global threat to human health
Abstract Background Emerging fungal pathogens pose important threats to global public health. The World Health Organization has responded to the rising threat of traditionally neglected fungal infections by developing a Fungal Priority Pathogens List (FPPL). Taking the highest-ranked fungal pathogen...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Infectious Diseases of Poverty |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40249-023-01073-4 |
| _version_ | 1797863194047283200 |
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| author | Youbao Zhao Leixin Ye Fujie Zhao Lanyue Zhang Zhenguo Lu Tianxin Chu Siyu Wang Zhanxiang Liu Yukai Sun Min Chen Guojian Liao Chen Ding Yingchun Xu Wanqing Liao Linqi Wang |
| author_facet | Youbao Zhao Leixin Ye Fujie Zhao Lanyue Zhang Zhenguo Lu Tianxin Chu Siyu Wang Zhanxiang Liu Yukai Sun Min Chen Guojian Liao Chen Ding Yingchun Xu Wanqing Liao Linqi Wang |
| author_sort | Youbao Zhao |
| collection | DOAJ |
| description | Abstract Background Emerging fungal pathogens pose important threats to global public health. The World Health Organization has responded to the rising threat of traditionally neglected fungal infections by developing a Fungal Priority Pathogens List (FPPL). Taking the highest-ranked fungal pathogen in the FPPL, Cryptococcus neoformans, as a paradigm, we review progress made over the past two decades on its global burden, its clinical manifestation and management of cryptococcal infection, and its antifungal resistance. The purpose of this review is to drive research efforts to improve future diagnoses, therapies, and interventions associated with fungal infections. Methods We first reviewed trends in the global burden of HIV-associated cryptococcal infection, mainly based on a series of systematic studies. We next conducted scoping reviews in accordance with the guidelines described in the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews using PubMed and ScienceDirect with the keyword Cryptococcus neoformans to identify case reports of cryptococcal infections published since 2000. We then reviewed recent updates on the diagnosis and antifungal treatment of cryptococcal infections. Finally, we summarized knowledge regarding the resistance and tolerance of C. neoformans to approved antifungal drugs. Results There has been a general reduction in the estimated global burden of HIV-associated cryptococcal meningitis since 2009, probably due to improvements in highly active antiretroviral therapies. However, cryptococcal meningitis still accounts for 19% of AIDS-related deaths annually. The incidences of CM in Europe and North America and the Latin America region have increased by approximately two-fold since 2009, while other regions showed either reduced or stable numbers of cases. Unfortunately, diagnostic and treatment options for cryptococcal infections are limited, and emerging antifungal resistance exacerbates the public health burden. Conclusion The rising threat of C. neoformans is compounded by accumulating evidence for its ability to infect immunocompetent individuals and the emergence of antifungal-resistant variants. Emphasis should be placed on further understanding the mechanisms of pathogenicity and of antifungal resistance and tolerance. The development of novel management strategies through the identification of new drug targets and the discovery and optimization of new and existing diagnostics and therapeutics are key to reducing the health burden. |
| first_indexed | 2024-04-09T22:32:43Z |
| format | Article |
| id | doaj.art-4f735d24eacb44d183c2c479c088a036 |
| institution | Directory Open Access Journal |
| issn | 2049-9957 |
| language | English |
| last_indexed | 2024-04-09T22:32:43Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Diseases of Poverty |
| spelling | doaj.art-4f735d24eacb44d183c2c479c088a0362023-03-22T12:41:07ZengBMCInfectious Diseases of Poverty2049-99572023-03-0112111810.1186/s40249-023-01073-4Cryptococcus neoformans, a global threat to human healthYoubao Zhao0Leixin Ye1Fujie Zhao2Lanyue Zhang3Zhenguo Lu4Tianxin Chu5Siyu Wang6Zhanxiang Liu7Yukai Sun8Min Chen9Guojian Liao10Chen Ding11Yingchun Xu12Wanqing Liao13Linqi Wang14College of Veterinary Medicine, Henan Agricultural UniversityState Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of SciencesCollege of Veterinary Medicine, Henan Agricultural UniversityState Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of SciencesCollege of Veterinary Medicine, Henan Agricultural UniversityCollege of Veterinary Medicine, Henan Agricultural UniversityCollege of Veterinary Medicine, Henan Agricultural UniversityCollege of Veterinary Medicine, Henan Agricultural UniversityCollege of Veterinary Medicine, Henan Agricultural UniversityDepartment of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng HospitalThe Medical Research Institute, College of Pharmaceutical Sciences, Southwest UniversityCollege of Life and Health Sciences, Northeastern UniversityDepartment of Laboratory Medicine, and Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical SciencesDepartment of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Changzheng HospitalState Key Laboratory of Mycology, Institute of Microbiology, Chinese Academy of SciencesAbstract Background Emerging fungal pathogens pose important threats to global public health. The World Health Organization has responded to the rising threat of traditionally neglected fungal infections by developing a Fungal Priority Pathogens List (FPPL). Taking the highest-ranked fungal pathogen in the FPPL, Cryptococcus neoformans, as a paradigm, we review progress made over the past two decades on its global burden, its clinical manifestation and management of cryptococcal infection, and its antifungal resistance. The purpose of this review is to drive research efforts to improve future diagnoses, therapies, and interventions associated with fungal infections. Methods We first reviewed trends in the global burden of HIV-associated cryptococcal infection, mainly based on a series of systematic studies. We next conducted scoping reviews in accordance with the guidelines described in the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews using PubMed and ScienceDirect with the keyword Cryptococcus neoformans to identify case reports of cryptococcal infections published since 2000. We then reviewed recent updates on the diagnosis and antifungal treatment of cryptococcal infections. Finally, we summarized knowledge regarding the resistance and tolerance of C. neoformans to approved antifungal drugs. Results There has been a general reduction in the estimated global burden of HIV-associated cryptococcal meningitis since 2009, probably due to improvements in highly active antiretroviral therapies. However, cryptococcal meningitis still accounts for 19% of AIDS-related deaths annually. The incidences of CM in Europe and North America and the Latin America region have increased by approximately two-fold since 2009, while other regions showed either reduced or stable numbers of cases. Unfortunately, diagnostic and treatment options for cryptococcal infections are limited, and emerging antifungal resistance exacerbates the public health burden. Conclusion The rising threat of C. neoformans is compounded by accumulating evidence for its ability to infect immunocompetent individuals and the emergence of antifungal-resistant variants. Emphasis should be placed on further understanding the mechanisms of pathogenicity and of antifungal resistance and tolerance. The development of novel management strategies through the identification of new drug targets and the discovery and optimization of new and existing diagnostics and therapeutics are key to reducing the health burden.https://doi.org/10.1186/s40249-023-01073-4Fungal infectionsCryptococcus neoformansCryptococcal meningitisAntifungal resistanceAntifungal tolerance |
| spellingShingle | Youbao Zhao Leixin Ye Fujie Zhao Lanyue Zhang Zhenguo Lu Tianxin Chu Siyu Wang Zhanxiang Liu Yukai Sun Min Chen Guojian Liao Chen Ding Yingchun Xu Wanqing Liao Linqi Wang Cryptococcus neoformans, a global threat to human health Infectious Diseases of Poverty Fungal infections Cryptococcus neoformans Cryptococcal meningitis Antifungal resistance Antifungal tolerance |
| title | Cryptococcus neoformans, a global threat to human health |
| title_full | Cryptococcus neoformans, a global threat to human health |
| title_fullStr | Cryptococcus neoformans, a global threat to human health |
| title_full_unstemmed | Cryptococcus neoformans, a global threat to human health |
| title_short | Cryptococcus neoformans, a global threat to human health |
| title_sort | cryptococcus neoformans a global threat to human health |
| topic | Fungal infections Cryptococcus neoformans Cryptococcal meningitis Antifungal resistance Antifungal tolerance |
| url | https://doi.org/10.1186/s40249-023-01073-4 |
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