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应对多种隐球菌物种及其引发疾病的挑战。

Rising to the challenge of multiple Cryptococcus species and the diseases they cause.

作者信息

Idnurm Alexander, Lin Xiaorong

机构信息

School of BioSciences, University of Melbourne, VIC 3010, Australia.

Department of Biology, Texas A&M University, College Station, TX 77843, USA.

出版信息

Fungal Genet Biol. 2015 May;78:1-6. doi: 10.1016/j.fgb.2015.05.002. Epub 2015 May 14.

Abstract

Cryptococcus neoformans and Cryptococcus gattii are well-studied basidiomyceteous yeasts that are capable of causing disease in healthy and immunocompromised people. The Conference on Cryptococcus and Cryptococcosis (ICCC) is held every three years: the accompanying Special Issue stems from the 9th ICCC and covers a subset of the topics related to these fungi in detail. This conference started with a revised and reduced estimate of disease burden globally, in part due to improved treatment for HIV(+) people. However, mortality from cryptococcosis remains consistently high for those unfortunate to have limited access to therapies or without underlying immunodeficiencies. As such, there are yet still great distances to be covered to address antifungal drug availability, the need for new antifungal agents and the timing and doses of these agents in conjunction with antiviral therapy, underscoring the importance of continued research. A notable point from the 9th ICCC was the research addressing the variation in the pathogen and host populations. Analysis of cryptococcal strain variability, particularly at the molecular level, has resolved distinct lineages with the consequence of a taxonomic revision that divides C. neoformans and C. gattii into seven Cryptococcus species. Similarly, analysis of host factors in so called "immune-competent" individuals revealed previously unrecognized risk factors. Research on these species has established them as important model organisms to understand gene evolution and function in other fungi and eukaryotes. The stage is set for the refinement of research directions, leading ultimately to better treatment of this monophyletic clade of pathogens in the genus Cryptococcus.

摘要

新型隐球菌和格特隐球菌是经过充分研究的担子菌酵母,能够在健康人群和免疫功能低下人群中引发疾病。隐球菌与隐球菌病会议(ICCC)每三年举办一次:随附的特刊源自第9届ICCC,详细涵盖了与这些真菌相关的部分主题。本次会议首先对全球疾病负担进行了修订和下调,部分原因是对HIV阳性人群的治疗有所改善。然而,对于那些不幸难以获得治疗或没有潜在免疫缺陷的人来说,隐球菌病的死亡率仍然居高不下。因此,在解决抗真菌药物的可及性、新型抗真菌药物的需求以及这些药物与抗病毒治疗联合使用的时机和剂量方面,仍有很长的路要走,这凸显了持续研究的重要性。第9届ICCC的一个显著亮点是针对病原体和宿主群体变异的研究。对隐球菌菌株变异性的分析,尤其是在分子水平上的分析,确定了不同的谱系,结果导致了一次分类学修订,将新型隐球菌和格特隐球菌分为七个隐球菌物种。同样,对所谓“免疫功能正常”个体中的宿主因素分析揭示了以前未被认识到的风险因素。对这些物种的研究已将它们确立为理解其他真菌和真核生物中基因进化和功能的重要模式生物。研究方向的细化已准备就绪,最终将更好地治疗隐球菌属中的这一单一病原体分支。

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