Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo, 777, São José dos Campos, São Paulo, 12245-000, Brazil.
Multicampi School of Medical Science, Federal University of Rio Grande Do Norte (UFRN), Rua Coronel Martiniano, 541, Caiacó, Rio Grande do Norte, 59300-000, Brazil.
Braz J Microbiol. 2022 Sep;53(3):1321-1337. doi: 10.1007/s42770-022-00744-y. Epub 2022 Apr 29.
Cryptococcosis is a global fungal infection caused by the Cryptococcus neoformans/Cryptococcus gattii yeast complex. This infection is acquired by inhalation of propagules such as basidiospores or dry yeast, initially causing lung infections with the possibility of progressing to the meninges. This infection mainly affects immunocompromised HIV and transplant patients; however, immunocompetent patients can also be affected. This review proposes to evaluate cryptococcosis focusing on studies of this mycosis in Brazilian territory; moreover, recent advances in the understanding of its virulence mechanism, animal models in research are also assessed. For this, literature review as realized in PubMed, Scielo, and Brazilian legislation. In Brazil, cryptococcosis has been identified as one of the most lethal fungal infections among HIV patients and C. neoformans VNI and C. gattii VGII are the most prevalent genotypes. Moreover, different clinical settings published in Brazil were described. As in other countries, cryptococcosis is difficult to treat due to a limited therapeutic arsenal, which is highly toxic and costly. The presence of a polysaccharide capsule, thermo-tolerance, production of melanin, biofilm formation, mechanisms for iron use, and morphological alterations is an important virulence mechanism of these yeasts. The introduction of cryptococcosis as a compulsory notification disease could improve data regarding incidence and help in the management of these infections.
隐球菌病是一种由新生隐球菌/格特隐球菌酵母复合体引起的全球性真菌感染。这种感染是通过吸入担子孢子或干燥酵母等繁殖体获得的，最初会导致肺部感染，并有进展为脑膜感染的可能。这种感染主要影响免疫功能低下的 HIV 和移植患者；然而，免疫功能正常的患者也可能受到影响。本综述旨在评估隐球菌病，重点关注巴西境内该真菌感染的研究；此外，还评估了对其毒力机制的最新理解以及研究中的动物模型。为此，在 PubMed、Scielo 和巴西法规中进行了文献回顾。在巴西，隐球菌病已被确定为 HIV 患者中最致命的真菌感染之一，新生隐球菌 VNI 和格特隐球菌 VGII 是最常见的基因型。此外，还描述了巴西发表的不同临床情况。与其他国家一样，由于治疗武器库有限，而且毒性大、成本高，隐球菌病的治疗难度很大。多糖荚膜的存在、耐热性、黑色素的产生、生物膜的形成、铁利用机制和形态改变是这些酵母的重要毒力机制。将隐球菌病作为强制性报告疾病引入，可能会改善关于发病率的数据，并有助于这些感染的管理。
