RadboudUMC-CWZ Centre of Expertise for Mycology, 6525GA Nijmegen, The Netherlands.
Foundation Atlas of Clinical Fungi, 1214GP Hilversum, The Netherlands.
FEMS Microbiol Rev. 2024 Sep 18;48(5). doi: 10.1093/femsre/fuae022.
Fungal primary pathogenicity on vertebrates is here described as a deliberate strategy where the host plays a role in increasing the species' fitness. Opportunism is defined as the coincidental survival of an individual strain in host tissue using properties that are designed for life in an entirely different habitat. In that case, the host's infection control is largely based on innate immunity, and the etiologic agent is not transmitted after infection, and thus fungal evolution is not possible. Primary pathogens encompass two types, depending on their mode of transmission. Environmental pathogens have a double life cycle, and tend to become enzootic, adapted to a preferred host in a particular habitat. In contrast, pathogens that have a host-to-host transmission pattern are prone to shift to a neighboring, immunologically naive host, potentially leading to epidemics. Beyond these prototypical life cycles, some environmental fungi are able to make large leaps between dissimilar hosts/habitats, probably due to the similarity of key factors enabling survival in an entirely different niche, and thus allowing a change from opportunistic to primary pathogenicity. Mostly, such factors seem to be associated with extremotolerance.
这里将脊椎动物上的真菌原发性致病性描述为一种蓄意策略,宿主在其中起到增加物种适应性的作用。机会主义是指个体菌株在宿主组织中偶然存活,利用的是专为完全不同生境设计的特性。在这种情况下,宿主的感染控制主要基于先天免疫,并且感染后不会传播病原体,因此真菌进化是不可能的。原发性病原体包括两种类型,具体取决于其传播方式。环境病原体具有双重生命周期,往往会成为地方性病原体,适应特定栖息地中的特定优势宿主。相比之下,具有宿主间传播模式的病原体更容易转移到邻近的、免疫幼稚的宿主,从而可能导致流行。除了这些典型的生命周期之外,一些环境真菌能够在不同的宿主/生境之间进行大规模跨越,这可能是由于在完全不同的小生境中生存的关键因素相似,从而允许从机会性病原体转变为原发性病原体。这种情况主要与极端耐受有关。