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The dimorphic fungus Talaromyces marneffei: An opportunistic killer in Southeast Asia

Summary

Talaromyces marneffei is a dangerous fungus found in Southeast Asian soil that people inhale, causing a serious disease called talaromycosis. The fungus is particularly deadly for people with weakened immune systems like those with advanced HIV. The fungus has evolved clever tricks to hide from and manipulate the body’s immune system, allowing it to multiply inside immune cells called macrophages.

Background

Talaromyces marneffei is a dimorphic fungus causing talaromycosis, a life-threatening fungal disease and leading opportunistic infection in Southeast Asia. The disease is acquired through inhalation of fungal conidia from soil associated with bamboo rats. Despite significant disease burden of over 25,000 cases annually with mortality rates of 15-30%, talaromycosis remains a neglected disease.

Objective

This Pearls review summarizes current understanding of talaromycosis pathogenesis and highlights key research gaps. The authors aim to provide a comprehensive overview of thermal dimorphism as a virulence factor, immune evasion mechanisms, and both innate and adaptive immune responses to T. marneffei infection.

Results

The review identifies thermal dimorphism as a key virulence factor allowing the fungus to survive within macrophages. T. marneffei employs multiple immune evasion strategies including production of heat shock proteins, catalase peroxidase, melanin synthesis, and secretion of Mp1p galactomannan protein. Recent clinical evidence demonstrates that T. marneffei-specific IgG antibody responses are associated with better outcomes in advanced HIV disease patients.

Conclusion

Understanding T. marneffei pathogenesis requires further research into immune responses, melanin’s role in virulence, potential sexual reproduction cycles, and development of improved animal models. Future genetic and genomic studies will deepen knowledge of disease mechanisms and inform development of diagnostics, therapeutics, and vaccines for this neglected tropical disease.
  • Published in:PLoS Pathogen,
  • Study Type:Review,
  • Source: PMID: 40929107, DOI: 10.1371/journal.ppat.1013444
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