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The emerging fungal pathogen Cryptococcus gattii: Epidemiology, pathogenesis, immunomodulatory attributes, and drug susceptibility

Summary

Cryptococcus gattii is a dangerous fungal infection that can affect even healthy people, unlike most fungal infections that target those with weak immune systems. The fungus uses clever tricks to hide from the immune system, including creating protective capsules and producing melanin. Current antifungal drugs like fluconazole are becoming less effective as the fungus develops resistance, making this an urgent public health concern that requires better treatments and early detection.

Background

Cryptococcus gattii is an emerging fungal pathogen that causes life-threatening meningitis in both immunocompromised and immunocompetent individuals. While C. neoformans is predominantly associated with cryptococcosis in immunocompromised patients, C. gattii infections have increased globally with high mortality rates. The pathogen exhibits distinct epidemiological patterns, geographic distribution, and genotypes compared to C. neoformans.

Objective

This review comprehensively discusses the epidemiology, virulence factors, regulatory mechanisms, immunomodulatory attributes, and drug susceptibility of C. gattii. The aim is to enhance understanding of this emerging fungal pathogen and contribute to development of more effective prevention and management strategies.

Results

The review identifies that C. gattii predominantly affects immunocompetent individuals with VGI and VGII genotypes being most common in non-AIDS patients. Key virulence factors include polysaccharide capsule, melanin production, biofilm formation, titan cells, and extracellular vesicles. C. gattii shows distinct immunomodulatory strategies and exhibits lower susceptibility to azole antifungals compared to C. neoformans.

Conclusion

C. gattii represents a serious public health threat requiring comprehensive understanding of its pathogenic mechanisms. Establishment of international collaborative networks integrating ecology, epidemiology, molecular biology, and clinical practices is imperative. Development of C. gattii-specific antifungal drug trials and refined diagnostic approaches are essential for improved patient outcomes.
  • Published in:PLoS Neglected Tropical Diseases,
  • Study Type:Review,
  • Source: PMID: 40608829, DOI: 10.1371/journal.pntd.0013245
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