Recent Advances in Fungal Infections: From Lung Ecology to Therapeutic Strategies With a Focus on Aspergillus spp.

Abstract

Fungal infections are estimated to be the main cause of death for more than 1.5 million people worldwide annually. However, fungal pathogenicity has been largely neglected. This is notably the case for pulmonary fungal infections, which are difficult to diagnose and to treat. We are currently facing a global emergence of antifungal resistance, which decreases the chances of survival for affected patients. New therapeutic approaches are therefore needed to face these life-threatening fungal infections. In this review, we will provide a general overview on respiratory fungal infections, with a focus on fungi of the genus Aspergillus. Next, the immunological and microbiological mechanisms of fungal pathogenesis will be discussed. The role of the respiratory mycobiota and its interactions with the bacterial microbiota on lung fungal infections will be presented from an ecological perspective. Finally, we will focus on existing and future innovative approaches for the treatment of respiratory fungal infections.

Carbon Nanotube Hybrid Materials: Efficient and Pertinent Platforms for Antifungal Drug Delivery

“…Although ≈1.5 million people die yearly due to fungal infections (predominantly associated with Candida, Cryptococcus, and Aspergillus species), modern researchers routinely disregard fungus pathogenicity. [3,[26][27][28] Thousands of instances of mucormycosis (predominantly caused by Mucor, Apophysomyces, Lichtheimia, and Rhizopus species) have recently been identified, most in India among 18 countries throughout the COVID-19 second wave, boosting awareness of this lethal but ignored infection. [28,29] Mycobiota and polymycobiota conditions have been linked to morbidities and co-morbidities, which can alter immunity and make the patient immunocompromised.…”

Editorial to ‘A score for predicting invasive pulmonary aspergillosis in immunocompetent critically ill patients’

“…This progression can result in the development of IPA. 6 Recent evidence has shown that IPA is a significant contributor to morbidity and mortality also among nonimmunosuppressed patients in intensive care units (ICU). An overall incidence of 0.3%-19% of IPA has been reported in ICU patients and a high proportion of these patients lacked the classical risk factors.…”

“…Within 4–5 h of entry into the lungs, conidia undergo swelling and germination, leading to the formation of hyphae within 12–15 h of entering the lungs. This progression can result in the development of IPA 6 …”

Clinical Aspergillus Signatures in COPD and Bronchiectasis

“…In the immune hyperreactive state, it induces sensitization responses, such as that seen in severe asthma with fungal sensitization (SAFS) or allergic bronchopulmonary mycoses (ABPM), resulting in high symptomatic burden and poor disease control [ 13 ]. With accompanying immune dysfunction, fungi may manifest acute, chronic, and/or invasive infection phenotypes that lead to high mortality [ 14 , 15 ]. The average person breathes 22,000 times a day, inhaling approximately 11,000 L of air.…”