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Current Opinion in Microbiology Dec 2020
Topics: Animals; Fungi; Host-Pathogen Interactions; Humans; Mycoses
PubMed: 33328087
DOI: 10.1016/j.mib.2020.11.007 -
BMC Infectious Diseases Oct 2023As current trend for physician tools, ChatGPT can sift through massive amounts of information and solve problems through easy-to-understand conversations, ultimately...
As current trend for physician tools, ChatGPT can sift through massive amounts of information and solve problems through easy-to-understand conversations, ultimately improving efficiency. Mycosis is currently facing great challenges, including high fungal burdens, high mortality, limited choice of antifungal drugs and increasing drug resistance. To address these challenges, We asked ChatGPT for fungal infection scenario-based questions and assessed its appropriateness, consistency, and potential pitfalls. We concluded ChatGPT can provide compelling responses to most prompts, including diagnosis, recommendations for examination, treatment and rational drug use. Moreover, we summarized exciting future applications in mycosis, such as clinical work, scientific research, education and healthcare. However, the largest barriers to implementation are deficits in indiviudal advice, timely literature updates, consistency, accuracy and data safety. To fully embrace the opportunity, we need to address these barriers and manage the risks. We expect that ChatGPT will become a new weapon in in the battlefield of mycosis.
Topics: Humans; Mycoses; Antifungal Agents; Communication; Educational Status; Health Facilities
PubMed: 37891532
DOI: 10.1186/s12879-023-08724-9 -
Future Microbiology Nov 2022Drugs used to fight fungal infections may cause toxic or adverse drug interactions. For this reason, there is an increase in the development of natural, semisynthetic... (Review)
Review
Drugs used to fight fungal infections may cause toxic or adverse drug interactions. For this reason, there is an increase in the development of natural, semisynthetic and synthetic antifungal peptides. This study aimed to perform a patent review to identify the advances in peptides to treat fungal infections. In a preliminary assessment, 597 patents were identified from the database. Then, duplicated patents (62) and those with titles in disagreement with the scope of this review (196) were excluded. Then, six patents were not in English or Spanish. Following the screening, 288 patents were outside the focus of this review, according to their abstract and description. The final selection covered 45 patents.
Topics: Humans; Antifungal Agents; Mycoses; Peptides
PubMed: 36169343
DOI: 10.2217/fmb-2022-0105 -
Current Opinion in Microbiology Dec 2020Immune cells, including macrophages and monocytes, remodel their metabolism and have specific nutritional needs when dealing with microbial pathogens. While we are just... (Review)
Review
Immune cells, including macrophages and monocytes, remodel their metabolism and have specific nutritional needs when dealing with microbial pathogens. While we are just beginning to understand immunometabolism in fungal infections, emerging themes include recognition of fungal cell surface molecule driving metabolic remodelling to increase glycolysis, the critical role of glycolysis in the production of antifungal cytokines and fungicidal effector molecules, and the need for maintaining host glucose homeostasis to defeat fungal infections. A crosstalk between host and pathogen metabolic pathways determines the fate of immune cells and fungi when they interact. Thus, immunometabolic interactions offer potential for innovation in antifungal treatments in the future. For this to become a reality, we must decipher the mechanisms by which diverse fungal pathogens activate and manipulate immunometabolism.
Topics: Animals; Cytokines; Fungi; Glycolysis; Humans; Macrophages; Mycoses
PubMed: 32781324
DOI: 10.1016/j.mib.2020.07.001 -
Current Opinion in Pulmonary Medicine May 2023The burden of invasive fungal infection is increasing worldwide, largely due to a growing population at-risk. Most serious human fungal pathogens enter the host via the... (Review)
Review
PURPOSE OF REVIEW
The burden of invasive fungal infection is increasing worldwide, largely due to a growing population at-risk. Most serious human fungal pathogens enter the host via the respiratory tract. Early identification and treatment of invasive fungal respiratory infections (IFRIs) in the immunocompromised host saves lives. However, their accurate diagnosis is a difficult challenge for clinicians and mortality remains high.
RECENT FINDINGS
This article reviews IFRIs, focussing on host susceptibility factors, clinical presentation, and mycological diagnosis. Several new diagnostic tools are coming of age including molecular diagnostics and point-of-care antigen tests. As diagnosis of IFRI relies heavily on invasive procedures like bronchoalveolar lavage and lung biopsy, several novel noninvasive diagnostic techniques are in development, such as metagenomics, 'volatilomics' and advanced imaging technologies.
SUMMARY
Where IFRI cannot be proven, clinicians must employ a 'weights-of-evidence' approach to evaluate host factors, clinical and mycological data. Implementation studies are needed to understand how new diagnostic tools can be best applied within clinical pathways. Differentiating invasive infection from colonization and identifying antifungal resistance remain key challenges. As our diagnostic arsenal expands, centralized clinical mycology laboratories and efforts to ensure access to new diagnostics in low-resource settings will become increasingly important.
Topics: Humans; Biopsy; Immunocompromised Host; Invasive Fungal Infections; Mycoses; Respiratory Tract Infections; Bronchoalveolar Lavage; Bronchoalveolar Lavage Fluid; Lung
PubMed: 36917216
DOI: 10.1097/MCP.0000000000000955 -
Transplantation Dec 2021Lung transplantation is an important treatment option for various end-stage lung diseases. However, survival remains limited due to graft rejection and infections.... (Review)
Review
BACKGROUND
Lung transplantation is an important treatment option for various end-stage lung diseases. However, survival remains limited due to graft rejection and infections. Despite that fungal infections are frequent and carry a bad prognosis, there is currently no consensus on efficacy, optimal drug, route, or duration of antifungal prophylaxis. This narrative review summarizes current strategies for antifungal prophylaxis after lung transplantation.
METHODS
English language articles in Embase, Pubmed, UptoDate, and bibliographies were used to assess the efficacy and safety of available antifungal agents for prophylaxis in adult lung transplant recipients.
RESULTS
Overall, there are limited high-quality data. Universal prophylaxis is more widely used and may be preferable over targeted prophylaxis. Both formulations of inhaled amphotericin B and systemic azoles are effective at reducing fungal infection rates, yet with their own specific advantages and disadvantages. The benefit of combination regimens has yet to be proven. Considering the post-transplant timing of the onset of fungal infections, postoperative prophylaxis during the first postoperative months seems indicated for most patients.
CONCLUSIONS
Based on existing literature, universal antifungal prophylaxis with inhaled amphotericin B and systemic voriconazole for at least 3-6 mo after lung transplantation may be advisable, with a slight preference for amphotericin B because of its better safety profile.
Topics: Adult; Antifungal Agents; Humans; Lung Transplantation; Mycoses; Transplant Recipients; Voriconazole
PubMed: 33982907
DOI: 10.1097/TP.0000000000003717 -
Current Opinion in Infectious Diseases Apr 2020This review aims to update on recent findings about epidemiology, risk factors and therapeutic options for fungi causing skin and soft tissue infections. The latest data... (Review)
Review
PURPOSE OF REVIEW
This review aims to update on recent findings about epidemiology, risk factors and therapeutic options for fungi causing skin and soft tissue infections. The latest data on emerging antifungal resistance are also discussed.
RECENT FINDINGS
In parallel with increased use of immunosuppression, the incidence of fungal infections is also on rise. This increase involves not only systemic infections but also infections with primary and secondary skin involvement. Antifungal resistance has become a major issue and covers several fungal pathogens including dermatophytes, Candida spp. and, Aspergillus fumigatus. Multidisciplinary usage of newly targeted, immunomodulatory therapies may predispose patients to have fungal infections through mimicking an immunosuppressed status caused by genetic factors or the disease itself. Nonimmunosupressed patients, although less frequently than those with immunosuppression may also be vulnerable.
SUMMARY
Physicians should be aware about skin and soft tissue findings related with systemic or locally occuring mycosis. Emerging antifungal resistance may hamper the success of the treatment. Antifungal susceptibility testing is advisable wherever available and particularly when a disseminated fungal infection is present.
Topics: Antifungal Agents; Dermatomycoses; Drug Resistance, Fungal; Humans; Mycoses; Soft Tissue Infections
PubMed: 31990815
DOI: 10.1097/QCO.0000000000000630 -
Frontiers in Immunology 2022
Topics: Humans; Immunologic Memory; Lung Diseases, Fungal; Mycoses; Vaccine Development
PubMed: 35572566
DOI: 10.3389/fimmu.2022.880037 -
Annual Review of Microbiology Oct 2021Ancient enzootic associations between wildlife and their infections allow evolution to innovate mechanisms of pathogenicity that are counterbalanced by host responses.... (Review)
Review
Ancient enzootic associations between wildlife and their infections allow evolution to innovate mechanisms of pathogenicity that are counterbalanced by host responses. However, erosion of barriers to pathogen dispersal by globalization leads to the infection of hosts that have not evolved effective resistance and the emergence of highly virulent infections. Global amphibian declines driven by the rise of chytrid fungi and chytridiomycosis are emblematic of emerging infections. Here, we review how modern biological methods have been used to understand the adaptations and counteradaptations that these fungi and their amphibian hosts have evolved. We explore the interplay of biotic and abiotic factors that modify the virulence of these infections and dissect the complexity of this disease system. We highlight progress that has led to insights into how we might in the future lessen the impact of these emerging infections.
Topics: Amphibians; Animals; Chytridiomycota; Mycoses; Virulence
PubMed: 34351790
DOI: 10.1146/annurev-micro-052621-124212 -
Annals of the American Thoracic Society Oct 2021
Topics: Antifungal Agents; Humans; Mycoses
PubMed: 33901414
DOI: 10.1513/AnnalsATS.202104-445LE