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Frontiers in Cellular and Infection... 2020and are related thermally dimorphic fungal pathogens that cause deadly mycoses (i.e., histoplasmosis and paracoccidioidomycosis, respectively) primarily in North,... (Review)
Review
and are related thermally dimorphic fungal pathogens that cause deadly mycoses (i.e., histoplasmosis and paracoccidioidomycosis, respectively) primarily in North, Central, and South America. Mammalian infection results from inhalation of conidia and their subsequent conversion into pathogenic yeasts. Macrophages in the lung are the first line of defense, but are generally unable to clear these fungi. Instead, and yeasts survive and proliferate within the phagosomal compartment of host macrophages. Growth within macrophages requires strategies for acquisition of sufficient nutrients (e.g., carbon, nitrogen, and essential trace elements and co-factors) from the nutrient-depleted phagosomal environment. We review the transcriptomic and recent functional genetic studies that are defining how these intracellular fungal pathogens tune their metabolism to the resources available in the macrophage phagosome. In addition, recent studies have shown that the nutritional state of the macrophage phagosome is not static, but changes upon activation of adaptive immune responses. Understanding the metabolic requirements of these dimorphic pathogens as they thrive within host cells can provide novel targets for therapeutic intervention.
Topics: Animals; Histoplasma; Histoplasmosis; Macrophages; Paracoccidioides; Paracoccidioidomycosis
PubMed: 33178634
DOI: 10.3389/fcimb.2020.592259 -
Mycopathologia 2008This review provides the background for understanding the role of a battery of diagnostic methods in paracoccidioidomycosis (PCM). This systemic mycosis is a disease... (Review)
Review
This review provides the background for understanding the role of a battery of diagnostic methods in paracoccidioidomycosis (PCM). This systemic mycosis is a disease endemic in many regions of Latin America, with sporadic cases also occurring throughout the world (mycosis of importation). Although excellent laboratory methods for diagnosis are available, there are deficiencies that must be met by continued research. Understanding the uses and limitations of a battery of laboratory methods is essential to diagnose PCM. Clinicians and laboratory directors must be familiar with the uses and limitations of a battery of serologic and mycological tests to accurately diagnose of PCM. Antibody and antigen detections are valuable adjuncts to histopathology and culture. More recently, the gp43 and gp70 antigen detection assay have improved the methodology of diagnosis of this mycosis, which improves reproducibility and facilitates monitoring antigen clearance during antifungal treatment. Furthermore, detection of antigen in cerebrospinal fluid and in bronchoalveolar lavage fluid increases the sensitivity for diagnosis of PCM in central nervous system and in pulmonary infections, respectively.
Topics: Adult; Aged; Antibodies, Fungal; Antigens, Fungal; Bronchoalveolar Lavage Fluid; Fungal Proteins; Glycoproteins; Humans; Middle Aged; Paracoccidioides; Paracoccidioidomycosis; Serologic Tests
PubMed: 18777635
DOI: 10.1007/s11046-007-9060-5 -
Clinical Microbiology Reviews Apr 2011Paracoccidioidomycosis, one of the most important endemic and systemic mycoses in Latin America, presents several clinical pictures. Epidemiological studies indicate a... (Review)
Review
Paracoccidioidomycosis, one of the most important endemic and systemic mycoses in Latin America, presents several clinical pictures. Epidemiological studies indicate a striking rarity of disease (but not infection) in females, but only during the reproductive years. This suggested a hormonal interaction between female hormones and the etiologic dimorphic fungus Paracoccidioides brasiliensis. Many fungi have been shown to use hormonal (pheromonal) fungal molecules for intercellular communication, and there are increasing numbers of examples of interactions between mammalian hormones and fungi, including the specific binding of mammalian hormones by fungal proteins, and suggestions of mammalian hormonal modulation of fungal behavior. This suggests an evolutionary conservation of hormonal receptor systems. We recount studies showing the specific hormonal binding of mammalian estrogen to proteins in P. brasiliensis and an action of estrogen to specifically block the transition from the saprophytic form to the invasive form of the fungus in vitro. This block has been demonstrated to occur in vivo in animal studies. These unique observations are consistent with an estrogen-fungus receptor-mediated effect on pathogenesis. The fungal genes responsive to estrogen action are under study.
Topics: Estrogens; Female; Humans; Immunity, Innate; Latin America; Paracoccidioides; Paracoccidioidomycosis; Pheromones; Sex Factors; Signal Transduction
PubMed: 21482727
DOI: 10.1128/CMR.00062-10 -
The American Journal of Tropical... Sep 2015
Topics: Aged; Colombia; Dermatomycoses; Humans; Male; Paracoccidioides; Paracoccidioidomycosis; Skin
PubMed: 26333727
DOI: 10.4269/ajtmh.15-0062 -
Jornal Brasileiro de Pneumologia :... 2010
Topics: Carcinoma, Bronchogenic; Female; Humans; Lung Neoplasms; Male; Paracoccidioidomycosis
PubMed: 21085834
DOI: 10.1590/s1806-37132010000500020 -
Clinical Microbiology Reviews Apr 1993This review summarizes knowledge on various aspects of paracoccidioidomycosis. Mycelial propagules, chlamydospores, and arthroconidia exhibit thermal dimorphism;... (Review)
Review
This review summarizes knowledge on various aspects of paracoccidioidomycosis. Mycelial propagules, chlamydospores, and arthroconidia exhibit thermal dimorphism; arthroconidia are infectious in animals and, by electron microscopy, appear well provided for survival. The mycelial-to-yeast-phase transformation requires a strict control of glucan synthesis probably mediated by membrane enzymes. Hormonal influences on the transformation of the fungus (mycelium or conidium to yeast phase) have been demonstrated. Estrogen-binding proteins have been detected in the fungal cytosol, and during the transformation novel proteins are produced as a result of estradiol incorporation. Clinical forms have been better defined on the basis of better experimental models. Emphasis has been placed on the lungs as the portal of entry and on the existence of silent pulmonary infections. A specific Paracoccidioides brasiliensis antigen, the 43-kDa glycoprotein (Gp43), has been identified, characterized, and cloned. This has led to improved reproducibility and specificity of serologic tests. The depression of cell-mediated immune responses has been associated with severe disease in humans and in the experimental host. T-cell subsets in patients' tissues were characterized by means of monoclonal antibodies, and a reduced CD4/CD8 ratio was demonstrated. This has been related to alterations in lymphokine and tumor necrosis factor production, production of antigen-antibody complexes, etc. Amphotericin B has provided effective therapy. Azole derivatives have also improved prognosis and facilitated therapy. Itraconazole is presently the drug of choice, yet incapacitating sequelae (mainly pulmonary fibrosis) still constitute major problems.
Topics: Adult; Animals; Antifungal Agents; Disease Models, Animal; Female; Humans; Immunity, Cellular; Male; Middle Aged; Paracoccidioides; Paracoccidioidomycosis; Sulfonamides; Virulence
PubMed: 8472249
DOI: 10.1128/CMR.6.2.89 -
The Cochrane Database of Systematic... Apr 2006Paracoccidioidomycosis is a fungal infection found in particular geographic localities in Latin America. Treatment can last for up to two years is often associated with... (Review)
Review
BACKGROUND
Paracoccidioidomycosis is a fungal infection found in particular geographic localities in Latin America. Treatment can last for up to two years is often associated with complications, including relapse, but people may die without it.
OBJECTIVES
To evaluate drugs used for treating paracoccidioidomycosis.
SEARCH STRATEGY
We searched the Cochrane Infectious Diseases Group Specialized Register (January 2006), CENTRAL (The Cochrane Library 2005, Issue 4), PubMed (1966 to January 2006), EMBASE (1974 to January 2006), LILACS (1982 to January 2006), conference proceedings, and reference lists. We also contacted researchers and pharmaceutical companies.
SELECTION CRITERIA
Randomized controlled trials comparing drugs for treating people with paracoccidioidomycosis.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed trial eligibility and methodological quality, and extracted data, including adverse events.
MAIN RESULTS
One trial with 42 participants met the inclusion criteria that compared imidazoles (itraconazole and ketoconazole) with sulfadiazine. No difference was detected for cure or clinical improvement, or serological titres after 10 months of treatment, and there was no difference detected in adverse events.
AUTHORS' CONCLUSIONS
The small number of participants and the short follow-up period impede definitive conclusions.
Topics: Antifungal Agents; Humans; Itraconazole; Ketoconazole; Paracoccidioidomycosis; Randomized Controlled Trials as Topic; Sulfadiazine
PubMed: 16625617
DOI: 10.1002/14651858.CD004967.pub2 -
The Brazilian Journal of Infectious... 2021Paracoccidioidomycosis is a systemic mycosis considered endemic and limited to Latin America with the majority of registered cases originating from Brazil. The purpose...
BACKGROUND
Paracoccidioidomycosis is a systemic mycosis considered endemic and limited to Latin America with the majority of registered cases originating from Brazil. The purpose of this paper was to report a case of a female patient with paracoccidioidomycosis mimicking inflammatory bowel disease and to systematically review available cases of the intestinal presentation of this infectious disease.
CASE REPORT
Female patient, 32-years old, previously asymptomatic, presenting with acute pain in the lower right abdomen, associated with signs of peritoneal irritation and abdominal distension. Urgent surgery was performed, which identified a severe suppurative perforated ileitis. The anatomopathological study revealed fungal structures shaped as a ship's pilot wheel in Grocott-Gomori's staining, suggestive of Paracoccidioides spp.
METHODS
Studies were retrieved based on Medical Subject Headings and Health Sciences Descriptors, which were combined using Boolean operators. Searches were run on the electronic databases Scopus, Web of Science, MEDLINE (PubMed), BIREME (Biblioteca Regional de Medicina), LILACS (Latin American and Caribbean Health Sciences Literature), SciELO (Scientific Electronic Library Online), Embase, and Opengray.eu. Languages were restricted to English, Spanish and Portuguese. There was no date of publication restrictions. The reference lists of the studies retrieved were searched manually. Simple descriptive analysis was used to summarize the results.
RESULTS
Our search strategy retrieved 581 references. In the final analysis, 34 references were included, with a total of 46 case reports. The most common clinical finding was abdominal pain and weight loss present in 31 (67.3%) patients. Most patients were treated with itraconazole (41.3%) and amphotericin B (36.9%). All-cause mortality was 12.8%.
CONCLUSIONS
Paracoccidioidomycosis should be suspected in endemics areas, specially as a differential diagnosis for inflammatory bowel disease. Endoscopic tests and biopsy are useful for diagnosis and treatment with antifungal drugs seem to be the first treatment option to achieve a significant success rate.
Topics: Adult; Amphotericin B; Antifungal Agents; Female; Humans; Itraconazole; Paracoccidioides; Paracoccidioidomycosis
PubMed: 34461048
DOI: 10.1016/j.bjid.2021.101605 -
Revista Da Sociedade Brasileira de... Oct 2011
Topics: Adult; Amphotericin B; Antifungal Agents; Brain Diseases; Central Nervous System Fungal Infections; Female; Humans; Paracoccidioidomycosis; Tomography, X-Ray Computed
PubMed: 22031091
DOI: 10.1590/s0037-86822011000500031 -
Archives of Iranian Medicine Mar 2022
Topics: Carcinoma; Diagnosis, Differential; Eyelid Neoplasms; Humans; Paracoccidioidomycosis; Skin Neoplasms
PubMed: 35429963
DOI: 10.34172/aim.2022.33