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[Blood coagulation in domestic deep-seated mycoses]
Maria Ntefidou1, Christine Elsner, Annette Spreer
1St. Vincentius-Kliniken Karlsruhe, Germany.
Abstract:
Activation of blood coagulation to a varying extent affect the course of domestic invasive mycoses. Upon invasion of blood vessels by Candida or aspergilli, occasionally thrombi are formed, which may cause septic embolism. In the course of mucormycosis (syn. zygomycosis) thrombotic occlusion of afflicted blood vessels and subsequent necrosis of dependent tissue regularly occurs. Coagulation during candidosis or aspergillosis may be triggered by secreted aspartic proteinases which are able to activate factor X as has been shown previously [1, 2]. During mucormycosis, severe blood coagulation apparently is due to paracoagulation of fibrinogen which is triggered by low concentrations of extracellular fungal subtilisin-like proteinase (Arp). The enzyme is also able to inactivate the major inhibitor of blood coagulation (antithrombin III). Recent findings on the action of Arp are discussed.
Insights
Invasive fungal infections can activate blood coagulation, leading to thrombi and tissue damage. A fungal enzyme, subtilisin-like proteinase (Arp), triggers severe coagulation in mucormycosis by affecting fibrinogen and antithrombin III.
Area of Science:
- Medical Mycology
- Hematology
- Biochemistry
Context:
- Invasive fungal infections, such as candidosis, aspergillosis, and mucormycosis, can significantly impact blood coagulation.
- Thrombus formation and septic embolism are observed during vascular invasion by Candida and aspergilli.
- Mucormycosis is characterized by regular thrombotic occlusion and tissue necrosis.
Purpose:
- To elucidate the mechanisms by which fungal pathogens activate blood coagulation.
- To investigate the role of fungal proteinases in coagulation disorders during mycoses.
- To discuss recent findings on the action of fungal subtilisin-like proteinase (Arp) in mucormycosis.
Summary:
- Fungal secreted aspartic proteinases can activate factor X in candidosis and aspergillosis.
- In mucormycosis, extracellular fungal subtilisin-like proteinase (Arp) causes severe coagulation via fibrinogen paracoagulation.
- Arp also inactivates antithrombin III, a key inhibitor of blood coagulation.
Impact:
- Understanding these fungal-induced coagulation pathways is crucial for managing invasive mycoses.
- This research highlights potential therapeutic targets for preventing thrombotic complications in fungal infections.
- The findings contribute to the knowledge of host-pathogen interactions in life-threatening fungal diseases.