[Pathogenesis and morphogenesis of candidiasis in immunosuppression]

Area of Science:

• Mycology
• Immunology
• Pathology

Background:

• Candidiasis is a significant opportunistic infection, particularly in immunocompromised individuals.
• Candida albicans has historically been the primary pathogen, but other species are emerging.
• Immunosuppression (IS) profoundly alters the host-pathogen interaction in candidiasis.

Purpose of the Study:

• To review the specific etiological, pathogenetic, and morphogenetic aspects of candidiasis in the context of immunosuppression.
• To highlight the changing landscape of Candida species involved in opportunistic infections.
• To elucidate the impact of IS on the sequential stages of candidiasis development.

Main Methods:

• Literature review of studies on candidiasis in immunosuppressed patients.
• Analysis of etiological factors, pathogenesis, and morphogenesis.
• Sequential analysis of clinical course and pathomorphogenetic stages.

Main Results:

• Non-albicans Candida species are increasingly implicated in mycotic complications of IS.
• Immunosuppression affects all pathomorphogenetic stages of candidiasis.
• IS influences fungal adherence, tissue invasion, hematogenous spread, and secondary lesion formation.
• Host responses, including histo- and organ pathology, are significantly altered by IS.

Conclusions:

• The etiology of candidiasis in IS is evolving, with a greater role for less pathogenic Candida species.
• Immunosuppression fundamentally alters the pathogenesis and progression of candidiasis.
• Understanding these IS-driven changes is crucial for managing candidiasis in vulnerable populations.