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Cryptococcosis: epidemiology, fungal resistance, and new alternatives for treatment

F P Gullo1, S A Rossi, J de C O Sardi

  • 1Faculty of Pharmaceutical Sciences of Araraquara, Department of Clinical Analysis, Laboratory of Clinical Mycology, Universidade Estadual Paulista (UNESP), R. Expedicionários do Brasil, 1621, 14801-902, Araraquara, São Paulo, Brazil.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|October 22, 2013
PubMed

Insights

Cryptococcosis, a fungal infection common in individuals with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), shows increasing antifungal resistance. Research is exploring novel plant-derived peptide nanoparticles as alternative treatments.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Cryptococcosis is a significant systemic mycosis, particularly prevalent in individuals with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS).
  • Cryptococcal meningitis affects approximately one million AIDS patients globally each year.
  • Emerging fungal species like *C. laurentii* and *C. albidus* are increasingly diagnosed in immunocompromised patients and animals, respectively.

Purpose of the Study:

  • To review the epidemiology of cryptococcosis.
  • To discuss the mechanisms of antifungal resistance in *Cryptococcus* species.
  • To explore novel therapeutic alternatives for cryptococcosis.

Main Methods:

  • Literature review of epidemiological data on cryptococcosis.
  • Analysis of mechanisms of azole resistance in *Cryptococcus neoformans*, including gene mutations and overexpression.
  • Investigation of biofilm-related antifungal resistance.
  • Review of emerging alternative antifungal agents, focusing on plant peptide-origin nanoparticles.

Main Results:

  • Antifungal resistance in *Cryptococcus* is linked to alterations in the *ERG11* gene and heteroresistance phenotypes in *C. gattii* and *C. neoformans*.
  • Biofilm formation is associated with increased resistance to antifungal agents in various *Cryptococcus* species.
  • Other *Cryptococcus* species beyond *C. neoformans* and *C. gattii* are implicated in infections, particularly in immunocompromised individuals.

Conclusions:

  • There is a critical need for alternative antifungal agents due to rising resistance in cryptococcosis.
  • Plant peptide-origin nanoparticles represent a promising avenue for developing new treatments against fungal infections.
  • Continued research into fungal resistance mechanisms and novel therapeutic strategies is essential for managing cryptococcosis effectively.

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