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Published on: February 27, 2018
Associations between Cryptococcus Genotypes, Phenotypes, and Clinical Parameters of Human Disease: A Review
Marhiah C Montoya1,2, Paul M Magwene3, John R Perfect1,2
1Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC 27710, USA.
Abstract:
The genus Cryptococcus contains two primary species complexes that are significant opportunistic human fungal pathogens: C. neoformans and C. gattii. In humans, cryptococcosis can manifest in many ways, but most often results in either pulmonary or central nervous system disease. Patients with cryptococcosis can display a variety of symptoms on a spectrum of severity because of the interaction between yeast and host. The bulk of our knowledge regarding Cryptococcus and the mechanisms of disease stem from in vitro experiments and in vivo animal models that make a fair attempt, but do not recapitulate the conditions inside the human host. To better understand the dynamics of initiation and progression in cryptococcal disease, it is important to study the genetic and phenotypic differences in the context of human infection to identify the human and fungal risk factors that contribute to pathogenesis and poor clinical outcomes. In this review, we summarize the current understanding of the different clinical presentations and health outcomes that are associated with pathogenicity and virulence of cryptococcal strains with respect to specific genotypes and phenotypes.
Insights
Cryptococcus neoformans and Cryptococcus gattii cause opportunistic infections. This review examines fungal genotypes and phenotypes linked to cryptococcosis severity and patient outcomes.
Area of Science:
- Mycology
- Infectious Diseases
- Human Pathogens
Background:
- The genus Cryptococcus includes two major opportunistic human fungal pathogens: C. neoformans and C. gattii.
- Cryptococcosis, a fungal infection, commonly affects the lungs or central nervous system.
- Current understanding of Cryptococcus pathogenesis largely relies on in vitro and animal models, which do not fully replicate the human host environment.
Purpose of the Study:
- To investigate the genetic and phenotypic variations within Cryptococcus species.
- To understand how these variations influence disease initiation and progression in humans.
- To identify human and fungal factors contributing to cryptococcal pathogenesis and adverse clinical outcomes.
Main Methods:
- Review of current scientific literature on Cryptococcus infections.
- Analysis of clinical presentations and health outcomes associated with Cryptococcus strains.
- Correlation of pathogenicity and virulence with specific fungal genotypes and phenotypes.
Main Results:
- Summary of diverse clinical manifestations of cryptococcosis.
- Discussion of varying disease severity based on host-pathogen interactions.
- Identification of links between specific Cryptococcus genotypes/phenotypes and clinical outcomes.
Conclusions:
- Understanding Cryptococcus genotype-phenotype-clinical outcome relationships is crucial for managing cryptococcosis.
- Further research is needed to bridge the gap between experimental models and human infection dynamics.
- Identifying specific risk factors can improve patient prognosis and therapeutic strategies.
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