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Updated: May 8, 2025
Histological Quantification to Determine Lung Fungal Burden in Experimental Aspergillosis
Published on: March 9, 2018
Aspergillus fumigatus biology, immunopathogenicity and drug resistance
Frank L van de Veerdonk1,2, Agostinho Carvalho3,4, Joost Wauters5
1Department of Internal Medicine, Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands. frank.vandeveerdonk@radboudumc.nl.
Abstract:
Aspergillus fumigatus is a saprophytic fungus prevalent in the environment and capable of causing severe invasive infection in humans. This organism can use strategies such as molecule masking, immune response manipulation and gene expression alteration to evade host defences. Understanding these mechanisms is essential for developing effective diagnostics and therapies to improve patient outcomes in Aspergillus-related diseases. In this Review, we explore the biology and pathogenesis of A. fumigatus in the context of host biology and disease, highlighting virus-associated pulmonary aspergillosis, a newly identified condition that arises in patients with severe pulmonary viral infections. In the post-pandemic landscape, in which immunotherapy is gaining attention for managing severe infections, we examine the host immune responses that are critical for controlling invasive aspergillosis and how A. fumigatus circumvents these defences. Additionally, we address the emerging issue of azole resistance in A. fumigatus, emphasizing the urgent need for greater understanding in an era marked by increasing antimicrobial resistance. This Review provides timely insights necessary for developing new immunotherapeutic strategies against invasive aspergillosis.
Insights
Aspergillus fumigatus evades immune defenses using various strategies. This review explores its biology, pathogenesis, and azole resistance, crucial for developing new immunotherapies against invasive aspergillosis.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Immunology
Background:
- Aspergillus fumigatus is a common environmental fungus causing severe human infections.
- It employs immune evasion strategies like molecule masking and immune response manipulation.
- Understanding these mechanisms is vital for treating Aspergillus-related diseases.
Purpose of the Study:
- To review the biology and pathogenesis of Aspergillus fumigatus.
- To highlight virus-associated pulmonary aspergillosis.
- To examine host immune responses and fungal evasion tactics, and address azole resistance.
Main Methods:
- Literature review of Aspergillus fumigatus biology, pathogenesis, and host-pathogen interactions.
- Analysis of immune evasion mechanisms employed by the fungus.
- Discussion of emerging challenges like virus-associated aspergillosis and azole resistance.
Main Results:
- Aspergillus fumigatus utilizes diverse strategies to evade host immunity.
- Virus-associated pulmonary aspergillosis is a newly identified condition in immunocompromised patients.
- Azole resistance in Aspergillus fumigatus is a growing concern.
Conclusions:
- A comprehensive understanding of Aspergillus fumigatus pathogenesis and host immune responses is essential.
- New immunotherapeutic strategies are needed to combat invasive aspergillosis, especially in light of antimicrobial resistance.
- Addressing azole resistance and understanding virus-associated aspergillosis are critical for improving patient outcomes.
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