Cryptococcosis: update on therapeutics and new targets

Area of Science:

• Mycology
• Infectious Diseases
• Immunology

Background:

• Cryptococcus neoformans is a high-priority fungal pathogen causing life-threatening meningoencephalitis.
• Despite antifungal therapy, cryptococcosis has high mortality and morbidity rates.

Purpose of the Study:

• To review recent developments in antifungal therapy for cryptococcosis.
• To synthesize these advances with a better understanding of cryptococcosis pathophysiology.

Main Methods:

• Review of recent literature on antifungal therapy for cryptococcosis.
• Synthesis of therapeutic advances and understanding of disease mechanisms.

Main Results:

• Therapeutic outcomes for cryptococcosis are improving but remain suboptimal.
• Advances include optimizing existing antifungal drugs, intracerebral management, and early diagnosis.
• Recognition of immune responses contributing to damage has spurred research into immune modulators.

Conclusions:

• Optimizing current antifungal agents and clinical management may be reaching its limits.
• Transformative reductions in mortality and morbidity likely require novel antifungal agents and/or adjunctive immunotherapies.
• Promising new approaches are emerging for future clinical investigation.