scholarly journals Reinforcing the Immunocompromised Host Defense against Fungi: Progress beyond the Current State of the Art

2021 ◽  
Vol 7 (6) ◽  
pp. 451
Author(s):  
Georgios Karavalakis ◽  
Evangelia Yannaki ◽  
Anastasia Papadopoulou
Keyword(s):  
Host Defense ◽  
Hematopoietic Cell Transplantation ◽  
State Of The Art ◽  
Fungal Infections ◽  
Solid Organ Transplantation ◽  
Immunocompromised Host ◽  
Antifungal Drugs ◽  
Solid Organ ◽  
Cell Immunotherapy ◽  
Life Threatening

Despite the availability of a variety of antifungal drugs, opportunistic fungal infections still remain life-threatening for immunocompromised patients, such as those undergoing allogeneic hematopoietic cell transplantation or solid organ transplantation. Suboptimal efficacy, toxicity, development of resistant variants and recurrent episodes are limitations associated with current antifungal drug therapy. Adjunctive immunotherapies reinforcing the host defense against fungi and aiding in clearance of opportunistic pathogens are continuously gaining ground in this battle. Here, we review alternative approaches for the management of fungal infections going beyond the state of the art and placing an emphasis on fungus-specific T cell immunotherapy. Harnessing the power of T cells in the form of adoptive immunotherapy represents the strenuous protagonist of the current immunotherapeutic approaches towards combating invasive fungal infections. The progress that has been made over the last years in this field and remaining challenges as well, will be discussed.

Rashes associated with transplantations

2020 ◽  
pp. 535-538
Keyword(s):  
Fungal Infections ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Host Immunity ◽  
Solid Organ ◽  
Graft Versus Host ◽  
Gingival Hypertrophy ◽  
Life Threatening ◽  
Transplant Complications

Dermatological manifestations following transplantation are common but important to recognize and diagnose since they may be severe and life-threatening if not adequately and promptly treated. This chapter provides a systematic overview of the types of skin disease that may be encountered in children that have received a haematological or solid organ transplant. Complications relating to immunosuppression include an increased susceptibility to bacterial, viral, and fungal infections which may be significantly more virulent and hazardous in the context of reduced host immunity. Immune suppressant drugs may also cause drug rashes and aesthetic complications such as acne, hypertrichosis, or gingival hypertrophy, as well as longer-term risks from the development of malignancy. It is also important to recognize the range of mucocutaneous signs of acute and chronic graft versus host disease following bone marrow and solid organ transplantation which, again, may be severe and associated with significant morbidity and mortality.

Bk Polyoma Virus Nephropathy In An Immunocompromised Host.

2020 ◽  
Vol 01 ◽  
Author(s):  
Faraz Khan ◽  
Maroun El Khoury ◽  
Fahad Kouli ◽  
Aaron Han
Keyword(s):  
Renal Transplant ◽  
Graft Failure ◽  
Renal Transplant Patient ◽  
Relevant Literature ◽  
Late Complication ◽  
Solid Organ Transplantation ◽  
Immunocompromised Host ◽  
Polyoma Virus ◽  
Solid Organ ◽  
Early Graft

Background: Post-transplant Lymphopoliferative disorders(PTLD) are a well known late complication after solid organ transplantation including renal transplant. Among others, graft failure due to reactivation of BK polyoma virus in the grafted kidney is also a well recognized complication but tends to present early in the first several months after transplant. Case: Here we present the case of PTLD Burkitt's lymphoma(BL-PTLD) in a renal transplant patient who was successfully treated with multiagent chemo-immunotherapy but later developed BK polyoma virus nephropathy(BKVN) with graft failure only after completion of her systemic therapy for lymphoma and 7 years after transplant. Relevant literature is reviewed. Conclusion: In this case, reactivation and progression of BKVN was most likely associated with immunosuppression from chemoimmunotherapy for her BL–PTLD unlike early graft failures associated with BKVN.

Amyloidosis

2013 ◽  
pp. 1397-1409
Author(s):  
Philip N. Hawkins
Keyword(s):  
Protein Misfolding ◽  
Solid Organ Transplantation ◽  
The Body ◽  
Solid Organ ◽  
Body Protein ◽  
Amyloid Deposits ◽  
Life Threatening ◽  
And Function ◽  
Protein Misfolding And Aggregation ◽  
The Brain

Amyloidosis is a disorder of protein folding in which normally soluble proteins are deposited in the interstitial space as insoluble and remarkably stable fibrils that progressively disrupt tissue structure and function of organs throughout the body. Protein misfolding and aggregation have increasingly been recognized in the pathogenesis of various other diseases, but amyloidosis—the disease directly caused by extracellular amyloid deposition—is a precise term with critical implications for patients with a specific group of life-threatening disorders. Amyloidosis may be acquired or hereditary and the pattern of organ involvement varies within and between types, though clinical phenotypes overlap greatly. Virtually any tissue other than the brain may be directly involved. Although histology remains the diagnostic gold standard, developments in scintigraphy and MRI technology often produce pathognomonic findings. Systemic amyloidosis is usually fatal, but the prognosis has improved as the result of increasingly effective treatments for many of the conditions that underlie it, notably the use of biologic anti-inflammatory agents in patients with AA amyloidosis and new immunomodulatory agents in patients with AL type. Better supportive care, including dialysis and solid organ transplantation, have also influenced the prognosis favourably. A range of specific novel therapies are currently in clinical development, including RNA inhibitors that suppress production of amyloid precursor proteins, drugs that promote their normal soluble conformation in the plasma, and immunotherapy approaches that directly target the amyloid deposits.

scholarly journals CandidaInfections, Causes, Targets, and Resistance Mechanisms: Traditional and Alternative Antifungal Agents

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Claudia Spampinato ◽  
Darío Leonardi
Keyword(s):  
Antifungal Agents ◽  
Fungal Infections ◽  
Current Knowledge ◽  
Resistance Mechanisms ◽  
Antifungal Drugs ◽  
Diagnostic Methods ◽  
Opportunistic Pathogens ◽  
Yeast Infection ◽  
Life Threatening ◽  
Therapeutic Alternatives

The genusCandidaincludes about 200 different species, but only a few species are human opportunistic pathogens and cause infections when the host becomes debilitated or immunocompromised.Candidainfections can be superficial or invasive. Superficial infections often affect the skin or mucous membranes and can be treated successfully with topical antifungal drugs. However, invasive fungal infections are often life-threatening, probably due to inefficient diagnostic methods and inappropriate initial antifungal therapies. Here, we briefly review our current knowledge of pathogenic species of the genusCandidaand yeast infection causes and then focus on current antifungal drugs and resistance mechanisms. An overview of new therapeutic alternatives for the treatment ofCandidainfections is also provided.

scholarly journals ETIOLOGICAL AGENTS OF FUNGAL INFECTIONS IN PATIENTS AFTER SOLID ORGAN TRANSPLANTATIONS (SOT) - FUNGAL STRAINS AND THEIR SUSCEPTIBILITY TO ANTIFUNGAL DRUGS.

2008 ◽  
Vol 86 (Supplement) ◽  
pp. 396
Author(s):  
A Chmura ◽  
I Netsvyetayeva ◽  
E Swoboda-Kopec ◽  
D Kawecki ◽  
M Sikora ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Antifungal Drugs ◽  
Solid Organ ◽  
Fungal Strains ◽  
Etiological Agents

scholarly journals Application of Bioluminescence Imaging forIn VivoMonitoring of Fungal Infections

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Matthias Brock
Keyword(s):  
Bioluminescence Imaging ◽  
Fungal Infections ◽  
Immunocompromised Host ◽  
Infection Process ◽  
Diagnostic Tools ◽  
Populations At Risk ◽  
Invasive Infections ◽  
Life Threatening ◽  
Temporal And Spatial ◽  
Infection Processes

Fungi can cause severe invasive infections especially in the immunocompromised host. Patient populations at risk are increasing due to ongoing developments in cancer treatment and transplantation medicine. Only limited diagnostic tools and few antifungals are available, rendering a significant number of invasive fungal infections life threatening. To reduce mortality rates, a better understanding of the infection processes is urgently required. Bioluminescence imaging (BLI) is a powerful tool for such purposes, since it allows visualisation of temporal and spatial progression of infections in real time. BLI has been successfully used to monitor infections caused by various microorganisms, in particular bacteria. However, first studies have also been performed on the fungiCandida albicansandAspergillus fumigatus. Although BLI was, in principle, suitable to study the infection process, some limitations remained. Here, different luciferase systems are introduced, and current approaches are summarised. Finally, suggestions for further improvements of BLI to monitor fungal infections are provided.

scholarly journals EBV-Associated Post-Transplant Lymphoproliferative Disease (PTLD) in Allogeneic Transplantation

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Cutini I ◽  
◽  
Peruzzi B ◽  
Caporale R ◽  
Nozzoli C ◽  
...  
Keyword(s):  
Myeloid Leukemia ◽  
Solid Organ Transplantation ◽  
B Cell Lymphoma ◽  
Allogeneic Transplantation ◽  
Lymphoproliferative Disease ◽  
Solid Organ ◽  
Hematopoietic Stem ◽  
Post Transplant ◽  
Control Virus ◽  
Life Threatening

Post-Transplant Lymphoproliferative Disease (PTLD) following both Solid Organ Transplantation (SOT) and Hematopoietic Stem Cell Transplantation (HSCT) is a rare life-threatening complication. The majority of PLTDs are associated to Epstein Bar Virus (EBV) [1] reactivation, usually in the early phase [2] after transplant, when the patient is severely immunocompromised and is unable to control virus replication [3]. Despite the mortality of EBV-associated PTLD has been reduced over the years, the different histological patterns of its presentation, ranging from indolent to high grade B cell lymphoma, still play a role in the outcome. Herein, we report the case of a 60-years-old man diagnosed with acute myeloid leukemia who underwent allogeneic transplantation and developed a fatal Hemophagocytic Histiocytosis (HLH) secondary to an aggressive EBV-associated PTLD, not responding to a rituximab-based treatment.

scholarly journals Duplication and overexpression of the genes encoding a beta 1,3-glucan synthase confer the intrinsic resistance to echinocandin in Mucor circinelloides

2022 ◽  
Author(s):  
Soo Chan Lee ◽  
Alexis Garcia ◽  
Eun Young Huh
Keyword(s):  
Fungal Infections ◽  
Secondary Infection ◽  
Effective Means ◽  
Mucor Circinelloides ◽  
Antifungal Drugs ◽  
Solid Organ ◽  
Intrinsic Resistance ◽  
Glucan Synthase ◽  
Drug Classes ◽  
Genes Encoding

Procedures such as solid organ transplants and cancer treatments can leave many patients in an immunocompromised state resulting in an increased susceptibility to opportunistic diseases including fungal infections. Mucormycosis infections are continually emerging and pose a serious threat to immunocompromised patients. Currently there has been a sharp increase in mucormycosis cases as a secondary infection in patients battling SARS-CoV-2 infections. Mucorales fungi are notorious for presenting resistance to most antifungal drugs. The absence of effective means to treat these infections results in mortality rates approaching 100% in cases of disseminated infection. One of the most effective antifungal drug classes currently available are echinocandins. Echinocandins seem to be efficacious in treatment of many other fungal infections. Unfortunately, susceptibility testing has found that echinocandins have no to little effect on Mucorales. In this study, we found that the model Mucorales Mucor circinelloides genome carries three copies of the genes encoding for the echinocandin target protein β-(1,3)-D-glucan synthase (fksA, fksB, and fksC). Interestingly, we revealed that exposing M. circinelloides to micafungin significantly increased the expression of the fksA and fksB genes when compared to an untreated control. We further uncovered that the serine/threonine phosphatase calcineurin is responsible for the overexpression of fksA and fksB as deletion of calcineurin results in a decrease in expression of all three fks genes and a lower minimal inhibitory concentration (MIC) to micafungin. Taken together, this study demonstrates that the fks gene duplication and overexpression by calcineurin contribute to the intrinsic resistance to echinocandins in Mucor.

Fungal infections in solid organ transplantation

2017 ◽  
Author(s):  
Darius Armstrong James ◽  
Anand Shah ◽  
Anna Reed
Keyword(s):  
Organ Transplantation ◽  
Fungal Infections ◽  
Wide Spectrum ◽  
Treatment Options ◽  
Solid Organ Transplantation ◽  
Invasive Disease ◽  
Global Scale ◽  
Molecular Diagnostic ◽  
Individual Risk ◽  
Solid Organ

Fungal infections are a significant and life-threatening complication of organ transplantation, on a global scale. Risk varies according to transplant type, with liver, lung, and small bowel transplant recipients being at particular risk. Whilst invasive candidiasis is the most common fungal infection in organ transplantation overall, aspergillosis is a particular problem in lung transplantation. In addition, a wide spectrum of fungi may cause invasive disease in organ transplantation, consequently diagnosis and treatment can be challenging. Key challenges are to understand individual risk for infection, appropriate prophylactic strategies, and molecular diagnostic approaches. Treatment options are complicated by drug–drug interactions with transplant therapy, as well as intrinsic allograft dysfunction seen in many patients. In this chapter, we review the epidemiology, risk factors, diagnosis, and management of fungal infections in solid organ transplantation.

Sign in / Sign up

Export Citation Format

Share Document