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Pathogenesis of Fungal Infections

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Fungal Infections of the Central Nervous System

Abstract

Invasive fungal infections can cause significant morbidity and mortality as they are more difficult to treat. Understanding of the pathogenesis of fungal infections can aid in the prevention and management of the disease. Over a period of time, human beings have become a substrate for fungi. Apart from dysfunctional immune system of host, fungi are capable of tolerating high temperature and invading the human host tissue barrier to parasitize humans. Various immunoregulatory mechanisms determine the outcome of exposure to fungal pathogens. The following discussion intends to highlight the pathogenesis of fungal infections with special reference to central nervous system in humans.

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Abbreviations

ALS proteins:

Agglutinin-like sequence proteins

CARD 9:

Caspase recruitment domain-containing protein 9

CD:

Cluster of differentiation

CLR:

C-type lectin receptors

CNS:

Central nervous system

CR:

Complement receptor

CTLA-4:

Cytotoxic T lymphocyte-associated protein 4

DC:

Dendritic cell

DNA:

Deoxyribonucleic acid

EC:

Epithelial cell

EPA:

Epithelial adhesin gene

HIV:

Human immunodeficiency virus

Hsp:

Heat shock protein

HYR:

Hyphally regulated protein gene

IFN:

Interferons

IL:

Interleukin

IRIS:

Immune reconstitution inflammatory syndrome

MR:

Mannose receptors

NK:

Natural killer

PAMP:

Pathogen-associated molecular patterns

PD-1:

Programmed cell death protein-1

PRR:

Pattern recognition receptors

ROI:

Reactive oxygen intermediates

Saps:

Secreted aspartyl proteinases

Th:

Thymus helper

TLO:

Telomere-associated gene

TLR:

Toll-like receptor

TNF-α:

Tumor necrosis factor α

Treg cells:

Regulatory T cells

YWP:

Yeast-form wall protein

References

  • de Almeida SM. Central nervous system paracoccidioidomycosis: an overview. Braz J Infect Dis. 2005;9:126–33.

    Article  PubMed  Google Scholar 

  • Anand VK, Alemar G, Griswold JA Jr. Intracranial complications of mucormycosis: an experimental model and clinical review. Laryngoscope. 1992;102:656–62.

    Article  CAS  PubMed  Google Scholar 

  • Aristizabal BH, Clemons KV, Cock AM, Restrepo A, Stevens DA. Experimental Paracoccidioides brasiliensis infection in mice: influence of the hormonal status of the host on tissue responses. Med Mycol. 2002;40:169–78.

    Article  CAS  PubMed  Google Scholar 

  • Bellocchio S, Montagnoli C, Bozza S, Gaziano R, Rossi G, Mambula SS, et al. The contribution of the Toll-like receptor superfamily to innate and adaptive immunity to fungal pathogens in vivo. J Immunol. 2004;172(5):3059–69.

    Article  CAS  PubMed  Google Scholar 

  • Bhabhra R, Miley MD, Mylonakis E, Boettner D, Fortwendel J, Panepinto JC, et al. Disruption of the Aspergillus fumigatus gene encoding nucleolar protein CgrA impairs thermotolerant growth and reduces virulence. Infect Immun. 2004;72:4731–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Breneman E, Colford JM Jr. Aspergillosis of the CNS presenting as a aseptic meningitis. Clin Infect Dis. 1992;15:737–8.

    Article  CAS  PubMed  Google Scholar 

  • Brown GD, Denning DW, Gow NA, Levitz SM, Netea MG, White TC. Hidden killers: human fungal infections. Sci Transl Med. 2012;4:165rv13.

    Article  CAS  PubMed  Google Scholar 

  • Byrnes I, Edmond J, Bildfell RJ, Frank SA, Mitchell TG, Marr KA, et al. Molecular evidence that the range of the Vancouver Island outbreak of Cryptococcus gattii infection has expanded into the pacific northwest in the United States. J Infect Dis. 2009;199(7):1081–6.

    Article  PubMed  Google Scholar 

  • Colombo AL, Tobón A, Restrepo A, Queiroz-Telles F, Nucci M. Epidemiology of endemic systemic fungal infections in Latin America. Med Mycol. 2011;49(8):785–98.

    PubMed  Google Scholar 

  • Dadiee P, Hashemizadeh Z. Opportunistic invasive fungal infections: diagnosis & clinical management. Indian J Med Res. 2014;139(2):195–204.

    Google Scholar 

  • Davis LE. Fungal infections of the central nervous system. Neurol Clin. 1999;17:761–81.

    Article  CAS  PubMed  Google Scholar 

  • van de Veerdonk FL, Netea MG. T-cell subsets and antifungal host defenses. Curr Fungal Infect Rep. 2010;4:238–43.

    Article  PubMed  PubMed Central  Google Scholar 

  • Drewniak A, Gazendam RP, Tool ATJ, van Houdt M, Jansen MH, van Hamme JL, et al. Invasive fungal infection and impaired neutrophil killing in human CARD9 deficiency. Blood. 2013;121(13):2385–92.

    Article  CAS  PubMed  Google Scholar 

  • Drummond RA, Brown GD. The role of Dectin-1 in the host defence against fungal infections. Curr Opin Microbiol. 2011;14(4):392–9.

    Article  CAS  PubMed  Google Scholar 

  • Drummond RA, Saijo S, Iwakura Y, Brown GD. The role of Syk/CARD9 coupled C-type lectins in antifungal immunity. Eur J Immunol. 2011;41(2):276–81.

    Article  CAS  PubMed  Google Scholar 

  • Eggimann P, Garbino J, Pittet D. Epidemiology of Candida species infections in critically ill non-immunosuppressed patients. Lancet Infect Dis. 2003;3:685–702.

    Article  PubMed  Google Scholar 

  • Elluru SR, Kaveri SV, Bayry J. The protective role of immunoglobulins in fungal infections and inflammation. Semin Immunopathol. 2014;37(2):187–97.

    Article  PubMed  CAS  Google Scholar 

  • Engelhardt B, Carare RO, Bechmann I, Flügel A, Laman JD, Welle RO. Vascular, glial, and lymphatic immune gateways of the central nervous system. Acta Neuropathol. 2016;132:317.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Farley PC, Sullivan PA. The Rhizopus oryzae secreted aspartic proteinase gene family: an analysis of gene expression. Microbiology. 1998;144:2355–66.

    Article  CAS  PubMed  Google Scholar 

  • Filler SG, Sheppard DC. Fungal invasion of normally non-phagocytic host cells. PLoS Pathog. 2006;e129:2.

    Google Scholar 

  • Flaherman VJ, Hector R, Rutherford GW. Estimating severe coccidioidomycosis in California. Emerg Infect Dis. 2007;13(7):1087–90.

    Article  PubMed  PubMed Central  Google Scholar 

  • Freeman GJ, Long AJ, Iwai Y, Bourque K, Chernova T, Nishimura H, et al. Engagement of the PD-1 immunoinhibitory receptor by a novel B7 family member leads to negative regulation of lymphocyte activation. J Exp Med. 2000;192:1027–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Friedman JA, Wijdicks EF, Fulgham JR, Wright AJ. Meningoencephalitis due to Blastomyces dermatitidis: case report and literature review. Mayo Clin Proc. 2000;75:403–8.

    Article  CAS  PubMed  Google Scholar 

  • Garcia-Solache MA, Casadevall A. Global warming will bring new fungal diseases for mammals. MBio. 2010;1(1):e00061–10.

    Article  PubMed  PubMed Central  Google Scholar 

  • Garcia-Vidal C, Viasus D, Carratala J. Pathogenesis of invasive fungal infections. Curr Opin Infect Dis. 2013;26:270–6.

    Article  CAS  PubMed  Google Scholar 

  • Hamilton AJ, Holdon MD. Antioxidant systems in the pathogenic fungi of man and their role in virulence. Med Mycol. 1999;37:375–89.

    Article  CAS  PubMed  Google Scholar 

  • Han X, Yu R, Zhen D, Tao S, Schmidt M, Han L. β-1,3-Glucan-induced host phospholipase D activation is involved in Aspergillus fumigatus internalization into type II human pneumocyte A549 cells. PLoS One. 2011;6:e21468.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hardison SE, Brown GD. C type lectin receptors orchestrate antifungal immunity. Nat Immunol. 2012;13(9):817–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hawser SP, Douglas LJ. Biofilm formation by Candida species on the surface of catheter materials in vitro. Infect Immun. 1994;62:915–21.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Heymann P, Gerads M, Schaller M, Dromer F, Winkelmann G, Ernst JF. The siderophore iron transporter of Candida albicans (Sit1p/Arn1p) mediates uptake of ferrichrome-type siderophores and is required for epithelial invasion. Infect Immun. 2002;70:5246–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hilty J, George Smulian A, Newman SL. Histoplasma capsulatum utilizes siderophores for intracellular iron acquisition in macrophages. Med Mycol. 2011;49:633–42.

    CAS  PubMed  Google Scholar 

  • Hole CR, Wormley FL Jr. Vaccine and immunotherapeutic approaches for the prevention of cryptococcosis: lessons learned from animal models. Front Microbiol. 2012;3:291.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hwang LH, Mayfield JA, Rine J, Sil A. Histoplasma requires SID1, a member of an iron-regulated siderophore gene cluster, for host colonization. PLoS Pathog. 2008;4:e1000044.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Ibrahim AS, Spellberg B, Walsh TJ, Kontoyiannis DP. Pathogenesis of mucormycosis. Clin Infect Dis. 2012;54:S16–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Jantunen E, Volin L, Salonen O, Piilonen A, Parkkali T, Anttila VJ, et al. Central nervous system aspergillosis in allogenic stem cell transplant recipients. Bone Marrow Transplant. 2003;31:191–6.

    Article  CAS  PubMed  Google Scholar 

  • Juvvadi PR, Lee SC, Heitman J, Steinbach WJ. Calcineurin in fungal virulence and drug resistance: prospects for harnessing targeted inhibition of calcineurin for an antifungal therapeutic approach. Virulence. 2017;8:186–97.

    Article  CAS  PubMed  Google Scholar 

  • Kamai Y, Lossinsky AS, Liu H, Sheppard DC, Filler SG. Polarized response of endothelial cells to invasion by Aspergillus fumigatus. Cell Microbiol. 2009;11:170–82.

    Article  CAS  PubMed  Google Scholar 

  • Kauffman CA. Histoplasmosis: a clinical and laboratory update. Clin Microbiol Rev. 2007;20(1):115–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Khan AAH, Karuppayil SM. Fungal pollution of indoor environments and its management. Saudi J Biol Sci. 2012;19:405–26.

    Article  CAS  Google Scholar 

  • Khan MS, Ahmad I, Aqil F, Owais M, Shahid M, Musarrat J. Virulence and pathogenicity of fungal pathogens with special reference to Candida albicans. In: Ahmad I, Owais M, Shahid M, Aqil F, editors. Combating fungal infections: problems and remedy. Berlin, Heidelberg, Germany: Springer-Verlag; 2010. p. 21–45.

    Chapter  Google Scholar 

  • Khuu D, Shafir S, Bristow B, Sorvillo F. Blastomycosis mortality rates, United States, 1990–2010. Emerg Infect Dis. 2014;20(11):1789–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kobayashi GS. Chapter 74: Disease mechanisms of fungi. In: Baron S, editor. Medical microbiology. 4th ed. Galveston, TX: University of Texas Medical Branch at Galveston; 1996.

    Google Scholar 

  • Kohler JR, Casadevall A, Perfect J. The spectrum of fungi that infects humans. Cold Spring Harb Perspect Med. 2014;5:a019273.

    Article  PubMed  CAS  Google Scholar 

  • Kojic EM, Darouiche RO. Candida infections of medical devices. Clin Microbiol Rev. 2004;17:255–67.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kunadharaju R, Choe U, Harris JR, Lockhart SR, Greene JN. Cryptococcus gattii, Florida, USA, 2011 [Letter]. Emerg Infect Dis. 2013;19(3):519–21.

    Article  PubMed  PubMed Central  Google Scholar 

  • Leach MD, Cowen LE. Surviving the heat of the moment: a fungal pathogens perspective. PLoS Pathog. 2013;9:e1003163.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lee PPW, Chan K-W, Lee T-L, Ho MH-K, Chen X-Y, Li C-H, et al. Penicilliosis in children without HIV infection—are they immunodeficient? Clin Infect Dis. 2012;54(2):e8–e19.

    Article  PubMed  Google Scholar 

  • Li L, Eter N, Heiduschka P. The microglia in healthy and diseased retina. Exp Eye Res. 2015;136:116–30.

    Article  CAS  PubMed  Google Scholar 

  • Lin H, Rathmell JC, Gray GS, Thompson CB, Leiden JM, Alegre ML. Cytotoxic T lymphocyte antigen 4 (CTLA4) blockade accelerates the acute rejection of cardiac allografts in CD28-deficient mice: CTLA4 can function independently of CD28. J Exp Med. 1998;188:199–204.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lin XR, Alspaugh JA, Liu HP, Harris S. Fungal morphogenesis. Cold Spring Harb Perspect Med. 2015;5:a019679.

    Article  PubMed Central  CAS  Google Scholar 

  • Long KH, Gomez FJ, Morris RE, Newman SL. Identification of heat shock protein 60 as the ligand on Histoplasma capsulatum that mediates binding to CD18 receptors on human macrophages. J Immunol. 2003;170:487–94.

    Article  CAS  PubMed  Google Scholar 

  • Loza L, Fu Y, Ibrahim AS, Sheppard DC, Filler SG, Edwards JE Jr. Functional analysis of the Candida albicans ALS1 gene product. Yeast. 2004;21:473–82.

    Article  CAS  PubMed  Google Scholar 

  • Lupi O, Tyring SK, McGinnis MR. Tropical dermatology: fungal tropical diseases. J Am Acad Dermatol. 2005;53:931–51.

    Article  PubMed  Google Scholar 

  • McDonagh A, Fedorova ND, Crabtree J, Yu Y, Kim S, Chen D, et al. Sub-telomere directed gene expression during initiation of invasive aspergillosis. PLoS Pathog. 2008;4:e1000154.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Mendoza L, Vilela R, Voelz K, Ibrahim AS, Voigt K, Lee SC. Human fungal pathogens of Mucorales and Entomophthorales. Cold Spring Harb Perspect Med. 2015;5:1–33.

    Article  CAS  Google Scholar 

  • Mohan S, Jain KK, Arabi M, Shah GV. Imaging of meningitis and ventriculitis. Neuroimaging Clin N Am. 2012;22:557–83.

    Article  PubMed  Google Scholar 

  • Moran GP, Coleman DC, Sullivan DJ. Comparative genomics and the evolution of pathogenicity in human pathogenic fungi. Eukaryot Cell. 2011;10(1):34–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Murdock BJ, Teitz-Tennenbaum S, Chen GH, Dils AJ, Malachowski AN, Curtis JL, et al. Early or late IL-10 blockade enhances Th1 and Th17 effector responses and promotes fungal clearance in mice with cryptococcal lung infection. J Immunol. 2014;193:4107–16.

    Article  CAS  PubMed  Google Scholar 

  • Newman SL, Chaturvedi S, Klein BS. The WI-1 antigen of Blastomyces dermatitidis yeasts mediates binding to human macrophage CD11b/CD18 (CR3) and CD14. J Immunol. 1995;154:753–61.

    CAS  PubMed  Google Scholar 

  • Nosanchuk JD, Valadon P, Feldmesser M, Casadevall A. Melanization of Cryptococcus neoformans in murine infection. Mol Cell Biol. 1999;19:745–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Olszewski MA, Noverr MC, Chen GH, Toews GB, Cox GM, Perfect JR, et al. Urease expression by Cryptococcus neoformans promotes microvascular sequestration, thereby enhancing central nervous system invasion. Am J Pathol. 2004;164:1761–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pandiyan P, Conti HR, Zheng L, Peterson AC, Mathern DR, Hernandez-Santos N, et al. CD4+CD25+Foxp3+ regulatory T cells promote Th17 cells in vitro and enhance host resistance in mouse Candida albicans Th17 cell infection model. Immunity. 2011;34:422–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pappas PG, Kauffman CA, Andes D, Benjamin DK Jr, Calandra TF, Edwards JE Jr, et al. Infectious Diseases Society of a clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;48:503–35.

    Article  CAS  PubMed  Google Scholar 

  • de Pauw BE. What are fungal infections? Mediterr J Hematol Infect Dis. 2011;3(1):e2011001.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pendelbury WW, Perl DP, Munoz DG. Multiple microabscesses in the central nervous system: a clinicopathologic study. J Neuropathol Exp Neurol. 1989;48:290–300.

    Article  Google Scholar 

  • Pfaller MA, Diekema DJ. Epidemiology of invasive mycoses in North America. Crit Rev Microbiol. 2010;36:1–53.

    Article  PubMed  Google Scholar 

  • Polvi EJ, Li X, O’Meara TR, Leach MD, Cowen LE. Opportunistic yeast pathogens: reservoirs, virulence mechanisms, and therapeutic strategies. Cell Mol Life Sci. 2015;72:2261–87.

    Article  CAS  PubMed  Google Scholar 

  • Prinz M, Priller J. Microglia and brain macrophages in the molecular age: from origin to neuropsychiatric disease. Nat Rev Neurosci. 2014;15:300–12.

    Article  CAS  PubMed  Google Scholar 

  • Rangel-Guerra RA, Martinezz HR, Saenz C, Bosques-Padilla F, Estrada-Bellmann I. Rhinocerebral and systemic mucormycosis. Clinical experience with 36 cases. J Neurol Surg. 1996;143:19–30.

    CAS  Google Scholar 

  • Rappleye CA, Goldman WE. Defining virulence genes in the dimorphic fungi. Annu Rev Microbiol. 2006;60:281–303.

    Article  CAS  PubMed  Google Scholar 

  • Rappleye CA, Eissenberg LG, Goldman WE. Histoplasma capsulatum a-(1,3)-glucan blocks innate immune recognition by the b-glucan receptor. Proc Natl Acad Sci U S A. 2007;104:1366–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Ries LNA, Beattie S, Cramer RA, Goldman GH. Overview of carbon and nitrogen catabolite metabolism in the virulence of human pathogenic fungi. Mol Microbiol. 2018;107:277–97.

    Article  CAS  PubMed  Google Scholar 

  • Romani L. Immunity to fungal infections. Nat Rev Immunol. 2004;4:1–23.

    Article  PubMed  CAS  Google Scholar 

  • Romani L, Puccetti P. Protective tolerance to fungi: the role of IL-10 and tryptophan catabolism. Trends Microbiol. 2006;14:183–9.

    Article  CAS  PubMed  Google Scholar 

  • Roussey JA, Olszewski MA, Osterholzer JJ. Immunoregulation in fungal diseases. Microorganisms. 2016;4:47.

    Article  PubMed Central  CAS  Google Scholar 

  • Roy M, Benedict K, Deak E, Kirby MA, McNiel JT, Sickler CJ, et al. A large community outbreak of blastomycosis in Wisconsin with geographic and ethnic clustering. Clin Infect Dis. 2013;57(5):655–62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rutz S, Ouyang W. Regulation of interleukin-10 expression. Adv Exp Med Biol. 2016;941:89–116.

    Article  CAS  PubMed  Google Scholar 

  • Santelli AC, Blair JE, Roust LR. Coccidioidomycosis in patients with diabetes mellitus. Am J Med. 2006;119(11):964–9.

    Article  PubMed  Google Scholar 

  • Sharma RR. Fungal infections of the nervous system: current perspective and controversies in management. Int J Surg. 2010;8:591–601.

    Article  Google Scholar 

  • Sharpton TJ, Stajich JE, Rounsley SD, Gardner MJ, Wortman JR, Jordar VS, et al. Comparative genomic analyses of the human fungal pathogens Coccidioides and their relatives. Genome Res. 2009;19:1722–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Shelburne SA 3rd, Hamill RJ, Rodriguez-Barradas MC, Greenberg SB, Atmar RL, Musher DW, et al. Immune reconstitution inflammatory syndrome: emergence of a unique syndrome during highly active antiretroviral therapy. Medicine. 2002;81:213–27.

    Article  PubMed  Google Scholar 

  • Sheppard DC, Filler SG. Host cell invasion by medically important fungi. Cold Spring Harb Perspect Med. 2015;5:a019687.

    Article  PubMed Central  CAS  Google Scholar 

  • Shih RY, Koeller KK. Bacterial, fungal, and parasitic infections of the central nervous system: radiologic-pathologic correlation and historical perspectives. Radiographics. 2015;35:1141–69.

    Article  PubMed  Google Scholar 

  • Simoes SA, Leite DP Jr, Hahn RC. Fungal microbiota in air-conditioning installed in both adult and neonatal intensive treatment units and their impact in two university hospitals of the central western region, Mato Grosso, Brazil. Mycopathologia. 2011;172:109–16.

    Article  Google Scholar 

  • Stearman R, Yuan DS, Yamaguchi-Iwai Y, Klausner RD, Dancis A. A permease-oxidase complex involved in high-affinity iron uptake in yeast. Science. 1996;271:1552–7.

    Article  CAS  PubMed  Google Scholar 

  • Sundaram C, Shankar SK, Thong WK, Pardo-Villamizar CA. Pathology and diagnosis of central nervous system infections. Pathol Res Int. 2011;2011:878263.

    CAS  Google Scholar 

  • Tangen KL, Jung WH, Sham AP, Lian T, Kronstad JW. The iron- and cAMP-regulated gene SIT1 influences ferrioxamine B utilization, melanization and cell wall structure in Cryptococcus neoformans. Microbiology. 2007;153:29–41.

    Article  CAS  PubMed  Google Scholar 

  • Taylor LH, Latham SM, Woolhouse ME. Risk factors for human disease emergence. Philos Trans R Soc Lond B Biol Sci. 2001;356:983–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Tronchin G, Pihet M, Lopes-Bezerra LM, Bouchara JP. Adherence mechanisms in human pathogenic fungi. Med Mycol. 2008;46:749–72.

    Article  CAS  PubMed  Google Scholar 

  • Tuch BB, Galgoczy DJ, Hernday AD, Li H, Johnson AD. The evolution of combinatorial gene regulation in fungi. PLoS Biol. 2008;6:e38.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Verma A, Wuthrich M, Deepe G, Klein B. Adaptive immunity to fungi. Cold Spring Harb Perspect Med. 2015;5:a019612.

    Article  PubMed Central  CAS  Google Scholar 

  • Wheat LJ, Batteiger BE, Sathapatayavongs B. Histoplasma capsulatum infections of the central nervous system. Medicine. 1990;69:244–60.

    Article  CAS  PubMed  Google Scholar 

  • Whibley N, Maccallum DM, Vickers MA, Zafreen S, Waldmann H, Hori S, et al. Expansion of Foxp3+ T-cell populations by Candida albicans enhances both Th17-cell responses and fungal dissemination after intravenous challenge. Eur J Immunol. 2014;44:1069–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zaragoza O, Nielsen K. Titan cells in Cryptococcus neoformans: cells with a giant impact. Curr Opin Microbiol. 2013;16:409–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zaragoza O, Garcia-Rodas R, Nosanchuk JD, Cuenca-Estrella M, Rodriguez-Tudela JL, Casadevall A. Fungal cell gigantism during mammalian infection. PLoS Pathog. 2010;6:e1000945.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

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Banushree, C.S., Madhusudhan, N.S. (2019). Pathogenesis of Fungal Infections. In: Turgut, M., Challa, S., Akhaddar, A. (eds) Fungal Infections of the Central Nervous System. Springer, Cham. https://doi.org/10.1007/978-3-030-06088-6_4

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