Título:	Cryptococcal virulence in humans : learning from translational studies with clinical isolates
Autor(es):	Sousa, Herdson Renney de Frazão, Stefânia de Oliveira Oliveira Júnior, Getúlio Pereira de Albuquerque, Patrícia Nicola, André Moraes
Assunto:	Criptococose Cryptococcus neoformans Meningite Virulência (Microbiologia)
Data de publicação:	2021
Editora:	Frontiers
Referência:	SOUZA, Herdson Renney de et al. Cryptococcal virulence in humans: learning from translational studies with clinical isolates. Frontiers in Cellular Infection Microbiology,v. 11, 657502, 2021. DOI: https://doi.org/10.3389/fcimb.2021.657502. Disponível em: https://www.frontiersin.org/articles/10.3389/fcimb.2021.657502/full. Acesso em: 26 jul. 2021.
Abstract:	Cryptococcosis, an invasive mycosis caused by Cryptococcus spp, kills between 20% and 70% of the patients who develop it. There are no vaccines for prevention, and treatment is based on a limited number of antifungals. Studying fungal virulence and how the host responds to infection could lead to new therapies, improving outcomes for patients. The biggest challenge, however, is that experimental cryptococcosis models do not completely recapitulate human disease, while human experiments are limited due to ethical reasons. To overcome this challenge, one of the approaches used by researchers and clinicians is to: 1) collect cryptococcal clinical isolates and associated patient data; 2) study the set of isolates in the laboratory (virulence and host-pathogen interaction variables, molecular markers); 3) correlate the laboratory and patient data to understand the roles fungal attributes play in the human disease. Here we review studies that have shed light on the cryptococcosis pathophysiology using these approaches, with a special focus on human disease. Isolates that more effectively evade macrophage responses, that secrete more laccase, melanize faster and have larger capsules in the cerebrospinal fluid are associated with poorer patient outcomes. Additionally, molecular studies have also shown that cryptococcal clades vary in virulence, with clinical impact. Limitations of those studies include the use of a small number of isolates or retrospectively collected clinical data. The fact that they resulted in very important information is a reflection of the impact this strategy has in understanding cryptococcosis and calls for international collaboration that could boost our knowledge.
Unidade Acadêmica:	Faculdade de Medicina (FMD)
Licença:	Copyright © 2021 de Sousa, Frazão, Oliveira Júnior, Albuquerque and Nicola. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
DOI:	https://doi.org/10.3389/fcimb.2021.657502
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