The pathogenicity of Aspergillus fumigatus, drug resistance, and nanoparticle delivery

Can J Microbiol. 2018 Jul;64(7):439-453. doi: 10.1139/cjm-2017-0749. Epub 2018 Mar 27.

Abstract

The genus Aspergillus includes fungal species that cause major health issues of significant economic importance. These microorganisms are also the culprit for production of carcinogenic aflatoxins in grain storages, contaminating crops, and economically straining the production process. Aspergillus fumigatus is a very important pathogenic species, being responsible for high human morbidity and mortality on a global basis. The prevalence of these infections in immunosuppressed individuals is on the rise, and physicians struggle with the diagnosis of these deadly pathogens. Several virulence determinants facilitate fungal invasion and evasion of the host immune response. Metabolic functions are also important for virulence and drug resistance, since they allow fungi to obtain nutrients for their own survival and growth. Following a positive diagnostic identification, mortality rates remain high due, in part, to emerging resistance to frequently used antifungal drugs. In this review, we discuss the role of the main virulence, drug target, and drug resistance determinants. We conclude with the review of new technologies being developed to treat aspergillosis. In particular, microsphere and nanoparticle delivery systems are discussed in the context of improving drug bioavailability. Aspergillus will likely continue to cause problematic infections in immunocompromised patients, so it is imperative to improve treatment options.

Keywords: Aspergillus fumigatus; antifungal drugs; aspergillose invasive; fungal pathogen; invasive aspergillosis; médicaments antifongiques; nanoparticle delivery systems; pathogène fongique; systèmes d’administration par nanoparticules.

Publication types

  • Review

MeSH terms

  • Antifungal Agents / administration & dosage*
  • Aspergillosis / drug therapy
  • Aspergillus fumigatus / drug effects*
  • Aspergillus fumigatus / pathogenicity*
  • Drug Resistance, Fungal*
  • Humans
  • Immunocompromised Host
  • Nanoparticles / administration & dosage*
  • Virulence / drug effects
  • Virulence Factors / metabolism

Substances

  • Antifungal Agents
  • Virulence Factors