RESUMO
The thermally-dimorphic systemic fungal group includes several important human pathogens: Blastomyces dermatitides, Coccidioides immitis and C. posadasii, Histoplasma capsulatum, Paracoccidioides brasiliensis, P. lutzii, and Talaromyces (Penicillium) marneffei. They usually are geographically restricted and have natural habitats in soil or in plants, and when fungal propagules invade mammalian host by inhalation, they initiate an inflammatory reaction that can result in self-resolution of the infection or cause an acute or chronic disease. In the setting of the AIDS pandemic and the developments in modern medicine, such as immunosuppressive therapy in cancer surgery patients and in transplantation and autoimmune diseases, the incidence of endemic mycoses has progressively increased. Another important factor of the increased incidence of systemic mycoses in certain regions is the progressive devastation of tropical and subtropical forests. In this review, we focus on two of the most important systemic mycoses: paracoccidioidomycosis and histoplasmosis, and their major characteristics in epidemiology, clinical aspects and laboratorial diagnosis.
Assuntos
Antifúngicos/farmacologia , Histoplasma/efeitos dos fármacos , Histoplasmose/diagnóstico , Histoplasmose/tratamento farmacológico , Paracoccidioides/efeitos dos fármacos , Paracoccidioidomicose/diagnóstico , Paracoccidioidomicose/tratamento farmacológico , Antifúngicos/química , Histoplasma/isolamento & purificação , Histoplasmose/epidemiologia , Humanos , Testes de Sensibilidade Microbiana , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/epidemiologiaRESUMO
Trichosporon species are rare etiologic agents of invasive fungal infection in solid organ transplant (SOT) recipients. We report 2 well-documented cases of Trichosporon inkin invasive infection in SOT patients. We also conducted a detailed literature review of Trichosporon species infections in this susceptible population. We gathered a total of 13 cases of Trichosporon species infections. Any type of organ transplantation can be complicated by Trichosporon infection. Bloodstream infections and disseminated infections were the most common clinical presentations. Liver recipients with bloodstream or disseminated infections had poor prognoses. Although the most common species was formerly called Trichosporon beigelii, this species name should no longer be used because of the changes in the taxonomy of this genus resulting from the advent of molecular approaches, which were also used to identify the strains isolated from our patients. Antifungal susceptibility testing highlights the possibility of multidrug resistance. Indeed, Trichosporon has to be considered in cases of breakthrough infection or treatment failure under echinocandins or amphotericin therapy. Voriconazole seems to be the best treatment option.
Assuntos
DNA Fúngico/análise , Empiema/imunologia , Rejeição de Enxerto/prevenção & controle , Transplante de Coração , Hospedeiro Imunocomprometido , Imunossupressores/uso terapêutico , Pneumopatias Fúngicas/imunologia , Transplante de Pulmão , Mediastinite/imunologia , Pericardite/imunologia , Trichosporon/genética , Tricosporonose/imunologia , Adulto , Antifúngicos/uso terapêutico , DNA Intergênico/análise , DNA Ribossômico/análise , Farmacorresistência Fúngica , Empiema/diagnóstico , Empiema/tratamento farmacológico , Humanos , Pneumopatias Fúngicas/diagnóstico , Pneumopatias Fúngicas/tratamento farmacológico , Masculino , Mediastinite/diagnóstico , Mediastinite/tratamento farmacológico , Testes de Sensibilidade Microbiana , Pericardite/diagnóstico , Pericardite/tratamento farmacológico , Derrame Pleural/diagnóstico , Derrame Pleural/tratamento farmacológico , Derrame Pleural/imunologia , Pirimidinas/uso terapêutico , Análise de Sequência de DNA , Triazóis/uso terapêutico , Tricosporonose/diagnóstico , Tricosporonose/tratamento farmacológico , Voriconazol , Adulto JovemRESUMO
With the extraordinary progress of mitochondrial science and cell biology, novel biochemical pathways have emerged as strategic points of bioenergetic regulation and control. They include mitochondrial fusion, fission and organellar motility along microtubules and microfilaments (mitochondrial dynamics), mitochondrial turnover (biogenesis and degradation), and mitochondrial phospholipids synthesis. Yet, much is still unknown about the mutual interaction between mitochondrial energy state, biogenesis, dynamics and degradation. Meanwhile, clinical research into metabolic abnormalities in tumors as diverse as renal carcinoma, glioblastomas, paragangliomas or skin leiomyomata, has designated new genes, oncogenes and oncometabolites involved in the regulation of cellular and mitochondrial energy production. Furthermore, the examination of rare neurological diseases such as Charcot-Marie Tooth type 2a, Autosomal Dominant Optic Atrophy, Lethal Defect of Mitochondrial and Peroxisomal Fission, or Spastic Paraplegia suggested involvement of MFN2, OPA1/3, DRP1 or Paraplegin, in the auxiliary control of mitochondrial energy production. Lastly, advances in the understanding of mitochondrial apoptosis have suggested a supplementary role for Bcl2 or Bax in the regulation of mitochondrial respiration and dynamics, which has fostered the investigation of alternative mechanisms of energy regulation. In this review, we discuss the regulatory mechanisms of cellular and mitochondrial energy production, and we emphasize the importance of the study of rare neurological diseases in addition to more common disorders such as cancer, for the fundamental understanding of cellular and mitochondrial energy production.
Assuntos
Mitocôndrias/metabolismo , Trifosfato de Adenosina/biossíntese , Animais , Núcleo Celular/metabolismo , Metabolismo Energético , Homeostase , Humanos , Modelos Biológicos , Neoplasias/metabolismo , Doenças do Sistema Nervoso/metabolismo , Organelas/metabolismo , Fosforilação Oxidativa , Transdução de SinaisRESUMO
Little is known on the metabolic profile of lung tumors and the reminiscence of embryonic features. Herein, we determined the bioenergetic profiles of human fibroblasts taken from lung epidermoid carcinoma (HLF-a) and fetal lung (MRC5). We also analysed human lung tumors and their surrounding healthy tissue from four patients with adenocarcinoma. On these different models, we measured functional parameters (cell growth rates in oxidative and glycolytic media, respiration, ATP synthesis and PDH activity) as well as compositional features (expression level of various energy proteins and upstream transcription factors). The results demonstrate that both the lung fetal and cancer cell lines produced their ATP predominantly by glycolysis, while oxidative phosphorylation was only capable of poor ATP delivery. This was explained by a decreased mitochondrial biogenesis caused by a lowered expression of PGC1alpha (as shown by RT-PCR and Western blot) and mtTFA. Consequently, the relative expression of glycolytic versus OXPHOS markers was high in these cells. Moreover, the re-activation of mitochondrial biogenesis with resveratrol induced cell death specifically in cancer cells. A consistent reduction of mitochondrial biogenesis and the subsequent alteration of respiratory capacity was also observed in lung tumors, associated with a lower expression level of bcl2. Our data give a better characterization of lung cancer cells' metabolic alterations which are essential for growth and survival. They designate mitochondrial biogenesis as a possible target for anti-cancer therapy.