The Fungus Versus the Weak and Weary

2009-08-21 | |
Last updated: 2009-08-21

The human body is continually exposed to various types of bacteria, virus and fungus that our immune systems are usually well equipped to eradicate. However, when our immune systems are significantly weakened, these undesirable visitors can do significant damage to our health. Of the three types of infection, the fungal infection is usually the least damaging for those who are healthy, but can be the most difficult to treat for those with low immunity. In such cases of weakened immunity, some fungal infections can even be life threatening.

No matter how clean one’s home is, fungus is everywhere. The microscopic spores are found in the cleanest of shower stalls, in the soil of our potted plants, in the air we breathe and in great number in the pillows on which we rest our weary heads. For the most part, the worst effects that any of us will face from fungus are cracks in the skin between our toes from foot fungus, also called athlete’s foot or in medical terms tinea pedis. Children can also develop ringworm or tinea capitas on their scalp that, in the worst case, causes small scars and bald patches if not treated promptly.

Slightly more serious, a thrush fungal yeast infection in either the mouth or the vagina can make the soft skin in these areas raw and very painful. For those with asthma, the spores in our pillows and in the air can prompt asthma attacks. In all these cases, however, antifungal creams, antifungal pills and frequent cleaning of our linens and pillows tends to keep the fungus from taking control.

However, for patients with weak immune systems such as those taking steroids, those with HIV, those taking chemotherapy for cancer treatment or those with transplants taking antirejection drugs, fungal infections are often much more invasive and dangerous. For those with a suppressed immune system, having one type of Candida fungus get into the bloodstream to cause septicaemia or blood poisoning will cause death 30-40% of the time. Similarly, another type of Aspergillus fungus, breathed in through the air as spores can cause death in 90% of those infected.

With these sorts of very negative effects from fungal infection, researchers are tackling the problem from a number of different angles. Only recently, University of Aberdeen researchers completed the genetic decoding for 6 different species of Candida fungus. This work is very important because with the genetic knowledge of the fungus, the researchers will have a greater chance of developing treatments. For the same fungus, researchers at Case Western Reserve University identified how certain immune system proteins in our bodies work to activate the immune system against the fungus. One hope from this continuing research is to identify human genetic differences that determine who is more susceptible to such infections. In any case, the results from this research should help in the fight against drug resistant forms of the fungus.

In research targeted toward more immediate benefits, other scientists are working on better testing techniques for managing infection. In one case, researchers at Albert Einstein College of Medicine of Yeshiva University have determined how to predict who is more likely to develop Cryptococcus fungal infections based on a count of certain immune cells in the blood stream. Those with low levels of the specific blood cell are much more likely to develop an infection and should be given antifungal treatments. The value of this test is that it reduces the costs of providing the antifungal treatments because only those at risk need to be treated. At the same time, by treating fewer patients in a more focused manner, the risk of the fungus developing resistance to the antifungal drugs is reduced.

Another important test that has been developed at the University of Exeter enables easier detection of Aspergillus fungus infection. When the airborne fungus spores enter the lung and begin to spread within the lungs, it is very difficult to detect the infection early. In the past a lung tissue sample was required and this was not something that could not always be obtained in very sick patients. It also took some time to perform the analysis. The researchers have created a blood test that checks for chemicals created by the fungus. The benefit of the test is that it can be performed routinely for high-risk patients without excessive cost and without highly invasive tissue sampling.

Though considerable research effort is still needed to reduce the risks of fungal infection in patients with weakened immune systems, efforts currently under way are creating knowledge that will eventually aid in protecting these patients. In addition, the far more sophisticated test techniques will result in faster patient treatment and fewer casualties from fungus. Although most of will generally face little risk from fungus, its important to keep the research moving to protect our less robust comrades.

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