4.6 Review

Associations between Cryptococcus Genotypes, Phenotypes, and Clinical Parameters of Human Disease: A Review

Journal

JOURNAL OF FUNGI
Volume 7, Issue 4, Pages -

Publisher

MDPI
DOI: 10.3390/jof7040260

Keywords

Cryptococcus; genotype; phenotype; virulence; cryptococcal meningitis; pulmonary cryptococcosis; clinical presentation; clinical outcomes

Funding

  1. Public Health Service National Institute of Allergy and Infectious Diseases [R01AI073896, R01AI093257, R01AI104533, T32AI052080, R01AI133654]

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Cryptococcus genus consists of two primary species complexes that are important human fungal pathogens, leading to various manifestations in humans, most commonly affecting the pulmonary or central nervous system. Knowledge about Cryptococcus mainly comes from experiments and animal models, but fails to fully replicate human conditions. Understanding genetic and phenotypic differences in human infections is crucial for identifying risk factors contributing to pathogenesis and clinical outcomes associated with cryptococcal strains.
The genus Cryptococcus contains two primary species complexes that are significant opportunistic human fungal pathogens: C. neoformans and C. gattii. In humans, cryptococcosis can manifest in many ways, but most often results in either pulmonary or central nervous system disease. Patients with cryptococcosis can display a variety of symptoms on a spectrum of severity because of the interaction between yeast and host. The bulk of our knowledge regarding Cryptococcus and the mechanisms of disease stem from in vitro experiments and in vivo animal models that make a fair attempt, but do not recapitulate the conditions inside the human host. To better understand the dynamics of initiation and progression in cryptococcal disease, it is important to study the genetic and phenotypic differences in the context of human infection to identify the human and fungal risk factors that contribute to pathogenesis and poor clinical outcomes. In this review, we summarize the current understanding of the different clinical presentations and health outcomes that are associated with pathogenicity and virulence of cryptococcal strains with respect to specific genotypes and phenotypes.

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