3.8 Article

Novel Approaches in the Management of Mucormycosis

Journal

CURRENT FUNGAL INFECTION REPORTS
Volume 17, Issue 2, Pages 98-107

Publisher

SPRINGER
DOI: 10.1007/s12281-023-00463-3

Keywords

Mucor; Rhizopus; Antifungal therapy; Fosmanogepix; Spore coat protein

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Invasive mucormycosis (IM) is a deadly fungal infection that is increasingly reported in immunocompetent individuals, especially with the COVID-19 pandemic. This review discusses the current advances in the diagnosis and treatment of IM, including the use of Mucorales-specific PCR and lateral-flow immunoassays for early diagnosis, as well as targeting spore coat proteins and boosting immune response as potential therapeutic approaches.
Purpose of ReviewInvasive mucormycosis (IM), caused by fungi of the order Mucorales, is one of the deadliest fungal infection among hematologic cancer patients. Its incidence is also increasingly reported in immunocompetent individuals, notably with the COVID-19 pandemic. Therefore, there is an urgent need for novel diagnostic and therapeutic approaches of IM. This review discusses the current advances in this field.Recent FindingsEarly diagnosis of IM is crucial and can be improved by Mucorales-specific PCR and development of lateral-flow immunoassays for specific antigen detection. The spore coat proteins (CotH) are essential for virulence of the Mucorales and may represent a target for novel antifungal therapies. Adjuvant therapies boosting the immune response, such as interferon-gamma, anti-PDR1 or fungal-specific chimeric antigen receptor (CAR) T-cells, are also considered.The most promising perspectives for improved management of IM consist of a multilayered approach targeting both the pathogen and the host immune system.

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