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[Morphology of severe mycoses. Role of the pathologist in the diagnosis].

Mycoses are diseases caused by fungi. To be regarded as pathogenic, a fungus has to be able to complete a number of steps in order to initiate infection. Although culture remains the gold standard to diagnose the causative agent, presumptive identification of these fungi in histologic slides is of great value because invasion is only demonstrated in tissue sections. When culture is not available, histopathologic examination may be the sole source of information about the nature of the infection. To make a diagnosis, the pathologist needs to be familiar with the morphologic appearance of the different types of fungi, and has also to be aware of the limitations in their identification. The purpose of this work is to review the current problems on this subject, specially referring to the most frequent severe mycoses of our environment.

English Abstract↗

Paracoccidioidomycosis and its etiologic agent Paracoccidioides brasiliensis.

Paracoccidioides brasiliensis is the causative agent of paracoccidioidomycosis, a systemic mycosis endemic to Latin America. In this paper we review clinical, therapeutic and immunological aspects of the disease, as well as the biology and ecology of the fungus, restricting the review to the period 1989-1992.

Adult↗

pH regulates endoglucanase expression and virulence of Alternaria alternata in persimmon fruit.

The phytopathogenic fungus Alternaria alternata produces one endo-1,4-beta-glucanase, AaK1, which is an important factor in disease development in persimmon fruit. During growth of A. alternata in media containing acidified yeast extract or cell walls from persimmon fruit, the fungus secreted ammonia and raised the medium pH. A rise in media pH from 3.8 to 6.0 in the presence of cell walls induced the expression of AaK1, whereas a glucose-induced decline in pH to 2.5 repressed transcription and enzymatic production. Treatments with buffered solutions at pH 6.0 during growth of A. alternata in the presence of glucose derepressed AaK1 expression and endo-1,4-beta-glucanase production and enhanced decay development on the fruit. The results suggest that conditions affecting environmental pH modulate gene expression of AaK1 and virulence of A. alternata in persimmon fruit

Alternaria↗

[Immunodiagnosis of Aspergillus-induced bronchopulmonary diseases].

Studies using the immunoblot technique were carried out to identify the components of Aspergillus fumigatus against which the IgE and IgG antibodies of 22 patients with Aspergillus-related lung diseases are directed. Asthmatics exhibit IgE antibodies against 2-6 of the fungus components and, surprisingly, an even more pronounced IgG antibody reaction. It was determined that persons suffering from allergic bronchopulmonary aspergillosis show massive IgE-and IgG-mediated sensitization, generally against more than 20 components. However, treatment with corticosteroids, which produces remarkable improvement in cases with allergic bronchopulmonary aspergillosis, is associated with very low amounts of specific IgE. Patients with farmer's lung disease and aspergilloma possess--with one exception--no specific IgE antibodies, but all have comparable spectra of specific IgG antibodies; in the latter group the especially high antigenic activity of components with a molecular weight of about 18,000 daltons was noticeable. Healthy subjects display weak IgG antibody reactions with only a few Aspergillus antigens. These results show that more than 30 antigen-active components of Aspergillus fumigatus can be identified by means of the immunoblot technique, and that the IgE and IgG antibodies of persons with Aspergillus-related bronchopulmonary illnesses show characteristic reaction patterns which may be useful in differential diagnosis.

Aspergillosis↗

MfLIP1, a gene encoding an extracellular lipase of the lipid-dependent fungus Malassezia furfur.

Malassezia furfur is a dimorphic fungus and a member of the normal cutaneous microflora of humans. However, it is also a facultative pathogen, associated with a wide range of skin diseases. One unusual feature of M. furfur is an absolute dependency on externally provided lipids which the fungus hydrolyses by lipolytic activity to release fatty acids necessary for both growth and pathogenicity. In this study, the cloning and characterization of the first gene encoding a secreted lipase of M. furfur possibly associated with this activity are reported. The gene, MfLIP1, shows high sequence similarity to other known extracellular lipases, but is not a member of a lipase gene family in M. furfur. MfLIP1 consists of 1464 bp, encoding a protein with a molecular mass of 54.3 kDa, a conserved lipase motif and an N-terminal signal peptide of 26 aa. By using a genomic library, two other genes were identified flanking MfLIP1, one of them encoding a putative secreted catalase, the other a putative amine oxidase. The cDNA of MfLIP1 was expressed in Pichia pastoris and the biochemical properties of the recombinant lipase were analysed. MfLip1 is most active at 40 degrees C and the pH optimum was found to be 5.8. The lipase hydrolysed lipids, such as Tweens, frequently used as the source of fatty acids in M. furfur media, and had minor esterase activity. Furthermore, the lipase is inhibited by different bivalent metal ions. This is the first molecular description of a secreted lipase from M. furfur.

Fungal Proteins↗

[Pulmonary coccidioidomycosis].

Coccidioidomycosis is an acute, generally mild, respiratory disease that rarely becomes chronic or disseminated and fatal. The aetiologic agent is Coccidioides immitis, a dimorphic fungus growing in soil. The fungus is endemic in hot semi-arid areas in the USA and South America. Human beings and animals become infected by inhaling dust with arthroconidia. The fungus gives rise to either a purulent or a granulomatous inflammation or both. Clinically and radiologically, it can be confused with neoplasms and tuberculosis. The disease may be fatal in immuno-deprived persons who are also at risk of reactivation of a latent infection. Coccidioidomycosis can be detected serologically. The standard treatment of severe illness is Amphotericin B. The authors present the first histologically and serologically verified case of pulmonary coccidioidomycosis in Denmark. An increased number of coccidioidomycosis can be expected with increased travelling and an increased number of immuno-deprived persons.

Coccidioidomycosis↗

Use of Polymerase Chain Reaction To Detect the Take-All Fungus, Gaeumannomyces graminis, in Infected Wheat Plants.

Gaeumannomyces graminis, the causative agent of take-all disease of wheat, barley, and oats, was detected in infected wheat seedlings by using the polymerase chain reaction to amplify Gaeumannomyces-specific DNA fragments. Nested primers and two rounds of amplification were used to amplify two fragments, approximately 287 and 188 bp in size, from G. graminis-infected wheat seedlings. The use of nested primers greatly decreased the number of nonspecific amplification products. Polymerase chain reaction products were not obtained with DNA from seedlings infected with several other phytopathogenic fungi or with DNA from uninfected seedlings. Amplified products were visualized on agarose gels, and their identities were confirmed by DNA hybridization. This method did not require culturing the fungus and has potential for detecting G. graminis in infested wheat, barley, or oat fields.

Journal Article↗

Mapping a resistance gene in wheat cultivar Yangfu 9311 to yellow mosaic virus, using microsatellite markers.

Wheat yellow mosaic disease, which is caused by wheat yellow mosaic bymovirus (WYMV) and transmitted by soil-borne fungus, results in severe damage on wheat (Triticum aestivum L.) production in China. For development of resistant cultivars to reduce wheat yield losses due to wheat yellow mosaic disease, resistance test and genetic analysis indicated that a single dominant gene in wheat cultivar Yangfu 9311 contributed to the resistance. Bulk segregant analysis was used to identify microsatellite markers linked to the resistance gene in an F(2) population derived from the cross Yangfu 9311 (resistant) x Yangmai 10 (susceptible). Microsatellite markers Xwmc41, Xwmc181, Xpsp3039, and Xgwm349 were co-dominantly or dominantly linked with the gene responsible for WYMV resistance at a distance of 8.1-11.6 cM. Based on the wheat microsatellite consensus map and the results from amplification of the cultivar Chinese Spring nulli-tetrasomic stocks, the resistance gene to wheat yellow mosaic disease derived from Yangfu 9311, temporarily named as YmYF, was thus mapped on the long arm of chromosome 2D (2DL).

China↗

Seed fitness of hermaphrodites in areas with females and anther smut disease: Silene acaulis and Microbotryum violaceum.

Sex-dependent infection rates could change the effective sex ratio of a population. Here, I tested whether females and hermaphrodites of Silene acaulis were equally likely to be infected by Microbotryum violaceum, a fungus that sterilizes the host, and whether sex allocation in hermaphrodites differed between low and high disease plots. Sex ratios of healthy and diseased plants were estimated in five natural plots. Fitness gained through seed production was estimated by measuring seed quantity and quality for each sex morph in eight plots for 2 yr; four plots had 1-5% disease frequency and four plots had 18-25% disease frequency. Sex ratios of healthy and diseased plants did not differ in five plots. The proportion of fitness hermaphrodites gained through ovules varied from 25 to 48%, indicating that this population is near the cosexual end of gynodioecy. Variation in functional gender of hermaphrodites was not explained by sex-dependent infection rates. Spatial heterogeneity in resources and microclimate seems to be important in explaining both disease frequency and variation in seed production by females and hermaphrodites.

Basidiomycota↗

The many faces of pulmonary aspergillosis.

The recognition of aspergillus in all its clinical disguises remains a challenge to clinicians in all fields of medicine. Fortunately, aspergillus has low pathogenicity for humans and requires very heavy inoculum of spores (aspergillary pneumonitis) in order to infect those whose pulmonary defense mechanisms, inherent structure, and physiology are intact. Patients with problems from aspergillus may be seen in either inpatient or outpatient clinical practice. The patient with fibrotic or cavitary lung disease finds himself at risk to be colonized and develop an aspergilloma (fungus ball). Conservative therapy (that is, antibiotics, pulmonary hygiene) or simple observation is often all that is required. With significant hemoptysis, surgical removal could be definitive treatment; but these patients often have such compromised pulmonary function that alternative therapies like infusion of antifungal agents locally are tempting. Part of the problem of the patient with asthma or COPD may actually be secondary to hypersensitivity to aspergillus (ABPA), which exacerbates bronchospasm and adds "pulmonary infiltrates" to the underlying disease. The recognition of this entity and then the judicious use of corticosteroids to control the symptoms will stabilize the clinical course of the disease. The immunocompromised patient may be relatively free of pulmonary disease.; but aspergillus, waiting until cytotoxic agents, corticosteroids, granulocytopenia, broad-spectrum antibiotics, and previous pneumonias destroy the local lung defense mechanisms, will then attack with a vengeance. The resultant invasive pulmonary aspergillosis requires treatment with amphotericin B, along with its own inherent toxicity.

Acute Disease↗

Epidemiologic aspects of blastomycosis, the enigmatic systemic mycosis.

A growing body of epidemiologic information derives from the study of sporadic cases and seven epidemics of blastomycosis, although a complete epidemiologic description of the disease is impeded by the absence of a skin test and difficulty isolating the causative fungus, Blastomyces dermatitidis, from nature. Most cases occur sporadically in humans and dogs in a worldwide distribution. Endemic areas in the United States include southeastern, southcentral, and midwestern states, particularly Arkansas, Kentucky, Mississippi, and Wisconsin. Blastomycosis is acquired by inhalation of spores from nature and acute disease occurs 21 to 106 days (median 43 days) after exposure; cutaneous inoculation and sexual and intrauterine transmission are rare. Most human cases are in middle aged men with occupation-, or leisure-related activities involving the soil or wooded areas. Identification of a point source in nature at a beaver pond and lodge was first accomplished during a 1984 Wisconsin epidemic, advancing knowledge of the natural habitat and ecology of the fungus. Blastomcyces alkali- and water-soluble antigen, utilized for in vitro lymphocyte transformation studies during the epidemic, may hold considerable promise for incorporation into a skin test.

Animals↗