María Guadalupe Frías De León

By María del Rocío Reyes-Montes, Esperanza Duarte-Escalante, María Guadalupe Frías-De-León, Erick Obed Martínez-Herrera and Gustavo Acosta-Altamirano

Invasive aspergillosis (IA) is a disease that is difficult to manage and is associated with a significantly high morbidity and mortality, caused by different species of the genus Aspergillus, and closely related to immunocompromised patients; thus, it is important to understand the distribution and molecular epidemiology of the species causing this disease. Even though Aspergillus fumigatus sensu stricto is the most common species that cause IA, in recent years, there has been an increase in the number of species in the different sections which makes the diagnosis of this invasive fungal disease a great challenge. Conventional tests for the diagnosis of IA present limitations in sensitivity and specificity, while molecular tests have the potential to improve diagnosis by offering a more sensitive and rapid identification, but they are not yet standardized for reliable use in clinic. Nevertheless, there are some tests for the presumptive diagnosis of aspergillosis which, although are not specific for the identification of species, have been decisive in the case of IA. Among these are the Galactomannan test (GM), the Beta-D-glucan assay and volatile organic compounds (VOCs) testing. In this chapter, the recent advances and challenges in the molecular diagnosis of IA are revised.

Part of the book: Molecular Medicine

By María Guadalupe Frías-De-León, Eduardo García-Salazar and Gustavo Acosta-Altamirano

Aspergillus fumigatus is one of the most important opportunistic fungal pathogens. It causes various types of infections in humans, from skin, lung, and allergic infections to invasive infections. However, these stand out because their mortality rate can reach up to 95%. A. fumigatus is a ubiquitous fungus and, therefore, humans are in constant contact with it without major risk, except when there is a predisposing factor on the host, that allows the fungus to penetrate and invade the tissues. It is fascinating how this fungus manages to go from harmless to pathogenic as, in addition to the predisposing factors of the human, multiple attributes of the fungus intervene that favor its growth and survival in the host. Among these virulence attributes are thermotolerance, the ability to evade the immune response, some components of the cell wall, the production of secondary metabolites, compliance with nutritional requirements, and the production of melanin, among others. Furthermore, some of these virulence attributes are interrelated, making understanding the pathogenesis of aspergillosis more complex. This chapter presents a review of some virulence attributes that are known, to date, in A. fumigatus.

Part of the book: Aspergillus and Aspergillosis