title: Pathogenesis of mucormycosis.
abstract: Mucormycosis is a life-threatening infection that occurs in patients who are immunocompromised because of diabetic ketoacidosis, neutropenia, organ transplantation, and/or increased serum levels of available iron. Because of the increasing prevalence of diabetes mellitus, cancer, and organ transplantation, the number of patients at risk for this deadly infection is increasing. Despite aggressive therapy, which includes disfiguring surgical debridement and frequently adjunctive toxic antifungal therapy, the overall mortality rate is high. New strategies to prevent and treat mucormycosis are urgently needed. Understanding the pathogenesis of mucormycosis and the host response to invading hyphae ultimately will provide targets for novel therapeutic interventions. In this supplement, we review the current knowledge about the virulence traits used by the most common etiologic agent of mucormycosis, Rhizopus oryzae. Because patients with elevated serum levels of available iron are uniquely susceptible to mucormycosis and these infections are highly angioinvasive, emphasis is placed on the ability of the organism to acquire iron from the host and on its interactions with endothelial cells lining blood vessels. Several promising therapeutic strategies in preclinical stages are identified.
authors.affiliation: Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, University of California-Los Angeles, 1124 W Carson St., Torrance, CA 90502, USA. ibrahim@labiomed.org
authors.forename: Ashraf S
authors.initials: AS
authors.lastname: Ibrahim
authors.forename: Brad
authors.initials: B
authors.lastname: Spellberg
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walsh
authors.forename: Dimitrios P
authors.initials: DP
authors.lastname: Kontoyiannis
mesh_terms: D016883:Diabetic Ketoacidosis / Q000378:metabolism / Q000382:microbiology; D042783:Endothelial Cells / Q000378:metabolism / Q000382:microbiology; D005800:Genes, Fungal; D054884:Host-Pathogen Interactions; D006801:Humans; D016867:Immunocompromised Host; D007501:Iron / Q000378:metabolism*; D009091:Mucormycosis / Q000378:metabolism / Q000382:microbiology / Q000473:pathology*; D010586:Phagocytes / Q000378:metabolism / Q000473:pathology; D012233:Rhizopus / Q000235:genetics / Q000378:metabolism / Q000472:pathogenicity*; D012307:Risk Factors; D037521:Virulence Factors / Q000378:metabolism
chemical_list: D037521:Virulence Factors; D007501:Iron