Implications of hypoxic microenvironments during invasive aspergillosis

Abstract

In order to cause disease, all pathogens must tolerate microenvironmental stresses encountered in vivo during infection. One microenvironmental stress that is known to occur at sites of tissue damage is hypoxia. Yet, the occurrence and impact of hypoxic microenvironments during invasive aspergillosis, caused by the mold Aspergillus fumigatus, are essentially unknown. Here, we briefly review the potential implications of hypoxic microenvironments on the Aspergillus-host interaction. We focus on three areas where hypoxia may play a role in determining the outcome of infection: fungal virulence, host immune responses, and efficacy of current antifungal drug treatments.

Keywords: Aspergillus fumigatus; Invasive Aspergillosis; antifungal drugs; fungal virulence; hypoxia.

Figure 1

Summary of key concepts covered in this review. Hypoxia may influence the outcome of the Aspergillus-host interaction on multiple fronts: alterations in fungal virulence, host response to the fungus, and changes in azole drug efficacy at the site of infection. These effects on the host-pathogen interaction are likely mediated at transcriptional, post-transcriptional, and post-translational levels.