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Review
. 2022 Jun 29;10(7):1317.
doi: 10.3390/microorganisms10071317.

Lomentospora prolificans: An Emerging Opportunistic Fungal Pathogen

Afroditi Konsoula  1 , Constantinos Tsioutis  2 , Ioulia Markaki  3 , Michail Papadakis  4 , Aris P Agouridis  2   5 , Nikolaos Spernovasilis  6   7
Affiliations
Review

Lomentospora prolificans: An Emerging Opportunistic Fungal Pathogen

Afroditi Konsoula et al. Microorganisms. .

Abstract

Lomentospora prolificans is an emerging opportunistic pathogen that primarily affects immunocompromised individuals leading to disseminated disease with high mortality rates while also causing infections in healthy populations. Successful recovery from infection is difficult due to high rates of intrinsic resistance to antifungals. Rapid and readily available diagnostic methods, aggressive surgical debridement wherever appropriate, and effective and timely antifungal treatment are the pillars for successful management. Future research will need to clarify the environmental niche of the fungus, further investigate the pathophysiology of infection and define species-specific therapeutic targets.

Keywords: Lomentospora prolificans; fungal infection; immunosuppression; opportunistic.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic representation of the immune response against Lomentospora prolificans. The conidia are inhaled by the host. The mucociliary escalator and pulmonary alveolar macrophages can clear the conidia. If these primary mechanisms fail, the conidia transform into hyphae, a process called germination. The hyphae can form a biofilm, invade cell tissues/extracellular matrices, or destroy the monolayer of epithelial cells. Potential virulence factors in the fungal cell wall are peptidorhamnomannan, glycosylceramide, and melanin. Pattern recognition receptors (PRRs) that are involved in the recognition of fungus by phagocytes are TLR2, TLR4, Dectin-1, ΜR and other unknown receptors. Recognition of fungal molecules leads to the activation of immune cells in response to the microbial presence. Polymorphonuclears (PMNs) damage hyphae by degranulating reactive oxygen species (ROS) and by forming neutrophil extracellular traps (NETs). Even if phagocytosed, conidia can germinate inside phagocytes and penetrate their cell membrane. The hyphae can invade blood vessels and sporulate, leading to widespread dissemination. Salivary IgA exclusively recognizes the conidia, whereas serum IgG recognizes both forms of the fungus, conidia and hyphae.
Figure 2
Figure 2
Optimal therapeutical pathway for L. prolificans infections in adults.
See this image and copyright information in PMC

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