Five reasons why we study fungal disease
To improve the outlook for patients with life-threatening fungal disease, we need a coordinated approach to tackle the infections. That’s why we set up the MRC Centre for Medical Mycology (MRC CMM) with the University of Aberdeen last year. Here Masters students Joanne Calley, Emily Speakman, Catherine Mark and Alexander Currie share five reasons why they chose to study fungi and are excited to be working at the forefront of fungal diseases research.
1. To fight a ‘hidden killer’
The most common fungal diseases are superficial infections of the skin and nails; they affect about 1.7 billion people. But these infections are rarely life-threatening. It’s the lesser-known invasive fungal infections that are the hidden killers, causing approximately 1.5 million deaths every year. This number is higher than deaths resulting from malaria or tuberculous. Invasive fungal infections are also devious, targeting the most vulnerable patients. Immunocompromised people are most at risk, including those with HIV-related disease or undergoing cancer treatment.
2. To improve diagnosis
We need to develop quicker and more accurate tests to help speed up diagnosis and allow targeted treatment. Identifying if a patient has a fungal infection in the first place is a challenge for doctors. Often symptoms aren’t specific enough to find the cause, and fungal disease is only suspected after first-line antibiotics don’t work. It can also be difficult to get appropriate samples for testing, so anti-fungal therapy is often started with no microbiological specimens to guide treatment. On top of this, current diagnostic tests for fungal disease take a long time and have poor sensitivity. A blood culture test to identify Candida detects 50-75% of cases at best.
3. To treat fungal infection
There’s an urgent need for new anti-fungal treatments. Currently there are just three major groups of drugs to treat invasive fungal infection, each with disadvantages; the azoles, the echinocandins, and polyenes. The azoles interact with commonly prescribed drugs, such as warfarin, which can lead to side-effects. And echinocandins are only available in IV formulation, limiting their use outside of hospitals. To make matters worse, we’re facing emerging resistance to anti-fungals.
4. To prevent fungal disease
Successful vaccine development could prevent the suffering of millions of people every year. But despite the major impact of fungal diseases, no vaccines yet exist for any fungal infection. There is now reason to hope, as some vaccine candidates are entering clinical trials. One major hurdle is that the weakened immune system of an immunocompromised patient cannot build up sufficient ‘memory’ against a fungal disease – this is vital for a vaccine to be effective. Another challenge is that the metabolic pathways of fungal cells are very similar to our own, which limits the number of fungi-specific targets for drugs.
5. To understand the enemy
To fight fungal disease, we need to understand the enemy better. Current research aims to advance our understanding of host immunity and how different types of fungi invade. We can use technology to see how hosts recognise fungal cells, such as real-time imaging, and to study the knock-on effects of removing individual fungal genes. Learning more about fungal cell biology will help the development of new drugs, vaccines and diagnostic tests.
Interested in getting involved? The MRC CMM is currently advertising for MRes/PhD Studentships in Fungal Infectious Disease with a deadline of 13 November.
Read about how MRC researchers are tackling drug resistance in other microbes.