On December 20th, in the prestigious journal “Science Translation Medicine”, Gordon Brown and his colleagues describe the numbers of people with various life-threatening fungal infections and the major development and research needs which are required to improve diagnosis, treatment and survival. They estimate there are over 200,000 cases of invasive aspergillosis; >400,000 cases of invasive candidiasis (Candida bloodstream infection), 1 million cases of cryptococcal meningitis and over 400,000 patients with Pneumocystis pneumonia in AIDS cases alone, worldwide. Numerous other estimates of the global frequency of fungal diseases are estimated including vaginal candidiasis, chronic and allergic aspergillosis, the endemic mycoses in N. America and other important fungal infections.
The authors point out the major advances in diagnosis and therapy, and yet there is a major gap in implementing these findings and in developing vaccines to prevent fungal infections. Immunity to fungal infections is now much better understood, and is ripe for translation into immuno-protection or immunotherapy approaches. Progressing antifungal vaccines into clinical trials is essential and will help reduce the global burden of fungal diseases. Rapid diagnostics will reduce mortality rates, yet funding is woefully inadequate for mycology compared to other pathogens. The total spent on medical mycology research was only 1.4 to 2.5% of that spent on immunology and infectious disease research by the Wellcome Trust, the U.K. Medical Research Council, and the U.S. National Institutes of Health. Much better diagnostics are required for all the serious fungal infections and because of emerging resistance – new antifungal drugs need to be developed.
Authors – Gordon D. Brown (Aberdeen), David W. Denning (Manchester), Neil A. R. Gow (Aberdeen), Stuart M. Levitz (Boston), Mihai G. Netea (Nijmegen) and Theodore C. White (Kansas City).