Adherence mechanisms in human pathogenic fungi.

Interactions of human pathogenic fungi with the host tissues are key factors in the pathogenesis of mycoses. Based on the concept that adherence of microorganisms is a prerequisite for initiation of the disease, numerous studies have been conducted to identify the fungal adhesins and their respective receptors. Several adhesins recognizing different host ligands, sometimes with multifunctional properties, have been described. Some of them have been extensively characterized, and their expression analyzed according to morphological changes or culture conditions. For some ligands, the amino acid or carbohydrate motifs participating in these interactions have been identified. Various host proteins or glycoproteins have been suggested as ligands, including components of biological fluids, or extracellular matrix and basement membrane proteins; equally adherence to several cell types, mainly epithelial and endothelial cells, or to biomaterials has been considered. This review synthesizes available information regarding adherence of the most important human fungal pathogens. It is divided into three sections corresponding to the three main groups of pathogenic fungi: Candida yeasts, opportunistic moulds and other filamentous fungal pathogens, and dimorphic fungi.