Research progress in pathological properties and antifungal resistance mechanisms of Cryptococcus neoformans

Abstract:

Cryptococcus neoformans is a common opportunistic pathogen, exhibiting pronounced neurotropism that often results in cryptococcal meningitis. Its invasive ability is closely associated with multiple factors, including capsular polysaccharides, melanin, hydrolases, and adaptability to the host environment. Conventional diagnostic methods such as fungal culture and India ink staining, though still in use, have notable limitations, whereas emerging techniques like molecular diagnostics, imaging technologies, and biochips have significantly enhanced the diagnostic accuracy and sensitivity. In clinical treatment, amphotericin B and fluconazole are widely used as first-line antifungals, while the resistance to azoles is a growing problem and results in an elevated rate of clinical treatment failure. This is mainly attributed to target alterations, upregulation of efflux pump expression and genomic ploidy changes. Recent studies on virulence factors and resistance mechanisms have driven the development of novel antifungal therapies, including drug repurposing, novel drug development, and innovative drug delivery strategies. This article reviews the latest research in the virulence factors, diagnostic techniques, antifungal resistance mechanisms, and therapeutic development of C. neoformans, providing insights into the clinical management of cryptococcosis.