The pathways and the mechanisms by which Cryptococcus enters the brain

Yangyu Zhou; Yemei Huang; Chen Yang; Xuelei Zang; Hengyu Deng; Jing Liu; Enqi Zhao; Tingyue Tian; Lei Pan; Xinying Xue

doi:10.1080/21501203.2023.2295409

The pathways and the mechanisms by which Cryptococcus enters the brain

Mycology. 2024 Feb 14;15(3):345-359. doi: 10.1080/21501203.2023.2295409. eCollection 2024.

Authors

Yangyu Zhou¹, Yemei Huang¹, Chen Yang², Xuelei Zang¹, Hengyu Deng³, Jing Liu³, Enqi Zhao¹, Tingyue Tian¹, Lei Pan¹, Xinying Xue^{1

3}

Affiliations

¹ Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
² Department of Respiratory and Critical Care, Weifang Medical College, Weifang, China.
³ Department of Laboratory Medicine, Chinese PLA General Hospital, the First Medical Centre, Beijing, China.

Abstract

Generally, Cryptococcus initially infects the respiratory tract, but can spread, eventually crossing the blood-brain barrier (BBB) and causing meningitis or meningoencephalitis. Specifically, Cryptococcus invades the vascular endothelial cells of the BBB, from which it enters the brain. The main mechanisms through which Cryptococcus crosses the BBB are transcellular traversal, the paracellular pathway, and via Trojan horse. In this paper, the mechanisms by which Cryptococcus crosses the BBB were explained in detail. In addition to pathways of entry to the brain, this paper presents a discussion on some rare cryptococcal infections and provides some insights for future research directions.

Keywords: Cryptococcus; blood-brain barrier; paracellular pathway; transcellular traversal; trojan horse mechanism.

Publication types

Review

Grants and funding

This work was supported by the National Key Research and Development Programme (2021YFC2302100), Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (XMLX202115).