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
Affiliations
Yangyu Zhou
Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Yemei Huang
Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Chen Yang
Department of Respiratory and Critical Care, Weifang Medical College, Weifang, China
Xuelei Zang
Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Hengyu Deng
Department of Laboratory Medicine, Chinese PLA General Hospital, the First Medical Centre, Beijing, China
Jing Liu
Department of Laboratory Medicine, Chinese PLA General Hospital, the First Medical Centre, Beijing, China
Enqi Zhao
Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Tingyue Tian
Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Lei Pan
Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
Xinying Xue
Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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.
