Fungal Research Deserves Our Attention

The Fungus Among Us

Above is a video of the yeast Candida albicans being engulfed by macrophages. Macrophages are one of the main lines of defence we have against infection. They are cells that circulate in our blood, looking for things that shouldn’t be there. When they find a target, they can move towards it, engulf it, and digest it, eliminating the threat. And they’re very good at this job. But Candida can fight back. 

Candida lives in our bodies as part of our normal flora, and most of the time it doesn’t hurt us (although most women will be familiar with Candida as the cause of painful yeast infections). In fact, the vast majority of us have Candida in our bodies, and it’s likely been with us for thousands of years. But when Candida gets into our bloodstreams, it changes and can cause big problems. The next part of the video shows exactly that: the Candida grow hyphae and are able to burst out of the macrophages, escaping our defences.

This can have very bad consequences: patients who have bloodstream infections with Candida can die from the infection within days. Candida can be difficult to diagnose, and there are few good drug options. Together, the speed of the disease, the difficulty in diagnosis, and the poor treatment options mean Candida albicans infections are a growing problem for doctors and patients.

Researchers around the world are working to find cures for Candida and others like it. Candida albicans is part of a group of organisms that are called fungi. In fact, it’s a close relative of the mushrooms you buy in the grocery store or the toadstools you find after it rains (but don’t worry, those fungi won’t grow in your bloodstream). Candida is also a close relative of the yeast Saccharomyces that we use to make beer, bread, wine, and other products we know and love. But Saccharomyces also won’t grow in your blood and doesn’t make you sick (unless, of course, you’re a bit reckless in your love of the fruits of its labor). The difference is that Candida is one a just a few fungi that are able to grow at human body temperature and cause infections.

Researchers working to understand exactly how these fungal infections cause disease have made some progress, but there’s a long way to go. And one of the biggest challenges to that progress is a lack of funding.

Fundable Fungi

The major funding agency for fungal infections is the National Institute of Allergy and Infectious Diseases. Their budget is less than half that of the National Cancer Institute. They are responsible for funding research into more than 300 different and disparate diseases including HIV and Tuberculosis (which together kill nearly 3 million people every year), Malaria (which, by itself, kills more than half a million people every year, mostly children), bacterial infections (think MRSA and C. diff.), viral infections (including the yearly Influenza viruses as well as the more unpredictable viruses like Rabies, SARS, and Ebola), and the all emerging pathogens that we still don’t understand, like the proteins that cause Mad Cow Disease and Creutzfeldt-Jakob Disease (prions).

With all these high-profile problems to solve, fungal infections have been pushed to the back of the line.

What’s worse is that research into fungal diseases does not benefit from donations from charitable organisations. There’s no such thing as a Fungal Walk or Candida Run where survivors and their families can help raise money to support research into the diseases they’ve been able to beat. In fact, the families of patients who are killed by fungal infections are often told that their loved one died as a result of complications from their cancer or other underlying disease. This is because fungal infections are a disease of the diseased: people who are already sick with cancer or because they need an organ transplant or have an autoimmune disease are the ones who are most often the victims of fungal infections. And it’s not just adults: Among premature babies, nearly one in five will experience a fungal infection within the first month of life.

The nail in the coffin of fungal research is the lack of awareness among drug companies of the true burden that fungal infections place on the health system. 75% of women (thats 2.9 billion people) will experience a Candida infection during their lifetime. Systemic fungal infections kill an estimated 1.5 million people each year. Getting a fungal infection while in the ICU can add nearly $25,000 to a single patient’s hospital bill over 8 days. Of those who develop a bloodstream infection, death rates can be as high as 70% if left untreated, and diagnosis can be very difficult.

Together, lack of government support, lack of public awareness, and lack of private research mean that fungal infections are severely underfunded.

Fighting Fungi, Curing Cancer. 

Despite this lack of funding, we’ve had some success in developing drugs against Candida and other fungal infections. And those successes give us a great platform on which to built future treatments. What’s even more promising is that research into fungal infections can also help us develop better drugs for other kinds of diseases, including cancers. This is because in addition to being close relatives of mushrooms, Candida and other fungi are close relatives of humans. The same drugs that can kill Candida can also be used to target cancer cells, and understanding fungi can tell us things about our own cells that we wouldn’t be able to figure out as quickly otherwise.

This is what economists mean when they say that money invested in research is a major driver of the economy and that cuts to research funding will cost us in both innovation and progress. The lack of funding for fungal research impacts us all, either directly or indirectly. The question now is what are we going to do about it?

 

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