Candidemia is a highly prevalent invasive fungal infection caused primarily by C. albicans, C. parapsilosis, C. glabrata (currently Nakaseomyces glabratus), C. tropicalis, and C. krusei (currently Pichia kudriavzevii). Risk factors for the development of candidemia include steroid-induced immunosuppression used in solid organ or hematopoietic transplantation, and neutropenia secondary to infectious or tumorous processes. Alterations in the gut microbiota in people living with HIV, caused by antiretroviral therapy, increase the possibility of colonization by C. albicans. Likewise, the presence of a central venous catheter, parenteral nutrition, and abdominal surgery stand out as the main risk factors for the development of candidemia. New diagnostic tools have been developed for the diagnosis of this mycosis that allow the identification of the main species, from improvements in conventional stains such as calcofluor white, which increases sensitivity, as well as technologies such as T2 Candida, MoiM assay, biomarker panel (1,3 β-D-glucan, C-reactive protein, presepsin, and procalcitonin), and, more recently, the development of biosensors for the identification of Candida spp. Regarding treatment, the use of micafungin and anidulafungin in patients with obesity defined by a BMI > 30 kg/m² has shown higher survival rates and therapeutic success. Meanwhile, newer antifungals such as rezafungin and fosmanogepix have demonstrated excellent results in the treatment of these patients. Therefore, this review aims to update the epidemiology and risk factors of candidemia, as well as analyze the diagnostic tools and treatments currently available.

Hypoxia and the accumulation of hypoxia-inducible factors (HIFs) in tumors have been associated with therapeutic resistance and with autophagy establishment. We examined the effects of stable knockdown of HIF-1α or HIF-2α expression on autophagy and drug resistance in colon cancer cells. We found that under normoxic conditions, malignant cells exhibit increased basal levels of autophagy, compared with non-malignant cells, in addition to the previously reported coexpression of HIF-1α and HIF-2α. Knockdown of HIF-1α or HIF-2α expression resulted in increased autophagic and apoptotic cell death, indicating that the survival of cells is HIF-dependent. Cytotoxic-induced cell death was significantly increased by knockdown of HIFs but not by autophagy inhibition. Strikingly, although malignancy-resistant cells were sensitized to death by nutrient stress, the combination with HIF-2α depletion, but not with HIF-1α depletion, induced severe cell death. Oxidative stress levels were significantly increased as a result of HIF-2α specific inhibition or silencing suggesting that this may contribute to sensitize cells to death. The in vitro results were confirmed in vivo using a xenograft mouse model. We found that coordinated autophagy and mTOR inhibition enhanced cell death and induced tumor remission only in HIF-2α-silenced cells. Finally, using a specific HIF-2α inhibitor alone or in combination with drugs in patient-derived primary colon cancer cells, overcame their resistance to 5-FU or CCI-779, thus emphasizing the crucial role played by HIF-2α in promoting resistance and cell survival.

Aspergillosis is one of the most common fungal infections worldwide, caused by various species belonging to the genus Aspergillus, affecting both immunocompetent and immunocompromised individuals. The objective of this review was to provide an update on the last five years regarding various aspects of this mycosis, including epidemiology, risk factors, diagnosis, susceptibility, and treatment. The results showed that aspergillosis is distributed throughout the world. Furthermore, A. terreus was found to be an increasing causative agent in cases of aspergillosis, along with other less common species. Regarding clinical forms, particularly in the case of Allergic Bronchopulmonary Aspergillosis (ABPA), it is necessary to consider patients with structural lung impairment (Chronic Obstructive Pulmonary Disease (COPD) and Interstitial Lung Diseases). Meanwhile, newly identified risk factors for the development of aspergillosis include chronic obstructive pulmonary disease (odds ratio 1.88) and interstitial lung disease (OR 3.71). Furthermore, the main diagnostic methodologies for aspergillosis were polymerase chain reaction (PCR), matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF), and next-generation sequencing (NGS). Additionally, the usefulness of isavuconazole compared to voriconazole was demonstrated, representing a better alternative for the treatment of aspergillosis, while novel antifungals such as olorofim and fosmanogepix show excellent results in the management of aspergillosis. Due to the discovery of new risk factors, coupled with antifungal resistance in Aspergillus spp. and the wide variety of diagnostic tools, individualized assessment of aspergillosis cases is necessary for the appropriate management of this mycosis.