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In addition, during invasive infection, fungal pathogens can proliferate as non-surface associated microcolonies embedded in extracellular matrix ( 18) (Figure 1B). In the clinical setting, fungal biofilms can propagate on artificial medical devices, such as catheters, as well as on epithelial and endothelial surfaces ( 3, 14вЂ“ 19) (Figure 1A). Many clinically relevant fungi have been shown to form biofilms, such as Candida spp., Aspergillus spp., Cryptococcus neoformans, Fusarium spp., Blastoschizomyces capitatus, Malassezia pachydermatis, Pneumocystis spp., Trichosporon asahii, Rhizopus spp., and Rhizomucor spp ( 3вЂ“ 13). We describe common themes involved in the resilience of fungal biofilms to host immunity and give examples of biofilm defenses that are pathogen-specific.ДЇungi frequently flourish as biofilms, which are aggregated communities encased in a protective extracellular matrix ( 1, 2).

Biofilms formed by Candida, Aspergillus, and Cryptococcus have received the most attention and are highlighted. In this manuscript, we review the host response to fungal biofilms, focusing on how these structures are recognized by the innate immune system. Altered immune recognition during this phase of growth is also evident by changes in the cytokine profiles of monocytes and macrophages exposed to biofilm. Biofilm formation can protect fungal pathogens from many aspects of the innate immune system, including killing by neutrophils and monocytes. Clinically, biofilm infections can be extremely difficult to eradicate due to their resistance to antifungals and host defenses. These biofilms are commonly found during infection caused by a variety of fungal pathogens.

4Department of Medical Microbiology and Immunology, University of Wisconsin, Madison, WI, United StatesДЇungal biofilms are communities of adherent cells surrounded by an extracellular matrix.

3Department of Medicine, McGill University, Montreal, QC, Canada.

2Department of Microbiology and Immunology, McGill University, Montreal, QC, Canada.

1Department of Medicine, University of Wisconsin, Madison, WI, United States.

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