The application of Tregs in the context of organ

transpla

The application of Tregs in the context of organ

transplantation is supported further by the seminal work by selleck inhibitor Sakaguchi et al. [6], who showed that Tregs from naive mice prevented rejection of allogeneic skin grafts in T cell-deficient nude mice given CD25– T cells. Subsequently, a series of preclinical rodent models of skin and cardiac transplantation demonstrated that Tregs present in the recipient at the time of transplantation are critical in the induction and maintenance of tolerance (reviewed in [40]). In support of such studies we have also generated Treg lines in vitro, and shown that these Tregs are very effective at inducing survival of MHC-mismatched heart allografts [41]. Furthermore, in a murine skin transplant model following thymectomy and partial T cell depletion, we have demonstrated previously the ability of in-vitro-expanded Tregs in inducing donor-specific transplantation tolerance in this system [42]. Selleck Dabrafenib The importance of adoptive Treg therapy in transplantation is supported further in mouse models of bone marrow transplantation, where the transfer of freshly isolated Tregs together with the bone-marrow allograft has been shown to ameliorate GVHD and facilitate engraftment [43]. GVHD was also the first model in which it was shown that the adoptive transfer of ex-vivo-expanded donor Tregs was highly

effective in preventing acute or chronic GVHD [44]. Moreover, the adoptive transfer of Tregs has been shown to prevent rejection of pancreatic islet [45] and other organ allografts [46, 47]. The use of currently available humanized mouse models of GVHD and allotransplantation [48, 49] has reinforced further the importance of Tregs in these settings. These models are based on the reconstitution of immunodeficient mice with human immune

cells. More recently we have also shown the efficacy of human Tregs in preventing alloimmune dermal tissue injury in a humanized mouse model of skin transplantation [50]. Furthermore, Nadig et al. [51] GNA12 developed a human vessel graft model to study the in-vivo function of Tregs. Their results showed convincingly that grafts from mice reconstituted with peripheral mononuclear cells (PBMCs) alone exhibited extensive vasculopathy, whereas the co-transfer of Tregs prevented this process. Such adoptive transfer experiments in rodents, therefore, support the notion that tolerance requires ‘tipping the balance’ between reactivity and regulation. Despite such data generated in preclinical animal models, showing successfully that Tregs can induce and maintain transplantation tolerance, we currently face many challenges in the laboratory that have hindered the widespread application of Treg cell therapy in the transplant setting. In addition, a number of different strategies have been proposed for the isolation and expansion of Tregs for cellular therapy.

For example, antiretroviral drugs as either preexposure prophylax

For example, antiretroviral drugs as either preexposure prophylaxis or treatment selleck screening library of established infection have been examined

in mice with reconstituted human immune system components, and preexposure prophylaxis with these reagents has been shown to block rectal transmission [26, 32-34]. In addition, experimental therapies against HIV infection using either antiviral siRNA delivery to T cells, siRNA-mediated silencing of the CCR5 coreceptor and of viral proteins, or cyclin-dependent kinase blockade to inhibit viral replication have been successfully employed in these mouse models [35-37]. Thus mice with reconstituted human immune system components recapitulate HIV infection and can be used as a preclinical model for therapies against this viral infection. Besides HIV, infection with the human tumor virus EBV has been studied in this in vivo model of the human immune system [6, 38-40]. For these studies the viral strain B95–8 Palbociclib was used almost exclusively, which was originally isolated from a patient with symptomatic primary EBV infection, called infectious mononucleosis [41]. i.p. infection with increasing infectious doses of EBV leads to

asymptomatic persistent infection, lymphoproliferative disease, or even hemophagocytic lymphohistiocytosis [40, 42]. During persistent infection, B cells primarily harbor the virus and strong evidence exists for both latent EBV infection as well as a low level of lytic EBV replication [38]. These persistently infected B cells can be purified from EBV-carrying animals and cultured in vitro as immortalized lymphoblastoid cell lines. They express all eight latent EBV antigens in so-called latency type III. However, it is much less clear if other PAK5 EBV latencies also develop in mice with reconstituted human immune system components, such as latency 0, which is found without

any EBV protein expression in memory B cells of healthy virus carriers; latency I, which is found in Burkitt’s lymphoma and homeostatic proliferating memory B cells in humans; and latency II, which is present in Hodgkin’s lymphoma and germinal center B cells in healthy EBV carriers [43]. Immunohistochemical studies provide some evidence to support the development of latencies 0, I, and II in reconstituted mice [44, 45]. However, false-negative immunohistochemistry for EBV gene products might erroneously suggest the presence of latency types other than latency III. Interestingly, EBV-encoded miRNAs are required to establish systemic persistent infection [46]. Furthermore, a latent nuclear antigen of the virus, called Epstein-Barr nuclear antigen 3B (EBNA3B), suppresses tumor formation in vivo [47].

The balance of this network of signaling molecules is clearly inc

The balance of this network of signaling molecules is clearly inclined to pro-inflammation. In addition, choriodecidual leukocytes secreted chemokines and active MMP-9. Based on these findings, https://www.selleckchem.com/products/PF-2341066.html we propose that term choriodecidua contains a potential cellular source of pro-inflammatory mediators and the enzymatic machinery required for amniochorion extracellular matrix degradation associated with normal delivery at the end of gestation. Characterization of the specific subsets of cells participating in the secretion of these compounds is currently under way in our laboratory. These findings add functional meaning to old and new observations

describing the infiltration of leukocytes in reproductive tissues near the time of labor.[10, 14, 18, 27, 28, 30] Our group recently provided evidence supporting that the choriodecidua cellular composition is actively and selectively modified at gestational term with the arrival of specific lymphocyte subsets, Ivacaftor some of them expressing MMP-9, IL-1β, and TNF-α.[10, 17]Our findings using in vitro-cultured choriodecidual leukocytes are also complementary to the previously reported in vivo presence of leukocytes in the choriodecidua expressing pro-inflammatory mediators, such as those described in this

article, in human tissues experiencing labor.[10, 18, 31] Specific chemo-attraction and homing of leukocytes to term gestation choriodecidua have been RAS p21 protein activator 1 proposed as the first step for conditioning a pro-inflammatory microenvironment resulting in the production of mediators for the induction

of labor at term pregnancy.[13, 32-34] Chemokines such as MIP-1α, MCP-1, IL-8, and RANTES are increased during labor in amniotic fluid, and this increase correlates with cervical dilation[33] and the number of leukocytes in reproductive tissues at term labor.[35-37] MIP-1α, IL-6, and MCP-1 are secreted by choriodecidual leukocytes,[8, 31] and these signals may attract and activate additional lymphocytes and monocytes, among other leukocytes.[34] According to the current hypothesis, once homing of leukocytes to the choriodecidua is under way, activation of the inflammatory cascade by a non-identified modulator will result in the massive local liberation of mediators, including IL-1β, TNF-α, and IL-6.[4, 5, 9, 12] Increased concentrations of these cytokines have been documented during labor in different compartments, including umbilical cord blood, amniotic fluid, and peripheral maternal blood.[3, 11, 16, 38] Choriodecidual cells may be a major source for these signals. These cytokines have been proposed as a first wave of signaling, acting on local cells and resulting in the production of a secondary wave of effector molecules.

11 Interleukin-32 is selectively expressed in activated natural k

11 Interleukin-32 is selectively expressed in activated natural killer cells, T cells, epithelial cells, endothelial cells and blood monocytes.11,12 The IL-32 induced by IL-18 has a number of splice variants, namely, IL-32α, -β, -γ, -δ, -ε and -ζ. Their receptors have yet to be identified, although proteinase 3 has been recently identified as a specific IL-32-binding protein. Interleukin-32 has emerged as

an important player in innate and adaptive immune responses13 and IL-32 associated with TNF-α appears to exacerbate TNF-α-related inflammatory arthritis and colitis.14 Expression of IL-32 may be a cancer biomarker, and high levels of IL-32 expression have been detected in several cancer cell types.15,16 Interleukin-32 knock-down was also shown to suppress anti-apoptotic proteins such as bcl-2, and induced apoptosis.15,17 this website Recent studies have

demonstrated that viral infection stimulates IL-32 expression; IL-32 suppressed replication of HIV18 during HIV infection, thereby reducing the levels of T helper type Sirolimus 1 and pro-inflammatory cytokines,19,20 and was induced by infection with the influenza A virus.21 However, the role of HPV in IL-32 expression remains unclear. We detected IL-32 expression in tissues and cells obtained from patients with cervical cancer. Furthermore, as HPV plays a critical role in cervical cancer, we attempted to assess the possible role of IL-32 as an inducer of cancer and inflammation in response to HPV infection. Cyclo-oxygenase-2 (COX-2) is over-expressed in HPV-induced diseases, including cervical cancer,22,23 and is stimulated by HPV-16 E6 and

E7 Thalidomide oncoproteins via the epidermal growth factor receptor/Ras/mitogen-activated protein kinase pathway.24 As COX-2 and IL-32 are associated with inflammatory processes, we attempted to characterize the relationship between COX-2 and IL-32 in the context of HPV infection. In this study, we evaluated the role of HPV in cervical cancer associated-IL-32 regulation as well as the feedback mechanisms between COX-2 and IL-32 occurring in response to the E7 oncogene. Human cervical cancer cells (C33A, SiHa and CaSki) were obtained from the American Type Culture Collection (Rockville, MD). An HPV-negative cervical cancer cell line (C33A) was prepared to establish stable cell lines expressing the E7 oncogene, and two stable cell lines (C33A/pOPI3, vector control C33A and C33A/E7, E7 expressing C33A) were established as previously described.25,26 All cells were grown in Dulbecco’s modified Eagle’s medium (DMEM) supplemented with 10% fetal bovine serum (Hyclone, Logan, UT) and were cultured at 37° in a humidified atmosphere of 5% CO2. N-(2-cyclohexylosyl-4-nitrophenyl)-methane sulphonamide (NS-398) was purchased from Alexis Biochemicals (San Diego, CA), dissolved in DMSO, and used at final concentrations of 50 μm and 100 μm.

, 2003; Gafan et al , 2005) In fact, the application of PCR-DGGE

, 2003; Gafan et al., 2005). In fact, the application of PCR-DGGE analysis to the biliary sludge occluding our stents allowed the identification of a large additional number of bacterial and fungal species that were not revealed by culture.

The only partial overlapping Selleck Bortezomib between the species identified by PCR-DGGE and those isolated by culturing is presumably due to the different stent portions analyzed by both techniques as well as the PCR-DGGE analysis performed on only 50% of stents. In fact, the number of isolated species, as well as the ratio between aerobic and anaerobic species, may vary considerably depending on the portion analyzed. However, our findings of such a large number of anaerobic species, both isolated by culturing or identified by PCR-DGGE, BMS-354825 price can be considered of particular interest. Apart from the paper of Leung et al., (2000), which reported the isolation from unblocked biliary stents of strains belonging to only three anaerobic species (C. perfringens, C. bifermentans and B. fragilis), this is the first report on the isolation from blocked biliary stents of anaerobic strains belonging to 14 different species as well as on the identification of five additional species by PCR-DGGE. Our SEM observations of sessile microorganisms remaining tightly attached to the surface of stent lumen after detachment of the covering

amorphous material occurring during the dehydration process seem

to significantly support the hypothesis that biliary stent clogging starts with the bacterial colonization of the stent lumen. This hypothesis finds a significant confirmation in the light micrograph of a cross-section of an occluded biliary stent recently published by Costerton (2007), in which concentric layers of a bacteria-rich biofilm are visible close to the inner surface of the stent lumen while large amounts of bile salts, Rebamipide mixed with dispersed small bacterial clusters, occupy the central part of the lumen, the remaining space allowing a slow bile flow. The isolation of anaerobic bacteria in 57% of the analyzed stents and the demonstrated ability of the majority of them to form a biofilm in vitro strongly suggest that anaerobic species presumably play a significant role in biliary stent clogging. On the basis of these evidences and the well-known antibiotic tolerance of biofilm-growing bacteria, further studies should be focused on strategies to prevent biofilm development on the inner surfaces of biliary stents in order to prolong their patency with important medical and economical outcomes. The authors gratefully acknowledge the collaboration of Professors Antonio Basoli and Fausto Fiocca for providing the clogged stents to be analyzed for their microbiological content.

Spots representing single Ab-secreting cells were developed with

Spots representing single Ab-secreting cells were developed with the substrate (a buffered solution containing 4 mg of 4-chloro-1-naphthol, Sigma–Aldrich). The spots were counted with the aid of a dissecting microscope. Flow cytometry.  Single cell suspensions (1 × 106/sample) of pooled NALT and NP from seven untreated and immunized mice were stained with fluorochrome-labelled mAbs as described previously [8]. The surface phenotype of cells was analysed using anti-mouse mAb (Becton Dickinson Technologies, Gaithersburg, MD, USA) purchased from PharMingen (San Diego, CA, USA). The mAbs used in this study

included anti-CD45R/B220+ phycoerythrin (PE) (RA3-6B2), anti-CD3+ fluorescein isothiocyanate (FITC) (molecular complex 17A2), anti-CD3+ peridinin chlorophyll protein (PerCP) (CD3e chain) Selleckchem Maraviroc (145-2C11), anti-CD4+ FITC (L3T4) (6K1.5) and anti-CD8a+ PE (Ly-2) (53–6.7).

For analysis of activation marker expression, the mAb used were anti-CD25 (FITC) (IL-2Ra chain, p55) (7D4), anti-CD25 (PE) (IL-2Ra chain, p55) (7D4), anti-CD69 (FITC) (very early activation antigen) (H1.2F3) and anti-CD69 (PE) (H1.2F3). To perform flow cytometric analyses, relative fluorescence intensities were measured using a FACSCalibur cytometer (Becton Dickinson, San Jose, CA, USA) and BD cell quest Pro v.5.1.1 software (Becton Dickinson). For each phenotypic characteristic data were collected for 20,000 events. Lymphocyte phenotypes were determined by two or three colours immunofluorescence. The percentage of cells labelled with each mAb was calculated in comparison with cells R788 cost stained with isotype control antibody. B and T-cells were analysed within

a lymphocyte gate defined by forward and side light tuclazepam scatter. Background staining was controlled by labelled isotype controls (Pharmingen) and never exceeded 1.0% of cells. The results represent the percentage of positively stained cells in the total cell population exceeding the background staining signal. Each analysis was performed at least three times for verification, and the data represent the mean ± standard deviation from three to five experiments using cells of a given tissue from seven mice. Detection of intracellular cytokines: IL-2, IFN-γ, IL-4, IL-5, IL-10 and TNF-α.  The production of cytokines was measured through intracellular staining, and all the phenotypic assays of NALT and NP were performed in parallel as described in [8]. Statistical analysis.  The statistical analysis was performed using Mann–Whitney U-test, taking P < 0.05 as significant. The number of lymphocytes recovered from NALT following immunization of BALB/c mice with Cry1Ac was increased. The yield of lymphocytes from normal mice in NALT was 7.2 (±0.7) × 105 cells, while in the immunized group the number of cells obtained was 1.2 ± 0.3 × 106 cells (P < 0.05). The number of cells obtained from NP was slightly increased by immunization 1.4 (±0.

001), Triglycerides (P = 0 002), total cholesterol (P = 0 001) le

001), Triglycerides (P = 0.002), total cholesterol (P = 0.001) level; and significantly lower high density lipoprotein (P = 0.013) values. Mean survival (patient-months) of patients with MS (30.7 (95%CI 27.1–34.3)) was significantly inferior to that of patients without MS (55.6 (95% CI 50.8–60.4), P = 0.001). Mean technique survival of patients with MS was also significantly lower (38.9 (95% CI 35.9–41.9)) compared to that of patients without MS (61.5 (95% CI 58.3–64.7),

P = 0.039). On univariate Cox regression analysis diastolic BP (P = 0.003), Systolic BP (P = 0.026), hypertension (HTN) (P = 0.001) and MS (P = 0.001) were found to be independent predictors of mortality. However on multivariate Cox hazard regression analysis, only MS (HR 5.39 (95% CI 2.06–14.14), P = 0.001) was found to be the significant predictors of mortality in these patients. Among the factors other than components of MS, the presence of comorbidities (P = 0.029), Inhibitor Library clinical trial serum albumin (P = 0.042), non-HDL cholesterol (P = 0.003), total cholesterol/HDL (P = 0.001) and MS (P = 0.001) were important factors predicting mortality on univariate Cox regression, while only MS (P = 0.001) and serum albumin (P = 0.013) were the independent factors predicting mortality on multivariate analysis.

Prevalence of MS in non-diabetic PD patient is high and predicts long term patient and technique survival. “
“Myocardial perfusion imaging (MPI) with SPECT (single photon emission computerized tomography) is commonly used for selleck compound preoperative renal transplant assessment. We performed an audit to evaluate the prognostic value of MPI in this cohort. Between 1999 and 2009, 838 transplants were performed in South Australia. A total of 387 patients had

393 preoperative MPI in three hospitals. Using a statewide electronic clinical information system (OACIS) cardiac events, MPI results (positive: any reversible defect; negative: fixed defects and normal), clinical follow up and comorbidities (diabetes and hypertension) were determined. End-point events were ‘soft’: admission with angina, percutaneous intervention or bypass; or ‘hard’: myocardial infarction or cardiac death. The end-point event rates were determined using Kaplan–Meier curves. Multivariate analyses were Exoribonuclease performed for age (60 years), gender, diabetes and hypertension. For negative MPI the event rates in dipyridamole stress were compared with tachycardic stress. Soft events: There was a statistically significant lower event rate for MPI negative versus positive, 3.9% versus 20.8% (hazard ratio 4.4 confidence interval: 2.1–9.6, P < 0.001) at 5 years of follow up – no effect from age, gender, diabetes and hypertension. Hard events: There was a lower event rate for MPI negative versus positive (also unaffected by age, gender, hypertension and diabetes) but the result was not statistically significant, P = 0.153. For negative MPI the soft and hard event rates were similar for dipyridamole and tachycardic stress.

Importantly, reconstitution of FcγRIIB−/− mice with FcγRIIB+ B ce

Importantly, reconstitution of FcγRIIB−/− mice with FcγRIIB+ B cells confers protection from disease, as does increasing the level of FcγRIIB expression through retroviral transduction 8. Together, these data suggest that B-cell expression of FcγRIIB is essential for the maintenance B-cell peripheral tolerance. Ku-0059436 supplier Early studies demonstrated that immune complexes (IC), composed

of rabbit F(ab′)2 anti-IgM bound by mouse IgG, activated B cells significantly less well than F(ab′)2 anti-IgM alone 9. However, chromatin/DNA-associated IC, present in the sera of autoimmune mice, very effectively activate both IgG2a-reactive high-affinity 20.8.3 and low-affinity AM14 B cells 10, 11. AM14 B-cell activation required engagement of both the BCR and TLR9 12. TLR9 was originally described as a pattern recognition receptor specific for particular DNA sequences, Luminespib molecular weight designated CpG motifs, frequently found in bacterial but not mammalian DNA 13. Nevertheless, the role of TLR9 in the detection of DNA-associated IC, as described above, clearly demonstrated that TLR9 also detects mammalian DNA. To better understand the nature of the endogenous TLR9 ligand, we have constructed dsDNA fragment IC that incorporate biotinylated DNA fragments bound by an IgG2a anti-biotin mAb. Stimulation of AM14 B cells with IC containing dsDNA fragments

corresponding Isotretinoin to the CG-rich sequences derived from endogenous CpG islands

strongly activate AM14 B-cell proliferation, whereas IC containing dsDNA fragments representative of the overall mammalian genome do not 14. The availability of DNA fragments that can engage TLR9 to varying degrees provides a useful tool for examining the regulation of autoreactive B-cell activation. Like TLR9, TLR7 is also located in endosomal compartments; however, this receptor recognizes single-stranded RNA 15–17. In an analogous manner to the BCR/TLR9 paradigm, RNA IC promote AM14 B-cell responses through a mechanism that involves both the BCR and the TLR7 18. However, AM14 B-cell responses to RNA IC are generally more dependent on coactivation with type I IFN. We had previously shown that FcγRIIB deficiency did not affect the capacity of high-affinity IgG2a-specific B cells to respond to chromatin IC 11. At the time, we surmised that the cell surface expression of FcγRIIB precluded its capacity to regulate signaling cascades emanating from TLR7 and TLR9, which were predominantly found in endosomal compartments. The capacity of FcγRIIB has now been re-examined in the context of low-affinity IgG2a-reactive AM14 B cells activated by chromatin/DNA and RNA IC. We find that FcγRIIB can regulate AM14 IC responses to DNA IC only when the complexes contain CpG-poor DNA. FcγRIIB further modulates AM14 B-cell responses to RNA IC, both in the absence and in the presence of IFN-α.

None of authors have financial support relevant to this study “<

None of authors have financial support relevant to this study. “
“Objective: Cold stress can elicit increases in urinary urgency and frequency. We determined if there was a relationship between finger and toe temperatures and BMN 673 manufacturer lower urinary tract symptoms (LUTS). Methods: We studied 50 people who visited a public health management seminar. The participants were divided into

two groups according to self-described sensitivity to cold stress. The cold non-sensitive (CNS) group consisted of 3 males and 20 females (66.9 ± 10.8 years old), and the cold sensitive (CS) group consisted of 4 males and 23 females (65.8 ± 8.01 years old). Each participant was assessed to determine international prostate symptom score (IPSS), overactive bladder symptom score (OABSS), and quality of life (QOL) score. They were then instructed on lifestyle changes and exercises that could improve peripheral blood flow and provide relief for their LUTS. Next, the temperatures of their middle fingers and toes were measured before and after 5–10 min of the exercises. Two weeks later, the IPSS, OABSS, and QOL scores were reassessed. Results: Before exercise, the middle fingers were significantly warmer than the middle toes. Exercise had no significant effect on the middle finger temperature of either Palbociclib mw group; however, it did increase the middle toe temperature for both groups. The increase

was greatest for the CS group. The CS group had higher LUTS storage symptoms than the CNS group, and these improved after 2 weeks of lifestyle changes and exercise. Conclusion: Improvements in lifestyle and daily exercise may be

effective for LUTS in CS people. “
“Increasing evidence from clinical tuclazepam and epidemiological studies has shown associations between lower urinary tract symptoms (LUTS) and major chronic medical diseases. Recent epidemiological studies have revealed that, to a large extent, lifestyle factors associated with metabolism, such as obesity, physical activity, blood glucose, and diet, contribute substantially to the development of these conditions. Multiple studies have demonstrated strong independent associations between LUTS and components of metabolic syndrome. Therefore, modification of lifestyle factors may lower the risk of LUTS. Prevalence of MS is age-dependent with gender differences, and LUTS have different manifestations in men and women. LUTS-associated benign prostatic hyperplasia (BPH) have multiple evidence of correlation with MS factors; however, results were inconsistent in their correlation among prostate volume and prostate-specific antigen. There is limited data on female LUTS or other diseases such as urinary incontinence or overactive bladder and MS. Further research is required to understand their connection in the pathogenesis of LUTS and to establish a more effective prevention and a therapeutic model.

The records at our stem-cell transplantation centre were reviewed

The records at our stem-cell transplantation centre were reviewed to identify the patients who underwent autologous HSCT between April 2009 and December 2010. Patients

were classified as having proven invasive aspergillosis (IA), probable IA, or possible IA on the basis of the criteria established by the European Organization for Research and Treatment of Cancer and Mycoses Study Group (independent of the BDG results). During the study period, the patients were screened for BDG twice a week from transplant (day 0) until engraftment. Three patients were diagnosed with probable IA and five were diagnosed with possible IA. A total of 354 serum Selleckchem NVP-AUY922 samples from79 patients who met the study inclusion criteria were used for statistical analysis. At the cut-off value of 80 pg ml−1, the sensitivity was 27.2% [95% confidence interval (CI); 7.3–60.6]; specificity, 94.4% (95% CI; 91.3–96.5); positive predictive value, 6.2%; and negative predictive, 93.7%. The clinical contribution find more of the BDG assay as a screening test was relatively limited in this cohort of patients undergoing autologous HSCT. “
“Centre for Microbial Biotechnology,

Panjab University, Chandigarh, India Mucormycosis remains a devastating invasive fungal infection, with high mortality rates even after Oxymatrine active management. The disease is being reported at an alarming frequency over the past decades from India. Indian mucormycosis has certain unique features. Rhino-orbito-cerebral presentation associated with uncontrolled diabetes is the predominant characteristic. Isolated renal mucormycosis has emerged as a new clinical entity. Apophysomyces elegans and Rhizopus

homothallicus are emerging species in this region and uncommon agents such as Mucor irregularis and Thamnostylum lucknowense are also being reported. This review focuses on these distinct features of mucormycosis observed in India. Fungi belonging to the class Zygomycetes and order Mucorales often cause devastating angioinvasive fungal infections, primarily in patients with underlying risk factors.[1] These moulds gain entry into the human body via respiratory tract or skin, and less commonly through the gastrointestinal tract, eliciting an acute inflammatory response.[2] Under favourable conditions such as those in immunocompromised hosts, they invade the blood vessels, causing extensive vessel thrombosis and ischaemic tissue necrosis.[2, 3] Most of these infections are rapidly progressive and exhibit high mortality (~50%) even after active management; the mortality rates approach nearly 100% among patients with disseminated disease.