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SUMMARY

Microsporidia are obligate intracellular pathogens identified ∼150 years ago as the cause of pébrine, an economically important infection in silkworms. There are about 220 genera and 1,700 species of microsporidia, which are classified based on their ultrastructural features, developmental cycle, host-parasite relationship, and molecular analysis. Phylogenetic analysis suggests that microsporidia are related to the fungi, being grouped with the Cryptomycota as a basal branch or sister group to the fungi. Microsporidia can be transmitted by food and water and are likely zoonotic, as they parasitize a wide range of invertebrate and vertebrate hosts. Infection in humans occurs in both immunocompetent and immunodeficient hosts, e.g., in patients with organ transplantation, patients with advanced human immunodeficiency virus (HIV) infection, and patients receiving immune modulatory therapy such as anti-tumor necrosis factor alpha antibody. Clusters of infections due to latent infection in transplanted organs have also been demonstrated. Gastrointestinal infection is the most common manifestation; however, microsporidia can infect virtually any organ system, and infection has resulted in keratitis, myositis, cholecystitis, sinusitis, and encephalitis. Both albendazole and fumagillin have efficacy for the treatment of various species of microsporidia; however, albendazole has limited efficacy for the treatment of Enterocytozoon bieneusi. In addition, immune restoration can lead to resolution of infection. While the prevalence rate of microsporidiosis in patients with AIDS has fallen in the United States, due to the widespread use of combination antiretroviral therapy (cART), infection continues to occur throughout the world and is still seen in the United States in the setting of cART if a low CD4 count persists.

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Author Bios

Department of Pathogenic Biology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
Bing Han, Ph.D., completed his thesis project in Dr. Louis Weiss’ laboratory in the Pathology Department of the Albert Einstein College of Medicine, New York, NY, as a joint student funded by the Chinese Scholarship Council. In 2017, he obtained his Ph.D. from Southwest University, Chongqing, China. He subsequently did a postdoctoral research fellowship in the laboratory of Dr. Weiss, examining the interaction of the polar tube with the host cell during invasion. Dr. Han is currently a Full Professor at the School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China. His research interests include the molecular mechanism(s) of microsporidian host cell invasion and the interaction of host mitochondria with the microsporidian sporoplasm.
Guoqing Pan
State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, China
Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China
Guoqing Pan, Ph.D., is a Full Professor of the State Key Laboratory of Silkworm Genome Biology, Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China. He earned his Ph.D. at Southwest University, Chongqing, China, in 2009. Dr. Pan was trained at the University of California San Diego as a visiting scholar during 2013-2014. Dr. Pan’s current research interests include the genomic biology of Nosema bombycis, a microsporidian pathogen of silkworms, the interaction of microsporidia with host cells, and the evolution of intestinal microorganisms in insects and their interaction with their hosts.
Department of Pathology, Albert Einstein College of Medicine, New York, New York, USA
Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA
Louis M. Weiss, M.D., M.P.H., is Professor of Pathology (Parasitology and Tropical Medicine) and Professor of Medicine (Infectious Diseases), at the Albert Einstein College of Medicine, Bronx, NY. In 1982, he earned his M.D. from the Johns Hopkins University School of Medicine, Baltimore, MD, and his M.P.H. from the Johns Hopkins University School of Public Health. He then completed a residency in internal medicine at the University of Chicago, followed by an Infectious Diseases Fellowship at Montefiore Medical Center-Albert Einstein College of Medicine. Dr. Weiss’ interest in these pathogens started with the recognition of microsporidia as opportunistic pathogens in patients with AIDS. His research on microsporidia over the last 25 years has included studies on diagnostic approaches, microsporidian taxonomy, drug development for the treatment of microsporidiosis, the structure and composition of the polar tube, and the interactions of polar tube proteins with host cell proteins.

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cover image Clinical Microbiology Reviews
Clinical Microbiology Reviews
Volume 34Number 415 December 2021
eLocator: e00010-20
PubMed: 34190570

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Published online: 30 June 2021

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KEYWORDS

  1. microsporidia
  2. therapy
  3. diagnostics
  4. prevention
  5. Enterocytozoon
  6. Encephalitozoon
  7. Anncaliia
  8. Vittaforma
  9. AIDS
  10. albendazole
  11. fumagillin

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Authors

Department of Pathogenic Biology, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
Guoqing Pan
State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, China
Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China
Department of Pathology, Albert Einstein College of Medicine, New York, New York, USA
Department of Medicine, Albert Einstein College of Medicine, New York, New York, USA

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