ReviewMedical gas research2026
Sensing the host atmosphere: carbon dioxide regulates virulence and drug response in medically relevant fungi.
Review in Medical gas research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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0 citing papers in PubMed.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Carbon dioxide (CO 2 ) is a pivotal environmental signal that influences the physiology, development and pathogenic potential of fungi. Beyond its role as a metabolic by-product, CO 2 functions as a conserved signaling molecule that enables fungal pathogens to sense and adapt to host niches. This review synthesizes current knowledge on how fluctuations in CO 2 concentration modulate growth dynamics, morphogenesis, virulence-associated attributes and antifungal susceptibility in clinically important yeasts and filamentous fungi. In Candida species, particularly Candida albicans , physiological CO 2 levels encountered in host tissues (~5%) act as a potent morphogenetic signal, driving the yeast-to-hypha transition, promoting biofilm formation and inducing metabolic reprogramming; processes tightly linked to tissue invasion and persistence. CO 2 exposure also alters membrane composition and stress response pathways, thereby modulating susceptibility to antifungal agents. In Cryptococcus neoformans , elevated CO 2 concentrations promote capsule biosynthesis and enlargement, alongside extensive remodeling of surface architecture and membrane composition. These CO 2 -driven adaptations strengthen resistance to host immune defenses and are associated with increased tolerance to antifungals. In Aspergillus species, CO 2 availability influences growth, mycotoxin biosynthesis and developmental trajectories by shifting the balance between asexual and sexual reproduction, with downstream effects on virulence and antifungal responsiveness. In Scedosporium / Lomentospora species, CO 2 promotes conidial germination and developmental transitions that may indirectly impact antifungal susceptibility and pathogenic fitness. Collectively, these findings highlight environmental CO 2 as a pivotal and dynamic regulator of fungal biology, offering key insights into host-pathogen interactions, informing the prediction of antifungal susceptibility profiles and supporting the rational optimization of therapeutic strategies in clinical settings.
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