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Tag: fungi

Published on Leave a comment on Studies Find Fungi In Cancer Tumors

We all know that microbes (fungi, viruses, bacteria) live throughout our bodies - this is the human microbiome or microbiota. What is really interesting is that cancer tumors also have microbiomes (tumor microbiome), and these microbial communities are different than that found in healthy people (without tumors).

For a while it has been known that tumors (e.g., breast cancers) have different bacterial species than healthy tissue - the microbiome is different. Several recent studies find that tumors can also contain fungi, and cancers with certain fungal species have worse outcomes than those without the fungi. The mycobiome is the community of fungi that live in or on humans.

Also, the combination of fungal species are different depending on what kind of cancer that a person has. A group of scientists have put together a list (mycobiome atlas) of the distinctive fungi that are found with 35 different cancer tumors. This is exciting because in the future cancers could potentially be found by the microbial (fungi and bacteria) DNA they shed in the blood.

However, no one knows really why the fungi are in the tumors. For example, are they aiding the cancer development? Or is the cancer allowing the fungi to grow? Are the fungi interacting with the immune system? Or??

Several recent articles discuss this exciting new research.

From NY Times: A New Approach to Spotting Tumors: Look for Their Microbes

Look up an image of a tumor on Google, and you’ll probably end up with a brightly colored cluster of cancer cells on a drab background of healthy tissue. But for Lian Narunsky Haziza, a cancer biologist at the Weizmann Institute of Science in Israel, the picture looks very different. A tumor may also contain millions of microbes, representing dozens of species.

Scientists have long known that our bodies are home to microbes, but have tended to treat tumors as if they were sterile. In recent years, however, researchers have laid that notion to rest, demonstrating that tumors are rife with microbes. ...continue reading "Studies Find Fungi In Cancer Tumors"

Published on Leave a comment on Antibiotics Alter Gut Microbes In Young Infants

Many studies show that antibiotics disrupt the gut microbiome (intestinal microbial community of bacteria, viruses, fungi) in adults, but what about infants? A recent study found alterations in the gut microbes of young babies from a single course of antibiotics, with an increase in fungal species. And 6 weeks later the gut microbial community still wasn't back to normal. Yikes.

Antibiotics can be life-saving, but they must be used carefully - only when needed. As research shows, when some microbes are killed off by antibiotics, then other microbes (e.g. fungi such as Candida) that are resistant to the antibiotics increase (multiply) and move into the vacated spaces. There are no empty spaces in the gut.

Babies normally have a variety of fungal species in the gut already at a very young age - and this community of fungi is called the gut mycobiota or mycobiome. The Univ. of Helsinki researchers concluded that normally bacteria control fungi numbers in the gut - there is balance of all sorts of microbes (bacteria, viruses, fungi). But if you kill off bacteria (with antibiotics), then fungi numbers increase - an example of an imbalance in the gut microbial community or dysbiosis.

From Science Daily: A single course of antibiotics affects the gut microbiota of infants

A study recently completed at the University of Helsinki revealed that the fungal microbiota in the gut is more abundant and diverse in children treated with antibiotics compared with the control group even six weeks following the start of the antibiotic course. In light of the findings, a reduction in the number of gut bacteria as a result of antibiotic therapy reduces competition for space and leaves more room for fungi to multiply. ...continue reading "Antibiotics Alter Gut Microbes In Young Infants"

Published on Leave a comment on Fungi Are Living In Your Lungs
Human lungs Credit: Wikipedia

We have millions of all sorts of microbes living throughout our respiratory tract (nose, sinuses, mouth, lungs, etc.). A recent study looked at the microbes in the lungs and found that fungi normally live in healthy lungs, including fungi that are usually thought of as harmful. Surprisingly, the fungi found in lungs of people with COPD (chronic obstructive pulmonary disease) are basically similar to those in healthy people.

The fungi living in different parts of the body is the mycobiome. The lung (pulmonary) microbiome is unique, meaning it is different than in other parts of the respiratory tract, such as the mouth. It used to be thought that the lungs were sterile (unless there was an infection). But now we know that is not true - we normally have fungi, bacteria, and viruses living in our lungs.

University of Bergen researchers analyzed both the oral (mouth) mycobiome and lung mycobiome of 93 persons with COPD and 100 healthy persons (the control group). Surprisingly, both the oral and lung mycobiomes of both healthy and COPD groups were dominated by Candida fungi, with more Candida in the mouth, than in the lungs for both groups. Finding that Candida resides in the lungs of heathy individuals was surprising because it can be a "fungal pathogen" (thus harmful and invasive) in different parts of the body.

One piece of good news - using inhaled steroids didn't seem to affect the lung mycobiome.

Keep in mind that fungi are all around us, both indoors and outdoors, and we are constantly breathing in fungal spores. Our bodies have evolved to handle normal amounts just fine. As the researchers wrote: "Healthy airways possess effective removal of such spores". It's when a person is immunocompromised or has COPD that problems can develop.

From Medical Xpress: Fungi are present in your lungs

The lungs were for a long time considered to be sterile in health, while in diseases like chronic obstructive pulmonary disease (COPD) failure in immune mechanisms were thought to allow microorganisms to proliferate and persist. New sequencing techniques have shown that several microorganisms reside in the lungs of healthy individuals, as well. Few studies have examined the fungal community in COPD and compared it to healthy controls using such techniques. ...continue reading "Fungi Are Living In Your Lungs"

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Published on 1 Comment on It Is Normal For Fungi To Be In Breast Milk

Researchers have known for a while that human breast milk contains hundreds of species of bacteria that a baby ingests while feeding. This is good! The bacteria is seeding the baby's gut microbiome (microbial community). A recent study of breast milk from different continents found that breast milk from healthy mothers also contains species of fungi - which is the breast milk mycobiome. What was noteworthy was that some  types of fungi in breast milk were found among breast milk samples from all locations (a fungi "core group"), while other types of fungi varied among breast milk from the different locations and even how the baby was delivered (vaginal or C-section birth).

After analyzing the 80 samples of breast milk (20 from each country: Spain, Finland, South Africa, China) it was found that some fungi were the same in breast milk from the different locations: Malassezia, Davidiella, Sistotrema, and Penicillium, while others were different. Fungi from the genus Cryptococcus were higher in breast milk from women who delivered vaginally (as compared to those who had a C-section).  [Note: Genus ranks above species, but below family, and the written name is capitalized.]

This study confirms the importance of breast milk as a source of microbes (along with many nutrients and protective compounds) to the infant and infant gut. From Science Daily:

Breast milk microbiome contains yeast and fungi: Do these benefit the infant?  ...continue reading "It Is Normal For Fungi To Be In Breast Milk"

Published on Leave a comment on Are Fungi Growing On Your Wallpaper?

Image result for moldy wallpaper How many people know this? That wallpaper could have fungi (mold) living on it, and this fungi can release toxins (mycotoxins) that can pollute the air and sicken people when people inhale the toxins. The releasing of toxins from the fungi (mold) into the air is called aerosolization - and when this indoor air pollution causes people  living or working in the building to become sick, it is called sick building syndrome. This study looked at 3 common indoor fungal species: Penicillium brevicompactum, Aspergillus versicolor, and Stachybotrys chartarum, and the mycotoxins they produce after growing on wallpaper.

Why does fungi grow on some wallpaper?  The researchers write that: "Many fungi can develop on building material in indoor environments if moisture is high enough". So either high humidity in the home (especially when the weather is hot) or water damage can result in mold growth. It is estimated that in Northern Europe and North America about 20 to 40 % of buildings have visible fungal growth on surfaces. How do the mycotoxins get into the air and move around inside the home? Ordinary living, with people moving around rooms, slamming doors, air drafts from opening windows, and ceiling fans all cause "air velocities" that move around the toxins. Please note that we normally breathe in fungi and bacteria, but inhaling an overload of mycotoxins from moldy wallpaper can sicken a person. From News-Medical:

Fungal toxins from wallpaper source of illness says new research

According to a new study, there are several toxins from fungi that could be released into the air indoors and the source could be fungi living in the wall papers. These may lead to serious health problems say researchers. These ordinary fungi that live with the household wallpaper are basically of three types found the study researchers. They can grow and eventually spread to the air. This leads to serious health consequences. These effects of transmission of the airborne fungi and their toxins on human health have not been studied or considered with importance till date say researchers.

The toxins released from the fungi are called mycotoxins. They can pollute the indoor air and lead to indoor air pollution – a condition called sick building syndrome. Sick building syndrome is a condition where the residents start to feel ill according to the time they have spent in a building.... Study co-author Jean-Denis Bailly, a professor of food hygiene at the National Veterinary School of Toulouse in France in a statement explained that these mycotoxins are released from moldy material of growth of the fungi. They are eventually inhaled by the inhabitants of the home. While investigating the quality of air indoors especially at homes that have higher fungal contamination, the indoor air quality also needs to be tested for fungal toxins, he explained.

According to researchers, there has been extensive study of fungal contamination of food. However there has been little work in terms of fungal toxins in air. For this study they looked at three fungi that commonly also contaminated foods - Penicillium brevicompactum, Aspergillus versicolor and Stachybotrys chartarum. A piece of wallpaper was found to be contaminated with these three fungi. A flowing stream of air was allowed over the wallpaper and samples of air of the room were then collected for testing.

On analysis of the indoor air the researchers found that the small particles of dust floating around in the house which could then be inhaled easily, contained toxins from these fungi. Also all fungi did not spread the toxins at the same rates they found. Some spread more toxins than others and this could help researchers to decide on which fungi species to concentrate on in terms of disease prevention they said.

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Published on 12 Comments on Kimchi Is Also Antifungal?

Last week a person told an amazing story in the comments section after a post on this site. After suffering from a "constant runny nose and a bad smell" in the nose for 2 years - which was diagnosed as "fungi and staph" in the sinuses - the person started doing "kimchi treatments" (as discussed in the Sinusitis Treatment Summary page). After 2 weeks a fungal ball was loosened, which came out of the sinuses and into the mouth, and was then spit out. About an inch in size - a smelly, grey/green, round fungal ball. Wow. Which leads to the question: Are any of the microbes in live kimchi anti-fungal?

Kimchi is an amazing live fermented food, typically made with cabbage and other vegetables and a variety of seasonings. Kimchi is the national dish of Korea and so there is tremendous interest in Korea in studying kimchi to learn about the many different microbial species in kimchi, including how they change over the course of fermentation.

It turns out that kimchi contains many species of bacteria, including various species of Lactobacillus - which are considered beneficial. Of course one of the species found in kimchi over the course of fermentation is Lactobacillus sakei - the bacteria that successfully treats sinusitis, and which I have written about extensively. L. sakei predominates over pathogenic bacteria (antibacterial) - which is why it is also used as a sausage starter culture (to kill off bacteria such as Listeria). One study found that the garlic, ginger, and leek used in making kimchi were the sources of L. sakei bacteria found in fermented kimchi.

Studies show that a number of the Lactobacillus species found in kimchi are antifungal against a number of different kinds of fungi.  Some of these antifungal bacteria are: Lactobacillus plantarum, L. cruvatus, L. lactis, L. casei, L. pentosus, L. acidophilus, and L. sakei (here, here).

A study from 2005 found that some Lactobacillus species found in kimchi are predominant over a fungi known to cause health problems in humans - Aspergillus fumigatus, a mold (fungi) which is the most common cause of Aspergillus infections. Aspergillus (of which there are many species) is very common both indoors and outdoors (on plants, soil, rotting plants, household dust, etc.), so people typically breathe in these fungal spores daily and without any negative effects. However, sometimes Aspergillus can cause allergic reactions, infections in the lungs and sinuses (including fungal balls), and other infections. (more information at CDC site).

The study found that 5 bacterial species in kimchi were also antifungal against other species of fungi (Aspergillus flavus, Fusarium moniliforme, Penicillium commune, and Rhizopus oryzae). The 5 bacterial species in kimchi that they found to be antifungal were: Lactobacillus cruvatus, L. lactis subsp. lactis, L. casei, L. pentosus, and L. sakei.

Just keep in mind that fungi are everywhere around us, and even part of the microbes that live in and on us - this is our mycobiome. We also breathe in a variety of fungi (mold spores) every day. In healthy individuals (even babies) all the microbes (bacteria, viruses, fungi, etc) live in balanced microbial communities, but the communities can become "out of whack" (dysbiosis) for various reasons, and microbes that formerly co-existed peacefully can multiply and become problematic.

If the populations get too unbalanced (e.g., antibiotics can kill off bacteria, and then an increase in fungi populations take their place) then ordinarily non-harmful fungi can become pathogenic. Or other pathogenic microbes can enter the community (e.g., through infection), and the person becomes ill.

IN SUMMARY: Kimchi has beneficial bacteria in it that are effective not just against bacteria (antibacterial), but also against some kinds of fungi (antifungal). One 2016 review study went so far as to say: "Kimchi possesses anti-inflammatory, antibacterial, antioxidant, anticancer, antiobesity, probiotic properties, cholesterol reduction, and antiaging properties."

Experiences of my family and people writing suggest that the L. sakei in kimchi (and other products) is also antibiofilm. Hopefully, there will be some research on this in the future. But in the meantime, please keep writing to me about fungal complications of sinusitis, and especially if kimchi, L. sakei products, or other probiotics helped.

Published on Leave a comment on All Babies Have Fungi Living In Them

A new study has summarized what we know about fungi that live in and on babies - and yes, we all have fungi both on and within us. It's called the mycobiome. In healthy individuals all the microbes (bacteria, viruses, fungi, etc) live in balanced microbial communities, but the communities can become "out of whack" (dysbiosis) for various reasons, and microbes that formerly co-existed peacefully can multiply and become problematic. Or other pathogenic microbes can enter the community, and the person becomes ill.

In healthy adults, approximately 0.1% of the microbes in the adult intestine are fungi, from approximately 60 unique species. Most species live peacefully in the body, and some fungi even have health benefits (e.g., Saccharomyces boulardii prevents gastrointestinal disease). Some fungi that many view as no good and involved with diseases (e.g., Candida and Aspergillus) are also found normally in healthy people. Studies show that normally infants also have fungi. Some fungi that live in the baby's gut (thus detected in fecal samples) are Candida (including C. albicans), Saccharomyces, and Cladosporium. The researchers (from the Univ. of Minnesota) point out that the study of fungi in babies has been neglected and much more research needs to be done.

Whether an infant is born vaginally or through cesarean delivery (C-section) affects the composition of the baby's bacterial communities over the first 6 months of life. And similarly, it looks like when the baby passes through the birth canal, the baby is exposed to the mother's mycobiota (fungi), and then these colonize in the infant's gut. Babies born by C-section have some differences in their fungi, such as being colonized by the mother's skin fungi (such as Malassezia fungi). After birth, a parent kissing and touching the baby (skin to skin contact) also transmits microbes, including fungi, to the baby.

Whether a baby drinks breast milk or formula strongly affects the infant's bacteria within the GI tract. For example, breast-fed infants have more Bifidobacteria and Labctobacilli in their gut compared to formula-fed infants. One study found about 700 species of bacteria in breast milk. Thus, scientists think that human breast milk also influences the infant gut mycobiota (fungi), although this research still needs to be done.

Whether a baby is born prematurely or at term (gestational age) is important. For infants born prematurely, intestinal fungi can cause big problems, such as an overgrowth in the gut. For example, 10% of premature babies get invasive, systemic Candidiasis, and about 20% die. Some factors leading to this are: a naïve immune system, bacterial communities out of whack (dysbiosis) due to antibiotic exposure, and use of parenteral nutrition (because this doesn't contain all the microbes from the mother that are in breast milk). In premature infants, beneficial fungi such as S. boulardii, may help to regulate the growth of opportunistic fungal colonizers such as Candida.

it is clear that whether the baby received antibiotics is important. The bacterial community of infants is altered by exposure to antibiotics in both term and preterm infants. For example, in a lengthy study over the first 3 years of life, infants receiving multiple courses of antibiotics had bacterial community changes following antibiotics and their gut bacterial microbiome became less diverse (fewer species). Although most commonly used antibiotics do not directly act on fungi, anti-bacterial antibiotic exposure is associated with alterations to the mycobiota (fungi) -  such as increased rates of fungal colonization, fungal overgrowth, and changes in the fungal community. For ex., premature infants exposed to cephalosporin antibiotics have an increased risk for invasive Candidiasis (a fungal overgrowth).

Out of whack (dysbiotic) microbial communities, incuding fungi, are found in IBD (intestinal bowel diseases) in children. They have more of some fungi (e.g. Pichia jadinii and Candida parapsilosis) and less of Cladosporium cladosporiodes, and an overall decrease in fungal diversity in the gut, as compared to healthy children.

From BMC Medicine: Infant fungal communities: current knowledge and research opportunities

The microbes colonizing the infant gastrointestinal tract have been implicated in later-life disease states such as allergies and obesity. Recently, the medical research community has begun to realize that very early colonization events may be most impactful on future health, with the presence of key taxa required for proper immune and metabolic development. However, most studies to date have focused on bacterial colonization events and have left out fungi, a clinically important sub-population of the microbiota. A number of recent findings indicate the importance of host-associated fungi (the mycobiota) in adult and infant disease states, including acute infections, allergies, and metabolism, making characterization of early human mycobiota an important frontier of medical research. This review summarizes the current state of knowledge with a focus on factors influencing infant mycobiota development and associations between early fungal exposures and health outcomes. We also propose next steps for infant fungal mycobiome research....

Published on

Could this be? Fungal infection being the cause of Alzheimer's disease? Noteworthy from a recent study conducted in Spain: all the Alzheimer's disease (AD) patients had evidence of fungal infections in their brains, central nervous systems, and vascular systems, but none were found in the control subjects (those without Alzheimer's disease). Many of the symptoms of AD (such as inflammation of the central nervous system and activation of the immune system) match those with long-lasting fungal infections. A "microbial cause" has long been suggested as a cause of AD, and interestingly other studies have also found fungal infections in AD patients. The research so far has found several fungal species in AD patients (including Candida albicans). The researchers mention that in one study anti-fungal treatment reversed clinical symptoms of AD in 2 patients (but it was written off  as misdiagnosis).

Another possibility that immediately occurs to  explain the findings is that perhaps Alzheimer's disease somehow results in fungal infections - that the AD makes them more prone to fungal infection. In case you're wondering - all the AD patients and control patients studied had died - this is why their brain tissue could be studied so thoroughly. Excerpts from a research article by D. Pisa et al in Nature:

Different Brain Regions are Infected with Fungi in Alzheimer’s Disease

The possibility that Alzheimer’s disease (AD) has a microbial aetiology has been proposed by several researchers. Here, we provide evidence that tissue from the central nervous system (CNS) of AD patients contain fungal cells and hyphae. Fungal material can be detected both intra- and extracellularly using specific antibodies against several fungi. Different brain regions including external frontal cortex, cerebellar hemisphere, entorhinal cortex/hippocampus and choroid plexus contain fungal material, which is absent in brain tissue from control individuals. Analysis of brain sections from ten additional AD patients reveals that all are infected with fungi. Fungal infection is also observed in blood vessels, which may explain the vascular pathology frequently detected in AD patients. Sequencing of fungal DNA extracted from frozen CNS samples identifies several fungal species. Collectively, our findings provide compelling evidence for the existence of fungal infection in the CNS from AD patients, but not in control individuals.  ...continue reading "Fungal Infections Involved in Alzheimer’s Disease?"

Published on Leave a comment on Fungi and Bacteria in Household Dust

Another article from results of the crowdsourced study in which household dust samples were sent to researchers at the University of Colorado from approximately 1200 homes across the United States. Some findings after the dust was analyzed: differences were found in the dust of households that were occupied by more males than females and vice versa, indoor fungi mainly comes from the outside and varies with the geographical location of the house, bacteria is determined by the house's inhabitants (people, pets, and insects), clothes do not prevent the spread of bacteria from our bodies, and dogs and cats had a dramatic influence on bacteria in the home. In other words: where you live determines the fungi in the house and who you live with determines the bacteria in the house. From Discovery News:

Household Dust Packed With Thousands of Microbes

Household dust is full of living organisms that are determined, in large part, by where the home is located and who is living in it, finds a new study that includes some surprising revelations. Homes with a greater ratio of male occupants, for example, were found to contain large amounts of skin and fecal-associated bacteria, while women-dominated households contained an abundance of vaginally shed bacteria that somehow wound up in dust.

He and his colleagues used DNA sequencing and high tech imaging to analyze dust samples from approximately 1,200 homes across the United States. They used volunteers to help collect the material. They discovered that indoor fungi mostly originates outside of the home, such that the geographical location of any home strongly predicts the types of fungi existing within dust.“If you want to change the types of fungi you are exposed to in your home, then it is best to move to a different home, preferably one far away,” Fierer and his team said.

Bacteria, on the other hand, were largely predicted by the home’s possible inhabitants, including humans, pets and even insects. Fierer said, “Our bodies are clearly the source for many bacteria that end up in our homes.” The researchers suspect that body size, relative abundance, and hygiene practices are why men tend to shed more Corynebacterium and Dermabacter (the skin-associated species), as well as the poop-associated Roseburia.

The vaginal-linked bacteria Lactobacillus, discovered in homes with a larger ratio of women, provides evidence that clothes do not fully contain the spread of microorganisms produced by our bodies. Members of this genus are actually thought to protect against allergies and asthma, based on earlier research, but further studies are needed to confirm how this, and other bacteria found in dust, impact human health.

Dogs and cats had such a dramatic effect on dust bacterial communities that the researchers could predict, with around 92 percent accuracy, whether or not such animals were in the home, just based on bacteria alone....So far, the news is good for dog lovers, as he pointed out that “previous work conducted by other groups has shown that living with a dog at a young age can actually reduce allergies.”

Published on Leave a comment on The Fungi That Live On Our Skin

This article discusses the fungi living on our skin. Recent research (using state of the art genetic analysis) has found that healthy people have lots of diversity in fungi living on their skin. Certain areas seem to have the greatest populations of fungi: in between toes (average of 40 species), the heel (average of 80 species), toenails (average of 80 species), and the genitals. Currently it is thought that there are "intricate interactions between fungi and immune cells on the skin surface", and that often this mutualistic relationship is beneficial, but at other times dysbiosis (when the microbial community is unbalanced or out of whack) can lead to diseases. If the populations get too unbalanced (e.g., antibiotics can kill off bacteria, and then an increase in fungi populations take their place) then ordinarily non-harmful fungi can become pathogenic. Note that: Mutualistic relationship is a relationship between two different species of organisms in which both benefit from the association. From E-Cronicon:

From Head to Toe: Mapping Fungi across Human Skin

The human microbiota refers to the complex aggregate of fungi, bacteria and archaea, found on the surface of the skin, within saliva and oral mucosa, the conjunctiva, the gastrointestinal. When microbial genomes are accounted for, the term microbiome is deployed. In recent years the first in-depth analysis, using sophisticated DNA sequencing, of the human microbiome has taken place through the U.S. National Institutes of Health led Human Microbiome Project. 

Many of the findings have extended, or even turned upside down, what was previously known about the relationship between humans and microorganisms. One of the most interesting areas related to fungi, especially in advancing our understanding about fungal types, locations and numbers and how this affects health and disease....some parts of the body have a greater prevalence of bacteria (such as the arms) whereas fungi are found in closer association with feet.  

A variety of bacteria and fungi are found on the typical 2 square meters that represent the surface of the skin, and within the deeper layers, of a typical adult. These can be considered as ‘residential’ (that is ordinarily found) or ‘transient’ (carried for a period of time by the host.) The resident microorganism types vary in relation to skin type on the human body; between men and women; and to the geographical region in which people live.

The first observation is that many locations across the skin contain considerable populations of fungi. Prime locations, as reported by Findley and colleagues, were inside the ear canal and behind the ear, within the eyebrows, at the back of the head; with feet: on the heel, toenails, between the toes; and with the rest of the body notable locations were the forearm, back, groin, nostrils, chest, palm, and the elbow.

The second observation is that several different species are found, and these vary according to different niches. Focusing on one ecological niche, a study by Oyeka found that the region between toes, taken from a sample of 100 people, discovered 14 genera of fungi. In terms of the individual species recovered, a relatively high number were observed (an average of 40 species.)....the greatest varieties of fungi are to be found on the heel (approximately 80 different species.) The second most populous area is with the toes, where toe nails recover around 80 different species.....With the genitals, where early investigations had suggested that Candida albicans was the most commonly isolated yeasts. However, an investigation of 83 patients by Bentubo., et al.  showed more variety, with high recoveries of Candida parapsilosis, Rhodotorulamucilaginos, Rhodotorulaglutinis, Candida tropicalis and Trichosporoninkin.

The importance of the investigative work into the human skin fungi helps medical researchers understand more fully the connections between the composition of skin-fungi and certain pathologies. Here the intricate interactions between fungi and immune cells on the skin surface is of importance; often this mutualistic relationship is beneficial, at other times dysbiosis can lead to the manifestation of diseases especially when there is a breakdown of the mutualistic relationship.

Changes to fungal diversity can be associated with several health conditions, including atopic dermatitis, psoriasis, acne vulgaris and chronic wounds. Diversity can alter through the over-use of antibiotics, where a decline in bacterial numbers can lead to a rise in fungal populations occupying the same space.

Moreover, research has indicted that patients who have a primary immunodeficiency are host to more populous fungal communities than healthy people. Here it is suggested that the weaknesses in the immune system allow higher numbers of fungi to survive, and, in turn these weaknesses can lead some ordinarily non-harmful species to become pathogenic. Such opportunistic fungi include species of Aspergillus and Candida.