Cover illustration:
A cross‐section of a paranasal sinus tissue in a diabetic patient which invaded by sporangiospore. (A) Due to hyperglycemia and ketoacidosis condition, hyphal extension takes a turn for the worse and further spores reach the sub‐endothelial matrix proteins, laminin and type IV collagen. (B) Although spores have ligands (cotH) for GRP78 receptors on the epithelial cells, Germinated spore (germling) is the main form that invades the endothelial cells. The damage to the endothelial cells causes fungal infiltration to the internal elastic arterial lamina. Low pH and fungal permease (FTR1) removes Fe ions from transferrin and provide it for the fungus. (C) The hyphae had been spread into the vascular system, angioinvasion occurred, which results in dissection and thrombosis of the artery and final anoxia and necrosis in the tissue (left side). (D) Although the germling are able to induce chemotactic factors in the site of infection, PMNs are dysfunctional in diabetic patients with poor metabolic control. (Figure: Fateme Taheri, Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran)