Biology, Immunology, Epidemiology, and Therapy of Fungal Infections: A Themed Issue Dedicated to Professor David A. Stevens

Dear Colleagues,

David A. Stevens, MD is Professor (Emeritus) of Medicine, Stanford University Medical School, and was Chief of an affiliated teaching hospital’s Infectious Diseases service, Hospital Epidemiologist, and Co-Director, Microbiology Laboratory, for 42 years. He has been President of the California Institute for Medical Research (CIMR), San Jose for 29 of the past 31 years, Principal Investigator of its Infectious Disease Research Laboratory (named and dedicated to him in 2022) engaged in laboratory and clinical research with fellows, students, graduate students for 50 years, and Director of its Clinical Laboratories. His group studies the biology, pathogenesis, immunology, epidemiology and therapy of fungal infections. He is an author of >750 full articles, editorials and book chapters, and an approximately equal number of abstracts. A recent computerized index indicated his publications have been cited >50,000 times. Fifteen of his former trainees are full professors in the faculty of professional schools, and others are at other ranks of the professoriate, clinical faculty, hospital chiefs of infectious diseases, directors of clinical microbiology laboratories, full-time laboratory researchers at national laboratories or research institutes, or clinicians. His publications include the discoveries of six new microbes, one of which was named after him by Korean scientists, owing to his efforts in study of the genus, and another named by him for CIMR, where the microbe was discovered. His honors include election to the American Society for Clinical Investigation in 1981, receipt of the Rhoda Benham Medal from the Medical Mycology Society of the Americas 1999, the 2006 recipient in Paris of the Lucille Georg Medal from the International Society for Human and Animal Mycology, the 2006 recipient of the Charles E. Smith Memorial Award from the Coccidioidomycosis Study Group, and election to these fellowships: American College of Physicians, Infectious Diseases Society of America (IDSA), and American Academy of Microbiology. He was a Project Leader in the NIAID Mycoses Study Group (National Institutes of Health multicenter clinical trials group) 1990-2000; Chair of the committee writing the first Practice Guidelines on Aspergillosis for IDSA, and later served on this committee as well as the committee writing the Practice Guidelines on Coccidioidomycosis; Chair of the Mycology Div., Amer. Soc. for Microbiology (a position also held by three of his former fellows); and Director of the NIH Fogarty International Training Grant at Stanford. He is a Co-Organizer of the biennial Advances Against Aspergillosis and Mucormycosis international meetings. His early accomplishments (while a resident) include describing a new disease (leukemia with Burkitt lymphoma cells); senior author (while a fellow) of the first controlled trial of the systemic use of an antiviral; and showing the importance of interferon in arresting progression of a viral disease. The text of a seminal review article co-authored on viral infections in non-congenital forms of immunodeficiency was later used when others were searching for a name for a new disease, namely acquired immune deficiency disease (AIDS). In mycology, he studied and introduced the first systemically useful azole antifungal, miconazole, at a time when therapy for this emerging area of infections was extremely limited, leading to the development of a dominant class of the antifungals. This led to his paper, the first on the initial oral agent of this class, on ketoconazole. His lab established a scientific base for inoculum-independent susceptibility testing of antifungals in vitro, and first demonstrated the utility of fluconazole in prophylaxis of the immunocompromised; the clinical utility of cyclodextrin for delivery of water-insoluble azoles; and that lifelong azole therapy was required for coccidioidal meningitis. His team reported the first case of azole-resistant Aspergillus (which has now become an international concern); and with his colleagues, the only randomized therapeutic trial in coccidioidomycosis, and the first clinical trial of a vaccine for coccidioidomycosis. His were many of the first reports of side effects of azoles, and of cytochrome P450 interactions of azoles with other drugs; perhaps the most important was the demonstration of blockade of host steroidal hormone synthesis, since this also led to the use of azoles as endocrinologic tools. His other studies first revealed the anti-Aspergillus activity of the echinocandins, showed the power of combined inhibition of cell wall glucan and chitin synthesis, and the “paradoxical effect” of echinocandins (losing inhibition at higher concentrations). His study was the first randomized trial of therapy in allergic bronchopulmonary aspergillosis—the first demonstration that an antimicrobial could ameliorate an allergic disease. He and his team introduced categorization of mycoses for entry into clinical trials, and an outcome scoring system, which became known as “the NIAID Mycoses Study Group criteria”, eventually evolving into the now canonical EORTC/MSG criteria. Publications include the role of cytokines in defense against mycoses, studies of how host hormones directly modulate fungal pathogen activity, and, in molecular epidemiology, molecular diagnostic methods and gene expression in fungal biologic processes. His lab developed many animal models of mycoses. A current focus in his laboratory is the nature of the interactions between prominent microbes affecting the course of airway disease in cystic fibrosis.

The Journal of Fungi is pleased to announce a Special Issue honoring David A. Stevens for his outstanding contributions to medical mycology. The submissions can be on any topic relevant to medical mycology.

Prof. Dr. Bertrand Dupont
Prof. Dr. Karl V. Clemons
Prof. Dr. Roderick J. Hay
Prof. Dr. Katsuhiko Kamei
Dr. Raquel Sabino
Guest Editors

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• biology
• pathogenesis
• immunology
• epidemiology
• therapy