Medical Research Council Centre for Medical Mycology

Fungi have a major impact on global health. These organisms infect billions of people annually, and global mortality figures for fungal diseases rival or exceed those for tuberculosis and malaria. Despite the high rates of death and the loss of health they cause, the enormous impact of fungi on human health is not widely appreciated, and fungal infections remain understudied compared with other diseases. Moreover, we are discovering new fungal species that cause life threatening infections, and learning that fungi can aggravate other serious infections, such as influenza or COVID19. There is a pressing need for more research in this field.

There are three priorities that require urgent attention if we are to successfully combat fungal infections. (i) We need to improve our ability to detect fungal infections in patients. (ii) We need to use our existing drugs more wisely and to generate improved antifungal drugs (especially to overcome a worrying increase in drug resistance). (iii) We need to enhance the understanding of how fungi cause disease and how our immune system combats these infections, to enable us to exploit this knowledge for novel therapies. Importantly, there is a world-wide shortage of scientists and doctors who are working in this field, and this is the main factor hindering our ability to tackle these challenges.

The Medical Research Council Centre for Medical Mycology (MRC CMM) is meeting this global challenge by pioneering interdisciplinary research, establishing international units in low and middle income regions of the world that suffer high burdens of fungal infections, and increasing capacity by training the next generation of scientists and doctors. We are also raising awareness and influencing policy regarding the management of fungal diseases within the scientific and medical communities, and the general public.

Since its launch in Aberdeen in 2016, and relocation to Exeter in 2019, the MRC CMM has grown considerably. We have established a satellite site in Africa (the AFGrica Unit in Cape Town) and will establish similar Units in South America (Brazil) and in Asia (tbc). The objectives of these Units are to promote research and training in fungal diseases relevant to those geographic regions. Through our MRC Centre and its satellite Units, we will promote awareness of fungal disease and of our activities through an ambitious programme of engagement that targets key audiences.

During the next quinquennium we will recruit two outstanding scientists who will enhance and expand the Centre's broad and complementary expertise in key areas. Our research will be focussed into five exciting and interdisciplinary themes that address major challenges facing this field. A key objective of the MRC CMM is to increase capacity in medical mycology in the UK and globally by delivering an outstanding cohort of researchers through our world leading training programmes. This will include a bespoke MRes-PhD programme that will provide 15 students with a broad interdisciplinary training that is not available anywhere else; 2 Early Career Fellowships to fast-track an independent research career in medical mycology for exceptional individuals; 3 PhD Fellowships for excellent clinicians wishing to pursue a clinical academic career in medical mycology; 10 summer scholarships for medical students, to stimulate their interest in academia and in medical mycology; and to promote training in medical mycology in low and middle income countries through our International Units via locally funded Studentships and Fellowships, bilateral exchanges, workshops and training courses. These Fellows, PhD students and clinical trainees will foster integration across the Centre and beyond, and help enable our innovative interdisciplinary research programmes. Importantly, the increased capacity offered by these individuals will greatly facilitate our ability to tackle these devastating diseases in the future.

Creation of the MRC CMM empowered expansion of critical mass that enabled interdisciplinary research in areas of scientific, translational and clinical importance. This has led to numerous discoveries, attracted significant additional funding, facilitated strategic interactions with other national and international groups, and enabled greater public engagement and understanding of our science. We also established the first International satellite centre in the field, the AFGrica Unit.
In the next quinquennium, a key objective is to further increase UK and global capacity in medical mycology through the recruitment of excellent Early Career Fellows, PhD students, and clinical trainees. Moreover, we will establish satellite Units in South America and Asia, to facilitate research and training in regions of the world that suffer high burdens of fungal disease. With the recruitment of two scientists in key areas, our research will be focused into the following interdisciplinary themes that will underpin the Centre's scientific and training strategy:
a. Fungal growth, adaptation and morphogenesis in the context of human infections, and implications for immunity, disease phenotypes and therapy.
b. Fungal components as antifungal drug targets, diagnostics, vaccine antigens and adjuvants.
c. Evolution and impact of antifungal drug resistance, and mitigation strategies.
d. Host-fungus interactions and key mediators of disease establishment and progression at molecular, cellular and organismal levels.
e. Determinants of patient susceptibility, including immunity and comorbidities, to enable directed diagnosis, treatment and prevention of fungal disease.

With continued MRC support over the next quinquennium, the MRC CMM will become the largest Centre of Excellence for research and training in Medical Mycology in the world. Our ambitious programme of training, research, engagement and international outreach is focused on tackling the major challenges facing the field.