CotH proteins are present exclusively in Mucorales and attach to the host endothelial receptor GRP78, resulting in fungus endocytosis after endothelial cells are exposed to acidosis and increased iron and glucose levels (hyperglycemia and diabetic ketoacidosis), both GRP78 endothelial surface expression and CotH fungal surface expression increase [51]. This evidence concerns the gene HSPA5 and diabetic ketoacidosis.