Brummer E
Department of Medicine, California Institute for Medical Research, Santa Clara Valley Medical Center, San Jose, USA.
Mycopathologia. 1998;143(3):121-5. doi: 10.1023/a:1006905331276.
Cryptococcus neoformans var. neoformans is an opportunistic fungal pathogen, especially in AIDS patients, and is found world-wide. On the other hand, Cryptococcus neoformans var. gatti (CN-g) is restricted to an association with two species of Eucalyptus trees. Alveolar macrophages (AM) constitute the first line of defense to Cryptococcus neoformans and offers some resistance. The inflammatory response to Cryptococcus neoformans with an influx of neutrophils and monocytes affords a second line of defense. Secretion of proinflammatory monokines by human AM is now being defined. The inflammatory phagocytes are efficient in killing Cryptococcus neoformans and offer strong resistance. T and B cell responses to infection, a third line of defense, results in production of lymphokines (IFNg, etc.) and specific antibodies. Enhancement of lymphocyte responses by IL-12 and IL-18 to Cryptococcus neoformans infection appears to be critical. Susceptibility of AIDS patients to Cryptococcus neoformans is associated with low CD4+ T cell counts and likely reduced efficacy of the second line of defense.
新型隐球菌新生变种是一种机会性真菌病原体，在艾滋病患者中尤为常见，且在全球范围内均有发现。另一方面，新型隐球菌加蒂变种（CN - g）仅限于与两种桉树相关联。肺泡巨噬细胞（AM）构成了抵御新型隐球菌的第一道防线，并提供一定的抵抗力。对新型隐球菌的炎症反应伴随着中性粒细胞和单核细胞的涌入，形成了第二道防线。目前正在明确人类AM分泌促炎单核因子的情况。炎症吞噬细胞能够有效地杀死新型隐球菌，并提供强大的抵抗力。T细胞和B细胞对感染的反应作为第三道防线，会导致淋巴因子（如IFNg等）和特异性抗体的产生。IL - 12和IL - 18增强淋巴细胞对新型隐球菌感染的反应似乎至关重要。艾滋病患者对新型隐球菌的易感性与CD4 + T细胞计数低以及可能降低的第二道防线功效有关。
