Altamura M, Casale D, Pepe M, Tafaro A
Department of Internal Medicine, Immunolgy and Infectious Diseases, University of Bari, Italy.
Curr Drug Targets Immune Endocr Metabol Disord. 2001 Nov;1(3):189-97. doi: 10.2174/1568008013341118.
Host responses to fungi result from a coordinate interplay between innate and adaptative immune system. Neutrophils and monocytes are involved in the non specific clearance of yeasts (e.g. Candida albicans and Cryptococcus neoformans), while T helper 1 type responses are protective via release of interferon gamma. By contrast, T helper 2 responses (IL-4 and IL 10 release) correlate with disease exacerbation and pathology. IL-12 production which enhances T helper 1 type responses seem to exert a beneficial role in the course of Candida infection. In particular, its production from neutrophilis may support memory T helper 1 cell responses of the fungus. With respect to anti-Candida vaccines several approaches are in progress, such as use of heat-killed Candida albicans in combination with adjuvants, purified peptides and proteins and immunogenic peptide-lipid conjugates. Furthermore, exogenous IL-12 may play an important role in inducing a T helper 1 anticandidal response, also replacing neutrophils in neutropenic patients. At the same time, granulocyte-colony stimulating factor has exhibited therapeutic efficacy in experimental and human models of fungal infection.
宿主对真菌的反应源于先天性免疫系统和适应性免疫系统之间的协同相互作用。中性粒细胞和单核细胞参与酵母（如白色念珠菌和新型隐球菌）的非特异性清除，而1型辅助性T细胞反应通过释放γ干扰素起到保护作用。相比之下，2型辅助性T细胞反应（释放白细胞介素-4和白细胞介素-10）与疾病加重和病理变化相关。增强1型辅助性T细胞反应的白细胞介素-12的产生似乎在念珠菌感染过程中发挥有益作用。特别是，中性粒细胞产生的白细胞介素-12可能支持针对该真菌的记忆性1型辅助性T细胞反应。关于抗念珠菌疫苗，有几种方法正在进行研究，例如使用热灭活的白色念珠菌与佐剂、纯化的肽和蛋白质以及免疫原性肽-脂质偶联物。此外，外源性白细胞介素-12在诱导1型辅助性T细胞抗念珠菌反应中可能发挥重要作用，在中性粒细胞减少的患者中还可替代中性粒细胞。同时，粒细胞集落刺激因子在真菌感染的实验模型和人体模型中已显示出治疗效果。
