Roilides Emmanuel, Lyman Caron A, Panagopoulou Paraskevi, Chanock Stephen
Third Department of Pediatrics, Aristotle University of Thessaloniki, Hippokration Hospital, Konstantinoupoleos 49, GR-54642 Thessaloniki, Greece.
Infect Dis Clin North Am. 2003 Mar;17(1):193-219. doi: 10.1016/s0891-5520(02)00070-3.
Genetic and acquired (disease- or therapy- related) host immune factors increase the risk for IFIs. In addition to antifungal drug therapy, modulation of host defenses by the use of HGFs and IFN-gamma has been supported by extensive in vitro and in vivo preclinical data. Clinical studies on the prevention or the adjunctive therapy of IFIs in combination with antifungal agents are limited, however, and do not allow specific recommendations for their cost-effective use in most of the immunodeficient settings. There is an urgent need to push forward with well-structured, randomized clinical trials to determine optimal dose, duration, and timing for different combinations of immunotherapy and antifungal agents in high-risk patients.
遗传和获得性(与疾病或治疗相关)宿主免疫因素会增加侵袭性真菌感染(IFI)的风险。除抗真菌药物治疗外,使用生长因子(HGFs)和γ干扰素调节宿主防御已得到广泛的体外和体内临床前数据支持。然而,关于IFI与抗真菌药物联合预防或辅助治疗的临床研究有限,在大多数免疫缺陷情况下,无法就其成本效益使用提出具体建议。迫切需要推进结构良好的随机临床试验,以确定高危患者免疫治疗和抗真菌药物不同组合的最佳剂量、持续时间和时机。