Antachopoulos Charalampos, Roilides Emmanuel
Third Department of Paediatrics, Aristotle University, Thessaloniki, Greece.
Br J Haematol. 2005 Jun;129(5):583-96. doi: 10.1111/j.1365-2141.2005.05498.x.
The very poor outcome of invasive fungal infections (IFI) in patients with haematological malignancies or recipients of haematopoietic stem cell transplantation is largely attributed to their compromised host defence mechanisms. The restoration or augmentation of immune responses in these patients is now considered as one of the cornerstones of effective antifungal therapy. Major advances in the field of experimental immunology have provided insight on the important regulatory role of cytokines in both innate and adaptive immunity to fungal pathogens. Preclinical studies have convincingly demonstrated that immunomodulation with cytokines can enhance the antifungal activity of neutrophils and monocytes/macrophages as well as upregulate protective T-helper type 1 adaptive immune responses. Evidence on the clinical use of cytokines in immunocompromised hosts with IFI is, however, still scant and inconclusive. The present review summarizes experimental and clinical data on the role of cytokines in the immune response to fungal pathogens and on their potential use for prevention or treatment of fungal infections. Implications for future research are also briefly discussed.
血液系统恶性肿瘤患者或造血干细胞移植受者侵袭性真菌感染（IFI）的预后极差，这在很大程度上归因于其受损的宿主防御机制。恢复或增强这些患者的免疫反应目前被视为有效抗真菌治疗的基石之一。实验免疫学领域的重大进展使人们深入了解了细胞因子在针对真菌病原体的固有免疫和适应性免疫中的重要调节作用。临床前研究令人信服地证明，细胞因子免疫调节可增强中性粒细胞和单核细胞/巨噬细胞的抗真菌活性，并上调保护性1型辅助性T细胞适应性免疫反应。然而，关于细胞因子在IFI免疫功能低下宿主中的临床应用证据仍然不足且尚无定论。本综述总结了有关细胞因子在针对真菌病原体免疫反应中的作用及其预防或治疗真菌感染潜在用途的实验和临床数据。还简要讨论了对未来研究的启示。
