Speth Cornelia, Rambach Günter, Würzner Reinhard, Lass-Flörl Cornelia
Department of Hygiene, Microbiology and Social Medicine, Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria.
Mycoses. 2008 Nov;51(6):477-96. doi: 10.1111/j.1439-0507.2008.01597.x. Epub 2008 Aug 13.
Fungal infections are a serious complication in immunocompromised patients such as human immunodeficiency virus-infected individuals, patients with organ transplantations or with haematological neoplasia. The lethality of opportunistic fungal infection is high despite a growing arsenal of antimycotic drugs, implying the urgent need for supportive immunological therapies to strengthen the current inefficient antimicrobial defences of the immunocompromised host. Therefore, increasing effort has been directed to investigating the interplay between fungi and the host immunity and thus to find starting points for additional therapeutic approaches. In this article, we review the actual state of the art concerning the role of complement in the pathogenesis of fungal infections. Important aspects include the activation of the complement system by the fungal pathogen, the efficiency of the complement-associated antimicrobial functions and the arsenal of immune evasion strategies applied by the fungi. The twin functions of complement as an interactive player of the innate immunity and at the same time as a modulator of the adaptive immunity make this defence weapon a particularly interesting therapeutic candidate to mobilise a more effective immune response and to strengthen in one fell swoop a broad spectrum of different immune reactions. However, we also mention the 'Yin-Yang' nature of the complement system in fungal infections, as growing evidence assigns to complement a contributory part in the pathogenesis of fungus-induced allergic manifestations.
真菌感染是免疫功能低下患者的严重并发症，如人类免疫缺陷病毒感染个体、器官移植患者或血液系统肿瘤患者。尽管抗真菌药物不断增加，但机会性真菌感染的致死率仍然很高，这意味着迫切需要支持性免疫疗法来加强免疫功能低下宿主目前低效的抗菌防御。因此，人们越来越致力于研究真菌与宿主免疫之间的相互作用，从而找到其他治疗方法的切入点。在本文中，我们综述了补体在真菌感染发病机制中作用的当前研究现状。重要方面包括真菌病原体激活补体系统、补体相关抗菌功能的效率以及真菌应用的免疫逃避策略。补体作为固有免疫的交互参与者以及同时作为适应性免疫的调节者的双重功能，使这种防御武器成为一个特别有趣的治疗候选者，以调动更有效的免疫反应并一举加强广泛的不同免疫反应。然而，我们也提到补体系统在真菌感染中的“阴阳”性质，因为越来越多的证据表明补体在真菌诱导的过敏表现的发病机制中起作用。
