Infectious Diseases Unit, 3rd Department of Pediatrics, Aristotle University School of Medicine, Hippokration Hospital, Thessaloniki, Greece.
Immunotherapy. 2012 Jan;4(1):107-20. doi: 10.2217/imt.11.159.
Invasive infections due to filamentous fungi, such as Aspergillus spp., Zygomycetes, Scedosporium and Fusarium spp., cause significant morbidity and mortality in immunocompromised patients with hematological malignancies, recipients of hematopoietic stem cell transplants and those with chronic granulomatous disease. Despite antifungal therapy, the outcome is often unfavorable in these patients; immune restoration is considered as the cornerstone of successful treatment. Important aspects of human immune response against fungi include effective innate immune response expressed as effective phagocytic functions and a balance between proinflammatory and regulatory adaptive immune responses. A number of immunomodulatory approaches, including the administration of enhancing cytokines, adoptive transfer of pathogen-specific T lymphocytes and granulocyte transfusions have been investigated as adjunctive treatments against serious mold infections. Despite encouraging in vitro and in vivo data, current clinical evidence is not sufficient to allow firm recommendations on the use of these immunomodulatory modalities in serious mold infections.
侵袭性丝状真菌（如曲霉菌属、接合菌、枝孢霉和镰刀菌属）感染可导致血液系统恶性肿瘤、造血干细胞移植受者和慢性肉芽肿病等免疫功能低下患者发生严重的发病率和死亡率。尽管进行了抗真菌治疗，但这些患者的预后往往不佳；免疫重建被认为是成功治疗的基石。人体针对真菌的免疫反应的重要方面包括有效的先天免疫反应，表现为有效的吞噬功能，以及促炎和调节适应性免疫反应之间的平衡。已经研究了许多免疫调节方法，包括细胞因子增强剂的给药、针对病原体特异性 T 淋巴细胞的过继转移和粒细胞输注，作为严重霉菌感染的辅助治疗。尽管有令人鼓舞的体外和体内数据，但目前的临床证据还不足以确定这些免疫调节方式在严重霉菌感染中的应用。
