Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, University of California-Los Angeles, 1124 W Carson St., Torrance, CA 90502, USA.
Clin Infect Dis. 2012 Feb;54 Suppl 1(Suppl 1):S16-22. doi: 10.1093/cid/cir865.
Mucormycosis is a life-threatening infection that occurs in patients who are immunocompromised because of diabetic ketoacidosis, neutropenia, organ transplantation, and/or increased serum levels of available iron. Because of the increasing prevalence of diabetes mellitus, cancer, and organ transplantation, the number of patients at risk for this deadly infection is increasing. Despite aggressive therapy, which includes disfiguring surgical debridement and frequently adjunctive toxic antifungal therapy, the overall mortality rate is high. New strategies to prevent and treat mucormycosis are urgently needed. Understanding the pathogenesis of mucormycosis and the host response to invading hyphae ultimately will provide targets for novel therapeutic interventions. In this supplement, we review the current knowledge about the virulence traits used by the most common etiologic agent of mucormycosis, Rhizopus oryzae. Because patients with elevated serum levels of available iron are uniquely susceptible to mucormycosis and these infections are highly angioinvasive, emphasis is placed on the ability of the organism to acquire iron from the host and on its interactions with endothelial cells lining blood vessels. Several promising therapeutic strategies in preclinical stages are identified.
毛霉病是一种危及生命的感染，发生在因糖尿病酮症酸中毒、中性粒细胞减少症、器官移植和/或血清中可用铁水平升高而免疫功能低下的患者中。由于糖尿病、癌症和器官移植的发病率不断增加，罹患这种致命感染的患者人数正在增加。尽管采用了包括毁容性外科清创术和经常辅助使用毒性抗真菌治疗在内的积极治疗方法，但总体死亡率仍然很高。迫切需要新的策略来预防和治疗毛霉病。了解毛霉病的发病机制和宿主对入侵菌丝的反应最终将为新型治疗干预提供靶点。在本增刊中，我们回顾了最常见的毛霉病病原体——根霉属的毒力特征的现有知识。由于血清中可用铁水平升高的患者对毛霉病具有独特的易感性，并且这些感染具有高度的血管侵袭性，因此重点介绍了该生物体从宿主获取铁的能力及其与血管内皮细胞的相互作用。确定了几种处于临床前阶段的有前途的治疗策略。
