Department of Respiratory Medicine, Beaumont Hospital, Dublin 9, Ireland.
Biomed Res Int. 2013;2013:723129. doi: 10.1155/2013/723129. Epub 2013 Jul 21.
Aspergillus moulds exist ubiquitously as spores that are inhaled in large numbers daily. Whilst most are removed by anatomical barriers, disease may occur in certain circumstances. Depending on the underlying state of the human immune system, clinical consequences can ensue ranging from an excessive immune response during allergic bronchopulmonary aspergillosis to the formation of an aspergilloma in the immunocompetent state. The severest infections occur in those who are immunocompromised where invasive pulmonary aspergillosis results in high mortality rates. The diagnosis of Aspergillus-associated pulmonary disease is based on clinical, radiological, and immunological testing. An understanding of the innate and inflammatory consequences of exposure to Aspergillus species is critical in accounting for disease manifestations and preventing sequelae. The major components of the innate immune system involved in recognition and removal of the fungus include phagocytosis, antimicrobial peptide production, and recognition by pattern recognition receptors. The cytokine response is also critical facilitating cell-to-cell communication and promoting the initiation, maintenance, and resolution of the host response. In the following review, we discuss the above areas with a focus on the innate and inflammatory response to airway Aspergillus exposure and how these responses may be modulated for therapeutic benefit.
曲霉菌广泛存在于孢子中，这些孢子每天都会被大量吸入。虽然大多数孢子会被解剖屏障清除，但在某些情况下仍会引发疾病。根据人类免疫系统的基本状况，临床后果可能会有所不同，从过敏性支气管肺曲霉病中过度的免疫反应到免疫功能正常状态下曲霉肿的形成。最严重的感染发生在免疫功能低下的人群中，侵袭性肺曲霉病会导致高死亡率。曲霉相关性肺部疾病的诊断基于临床、影像学和免疫学检查。了解接触曲霉菌种的先天和炎症后果对于解释疾病表现和预防后遗症至关重要。参与识别和清除真菌的先天免疫系统的主要成分包括吞噬作用、抗菌肽的产生以及模式识别受体的识别。细胞因子反应也很关键，它促进细胞间的通讯，并促进宿主反应的启动、维持和解决。在接下来的综述中，我们将讨论上述领域，重点关注气道曲霉暴露的先天和炎症反应，以及如何为了治疗获益而调节这些反应。
