Mihu Mircea R, Pattabhi Rodney, Nosanchuk Joshua D
Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine-Montefiore Medical Center Bronx, NY, USA.
Division of Infectious Diseases, Department of Medicine, Albert Einstein College of Medicine-Montefiore Medical Center Bronx, NY, USA ; Department of Microbiology and Immunology, Albert Einstein College of Medicine-Montefiore Medical Center Bronx, NY, USA.
Front Microbiol. 2014 Mar 14;5:99. doi: 10.3389/fmicb.2014.00099. eCollection 2014.
Fungi are increasingly recognized as major pathogens in immunocompromised individuals. With the increase in the number of fungal infections each year and the development of resistance to current therapy, new approaches to treatment including stimulation of the immune response in addition to concurrent pharmacotherapy is ongoing. The most common invasive fungal infections are caused by Candida spp., Aspergillus spp., and Cryptococcus spp. Amphotericin B (AmB) has remained the cornerstone of therapy against many fulminant fungal infections but its use is limited by its multitude of side effects. Echinocandins are a newer class of antifungal drugs with activity against Candida spp. and Aspergillus spp. and constitutes an alternative to AmB due to superior patient tolerability and fewer side effects. Due to their oral delivery, azoles continue to be heavily used for simple and complex diseases, such as fluconazole for candidal vaginitis and voriconazole for aspergillosis. The objective of this paper is to present current knowledge regarding the multiple interactions between the broad spectrum antifungals and the innate immune response, primarily focusing on the toll-like receptors.
真菌越来越被认为是免疫功能低下个体的主要病原体。随着每年真菌感染数量的增加以及对当前治疗产生耐药性，除了同时进行药物治疗外，包括刺激免疫反应在内的新治疗方法正在不断发展。最常见的侵袭性真菌感染由念珠菌属、曲霉属和隐球菌属引起。两性霉素B（AmB）仍然是治疗许多暴发性真菌感染的基石，但其使用受到众多副作用的限制。棘白菌素是一类新型抗真菌药物，对念珠菌属和曲霉属有活性，由于患者耐受性更好且副作用更少，可作为两性霉素B的替代品。由于其口服给药方式，唑类药物仍然大量用于治疗简单和复杂疾病，如氟康唑用于念珠菌性阴道炎，伏立康唑用于曲霉病。本文的目的是介绍关于广谱抗真菌药物与固有免疫反应之间多种相互作用的当前知识，主要聚焦于Toll样受体。
