Hohl Tobias M
Infectious Disease Service, Department of Medicine and Immunology Program, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
Curr Opin Infect Dis. 2017 Aug;30(4):364-371. doi: 10.1097/QCO.0000000000000381.
Invasive aspergillosis is a worldwide disease that primarily affects immune-compromised patients, agricultural workers with corneal abrasions, individuals with structural lung disease, and patients with primary immune deficiency. The critical function of the immune system is to prevent the germination of airborne conidia into tissue-invasive hyphae. This review covers recent advances that shape our understanding of anti-Aspergillus immunity at the molecular and cellular level.
Host defense against conidia and hyphae occurs via distinct molecular mechanisms that involve intracellular and extracellular killing pathways, as well as cooperation between different myeloid cell subsets. The strength and efficacy of the host response is shaped by the tissue microenvironment. In preclinical models of disease, host immune augmentation strategies have yielded benefits, yet translating these insights into therapeutic strategies in humans remains challenging.
Although advances in early diagnostic strategies and in antifungal drugs have ameliorated clinical outcomes of invasive aspergillosis, further improvements depend on gaining deeper insight into and translating advances in anti-Aspergillus immunity.
侵袭性曲霉病是一种全球性疾病，主要影响免疫功能低下的患者、角膜擦伤的农业工人、患有结构性肺病的个体以及原发性免疫缺陷患者。免疫系统的关键功能是防止空气中的分生孢子萌发为组织侵袭性菌丝。本综述涵盖了近期在分子和细胞水平上塑造我们对抗曲霉免疫理解的进展。
宿主对分生孢子和菌丝的防御通过不同的分子机制进行，这些机制涉及细胞内和细胞外杀伤途径，以及不同髓样细胞亚群之间的协作。宿主反应的强度和效力受组织微环境的影响。在疾病的临床前模型中，宿主免疫增强策略已取得成效，但将这些见解转化为人类治疗策略仍具有挑战性。
尽管早期诊断策略和抗真菌药物的进展改善了侵袭性曲霉病的临床结果，但进一步的改善取决于更深入地了解并转化抗曲霉免疫方面的进展。
