Fungal Pathogens Laboratory, National Heart and Lung Institute, Imperial College London, UK.
Aberdeen Fungal Group, MRC Centre for Medical Mycology, University of Aberdeen, Aberdeen, UK.
Lancet Infect Dis. 2017 Dec;17(12):e393-e402. doi: 10.1016/S1473-3099(17)30442-5. Epub 2017 Jul 31.
Fungal infections cause morbidity worldwide and are associated with an unacceptably high mortality despite the availability of antifungal drugs. The incidence of mycoses is rising because of the HIV pandemic and because immunomodulatory drugs are increasingly used to treat autoimmune diseases and cancer. New classes of antifungal drugs have only been partly successful in improving the prognosis for patients with fungal infection. Adjunctive host-directed therapy is therefore believed to be the only option to further improve patient outcomes. Recent advances in the understanding of complex interactions between fungi and host have led to the design and exploration of novel therapeutic strategies in cytokine therapy, vaccines, and cellular immunotherapy, each of which might become viable adjuncts to existing antifungal regimens. In this report, we discuss immunotherapeutic approaches-the rationale behind their design, the challenges in their use, and the progress that is so urgently needed to overcome the devastating effect of fungal diseases.
真菌感染在全球范围内导致发病率升高，并伴有不可接受的高死亡率，尽管有抗真菌药物可用。由于 HIV 大流行以及免疫调节剂越来越多地用于治疗自身免疫性疾病和癌症，真菌病的发病率正在上升。新型抗真菌药物在改善真菌感染患者的预后方面仅取得部分成功。因此，人们认为辅助以宿主为导向的治疗是进一步改善患者预后的唯一选择。最近对真菌与宿主之间复杂相互作用的理解的进展，导致了细胞因子治疗、疫苗和细胞免疫治疗中新型治疗策略的设计和探索，每种策略都可能成为现有抗真菌方案的可行辅助手段。在本报告中，我们讨论了免疫治疗方法——其设计背后的原理、使用中的挑战以及为克服真菌病的破坏性影响而急需取得的进展。
