Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892; email:
Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655; email:
Annu Rev Immunol. 2018 Apr 26;36:157-191. doi: 10.1146/annurev-immunol-042617-053318. Epub 2017 Dec 13.
In the last few decades, the AIDS pandemic and the significant advances in the medical management of individuals with neoplastic and inflammatory conditions have resulted in a dramatic increase in the population of immunosuppressed patients with opportunistic, life-threatening fungal infections. The parallel development of clinically relevant mouse models of fungal disease and the discovery and characterization of several inborn errors of immune-related genes that underlie inherited human susceptibility to opportunistic mycoses have significantly expanded our understanding of the innate and adaptive immune mechanisms that protect against ubiquitous fungal exposures. This review synthesizes immunological knowledge derived from basic mouse studies and from human cohorts and provides an overview of mammalian antifungal host defenses that show promise for informing therapeutic and vaccination strategies for vulnerable patients.
在过去几十年中,艾滋病的流行以及肿瘤和炎症性疾病患者的医学治疗的显著进展,导致了机会性、危及生命的真菌感染的免疫抑制患者人数急剧增加。临床相关的真菌感染小鼠模型的平行发展,以及对导致人类易患机会性真菌感染的几种免疫相关基因的先天缺陷的发现和特征描述,极大地扩展了我们对固有和适应性免疫机制的理解,这些机制可以防止普遍存在的真菌感染。这篇综述综合了从基础的小鼠研究和人类队列中获得的免疫学知识,并概述了哺乳动物抗真菌宿主防御的知识,这些知识有望为脆弱患者的治疗和疫苗接种策略提供信息。