Davidson Linda, Netea Mihai G, Kullberg Bart Jan
Department of Internal Medicine and Radboud Center for Infectious diseases (RCI), Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
J Fungi (Basel). 2018 Jan 9;4(1):9. doi: 10.3390/jof4010009.
spp. are colonizing fungi of human skin and mucosae of the gastrointestinal and genitourinary tract, present in 30-50% of healthy individuals in a population at any given moment. The host defense mechanisms prevent this commensal fungus from invading and causing disease. Loss of skin or mucosal barrier function, microbiome imbalances, or defects of immune defense mechanisms can lead to an increased susceptibility to severe mucocutaneous or invasive candidiasis. A comprehensive understanding of the immune defense against is essential for developing adjunctive immunotherapy. The important role of underlying genetic susceptibility to infections has become apparent over the years. In most patients, the cause of increased susceptibility to fungal infections is complex, based on a combination of immune regulation gene polymorphisms together with other non-genetic predisposing factors. Identification of patients with an underlying genetic predisposition could help determine which patients could benefit from prophylactic antifungal treatment or adjunctive immunotherapy. This review will provide an overview of patient susceptibility to mucocutaneous and invasive candidiasis and the potential for adjunctive immunotherapy.
念珠菌属是人类皮肤以及胃肠道和泌尿生殖道黏膜的定殖真菌，在任何特定时刻，人群中30%-50%的健康个体中都有念珠菌属存在。宿主防御机制可防止这种共生真菌入侵并引发疾病。皮肤或黏膜屏障功能丧失、微生物群失衡或免疫防御机制缺陷可导致对严重黏膜皮肤或侵袭性念珠菌病的易感性增加。全面了解针对念珠菌属的免疫防御对于开发辅助免疫疗法至关重要。多年来，潜在遗传易感性在念珠菌属感染中的重要作用已变得显而易见。在大多数患者中，真菌感染易感性增加的原因很复杂，是免疫调节基因多态性与其他非遗传易感因素共同作用的结果。识别具有潜在遗传易感性的患者有助于确定哪些患者可从预防性抗真菌治疗或辅助免疫疗法中获益。本综述将概述患者对黏膜皮肤和侵袭性念珠菌病的易感性以及辅助免疫疗法的潜力。
