Roth Maxwell T, Zamith-Miranda Daniel, Nosanchuk Joshua D
Department of Medicine (Division of Infectious Diseases) and Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA.
Curr Trop Med Rep. 2019 Jun;6(2):35-41. doi: 10.1007/s40475-019-00172-3. Epub 2019 Mar 26.
Histoplasmosis is an infection caused by the dimorphic fungus . Histoplasmosis is typically self-limited and presents asymptomatically in most people. Nevertheless, histoplasmosis can cause severe pulmonary disease and death. Histoplasmosis is increasingly found worldwide; however, it is best documented in the endemic region of the Mississippi river valley system in the Eastern part of the United States (US). Epidemiological studies from the US detailing the morbidity, mortality, and cost associated with histoplasmosis underscore the need to develop a vaccine.
This review will detail some of the major developments in potential vaccines against histoplasmosis, with particular emphasis on those that could be used to immunize immunocompromised hosts. Additionally, this review will highlight some non-traditional vaccine-like ideas for the prevention of diverse mycoses.
Historically, immunization strategies against histoplasmosis have largely focused on identifying immunogenic proteins that confer protection in animal models. More recently, novel active, therapeutic, and immunomodulatory strategies have been explored as potential alternatives for those with various immune-deficiencies.
The studies summarized in this review demonstrate that more research is needed to clarify the immunobiology, clinical role and efficacy of each candidate vaccine in the ever-expanding potential armamentarium against histoplasmosis.
组织胞浆菌病是由双相真菌引起的一种感染。组织胞浆菌病通常具有自限性,大多数人感染后无明显症状。然而,组织胞浆菌病可导致严重的肺部疾病甚至死亡。组织胞浆菌病在全球范围内的发现越来越多;不过,在美国东部密西西比河流域系统的地方病区有最充分的记录。美国详细阐述组织胞浆菌病发病率、死亡率及相关成本的流行病学研究强调了研发疫苗的必要性。
本综述将详细介绍抗组织胞浆菌病潜在疫苗的一些主要进展,尤其侧重于可用于免疫功能低下宿主免疫接种的疫苗。此外,本综述将突出一些预防多种真菌病的非传统类疫苗理念。
从历史上看,抗组织胞浆菌病的免疫策略主要集中在识别在动物模型中具有保护作用的免疫原性蛋白。最近,新型主动、治疗和免疫调节策略已被探索作为针对各种免疫缺陷患者的潜在替代方法。
本综述中总结的研究表明,在不断扩大的抗组织胞浆菌病潜在武器库中,需要更多研究来阐明每种候选疫苗的免疫生物学、临床作用和疗效。