Fidel Paul L, Yano Junko, Esher Shannon K, Noverr Mairi C
Center of Excellence in Oral and Craniofacial Biology, Louisiana State University Health Sciences Center School of Dentistry, New Orleans, LA 70119, USA.
Department of Microbiology and Immunology, Tulane University School of Medicine, New Orleans, LA 70112, USA.
J Fungi (Basel). 2020 Mar 11;6(1):35. doi: 10.3390/jof6010035.
Disease is a complex outcome that can occur as a result of pathogen-mediated damage, host-mediated damage or both. This has led to the revolutionary concept of the damage response framework (DRF) that defines microbial virulence as a function of host immunity. The DRF outlines six scenarios (classes) of host damage or beneficial outcomes, depending on the microbe and the strength of the immune response. is uniquely adapted to its human host and can exist as either a commensal, colonizing various anatomical sites without causing notable damage, or as a pathogen, with the ability to cause a diverse array of diseases, ranging from mucosal to invasive systemic infections that result in varying levels of microbe-mediated and/or host-mediated damage. We recently categorized six different forms of candidiasis (oropharyngeal, hematogenous, intra-abdominal, gastrointestinal, denture stomatitis, and vulvovaginitis) into independent DRF classes, supporting a contemporary view of unique mechanisms of pathogenesis for these infections. In this review, we summarize the evidence for the pathogenesis of these various forms of candidiasis in the context of the DRF with the further intent to provide insights into strategies to achieve a level of host response or outcome otherwise, that limits host damage.
疾病是一种复杂的结果，可能由病原体介导的损伤、宿主介导的损伤或两者共同作用引起。这导致了损伤反应框架（DRF）这一革命性概念的产生，该概念将微生物毒力定义为宿主免疫力的函数。DRF概述了六种宿主损伤或有益结果的情况（类别），这取决于微生物和免疫反应的强度。[此处原文似乎缺失了关于某个微生物的描述]独特地适应其人类宿主，既可以作为共生菌存在，定殖于各种解剖部位而不造成明显损伤，也可以作为病原体存在，能够引发多种疾病，从黏膜感染到侵袭性全身感染，导致不同程度的微生物介导和/或宿主介导的损伤。我们最近将六种不同形式的念珠菌病（口腔念珠菌病、血行播散性念珠菌病、腹腔内念珠菌病、胃肠道念珠菌病、义齿性口炎和外阴阴道念珠菌病）归类为独立的DRF类别，支持了对这些感染独特发病机制的当代观点。在本综述中，我们在DRF的背景下总结了这些各种形式念珠菌病发病机制的证据，进一步旨在深入了解实现某种宿主反应水平或结果的策略，否则这种策略会限制宿主损伤。
