Department of Microbiology, The University of Hong Kong, Hong Kong.
State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, Hong Kong.
Exp Biol Med (Maywood). 2020 Jul;245(13):1104-1114. doi: 10.1177/1535370220939862. Epub 2020 Jul 8.
The risk of opportunistic infections due to fungi is relatively less well addressed in patients receiving biologic agents, compared with other opportunistic bacterial and viral infections. There is a lack of consensus guideline on the screening, prophylaxis, and management of fungal infection in patients anticipated to receive or actively receiving biologic therapy. In addition, invasive mycosis in immunocompromised patients is associated with high mortality and morbidity. This review highlighted the risk of fungal infection in patients receiving cytokine antagonists and immune checkpoint inhibitors, two big categories of biologic agents that are widely used in the treatment of various autoimmune and malignant conditions, often in combination with other immunomodulatory or immunosuppressive agents but also as standalone therapy. The adverse outcomes of opportunistic fungal infection in these patients can be reduced by heightened awareness, active case finding, and prompt treatment.
与其他机会性细菌和病毒感染相比，接受生物制剂治疗的患者，其真菌感染的机会相对较少得到解决。对于预计或正在接受生物治疗的患者，真菌感染的筛查、预防和管理缺乏共识指南。此外，免疫功能低下患者的侵袭性真菌感染与高死亡率和发病率相关。本综述强调了接受细胞因子拮抗剂和免疫检查点抑制剂治疗的患者发生真菌感染的风险，这两种生物制剂广泛用于治疗各种自身免疫和恶性疾病，通常与其他免疫调节或免疫抑制药物联合使用，但也可作为单一疗法。提高认识、主动发现病例和及时治疗可以降低这些患者发生机会性真菌感染的不良后果。
