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免疫防御侵袭性真菌感染:全面综述。

Immune defence to invasive fungal infections: A comprehensive review.

机构信息

Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, People's Republic of China.

Department of Medical Mycology, Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, 210042, People's Republic of China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.

出版信息

Biomed Pharmacother. 2020 Oct;130:110550. doi: 10.1016/j.biopha.2020.110550. Epub 2020 Jul 30.

Abstract

The fungal infections are relatively common in humans that can range from common, mild superficial infections to life-threatening invasive infections. Most of the pathogenic fungi are opportunistic that cause disease under immunocompromised conditions such as HIV infection, cancer, chemotherapy, transplantation and immune suppressive drug users. Efficient detection and treatment of high-risk population remain the highest priority to avert most of the deaths. Majority of invasive infections are caused by Candida, Aspergillus and Cryptococcus species. Lack of effective vaccines, standardised diagnostic tools, efficient antifungal drugs and the emergence of drug-resistant species/strains pose a global threat to control Invasive fungal infections (IFI). A better understanding of the host immune response is one of the major approaches to developing new or improved antifungal strategies to control the IFIs. In this review, we have discussed pathogenesis of medically important fungi, fungal interaction with the host through pattern recognition receptors (PRRs) and the interplay of innate and adaptive immune cells in shaping host immunity to IFI. Further, we emphasized the role of memory cells by offering long-term protection in secondary or subsequent infections. Moreover, we depicted the role of unconventional innate-like immune cells in anti-fungal immunity. We also summarize the available information on the current vaccine strategies, genetic susceptibility to fungal infections, recent co-infections studies and the emergence of drug-resistance, a growing trend throughout the world. Finally, we emphasized the steps to be taken for the control of IFIs.

摘要

真菌感染在人类中较为常见,可从常见的轻度浅表感染发展为危及生命的侵袭性感染。大多数致病性真菌是机会性的,在免疫功能低下的情况下会引起疾病,如 HIV 感染、癌症、化疗、移植和免疫抑制药物使用者。高效检测和治疗高危人群仍然是避免大多数死亡的最高优先事项。大多数侵袭性感染是由念珠菌、曲霉和隐球菌引起的。缺乏有效的疫苗、标准化的诊断工具、有效的抗真菌药物以及耐药物种/菌株的出现,对控制侵袭性真菌感染(IFI)构成了全球性威胁。更好地了解宿主免疫反应是开发新的或改进的抗真菌策略以控制 IFI 的主要方法之一。在这篇综述中,我们讨论了医学上重要真菌的发病机制、真菌通过模式识别受体(PRRs)与宿主的相互作用以及固有和适应性免疫细胞在塑造宿主对 IFI 的免疫反应中的相互作用。此外,我们通过提供二次或后续感染的长期保护,强调了记忆细胞的作用。此外,我们还描述了非常规先天样免疫细胞在抗真菌免疫中的作用。我们还总结了关于当前疫苗策略、真菌感染的遗传易感性、最近的合并感染研究以及耐药性的出现的信息,这是全世界的一个日益增长的趋势。最后,我们强调了控制 IFI 所应采取的步骤。

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