Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Front Cell Infect Microbiol. 2020 Sep 15;10:469. doi: 10.3389/fcimb.2020.00469. eCollection 2020.
Opportunistic fungal infections are major causes of morbidity and mortality in patients with single or multiple defects in their immunity. Antifungal agents targeting the pathogen remain the treatment of choice for fungal infections. However, antifungal agents are toxic to the host mainly due to the close evolutionary similarity of fungi and humans. Moreover, antifungal therapy is ineffective in patients with immunosuppression. For this reason, there is an increased demand to develop novel strategies to enhance immune function and augment the existing antifungal drugs. In recent times, targeting the immune system to improve impaired host immune responses becomes a reasonable approach to improve the effectiveness of antifungal drugs. In this regard, immunomodulating therapeutic agents that turn up the immune response in the fight against fungal infections hold promise for enhancing the efficacy and safety of conventional antifungal therapy. In general, immunomodulating therapies are safe with decreased risk of resistance and broad spectrum of activity. In this review, therefore, clinical evidences supporting the opportunities and challenges of immunomodulation therapies in the treatment of invasive fungal infections are included.
机会性真菌感染是免疫功能单一或多种缺陷患者发病率和死亡率的主要原因。针对病原体的抗真菌药物仍然是真菌感染的首选治疗方法。然而,抗真菌药物对宿主具有毒性,主要是因为真菌和人类在进化上非常相似。此外,免疫抑制患者的抗真菌治疗效果不佳。出于这个原因,人们越来越需要开发新的策略来增强免疫功能并增强现有的抗真菌药物。最近,针对免疫系统以改善受损的宿主免疫反应成为提高抗真菌药物有效性的合理方法。在这方面,增强免疫反应以对抗真菌感染的免疫调节治疗剂有望提高常规抗真菌治疗的疗效和安全性。一般来说,免疫调节疗法具有安全性,降低了耐药风险和广谱活性。因此,在本综述中,包括了支持免疫调节疗法在治疗侵袭性真菌感染中的机会和挑战的临床证据。