Quantitative and Systems Biology, Graduate Program, University of California Merced, Merced, CA, United States.
Department of Molecular and Cell Biology, School of Natural Sciences, University of California Merced, Merced, CA, United States.
Front Cell Infect Microbiol. 2020 Nov 11;10:581101. doi: 10.3389/fcimb.2020.581101. eCollection 2020.
Coccidioidomycosis is a fungal, respiratory disease caused by and . This emerging infectious disease ranges from asymptomatic to pulmonary disease and disseminated infection. Most infections are cleared with little to no medical intervention whereas chronic disease often requires life-long medication with severe impairment in quality of life. It is unclear what differentiates hosts immunity resulting in disease resolution versus chronic infection. Current understanding in mycology-immunology suggests that chronic infection could be due to maladaptive immune responses. Immunosuppressed patients develop more severe disease and mouse studies show adaptive Th1 and Th17 responses are required for clearance. This is supported by heightened immunosuppressive regulatory responses and lowered anti-fungal T helper responses in chronic patients. Diagnosis and prognosis is difficult as symptoms are broad and overlapping with community acquired pneumonia, often resulting in misdiagnosis and delayed treatment. Furthermore, we lack clear biomarkers of disease severity which could aid prognosis for more effective healthcare. As the endemic region grows and population increases in endemic areas, the need to understand infection is becoming urgent. There is a growing effort to identify fungal virulence factors and host immune components that influence fungal immunity and relate these to patient disease outcome and treatment. This review compiles the known immune responses to spp. infection and various related fungal pathogens to provide speculation on immunity.
球孢子菌病是一种由 和 引起的真菌性呼吸道疾病。这种新发传染病的范围从无症状到肺部疾病和播散性感染。大多数感染在没有医疗干预的情况下就会清除，而慢性疾病通常需要终身药物治疗，生活质量严重受损。目前尚不清楚是什么导致宿主的免疫反应导致疾病的消退或慢性感染。真菌学-免疫学的现有认识表明，慢性感染可能是由于适应性免疫反应失调所致。免疫抑制患者的病情更严重，而小鼠研究表明，清除感染需要适应性 Th1 和 Th17 反应。慢性 患者中升高的免疫抑制性调节反应和降低的抗真菌辅助性 T 细胞反应支持了这一点。由于症状广泛且与社区获得性肺炎重叠，导致误诊和治疗延误，因此诊断和预后都很困难。此外，我们缺乏明确的疾病严重程度的生物标志物，这可能有助于预后，提供更有效的医疗保健。随着流行地区的不断扩大和人口的增加，了解 感染的需求变得越来越紧迫。人们越来越努力地识别影响真菌免疫的真菌毒力因子和宿主免疫成分，并将这些与患者的疾病结局和治疗联系起来。本综述总结了已知的 spp. 感染和各种相关真菌病原体的免疫反应，以推测 免疫。
