Poore T Spencer, Hong Gina, Zemanick Edith T
Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Pathogens. 2021 May 18;10(5):618. doi: 10.3390/pathogens10050618.
Fungi are frequently recovered from lower airway samples from people with cystic fibrosis (CF), yet the role of fungi in the progression of lung disease is debated. Recent studies suggest worsening clinical outcomes associated with airway fungal detection, although most studies to date are retrospective or observational. The presence of fungi can elicit a T helper cell type 2 (Th-2) mediated inflammatory reaction known as allergic bronchopulmonary aspergillosis (ABPA), particularly in those with a genetic atopic predisposition. In this review, we discuss the epidemiology of fungal infections in people with CF, risk factors associated with development of fungal infections, and microbiologic approaches for isolation and identification of fungi. We review the spectrum of fungal disease presentations, clinical outcomes after isolation of fungi from airway samples, and the importance of considering airway co-infections. Finally, we discuss the association between fungi and airway inflammation highlighting gaps in knowledge and future research questions that may further elucidate the role of fungus in lung disease progression.
真菌经常从囊性纤维化（CF）患者的下呼吸道样本中分离出来，但真菌在肺部疾病进展中的作用仍存在争议。最近的研究表明，气道真菌检测与临床结果恶化有关，尽管迄今为止大多数研究都是回顾性的或观察性的。真菌的存在可引发2型辅助性T细胞（Th-2）介导的炎症反应，即变应性支气管肺曲霉病（ABPA），尤其是在那些具有遗传性特应性倾向的患者中。在这篇综述中，我们讨论了CF患者真菌感染的流行病学、与真菌感染发生相关的危险因素，以及分离和鉴定真菌的微生物学方法。我们回顾了真菌疾病表现的范围、从气道样本中分离出真菌后的临床结果，以及考虑气道合并感染的重要性。最后，我们讨论了真菌与气道炎症之间的关联，强调了知识空白以及未来的研究问题，这些问题可能会进一步阐明真菌在肺部疾病进展中的作用。
