Department of Otolaryngology-Head and Neck Surgery, University of Minnesota School of Medicine, Minnesota, Minneapolis, USA.
Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Virginia, Norfolk, USA.
Int Forum Allergy Rhinol. 2021 Nov;11(11):1577-1587. doi: 10.1002/alr.22826. Epub 2021 Jun 2.
In the last two decades, the development of culture-independent genomic techniques has facilitated an increased appreciation of the microbiota-immunity interactions and their role in a multitude of chronic inflammatory diseases such as chronic rhinosinusitis (CRS), asthma, inflammatory bowel disease and dermatitis. While the pathologic role of bacteria in chronic inflammatory diseases is generally accepted, the understanding of the role of fungi remains controversial. Chronic rhinosinusitis, specifically the phenotype linked to nasal polyps, represents a spectrum of chronic inflammatory diseases typically characterized by a type 2 immune response. Studies on the microbiota within sinus cavities from healthy and diseased patients have focused on the bacterial community, mainly highlighting the loss of diversity associated with sinus inflammation. Within the various CRS with nasal polyps (CRSwNP) phenotypes, allergic fungal rhinosinusitis presents an opportunity to investigate the role of fungi in chronic type 2 immune responses as well as the antifungal immune pathways designed to prevent invasive fungal diseases. In this review, we examine the spectrum of fungi-associated sinus diseases highlighting the interaction between fungal species and host immune status on disease presentation. With a focus on fungi and type 2 immune response, we highlight the current knowledge and its limitations of the sinus mycobiota along with cellular interactions and activated molecular pathways linked to fungi.
在过去的二十年中，非培养基因组技术的发展促进了人们对微生物组-免疫相互作用及其在多种慢性炎症性疾病（如慢性鼻-鼻窦炎、哮喘、炎症性肠病和皮炎）中的作用的认识不断提高。虽然细菌在慢性炎症性疾病中的病理作用已被普遍接受，但真菌的作用仍存在争议。慢性鼻-鼻窦炎，特别是与鼻息肉相关的表型，代表了一系列慢性炎症性疾病，其特征通常为 2 型免疫反应。对健康和患病患者鼻窦腔内微生物组的研究集中在细菌群落上，主要强调了与鼻窦炎症相关的多样性丧失。在各种伴有鼻息肉的慢性鼻-鼻窦炎（CRSwNP）表型中，变应性真菌性鼻-鼻窦炎为研究真菌在慢性 2 型免疫反应中的作用以及设计用于预防侵袭性真菌病的抗真菌免疫途径提供了机会。在这篇综述中，我们检查了与真菌相关的鼻窦疾病谱，强调了真菌物种与宿主免疫状态对疾病表现的相互作用。我们重点关注真菌和 2 型免疫反应，强调了目前对鼻窦真菌群的了解及其局限性，以及与真菌相关的细胞相互作用和激活的分子途径。
