Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; email:
Annu Rev Immunol. 2022 Apr 26;40:121-141. doi: 10.1146/annurev-immunol-101220-034306. Epub 2022 Jan 10.
Invasive fungal diseases are rare in individuals with intact immunity. This, together with the fact that there are only a few species that account for most mycotic diseases, implies a remarkable natural resistance to pathogenic fungi. Mammalian immunity to fungi rests on two pillars, powerful immune mechanisms and elevated temperatures that create a thermal restriction zone for most fungal species. Conditions associated with increased susceptibility generally reflect major disturbances of immune function involving both the cellular and humoral innate and adaptive arms, which implies considerable redundancy in host defense mechanisms against fungi. In general, tissue fungal invasion is controlled through either neutrophil or granulomatous inflammation, depending on the fungal species. Neutrophils are critical against spp. and spp. while macrophages are essential for controlling mycoses due to spp., spp., and other fungi. The increasing number of immunocompromised patients together with climate change could significantly increase the prevalence of fungal diseases.
侵袭性真菌感染在免疫功能健全的个体中较为罕见。这一点，加上大多数真菌病仅由少数几种物种引起，意味着人体对致病性真菌具有显著的天然抵抗力。哺乳动物对真菌的免疫依赖于两大支柱，即强大的免疫机制和升高的体温，这为大多数真菌物种创造了一个热限制区。易感性增加的相关条件通常反映了免疫功能的重大紊乱，涉及细胞和体液固有免疫和适应性免疫的各个方面，这意味着宿主防御真菌的机制具有相当大的冗余性。一般来说，组织真菌感染的控制取决于真菌的种类，是通过中性粒细胞或肉芽肿炎症来实现的。中性粒细胞对于 spp. 和 spp. 至关重要，而巨噬细胞对于控制由 spp.、 spp. 和其他真菌引起的真菌感染则是必不可少的。免疫功能低下患者的数量不断增加以及气候变化可能会显著增加真菌感染的患病率。
