Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu, Daegu 42472, Republic of Korea.
Int J Mol Sci. 2023 Jan 25;24(3):2366. doi: 10.3390/ijms24032366.
Airborne fungi are ubiquitous in the environment and are commonly associated with airway inflammatory diseases. The innate immune defense system eliminates most inhaled fungi. However, some influence the development of chronic rhinosinusitis. Fungal CRS is thought of as not a common disease, and its incidence increases over time. Fungi are present in CRS patients and in healthy sinonasal mucosa. Although the immunological mechanisms have not been entirely explained, CRS patients may exhibit different immune responses than healthy people against airborne fungi. Fungi can induce Th1 and Th2 immune responses. In CRS, Th2-related immune responses against fungi are associated with pattern recognition receptors in nasal epithelial cells, the production of inflammatory cytokines and chemokines from nasal epithelial cells, and interaction with innate type 2 cells, lymphocytes, and inflammatory cells. Fungi also interact with neutrophils and eosinophils and induce neutrophil extracellular traps (NETs) and eosinophil extracellular traps (EETs). NETs and EETs are associated with antifungal properties and aggravation of chronic inflammation in CRS by releasing intracellular granule proteins. Fungal and bacterial biofilms are commonly found in CRS and may support chronic and recalcitrant CRS infection. The fungal-bacterial interaction in the sinonasal mucosa could affect the survival and virulence of fungi and bacteria and host immune responses. The interaction between the mycobiome and microbiome may also influence the host immune response, impacting local inflammation and chronicity. Although the exact immunopathologic role of fungi in the pathogenesis of CRS is not completely understood, they contribute to the development of sinonasal inflammatory responses in CRS.
空气中的真菌无处不在，通常与气道炎症性疾病有关。先天免疫系统可以消除大部分吸入的真菌。然而，有些真菌会影响慢性鼻-鼻窦炎的发展。真菌性 CRS 被认为是一种不常见的疾病，其发病率随时间推移而增加。真菌存在于 CRS 患者和健康的鼻腔鼻窦黏膜中。虽然免疫机制尚未完全阐明，但 CRS 患者对空气中的真菌可能表现出与健康人不同的免疫反应。真菌可以诱导 Th1 和 Th2 免疫反应。在 CRS 中，针对真菌的 Th2 相关免疫反应与鼻上皮细胞中的模式识别受体、鼻上皮细胞中炎症细胞因子和趋化因子的产生以及与先天 2 型细胞、淋巴细胞和炎症细胞的相互作用有关。真菌还与中性粒细胞和嗜酸性粒细胞相互作用，诱导中性粒细胞细胞外诱捕网（NETs）和嗜酸性粒细胞细胞外诱捕网（EETs）。NETs 和 EETs 与抗真菌特性有关，并通过释放细胞内颗粒蛋白加重 CRS 中的慢性炎症。真菌和细菌生物膜在 CRS 中很常见，可能支持慢性和难治性 CRS 感染。鼻黏膜中的真菌-细菌相互作用可能影响真菌和细菌的存活和毒力以及宿主的免疫反应。菌-微生物组的相互作用也可能影响宿主的免疫反应，影响局部炎症和慢性。尽管真菌在 CRS 发病机制中的确切免疫病理作用尚不完全清楚，但它们有助于 CRS 中鼻内炎症反应的发展。
