From the Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy & Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
Semin Immunol. 2023 May;67:101752. doi: 10.1016/j.smim.2023.101752. Epub 2023 Mar 29.
The continuous expansion of immunocompromised patient populations at-risk for developing life-threatening opportunistic fungal infections in recent decades has helped develop a deeper understanding of antifungal host defenses, which has provided the foundation for eventually devising immune-based targeted interventions in the clinic. This review outlines how genetic variation in certain immune pathway-related genes may contribute to the observed clinical variability in the risk of acquisition and/or severity of fungal infections and how immunogenetic-based patient stratification may enable the eventual development of personalized strategies for antifungal prophylaxis and/or vaccination. Moreover, this review synthesizes the emerging cytokine-based, cell-based, and other immunotherapeutic strategies that have shown promise as adjunctive therapies for boosting or modulating tissue-specific antifungal immune responses in the context of opportunistic fungal infections.
近几十年来，免疫功能低下的患者群体不断扩大，这些患者易患危及生命的机会性真菌感染，这有助于加深对抗真菌宿主防御的理解，为最终在临床上设计基于免疫的靶向干预措施奠定了基础。这篇综述概述了某些免疫途径相关基因的遗传变异如何导致观察到的真菌感染获得风险和/或严重程度的临床变异性，以及免疫遗传患者分层如何能够最终为抗真菌预防和/或疫苗接种制定个性化策略。此外，本综述综合了新兴的细胞因子、基于细胞的和其他免疫治疗策略，这些策略在机会性真菌感染的背景下作为增强或调节组织特异性抗真菌免疫反应的辅助疗法显示出了希望。
