Lamoth Frederic
Service of Infectious Diseases, Department of Medicine, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 48, 1011 Lausanne, Switzerland.
Institute of Microbiology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital, University of Lausanne, Rue du Bugnon 48, 1011 Lausanne, Switzerland.
Curr Fungal Infect Rep. 2023 May 8:1-10. doi: 10.1007/s12281-023-00463-3.
Invasive mucormycosis (IM), caused by fungi of the order Mucorales, is one of the deadliest fungal infection among hematologic cancer patients. Its incidence is also increasingly reported in immunocompetent individuals, notably with the COVID-19 pandemic. Therefore, there is an urgent need for novel diagnostic and therapeutic approaches of IM. This review discusses the current advances in this field.
Early diagnosis of IM is crucial and can be improved by Mucorales-specific PCR and development of lateral-flow immunoassays for specific antigen detection. The spore coat proteins (CotH) are essential for virulence of the Mucorales and may represent a target for novel antifungal therapies. Adjuvant therapies boosting the immune response, such as interferon-γ, anti-PDR1 or fungal-specific chimeric antigen receptor (CAR) T-cells, are also considered.
The most promising perspectives for improved management of IM consist of a multilayered approach targeting both the pathogen and the host immune system.
由毛霉目真菌引起的侵袭性毛霉病（IM）是血液系统癌症患者中最致命的真菌感染之一。在免疫功能正常的个体中，其发病率也越来越高，尤其是在新冠疫情期间。因此，迫切需要针对IM的新型诊断和治疗方法。本综述讨论了该领域的当前进展。
IM的早期诊断至关重要，毛霉目特异性PCR和用于特异性抗原检测的侧向流动免疫测定的开发可以改善诊断。孢子 coat 蛋白（CotH）对毛霉目的毒力至关重要，可能是新型抗真菌治疗的靶点。增强免疫反应的辅助治疗，如干扰素-γ、抗PDR1或真菌特异性嵌合抗原受体（CAR）T细胞，也在被考虑。
改善IM管理的最有前景的方法包括针对病原体和宿主免疫系统的多层方法。
