Pechacek Joseph, Lionakis Michail S
From the Fungal Pathogenesis Section, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
Expert Rev Anti Infect Ther. 2023 Jul-Dec;21(10):1087-1096. doi: 10.1080/14787210.2023.2264500. Epub 2023 Oct 27.
Candida auris is a pathogen of growing public health concern given its rapid spread across the globe, its propensity for long-term skin colonization and healthcare-related outbreaks, its resistance to a variety of antifungal medications, and the high morbidity and mortality associated with invasive disease. Despite that, the host immune response mechanisms that operate during C. auris skin colonization and invasive infection remains poorly understood.
In this manuscript, we review the available literature in the growing research field pertaining to C. auris host defenses and we discuss what is known about the ability of C. auris to thrive on mammalian skin, the role of lymphoid cell-mediated, IL-17-dependent defenses in controlling cutaneous colonization, and the contribution of myeloid phagocytes in curtailing systemic infection.
Understanding the mechanisms by which the host immune system responds to and controls colonization and infection with C. auris and developing a deeper knowledge of tissue-specific host-C. auris interactions and of C. auris immune-evading mechanisms may help devise improved strategies for decolonization, prognostication, prevention, vaccination, and/or directed antifungal treatment in vulnerable patient populations.
耳念珠菌是一种日益引起公众健康关注的病原体，因其在全球迅速传播、易于长期皮肤定植并引发与医疗保健相关的疫情、对多种抗真菌药物具有耐药性，以及侵袭性疾病相关的高发病率和死亡率。尽管如此，在耳念珠菌皮肤定植和侵袭性感染过程中起作用的宿主免疫反应机制仍知之甚少。
在本手稿中，我们回顾了在不断发展的关于耳念珠菌宿主防御的研究领域中的现有文献，并讨论了已知的耳念珠菌在哺乳动物皮肤上生存的能力、淋巴细胞介导的、白细胞介素-17依赖性防御在控制皮肤定植中的作用，以及髓样吞噬细胞在减少全身感染中的贡献。
了解宿主免疫系统对耳念珠菌定植和感染作出反应并进行控制的机制，深入了解组织特异性宿主-耳念珠菌相互作用以及耳念珠菌的免疫逃避机制，可能有助于制定改进的策略，用于在脆弱患者群体中进行去定植、预后评估、预防、疫苗接种和/或定向抗真菌治疗。
