Bilal Hazrat, Khan Muhammad Nadeem, Khan Sabir, Fang Wenjie, Chang Wenqiang, Yin Bin, Song Ning-Jing, Liu Zhongrong, Zhang Dongxing, Yao Fen, Wang Xun, Wang Qian, Cai Lin, Hou Bing, Wang Jiayue, Mao Chunyan, Liu Lingxi, Zeng Yuebin
Department of Dermatology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China.
Faculty of Biological Sciences, Department of Microbiology, Quaid-I-Azam University, Islamabad, Pakistan.
Mycology. 2023 Oct 20;15(1):30-44. doi: 10.1080/21501203.2023.2265664. eCollection 2024.
The application of interleukin-17 (IL-17) inhibitors, including secukinumab, ixekizumab, brodalumab, and bimekizumab, are associated with elevated risk of candidiasis. These medications interfere with the IL-17 pathway, which is essential for maintaining mucosal barriers and coordinating the immune response against species. The observational data and clinical trials demonstrate the increased incidence of candidiasis in individuals treated with IL-17 inhibitors. Brodalumab and bimekizumab pose a greater risk than secukinumab in eliciting candidiasis, whereas the data regarding ixekizumab are equivocal. Higher doses and prolonged treatment duration of IL-17 inhibitors increase the risk of candidiasis by compromising the immune response against species. Prior to prescribing IL-17 inhibitors, healthcare professionals should comprehensively evaluate patients' medical histories and assess their risk factors. Patients should be educated on the signs and symptoms of candidiasis to facilitate early detection and intervention. Future research should focus on identifying the risk factors associated with candidiasis in patients receiving IL-17 inhibitors. Prospective studies and long-term surveillance are required to explore the impact of specific inhibitors on the incidence and severity of candidiasis and to evaluate the effectiveness of combination therapies, such as concurrent use of IL-17 inhibitors and prophylactic antifungal agents.
包括司库奇尤单抗、依奇珠单抗、布罗达单抗和比美吉珠单抗在内的白细胞介素-17(IL-17)抑制剂的应用与念珠菌病风险升高相关。这些药物干扰IL-17通路,而该通路对于维持黏膜屏障和协调针对特定菌种的免疫反应至关重要。观察性数据和临床试验表明,接受IL-17抑制剂治疗的个体念珠菌病发病率增加。在引发念珠菌病方面,布罗达单抗和比美吉珠单抗比司库奇尤单抗带来的风险更大,而关于依奇珠单抗的数据尚不明确。IL-17抑制剂的高剂量和延长治疗时间会通过损害针对特定菌种的免疫反应而增加念珠菌病风险。在开具IL-17抑制剂处方之前,医疗保健专业人员应全面评估患者的病史并评估其风险因素。应告知患者念珠菌病的体征和症状,以便于早期发现和干预。未来的研究应侧重于确定接受IL-17抑制剂治疗的患者中与念珠菌病相关的风险因素。需要进行前瞻性研究和长期监测,以探讨特定抑制剂对念珠菌病发病率和严重程度的影响,并评估联合治疗的有效性,如同时使用IL-17抑制剂和预防性抗真菌药物。