Department of Dermatology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
Department of Microbiology, Faculty of Biological Sciences, Quaid-I-Azam University, Islamabad, Pakistan.
Front Immunol. 2024 Mar 28;15:1372693. doi: 10.3389/fimmu.2024.1372693. eCollection 2024.
Interleukins (ILs) are vital in regulating the immune system, enabling to combat fungal diseases like candidiasis effectively. Their inhibition may cause enhanced susceptibility to infection. IL inhibitors have been employed to control autoimmune diseases and inhibitors of IL-17 and IL-23, for example, have been associated with an elevated risk of infection. Thus, applying IL inhibitors might impact an individual's susceptibility to infections. Variations in the severity of infections have been observed between individuals with different IL inhibitors, necessitating careful consideration of their specific risk profiles. IL-1 inhibitors (anakinra, canakinumab, and rilonacept), IL-2 inhibitors (daclizumab, and basiliximab), and IL-4 inhibitors (dupilumab) have rarely been associated with infection. In contrast, tocilizumab, an inhibitor of IL-6, has demonstrated an elevated risk in the context of coronavirus disease 2019 (COVID-19) treatment, as evidenced by a 6.9% prevalence of candidemia among patients using the drug. Furthermore, the incidence of infections appeared to be higher in patients exposed to IL-17 inhibitors than in those exposed to IL-23 inhibitors. Therefore, healthcare practitioners must maintain awareness of the risk of candidiasis associated with using of IL inhibitors before prescribing them. Future prospective studies need to exhaustively investigate candidiasis and its associated risk factors in patients receiving IL inhibitors. Implementing enduring surveillance methods is crucial to ensure IL inhibitors safe and efficient utilization of in clinical settings.
白细胞介素 (ILs) 在调节免疫系统方面至关重要,能够有效地对抗念珠菌病等真菌感染。它们的抑制可能会导致易感性增加。IL 抑制剂已被用于控制自身免疫性疾病,例如,IL-17 和 IL-23 的抑制剂与感染风险增加有关。因此,应用 IL 抑制剂可能会影响个体对感染的易感性。不同 IL 抑制剂的个体之间观察到感染的严重程度存在差异,因此需要仔细考虑其特定的风险状况。IL-1 抑制剂(阿那白滞素、卡那单抗和瑞立昔单抗)、IL-2 抑制剂(达珠单抗和巴利昔单抗)和 IL-4 抑制剂(度普利尤单抗)很少与感染有关。相比之下,IL-6 抑制剂托珠单抗在治疗 2019 冠状病毒病 (COVID-19) 时显示出更高的风险,使用该药物的患者中有 6.9%的念珠菌血症患病率。此外,与接受 IL-23 抑制剂治疗的患者相比,接受 IL-17 抑制剂治疗的患者感染的发生率似乎更高。因此,临床医生在开具 IL 抑制剂之前必须意识到使用 IL 抑制剂相关的念珠菌病风险。未来的前瞻性研究需要全面调查接受 IL 抑制剂治疗的患者中的念珠菌病及其相关危险因素。实施持久的监测方法对于确保 IL 抑制剂在临床环境中的安全和有效利用至关重要。