Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy & Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
Fungal Pathogenesis Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy & Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
Cell Host Microbe. 2024 Oct 9;32(10):1654-1667. doi: 10.1016/j.chom.2024.08.018.
Candida spp. are members of the human mucosal microbiota that can cause opportunistic diseases ranging from superficial infections to life-threatening invasive candidiasis. In humans, the most common infection caused by Candida spp. is vulvovaginal candidiasis (VVC), which affects >70% of women at least once in their lifetime. Of those women, ∼5%-10% develop recurrent VVC (RVVC). In this review, we summarize our current understanding of the host and fungal factors that contribute to susceptibility to VVC and RVVC. We synthesize key findings that support the notion that disease symptoms are driven by neutrophil-associated dysfunction and immunopathology and describe how antifungal immune mechanisms in the vagina are distinct from other mucosal barrier sites. Finally, we highlight key, unanswered research areas within the field that can help us better understand the immunopathogenesis of this infection and facilitate the development of novel preventive, therapeutic, and/or vaccination strategies to combat these common, poorly understood diseases.
假丝酵母菌属是人类黏膜微生物群的成员，可引起从浅表感染到危及生命的侵袭性念珠菌病等机会性疾病。在人类中，由假丝酵母菌属引起的最常见感染是外阴阴道念珠菌病（VVC），一生中至少有＞70%的女性会受到影响。其中，约 5%-10%的女性会发展为复发性 VVC（RVVC）。在这篇综述中，我们总结了目前对宿主和真菌因素的理解，这些因素导致易患 VVC 和 RVVC。我们综合了关键发现，这些发现支持这样一种观点，即疾病症状是由中性粒细胞相关功能障碍和免疫病理学驱动的，并描述了阴道中的抗真菌免疫机制与其他黏膜屏障部位的不同。最后，我们强调了该领域内关键的、未解决的研究领域，这有助于我们更好地理解该感染的免疫发病机制，并促进新型预防、治疗和/或疫苗接种策略的开发，以应对这些常见但了解甚少的疾病。
