Vinh Donald C
Department of Medicine (Division of Infectious Diseases), McGill University Health Center, Montreal, Canada.
Department of OptiLab (Division of Medical Microbiology, Division of Molecular Genetics-Immunology), McGill University Health Center, Montreal, Canada.
J Exp Med. 2025 Jun 2;222(6). doi: 10.1084/jem.20241215. Epub 2025 Apr 15.
Fungi increasingly threaten health globally. Mycoses range from life-threatening, often iatrogenic conditions, to enigmatic syndromes occurring without apparent immunosuppression. Despite some recent advances in antifungal drug development, complementary therapeutic strategies are essential for addressing these opportunistic pathogens. One promising avenue is leveraging host immunity to combat fungal infections; this necessitates deeper understanding of the molecular immunology of human fungal susceptibility to differentiate beneficial versus harmful immunopathological responses. Investigating human models of fungal diseases in natural settings, particularly through genetic immunodeficiencies and ethnographic-specific genetic vulnerabilities, reveals crucial immune pathways essential for fighting various yeasts and molds. This review highlights the diversity in intrinsic fungal susceptibility across individuals and populations, through genetic- and autoantibody-mediated processes, complementing previous principles learned from animal studies and iatrogenic contexts. Improved understanding of human immunity to fungal diseases will facilitate the development of host-directed immunotherapies and targeted public health interventions, paving the way for precision medicine in fungal disease management.
真菌对全球健康的威胁日益增加。真菌病的范围从危及生命的、通常为医源性的疾病,到在无明显免疫抑制情况下出现的神秘综合征。尽管抗真菌药物研发最近取得了一些进展,但补充性治疗策略对于应对这些机会性病原体至关重要。一个有前景的途径是利用宿主免疫力来对抗真菌感染;这需要更深入地了解人类对真菌易感性的分子免疫学,以区分有益和有害的免疫病理反应。在自然环境中研究真菌病的人类模型,特别是通过基因免疫缺陷和特定人种的遗传易感性,揭示了对抗各种酵母和霉菌至关重要的免疫途径。本综述强调了个体和人群之间通过基因和自身抗体介导的过程在内在真菌易感性方面的多样性,补充了先前从动物研究和医源性背景中学到的原理。更好地理解人类对真菌病的免疫力将有助于开发宿主导向的免疫疗法和有针对性的公共卫生干预措施,为真菌病管理中的精准医学铺平道路。