van de Veerdonk Frank L, Carvalho Agostinho, Wauters Joost, Chamilos George, Verweij Paul E
Department of Internal Medicine, Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
Radboudumc/CWZ Center of Expertise in Mycology (RCEM), Radboud University Medical Center, Nijmegen, The Netherlands.
Nat Rev Microbiol. 2025 May 2. doi: 10.1038/s41579-025-01180-z.
Aspergillus fumigatus is a saprophytic fungus prevalent in the environment and capable of causing severe invasive infection in humans. This organism can use strategies such as molecule masking, immune response manipulation and gene expression alteration to evade host defences. Understanding these mechanisms is essential for developing effective diagnostics and therapies to improve patient outcomes in Aspergillus-related diseases. In this Review, we explore the biology and pathogenesis of A. fumigatus in the context of host biology and disease, highlighting virus-associated pulmonary aspergillosis, a newly identified condition that arises in patients with severe pulmonary viral infections. In the post-pandemic landscape, in which immunotherapy is gaining attention for managing severe infections, we examine the host immune responses that are critical for controlling invasive aspergillosis and how A. fumigatus circumvents these defences. Additionally, we address the emerging issue of azole resistance in A. fumigatus, emphasizing the urgent need for greater understanding in an era marked by increasing antimicrobial resistance. This Review provides timely insights necessary for developing new immunotherapeutic strategies against invasive aspergillosis.
烟曲霉是一种在环境中普遍存在的腐生真菌，能够在人类中引起严重的侵袭性感染。这种生物体可以利用分子掩盖、免疫反应操纵和基因表达改变等策略来逃避宿主防御。了解这些机制对于开发有效的诊断方法和治疗方法以改善曲霉相关疾病的患者预后至关重要。在本综述中，我们在宿主生物学和疾病的背景下探讨烟曲霉的生物学和发病机制，重点介绍病毒相关肺曲霉病，这是一种在严重肺部病毒感染患者中 newly identified condition 。在免疫疗法因管理严重感染而受到关注的大流行后格局中，我们研究了对控制侵袭性曲霉病至关重要的宿主免疫反应以及烟曲霉如何规避这些防御。此外，我们讨论了烟曲霉中唑类耐药性这一新兴问题，强调在一个以抗菌药物耐药性增加为特征的时代，迫切需要加深了解。本综述为开发针对侵袭性曲霉病的新免疫治疗策略提供了及时的见解。
