人兽共患和嗜人型须癣毛癣菌复合感染:最新进展与叙述性综述

Zoonotic and Anthropophilic Trichophyton mentagrophytes Complex Infection in Human: An Update and Narrative Review.

作者信息

Plangsiri Settanan, Arenas Roberto, Rattananukrom Teerapong

机构信息

Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Mycology Section, "Dr. Manuel Gea Gonzalez" General Hospital, Mexico City, Mexico.

出版信息

Mycoses. 2025 Jun;68(6):e70082. doi: 10.1111/myc.70082.

Abstract

BACKGROUND

Trichophyton mentagrophytes species complex comprises dermatophytes responsible for common superficial fungal infections affecting keratinised tissues. Recent shifts in taxonomy and increasing antifungal resistance-necessitate an updated understanding of this fungal complex.

OBJECTIVE

This narrative review provides a comprehensive update on the taxonomy, host immune response and clinical genotyping of the T. mentagrophytes complex, with a focus on zoonotic and anthropophilic infections in humans.

METHODS

A comprehensive literature search was conducted across PubMed and Scopus using MeSH terms and relevant keywords related to T. mentagrophytes, T. interdigitale, and T. indotineae. Eligible English-language publications up to March 2025-including original research, case reports, reviews and guidelines-were included.

RESULTS

The T. mentagrophytes complex includes several genotypes with distinct transmission profiles. Genotypes III/III* are primarily zoonotic; genotype VII is sexually transmitted, especially in MSM populations; genotype VIII (T. indotineae) is anthropophilic and associated with terbinafine resistance. Infection involves keratinocyte adhesion, enzymatic skin barrier degradation and activation of pro-inflammatory cytokines and antimicrobial peptides. Both innate and adaptive immunity, particularly Th1 and Th17 responses, are critical for fungal clearance, whereas chronic infections are associated with impaired T-cell function and skewed Th2 responses.

CONCLUSION

Emerging genotypes and drug resistance within the T. mentagrophytes complex pose increasing clinical challenges. Awareness of transmission patterns, immune evasion mechanisms and resistance profiles is essential for accurate diagnosis and effective management of dermatophytosis.

摘要

背景

须癣毛癣菌复合种包含引起影响角化组织的常见浅表真菌感染的皮肤癣菌。分类学的最新变化以及抗真菌耐药性的增加,使得有必要对这种真菌复合体有更新的认识。

目的

本叙述性综述全面更新了须癣毛癣菌复合体的分类学、宿主免疫反应和临床基因分型,重点关注人类的人畜共患感染和嗜人感染。

方法

使用与须癣毛癣菌、指间毛癣菌和印多毛癣菌相关的医学主题词和相关关键词,在PubMed和Scopus上进行了全面的文献检索。纳入截至2025年3月符合条件的英文出版物,包括原创研究、病例报告、综述和指南。

结果

须癣毛癣菌复合体包括几种具有不同传播特征的基因型。基因型III/III*主要是人畜共患的;基因型VII是性传播的,尤其是在男男性行为人群中;基因型VIII(印多毛癣菌)是嗜人的,且与特比萘芬耐药有关。感染涉及角质形成细胞黏附、酶促皮肤屏障降解以及促炎细胞因子和抗菌肽的激活。固有免疫和适应性免疫,特别是Th1和Th17反应,对于真菌清除至关重要,而慢性感染与T细胞功能受损和Th2反应失衡有关。

结论

须癣毛癣菌复合体内新出现的基因型和耐药性带来了越来越多的临床挑战。了解传播模式、免疫逃逸机制和耐药情况对于准确诊断和有效管理皮肤癣菌病至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee68/12181758/a277eab63e62/MYC-68-e70082-g003.jpg

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