Immune responses to fungal infections and therapeutic implications.
Host responses to fungi result from a coordinate interplay between innate and adaptative immune system. Neutrophils and monocytes are involved in the non specific clearance of yeasts (e.g. Candida albicans and Cryptococcus neoformans), while T helper 1 type responses are protective via release of interferon gamma. By contrast, T helper 2 responses (IL-4 and IL 10 release) correlate with disease exacerbation and pathology. IL-12 production which enhances T helper 1 type responses seem to exert a beneficial role in the course of Candida infection. In particular, its production from neutrophilis may support memory T helper 1 cell responses of the fungus. With respect to anti-Candida vaccines several approaches are in progress, such as use of heat-killed Candida albicans in combination with adjuvants, purified peptides and proteins and immunogenic peptide-lipid conjugates. Furthermore, exogenous IL-12 may play an important role in inducing a T helper 1 anticandidal response, also replacing neutrophils in neutropenic patients. At the same time, granulocyte-colony stimulating factor has exhibited therapeutic efficacy in experimental and human models of fungal infection.
Altamura
M
M
Department of Internal Medicine, Immunolgy and Infectious Diseases, University of Bari, Italy. m.altamura@midim.uniba.it
Casale
D
D
Pepe
M
M
Tafaro
A
A
D000818:Animals; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000188:drug therapy / Q000276:immunology; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy / Q000276:immunology; D003453:Cryptococcosis / Q000188:drug therapy / Q000276:immunology; D003455:Cryptococcus neoformans / Q000276:immunology; D005260:Female; D005658:Fungi / Q000276:immunology*; D006801:Humans; D009181:Mycoses / Q000188:drug therapy* / Q000276:immunology*
D000935:Antifungal Agents