Immunogenetics of invasive aspergillosis.
Invasive aspergillosis is one of the most important infections in hematopoietic stem cell transplant recipients, with an incidence rate of 5-15% and an associated mortality of 30-60%. It remains unclear why certain patients develop invasive aspergillosis while others, undergoing identical transplant regimen and similar post transplant immunosuppression, do not. Over the last decade, pattern recognition receptors such as Toll-like receptors (TLRs) and the C-type lectin receptors (CLRs) have emerged as critical components of the innate immune system. By detecting specific molecular patterns from invading microbes and initiating inflammatory and subsequent adaptive immune responses, pattern recognition receptors are strategically located at the molecular interface of hosts and pathogens. Polymorphisms in pattern recognition receptors and downstream signaling molecules have been associated with increased or decreased susceptibility to infections, suggesting that their detection may have an increasing impact on the treatment and prevention of infectious diseases in the coming years. Infectious risk stratification may be particularly relevant for patients with hematologic malignancies, because of the high prevalence and severity of infections in this population. This review summarizes the innate immune mechanisms involved in Aspergillus fumigatus detection and the role of host genetic polymorphisms in susceptibility to invasive aspergillosis.
Lamoth
Frédéric
F
Infectious Diseases Service, Department of Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Rue du Bugnon 48, Lausanne, Switzerland.
Rubino
Ivana
I
Bochud
Pierre-Yves
PY
D001228:Aspergillosis / Q000235:genetics* / Q000276:immunology*; D001230:Aspergillus / Q000276:immunology* / Q000472:pathogenicity; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007113:Immunity, Innate; D007125:Immunogenetics; D007165:Immunosuppression Therapy / Q000009:adverse effects; D037181:Lectins, C-Type / Q000235:genetics / Q000276:immunology; D011110:Polymorphism, Genetic; D051192:Receptors, Pattern Recognition / Q000235:genetics* / Q000276:immunology; D012307:Risk Factors; D015398:Signal Transduction / Q000276:immunology; D051193:Toll-Like Receptors / Q000235:genetics / Q000276:immunology / Q000502:physiology
D037181:Lectins, C-Type; D051192:Receptors, Pattern Recognition; D051193:Toll-Like Receptors