title: Immunotherapy for invasive mold disease in severely immunosuppressed patients.
abstract: Response to systemic antifungal therapy alone remains disproportionately less satisfactory in immunosuppressed transplant and oncology patients. As insight in fungal immunopathogenesis forges ahead, interventions for boosting immune functions along with antimicrobial drugs has shown promise in preclinical experiments. The clinical experience with immunotherapy for invasive mold disease is limited. Most studies have involved small numbers of patients at a single institution or data collected retrospectively. An overview of various facts of immune modulatory drug intervention is presented, including major considerations in antifungal immunotherapy in immunosuppressed patients. Patients in whom immunotherapy is being considered must be critically evaluated to identify the underlying immune defects, including treatment-induced immunosuppression. Antifungal immunotherapy is appealing; however, before routine clinical use is recommended, well-designed prospective comparative clinical trials are urgently needed.
authors.affiliation: New York University Langone Medical Center, New York University School of Medicine, 550 First Ave, New York, NY 10016, USA. amar.safdar@nyumc.org
authors.forename: Amar
authors.initials: A
authors.lastname: Safdar
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D009181:Mycoses / Q000382:microbiology / Q000628:therapy*; D009369:Neoplasms / Q000188:drug therapy; D014180:Transplantation
chemical_list: D000935:Antifungal Agents; D007155:Immunologic Factors; D007166:Immunosuppressive Agents
keywords: antifungal drugs; aspergillosis; fungal cytoskeleton; interferon gamma; myeloid growth factors