title: Paving the way for predictive diagnostics and personalized treatment of invasive aspergillosis.
abstract: Invasive aspergillosis (IA) is a life-threatening fungal disease commonly diagnosed among individuals with immunological deficits, namely hematological patients undergoing chemotherapy or allogeneic hematopoietic stem cell transplantation. Vaccines are not available, and despite the improved diagnosis and antifungal therapy, the treatment of IA is associated with a poor outcome. Importantly, the risk of infection and its clinical outcome vary significantly even among patients with similar predisposing clinical factors and microbiological exposure. Recent insights into antifungal immunity have further highlighted the complexity of host-fungus interactions and the multiple pathogen-sensing systems activated to control infection. How to decode this information into clinical practice remains however, a challenging issue in medical mycology. Here, we address recent advances in our understanding of the host-fungus interaction and discuss the application of this knowledge in potential strategies with the aim of moving toward personalized diagnostics and treatment (theranostics) in immunocompromised patients. Ultimately, the integration of individual traits into a clinically applicable process to predict the risk and progression of disease, and the efficacy of antifungal prophylaxis and therapy, holds the promise of a pioneering innovation benefiting patients at risk of IA.
authors.affiliation: Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho , Braga, Portugal ; ICVS/3B's - PT Government Associate Laboratory , Braga/Guimarães, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Oliveira-Coelho
authors.affiliation: Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho , Braga, Portugal ; ICVS/3B's - PT Government Associate Laboratory , Braga/Guimarães, Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodrigues
authors.affiliation: Serviço de Transplantação de Medula Óssea, Instituto Português de Oncologia do Porto , Porto, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Campos
authors.affiliation: Instituto de Medicina Molecular, Faculdade de Medicina de Lisboa , Lisboa, Portugal ; Serviço de Hematologia e Transplantação de Medula, Hospital de Santa Maria , Lisboa, Portugal.
authors.forename: João F
authors.initials: JF
authors.lastname: Lacerda
authors.affiliation: Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho , Braga, Portugal ; ICVS/3B's - PT Government Associate Laboratory , Braga/Guimarães, Portugal.
authors.forename: Agostinho
authors.initials: A
authors.lastname: Carvalho
authors.affiliation: Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho , Braga, Portugal ; ICVS/3B's - PT Government Associate Laboratory , Braga/Guimarães, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Cunha
keywords: antifungal immunity; invasive aspergillosis; personalized medicine; single nucleotide polymorphism; stem cell transplantation