Fungal Pathogens in CF Airways: Leave or Treat?
Fungal Pathogens in CF Airways: Leave or Treat?
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DOI：
10.1007/s11046-017-0184-y
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发表时间：
2018-02-01
期刊：
影响因子：
5.5
通讯作者：
Hector, A.
中科院分区：
文献类型：
--
作者：
Singh, A.;Ralhan, A.;Hector, A.
慢性气道感染在囊性纤维化（CF）肺疾病的进展中起着至关重要的作用。在过去的几十年里，主要是细菌性病原体，如铜绿假单胞菌，一直是研究人员和临床医生的重点。然而，在CF气道中经常检测到真菌，并且越来越多的证据表明真菌病原体可能在CF肺病中起作用。几项研究表明，真菌，特别是烟曲霉菌和白色念珠菌，与CF患者的肺部疾病病程有关。从机制上讲，体外和体内研究表明，CF气道中对真菌病原体的免疫应答受损使其更易受真菌感染。然而，真菌是否积极参与CF肺病病理学或它们是否反映了气道定植失调并充当微生物旁观者仍然是难以捉摸的。剖析真菌在CF肺病中的作用的一个关键问题是动态真菌-宿主相互作用实体的区别，即定殖、致敏或感染。这篇综述总结了真菌在CF肺病中的病理生理机制和临床影响的关键发现。
Chronic airway infection plays an essential role in the progress of cystic fibrosis (CF) lung disease. In the past decades, mainly bacterial pathogens, such as Pseudomonas aeruginosa, have been the focus of researchers and clinicians. However, fungi are frequently detected in CF airways and there is an increasing body of evidence that fungal pathogens might play a role in CF lung disease. Several studies have shown an association of fungi, particularly Aspergillus fumigatus and Candida albicans, with the course of lung disease in CF patients. Mechanistically, in vitro and in vivo studies suggest that an impaired immune response to fungal pathogens in CF airways renders them more susceptible to fungi. However, it remains elusive whether fungi are actively involved in CF lung disease pathologies or whether they rather reflect a dysregulated airway colonization and act as microbial bystanders. A key issue for dissecting the role of fungi in CF lung disease is the distinction of dynamic fungal-host interaction entities, namely colonization, sensitization or infection. This review summarizes key findings on pathophysiological mechanisms and the clinical impact of fungi in CF lung disease.