Immunotherapy of invasive fungal infection in hematopoietic stem cell transplant recipients.
Immunotherapy of invasive fungal infection in hematopoietic stem cell transplant recipients.
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DOI：
10.3389/fonc.2013.00017
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发表时间：
2013
影响因子：
4.7
通讯作者：
Klingebiel T
中科院分区：
文献类型：
--
作者：
Lehrnbecher T;Schmidt S;Tramsen L;Klingebiel T
尽管有新的抗真菌化合物，侵袭性真菌感染仍然是儿童和成人接受同种异体造血干细胞移植（HSCT）发病和死亡的重要原因。同种异体造血干细胞移植受者在不同的免疫系统臂遭受长期的缺陷，这增加了侵袭性真菌感染的风险并恶化了预后。反过来，了解这些免疫缺陷的进展导致了有希望的策略来增强或恢复异体造血干细胞受体的关键免疫功能。潜在的方法包括给药粒细胞，因为中性粒细胞减少症是侵袭性真菌感染的最重要的危险因素，初步的临床结果表明过继转移供体来源的抗真菌T细胞是有益的。体外实验数据和动物实验表明自然杀伤细胞具有抗真菌作用，但迄今缺乏临床数据。这篇综述总结并批判性地讨论了同种异体造血干细胞移植受者侵袭性真菌感染的免疫治疗策略的现有数据。
Despite the availability of new antifungal compounds, invasive fungal infection remains a significant cause of morbidity and mortality in children and adults undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Allogeneic HSCT recipients suffer from a long lasting defect of different arms of the immune system, which increases the risk for and deteriorates the prognosis of invasive fungal infections. In turn, advances in understanding these immune deficits have resulted in promising strategies to enhance or restore critical immune functions in allogeneic HSCT recipients. Potential approaches include the administration of granulocytes, since neutropenia is the single most important risk factor for invasive fungal infection, and preliminary clinical results suggest a benefit of adoptively transferred donor-derived antifungal T cells. In vitro data and animal studies demonstrate an antifungal effect of natural killer cells, but clinical data are lacking to date. This review summarizes and critically discusses the available data of immunotherapeutic strategies in allogeneic HSCT recipients suffering from invasive fungal infection.