Pathogenic fungi cause a wide range of syndromes in immune-competent and immune-compromised individuals, with life-threatening disease primarily seen in humans with HIV/AIDS and in patients receiving immunosuppressive therapies for cancer, autoimmunity, and end-organ failure. The discovery that specific primary immune deficiencies manifest with fungal infections and the development of animal models of mucosal and invasive mycoses have facilitated insight into fungus-specific recognition, signaling, effector pathways, and adaptive immune responses. Progress in deciphering the molecular and cellular basis of immunity against fungi is guiding preclinical studies into vaccine and immune reconstitution strategies for vulnerable patient groups. Furthermore, recent work has begun to address the role of endogenous fungal communities in human health and disease. In this review, we summarize a contemporary understanding of protective immunity against fungi.
Michail S. Lionakis, Iliyan D. Iliev, Tobias M. Hohl
Human fungal diseases.
The figure depicts the anatomic sites that are most commonly affected by the fungal genera listed below each organ system. At several sites, fungal disease occurs due to inoculation at the site. For example, humans inhale infectious conidia or desiccated fungal cells of all genera listed under lungs and respiratory tree. For other sites, such as the liver, spleen, and blood stream, disease is the result of dissemination of the indicated fungus from the initial inoculation site. Illustrated by Mao Miyamoto.