Immunity to Fungi

Abstract

Fungi are microorganisms that are ubiquitous in the environment. To establish themselves in the host, they employ a broad variety of virulence strategies. Fungi are an important source of morbidity in humans. However, despite millions of species, only about a hundred cause disease, owing to a remarkable collaboration of the innate and adaptive immune systems. In individuals who have immunocompromised cellular immunity, fungi readily cause invasive disease. Our knowledge of how the immune system prevents invasive fungal disease has been greatly aided by the study of acquired or inherited immune defects. However, much remains to be known in order to improve our ability to treat fungal infections, and our ability to control endemic disease in many areas of the world remains limited, warranting more research towards immunomodulatory interventions.

Key Concepts

  • Fungi readily colonise the environment including our skin and mucosal surfaces.
  • Invasive fungal infections largely occur in individuals with impaired immunity, although infections are endemic in many areas of the world in immunocompetent hosts.
  • T cells and neutrophils are essential in preventing invasive fungal disease.
  • In immunocompromised hosts, fungi frequently cause disease by direct invasion, and also indirectly (i.e. through exaggerated host immune responses).
  • Fungal infections are a major cause of morbidity and mortality worldwide.

Keywords: immune system; fungus; humoral immunity; cellular immunity; immunotherapy; humans; immunodeficiency

Figure 1. Interplay of innate and adaptive immunity to fungi. Orange boxes show potential therapeutic interventions. Key: Th, T helper cell; TReg, T regulatory cell; IL, interleukin; TNF, tumour necrosis factor; IFN, interferon; TGF, transforming growth factor; PRR, pattern‐recognition receptor; MBL, mannan‐binding lectin; GM‐CSF, granulocyte–macrophage colony‐stimulating factor; G‐CSF, granulocyte colony‐stimulating factor.
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Further Reading

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Li J, Vinh DC, Casanova JL, et al. (2017) Inborn errors of immunity underlying fungal diseases in otherwise healthy individuals. Current Opinion in Microbiology 40: 46–57.

Lionakis MS and Levitz SM (2017) Host control of fungal infections: lessons from basic studies and human cohorts. Annual Review of Immunology [Epub ahead of print].

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Scriven JE, Tenforde MW, Levitz SM, et al. (2017) Modulating host immune responses to fight invasive fungal infections. Current Opinion in Microbiology 40: 95–103.

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Michalski, Christina, Sadarangani, Manish, and Lavoie, Pascal M(Apr 2018) Immunity to Fungi. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0000494.pub3]