Immune Reconstitution Inflammatory Syndrome in Invasive Fungal Infections: What We Know and What We Need to Know?

被引:5
作者
Chang C.C. [1 ]
French M.A. [2 ,3 ]
机构
[1] Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne
[2] School of Pathology and Laboratory Medicine, University of Western Australia, Perth
[3] Department of Clinical Immunology, Royal Perth Hospital and PathWest Laboratory Medicine, Perth
关键词
Cryptococcosis-associated IRIS; Fungal immunity; Histoplasmosis-associated IRIS; Immune reconstitution inflammatory syndrome; Invasive fungal infection; Pneumocystis-associated-IRIS; Talaromycosis/penicilliosis-IRIS;
D O I
10.1007/s40588-016-0033-7
中图分类号
学科分类号
摘要
Invasive fungal infections (IFIs) cause significant mortality and morbidity in HIV-infected patients, patients with malignancy on chemotherapy, recipients of solid organ and haematological stem cell transplantation, patients with primary immunodeficiencies and those on immunomodulators such as steroids and tumour necrosis factor-alpha inhibitors. Immune reconstitution inflammatory syndrome (IRIS), an exaggerated, unexpected inflammatory phenomena occurring in temporal association with enhanced immune function in these conditions, is difficult to recognise and manage. Here, we detail what we have learnt from studies in cryptococcosis-associated IRIS and discuss other common fungal IRIS including histoplasmosis-IRIS, talaromycosis/penicilliosis-IRIS, pneumocystis-IRIS and a less well-recognised IRIS seen with invasive aspergillosis in the setting of neutrophil recovery. We also reflect on the enormity of what we are yet to understand about IRIS immunopathogenesis, diagnosis and management. © 2016, Springer International Publishing AG.
引用
收藏
页码:63 / 70
页数:7
相关论文
共 48 条
  • [1] French M.A., HIV/AIDS: immune reconstitution inflammatory syndrome: a reappraisal, Clin Infect Dis, 48, 1, pp. 101-107, (2009)
  • [2] Sun H.Y., Et al., Predictors of immune reconstitution syndrome in organ transplant recipients with cryptococcosis: implications for the management of immunosuppression, Clin Infect Dis, 60, 1, pp. 36-44, (2015)
  • [3] Sun H.Y., Singh N., Opportunistic infection-associated immune reconstitution syndrome in transplant recipients, Clin Infect Dis, 53, 2, pp. 168-176, (2011)
  • [4] Ferwerda B., Et al., Human dectin-1 deficiency and mucocutaneous fungal infections, N Engl J Med, 361, 18, pp. 1760-1767, (2009)
  • [5] Al-Herz W., Et al., Primary immunodeficiency diseases: an update on the classification from the international union of immunological societies expert committee for primary immunodeficiency, Front Immunol, 5, (2014)
  • [6] Meintjes G., Et al., Tuberculosis-associated immune reconstitution inflammatory syndrome: case definitions for use in resource-limited settings, Lancet Infect Dis, 8, 8, pp. 516-523, (2008)
  • [7] Haddow L.J., Et al., Cryptococcal immune reconstitution inflammatory syndrome in HIV-1-infected individuals: proposed clinical case definitions, Lancet Infect Dis, 10, 11, pp. 791-802, (2010)
  • [8] French M.A., Price P., Stone S.F., Immune restoration disease after antiretroviral therapy, AIDS, 18, 12, pp. 1615-1627, (2004)
  • [9] French M.A., Immune reconstitution inflammatory syndrome: immune restoration disease 20 years on, Med J Aust, 196, 5, pp. 318-321, (2012)
  • [10] Barber D.L., Et al., Immune reconstitution inflammatory syndrome: the trouble with immunity when you had none, Nat Rev Microbiol, 10, 2, pp. 150-156, (2012)