Insights into dysregulated innate immunity in the pathogenesis of COVID-19-associated pulmonary aspergillosis.

IF 5.4 2区 医学 Q1 INFECTIOUS DISEASES
Hanxue Xiang, Ling Zhang, Miaotian Cai, Yulin Zhang
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引用次数: 0

Abstract

Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a severe complication arising from the co-infection of viral and fungal pathogens in the lungs, with its incidence notably increasing. Although significant progress has been made in elucidating the pathogenesis of CAPA in recent years, the precise pathophysiological mechanisms underlying this condition remain only partially understood. Current evidence indicates that CAPA primarily results from dysregulation of innate antifungal immune responses. Key contributing factors include epithelial barrier dysfunction, impaired phagocytic activity against fungi, aberrant expression of antimicrobial peptides, immunologic tolerance, and lung dysbiosis, all of which collectively weaken host defense mechanisms. Concurrently, excessive pro-inflammatory responses-driven by cytokine storms and oxidative stress associated with antiviral immunity-further exacerbate lung injury in COVID-19 patients, creating a detrimental feedback loop that impairs immune function and heightens susceptibility to CAPA. In this review, we summarize and discuss recent advances in understanding the role of dysregulated innate immunity in the pathogenesis of CAPA. These insights may inform clinical management strategies and improve outcomes for patients suffering CAPA.

新冠肺炎相关肺曲霉病发病机制中先天免疫失调的研究
2019冠状病毒病(COVID-19)相关肺曲霉病(CAPA)是肺部病毒和真菌病原体共同感染引起的严重并发症,其发病率显著增加。尽管近年来在阐明CAPA的发病机制方面取得了重大进展,但其确切的病理生理机制仍仅部分被理解。目前的证据表明,CAPA主要由先天抗真菌免疫反应失调引起。关键因素包括上皮屏障功能障碍、抗真菌吞噬活性受损、抗菌肽异常表达、免疫耐受和肺生态失调,所有这些因素共同削弱了宿主的防御机制。与此同时,过度的促炎反应——由与抗病毒免疫相关的细胞因子风暴和氧化应激驱动——进一步加剧了COVID-19患者的肺损伤,形成了一个有害的反馈循环,损害了免疫功能,增加了对CAPA的易感性。在这篇综述中,我们总结和讨论了在理解先天免疫失调在CAPA发病机制中的作用方面的最新进展。这些见解可以为临床管理策略提供信息,并改善CAPA患者的预后。
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来源期刊
Infection
Infection 医学-传染病学
CiteScore
12.50
自引率
1.30%
发文量
224
审稿时长
6-12 weeks
期刊介绍: Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.
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