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Host-parasite relation in invasive aspergillosis.
1Department of Medicine, University Hospital, Zurich.
Summary
Glucocorticoids impair host defenses against invasive aspergillosis by affecting both macrophages and neutrophils. This immunosuppression compromises treatments like chemotherapy and transplantation, increasing infection risks.
Area of Science:
- Medical Mycology
- Immunology
- Infectious Diseases
Background:
- Invasive aspergillosis is a significant complication in intensive medicine, particularly impacting cancer treatments and transplants.
- Immunosuppressive therapies, underlying diseases, and fungal properties contribute to aspergillosis.
- Host defenses against Aspergillus spores and hyphae are compromised by glucocorticoids and myeloablative therapy.
Purpose of the Study:
- To elucidate the mechanisms by which glucocorticoids affect host defenses against Aspergillus.
- To understand how glucocorticoids impact macrophage and neutrophil functions in preventing aspergillosis.
Main Methods:
- The study reviews existing literature on host defense mechanisms against Aspergillus.
- It analyzes the effects of glucocorticoids on resident alveolar macrophages and neutrophil functions.
- The role of oxidative and non-oxidative killing systems in neutrophils is discussed.
Main Results:
- Glucocorticoids inhibit macrophages from preventing conidia germination and killing ingested conidia.
- Glucocorticoids suppress neutrophil mobilization by reducing macrophage chemokine expression.
- Both lines of host defense against Aspergillus are abrogated by glucocorticoids.
Conclusions:
- Glucocorticoids alone can dismantle host defenses against Aspergillus, affecting both spore and hyphal stages.
- Understanding these mechanisms is crucial for managing invasive aspergillosis in immunocompromised patients.
- Further research may explore the role of platelet-derived thrombocidins in combating angio-invasive Aspergillus.