Host-microbe interactions in stem cell transplantation: recognizing Candida in infection and inflammation

Area of Science:

• Immunology
• Microbiology
• Transplantation Science

Background:

• Host-pathogen interactions at epithelial barriers are crucial in health and disease.
• Deregulated sensing of microbes by pattern recognition receptors (PRRs) can cause complications in stem cell transplantation (SCT).

Purpose of the Study:

• To investigate the role of dectin-1 polymorphisms in Candida colonization and graft-versus-host disease (GvHD) in SCT recipients.
• To explore the potential of immunogenetics in personalizing SCT management.

Main Methods:

• Analysis of dectin-1 polymorphisms and their association with Candida colonization and GvHD incidence in SCT recipients.
• Evaluation of the role of Th17 immune responses in mediating anti-Candida immunity and GvHD pathogenesis.

Main Results:

• A 'loss-of-function' dectin-1 polymorphism (Y238X) was associated with increased Candida colonization and risk of candidaemia in SCT recipients.
• Candida colonization correlated with increased acute GvHD incidence in SCT recipients with wild-type dectin-1.
• Th17 immune responses may link anti-Candida immunity and GvHD pathogenesis.

Conclusions:

• Immunogenetics, particularly dectin-1 status, can inform individualized risk-based strategies for SCT recipients, including antifungal prophylaxis.
• Modulating PRR activity presents a potential therapeutic target to improve SCT outcomes.