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Review on host-pathogen interaction in dermatophyte infections.
Chhavi Gupta1, Shukla Das2, Vishal Gaurav3
1All India Institute of Medical Science, New Delhi, 110029, India; Present Address: Consultant Infectious Diseases, Fortis Hospital, Sector 62, Gautam Buddh Nagar, Noida, Uttar Pradesh, 201301, India.
Journal De Mycologie Medicale
|October 22, 2022
Summary
Dermatophytosis, a common fungal skin infection, persists due to evolving pathogens and a dysregulated immune response. Understanding virulence factors and host immunity is key to overcoming antifungal resistance and chronic infections.
Area of Science:
- Mycology
- Immunology
- Dermatology
Background:
- Dermatophytosis is a prevalent superficial fungal infection caused by dermatophytes.
- Pathogen evolution, influenced by migration and socioeconomic factors, impacts infection dynamics.
- Dermatophytes adhere to keratinized tissues using arthroconidia and employ proteolytic enzymes for survival and persistence.
Purpose of the Study:
- To review virulence factors contributing to dermatophytosis pathogenesis.
- To define the role of the host immune response in chronic infections.
- To identify potential therapeutic targets for recalcitrant dermatophytosis.
Main Methods:
- Literature review focusing on dermatophyte pathogenesis and host immune responses.
- Analysis of immune surveillance mechanisms, including T lymphocyte activation and polarization.
- Examination of factors contributing to chronic inflammation and antifungal resistance.
Main Results:
- Cutaneous immune response, typically Th17-polarized, fails to eliminate dermatophytes despite IFN-γ presence.
- Chronic infections involve a dysregulated Th17 response and a counterproductive iTreg response, exacerbating inflammation.
- Increasing antifungal resistance and persistent infections hinder clinical remission.
Conclusions:
- Understanding dermatophyte virulence factors is crucial for developing new management strategies.
- Targeting the dysregulated host immune response offers potential for treating chronic and resistant dermatophytosis.
- Human genetic research may reveal novel therapeutic avenues for recalcitrant cases.
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