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Immunity to fungi in the lung

Lena J Heung1, Darin L Wiesner2, Keyi Wang2

  • 1Division of Infectious Diseases, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Research Division of Immunology, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Women's Guild Lung Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.

Seminars in Immunology
|February 25, 2023
PubMed

Insights

The respiratory system defends against fungal pathogens, but immune compromise or viral infections can lead to serious lung fungal diseases and allergies. Understanding lung antifungal immunity is key to developing better diagnostics and treatments.

Area of Science:

  • Immunology
  • Pulmonology
  • Mycology

Background:

  • The respiratory tract is constantly exposed to airborne fungal pathogens, including molds, yeasts, and dimorphic fungi.
  • Fungal pneumonia classically affects immunocompromised individuals (e.g., HIV/AIDS, transplant recipients) and is exacerbated by viral infections like influenza and COVID-19.
  • Fungal exposure can also trigger or worsen allergic lung diseases.

Purpose of the Study:

  • To review emerging principles of lung-specific antifungal immunity.
  • To integrate the roles of lung epithelial cells, innate immune cells, and adaptive immune cells in mucosal barrier immunity against fungi.
  • To highlight the pathogenesis of fungal-associated allergic lung diseases.

Main Methods:

  • This is a review article, synthesizing existing research on lung antifungal immunity.
  • It integrates findings on cellular and molecular mechanisms of host defense against fungal pathogens.
  • The review also examines the immunopathogenesis of fungal allergies in the respiratory tract.

Main Results:

  • Lung epithelial cells and diverse immune cells (innate and adaptive) cooperate to maintain antifungal immunity.
  • Respiratory viral infections and their treatments can impair these fungus-specific host defense pathways.
  • Fungal antigens contribute to the development and exacerbation of allergic lung conditions.

Conclusions:

  • Enhanced understanding of lung antifungal immunity provides a foundation for improved diagnostics, preemptive strategies, therapies, and vaccines for pulmonary fungal diseases.
  • Targeting lung-specific immune responses holds promise for managing both invasive fungal infections and fungal allergies.
  • Further research into the complex interplay between host immunity and fungal pathogens in the lung is warranted.
Keywords:
AspergillusBlastomycesCryptococcusFungusHistoplasmaImmunityInfectionInnateLungLymphocyteMacrophageMonocyteMucomycosisMucoralesMycosisNeutrophilParacoccidioidesPneumoniaT cellTalaromyces

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