Immunity to fungi in the lung

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.