Title:Immunotherapy in Invasive Fungal Infection - Focus on Invasive Aspergillosis
Volume: 19
Issue: 20
Author(s): Thomas Lehrnbecher, Markus Kalkum, Jackson Champer, Lars Tramsen, Stanislaw Schmidt and Thomas Klingebiel
Affiliation:
Keywords:
Aspergillus, immunotherapy, granulocyte, T cell, antibody, vaccination, cytokine, interferon.
Abstract: Despite the availability of new antifungal compounds, morbidity and mortality of invasive aspergillosis are still unacceptably
high, in particular in immunocompromised patients such as patients with hematological malignancies or allogeneic hematopoietic stem
cell or solid organ transplant recipients. Over the last decades, our knowledge of the immunopathogenesis of invasive aspergillosis has
greatly advanced. This, in turn, provided critical information to augment host immunity against fungal pathogens. Potential approaches
for enhancing the host immune system in the combat against Aspergillus include the administration of effector and regulatory cells (e.g.,
granulocytes, antigen-specific T cells, natural killer cells, dendritic cells) as well as the administration of recombinant cytokines, interferons
and growth factors (e.g., interferon-γ,granulocyte- and granulocyte-macrophage colony stimulating factor) and various vaccination
strategies. Although promising results are reported on in vitro data and animal studies, current data are too limited to allow solid conclusions
on the risk and the benefit of these strategies in the clinical setting. Therefore, the real challenge in the future is to perform appropriately
designed and powered clinical trials. These require international, multi-center collaboration, but may ultimately improve the outcome
in immunocompromised patients suffering from invasive aspergillosis.
