儿童常见侵袭性肺部真菌病免疫机制和临床特点

doi:10.12372/jcp.2023.23e0435

临床儿科杂志 ›› 2023, Vol. 41 ›› Issue (8): 566-570.doi: 10.12372/jcp.2023.23e0435

儿童常见侵袭性肺部真菌病免疫机制和临床特点

秦涛, 许红梅()

重庆医科大学附属儿童医院感染科国家儿童健康与疾病临床医学研究中心儿童发育疾病研究教育部重点实验室儿童感染免疫重庆市重点实验室（重庆 400014）

收稿日期:2023-05-16 出版日期:2023-08-15 发布日期:2023-08-10
通讯作者: 许红梅 E-mail:xuhongm0095@sina.com
基金资助:
重庆市首批公共卫生重点学科（专科）

Clinical manifestations and immune mechanism of invasive pulmonary mycosis in children

QIN Tao, XU Hongmei()

Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing 400014, China

Received:2023-05-16 Online:2023-08-15 Published:2023-08-10
Contact: XU Hongmei E-mail:xuhongm0095@sina.com

摘要/Abstract

摘要：

侵袭性肺部真菌病是由真菌引起的支气管肺部感染，出现气道黏膜炎症和肺部炎症肉芽肿，严重者可能导致坏死性肺炎，甚至血行播散到其他脏器。其发生发展取决于外界真菌致病因素和患者免疫功能的相互作用。儿童患有原发免疫功能缺陷、血液恶性肿瘤、接受造血干细胞移植或高强度免疫抑制剂应用,长期侵入性置管或者重症感染等情况均可能造成对真菌易感。文章对儿童侵袭性肺部真菌病的免疫学发病机制、临床表现特点要素进行探讨，希望能为疾病的早期发现提供理论依据。

关键词: 侵袭性肺部真菌病, 免疫学发病机制, 临床表现

Abstract:

Invasive pulmonary mycosis is a fungal infection of the bronchi and lungs, causing inflammation of the airway mucosa and pulmonary inflammatory granulomas. In severe cases, necrotizing pneumonia may occur, and even hematogenous dissemination to other organs. Its occurrence and development depend on the interaction between external fungal pathogenic factors and the patient's immune function. Children with primary immune dysfunction, hematological malignancies, receiving hematopoietic stem cell transplantation or high-intensity immunosuppressive therapy, long-term invasive catheterization, or severe infections may be susceptible to fungi. This article discusses the immunological pathogenesis and clinical characteristics of invasive pulmonary mycosis in children, hoping to provide theoretical basis for the early detection of the disease.

Key words: invasive pulmonary mycosis, immunologic pathogenesis, clinical manifestations

秦涛, 许红梅. 儿童常见侵袭性肺部真菌病免疫机制和临床特点[J]. 临床儿科杂志, 2023, 41(8): 566-570.

QIN Tao, XU Hongmei. Clinical manifestations and immune mechanism of invasive pulmonary mycosis in children[J]. Journal of Clinical Pediatrics, 2023, 41(8): 566-570.

参考文献 28

[1]	Reddy GKK, Padmavathi AR, Nancharaiah YV. Fungal infections: pathogenesis, antifungals and alternate treatment approaches[J]. Curr Res Microb Sci, 2022, 3: 100137.
[2]	Page L, Wallstabe J, Lother J, et al. CcpA- and Shm2-pulsed myeloid dendritic cells induce T-cell activation and enhance the neutrophilic oxidative burst response to aspergillus fumigatus[J]. Front Immunol, 2021, 12: 659752. doi: 10.3389/fimmu.2021.659752
[3]	Mircescu MM, Lipuma L, van Rooijen N, et al. Essential role for neutrophils but not alveolar macrophages at early time points following Aspergillus fumigatus infection[J]. J Infect Dis, 2009, 200(4): 647-656. doi: 10.1086/600380 pmid: 19591573
[4]	Stappers MHT, Clark AE, Aimanianda V, et al. Recognition of DHN-melanin by a C-type lectin receptor is required for immunity to Aspergillus[J]. Nature, 2018, 555(7696): 382-386. doi: 10.1038/nature25974
[5]	Dietschmann A, Schruefer S, Westermann S, et al. Phosphatidylinositol 3-kinase (PI3K) orchestrates aspergillus fumigatus-induced eosinophil activation independently of canonical toll-like receptor (TLR)/C-type-lectin receptor (CLR) signaling[J]. mBio, 2022, 13(4): e0123922.
[6]	Chignard M, Balloy V, Sallenave JM, et al. Role of Toll-like receptors in lung innate defense against invasive aspergillosis. Distinct impact in immunocompetent and immunocompromized hosts[J]. Clin Immunol, 2007, 124(3): 238-243. doi: 10.1016/j.clim.2007.05.004 pmid: 17604224
[7]	Zhang W, He D, Wei Y, et al. Suppression of aspergillus fumigatus germination by neutrophils is enhanced by endothelial-derived CSF3 production[J]. Front Microbiol, 2022, 13: 837776. doi: 10.3389/fmicb.2022.837776
[8]	Taylor PR, Roy S, Leal SM Jr, et al. Activation of neutrophils by autocrine IL-17A-IL-17RC interactions during fungal infection is regulated by IL-6, IL-23, RORγt and dectin-2[J]. Nat Immunol, 2014, 15(2): 143-151. doi: 10.1038/ni.2797 pmid: 24362892
[9]	Rudman J, Evans RJ, Johnston SA. Are macrophages the heroes or villains during cryptococcosis?[J]. Fungal Genet Biol, 2019, 132: 103261. doi: 10.1016/j.fgb.2019.103261
[10]	Zhang M, Sun D, Shi M. Dancing cheek to cheek: Cryptococcus neoformans and phagocytes[J]. Springerplus, 2015, 4: 410. doi: 10.1186/s40064-015-1192-3
[11]	Wang Y, Pawar S, Dutta O, et al. Macrophage mediated immunomodulation during cryptococcus pulmonary infection[J]. Front Cell Infect Microbiol, 2022, 12: 859049. doi: 10.3389/fcimb.2022.859049
[12]	Alshabani K, Haq A, Miyakawa R, et al. Invasive pulmonary aspergillosis in patients with influenza infection: report of two cases and systematic review of the literature[J]. Expert Rev Respir Med, 2015, 9(1): 89-96. doi: 10.1586/17476348.2015.996132
[13]	Crum-Cianflone NF. Invasive aspergillosis associated with severe influenza infections[J]. Open Forum Infect Dis, 2016, 3(3): ofw171.
[14]	Tragiannidis A, Roilides E, Walsh TJ, et al. Invasive aspergillosis in children with acquired immunodeficiencies[J]. Clin Infect Dis, 2012, 54(2): 258-267. doi: 10.1093/cid/cir786 pmid: 22075793
[15]	Page ID, Richardson MD, Denning DW. Comparison of six Aspergillus-specific IgG assays for the diagnosis of chronic pulmonary aspergillosis (CPA)[J]. J Infect, 2016, 72(2): 240-249. doi: 10.1016/j.jinf.2015.11.003 pmid: 26680697
[16]	Wardlaw AJ, Rick EM, Pur Ozyigit L, et al. New perspectives in the diagnosis and management of allergic fungal airway disease[J]. J Asthma Allergy, 2021, 14: 557-573. doi: 10.2147/JAA.S251709 pmid: 34079294
[17]	Singh M, Chauhan A, Paul N, et al. Need to re-look cut-off of Aspergillus-specific IgE levels in children with ABPA[J]. Mycoses, 2019, 62(9): 761-764. doi: 10.1111/myc.12949 pmid: 31152616
[18]	Toma P, Bertaina A, Castagnola E, et al. Fungal infections of the lung in children[J]. Pediatr Radiol, 2016, 46(13): 1856-1865. pmid: 27663906
[19]	Kassner EG, Kauffman SL, Yoon JJ, et al. Pulmonary candidiasis in infants: clinical, radiologic, and pathologic features[J]. AJR Am J Roentgenol, 1981, 137(4): 707-716. doi: 10.2214/ajr.137.4.707
[20]	Huang J, Lan C, Li H, et al. Concomitant lung adenocarcinoma and pulmonary cryptococcosis confirmed by pathologic examinations[J]. Medicine, 2019, 98(50): e18316.
[21]	Yao K, Qiu X, Hu H, et al. Pulmonary cryptococcosis coexisting with central type lung cancer in an immuoc-ompetent patient: a case report and literature review[J]. BMC Pulm Med, 2020, 20(1): 161. doi: 10.1186/s12890-020-01200-z
[22]	Tobon AM, Gomez BL. Pulmonary histoplasmosis[J]. Mycopathologia, 2021, 186(5): 697-705. doi: 10.1007/s11046-021-00588-4 pmid: 34498137
[23]	Azar MM, Loyd JL, Relich RF, et al. Current concepts in the epidemiology, diagnosis, and management of histoplasmosis syndromes[J]. Semin Respir Crit Care Med, 2020, 41(1): 13-30. doi: 10.1055/s-0039-1698429 pmid: 32000281
[24]	Fischer GB, Mocelin H, Severo CB, et al. Histoplasmosis in children[J]. Paediatr Respir Rev, 2009, 10(4): 172-177. doi: 10.1016/j.prrv.2009.08.002 pmid: 19879506
[25]	Hage CA, Ribes JA, Wengenack NL, et al. A multicenter evaluation of tests for diagnosis of histoplasmosis[J]. Clin Infect Dis, 2011, 53(5): 448-454. doi: 10.1093/cid/cir435 pmid: 21810734
[26]	Jude CM, Nayak NB, Patel MK, et al. Pulmonary coccidioidomycosis: pictorial review of chest radiographic and CT findings[J]. Radiographics, 2014, 34(4): 912-925. doi: 10.1148/rg.344130134 pmid: 25019431
[27]	Galgiani JN, Ampel NM, Blair JE, et al. Cocci-dioidomycosis[J]. Clin Infect Dis, 2005, 41(9): 1217-1223. doi: 10.1086/496991 pmid: 16206093
[28]	Rego de Figueiredo I, Vieira Alves R, Drummond Borges D, et al. Pneumocystosis pneumonia: a comparison study between HIV and non-HIV immunocompromised patients[J]. Pulmonology, 2019, 25(5): 271-274. doi: S2531-0437(19)30087-X pmid: 31076291

儿童常见侵袭性肺部真菌病免疫机制和临床特点

Clinical manifestations and immune mechanism of invasive pulmonary mycosis in children

RichHTML

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献 28

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	卓木清, 李小晶, 彭炳蔚, 朱海霞, 田杨, 郑可鲁, 高媛媛, 吴文晓, 吴汶霖, 陈宗宗, 陈文雄, 曹彬彬. 儿童线粒体脑肌病临床特点分析[J]. 临床儿科杂志, 2023, 41(9): 661-667.
[2]	李逢潮, 章印红, 吕涛, 朱宝生, 韩思琪, 蔡世岩, 李利. HPRT1基因变异致Lesch-Nyhan综合征1例报告[J]. 临床儿科杂志, 2022, 40(6): 465-468.
[3]	刘智超, 李长春, 王珊, 孔祥如, 章均, 杨超, 赵珍珍. 儿童Castleman病21例临床回顾性分析[J]. 临床儿科杂志, 2022, 40(2): 139-143.
[4]	褚思嘉，汤继宏，张兵兵，等. 儿童急性淋巴细胞白血病伴白质脑病临床及影像学特点[J]. 临床儿科杂志, 2022, 40(1): 40-.
[5]	方志旭. SCN1A 基因相关癫痫研究进展[J]. 临床儿科杂志, 2021, 39(3): 231-.
[6]	应蓓，李宇红，邵晓珊，等. 紫癜性肾炎患儿动态血压与临床指标及病理的相关性[J]. 临床儿科杂志, 2021, 39(12): 895-.
[7]	姜涛，李双杰，欧阳文献，等. 330例遗传代谢性肝病患儿病因学分析[J]. 临床儿科杂志, 2021, 39(1): 6-.
[8]	李敏，张继要，董伟，等. 结节性硬化症5 家系临床及基因突变分析[J]. 临床儿科杂志, 2020, 38(7): 541-.
[9]	吴淑芬，吴芳，杨跃红，等. 儿童紫癜性肾炎血尿酸水平与临床及病理的关系[J]. 临床儿科杂志, 2020, 38(6): 406-.
[10]	胡恕香，李培，王央丹，等. 发作性过度运动诱发性运动障碍一家系临床及基因突变分析[J]. 临床儿科杂志, 2020, 38(10): 765-.
[11]	陆勇刚，姚如恩，李　牛，等. 罕见ICF综合征1例临床表型和分子遗传学分析[J]. 临床儿科杂志, 2019, 37(8): 621-.
[12]	姜涛，欧阳文献，谭艳芳，等. 20p12.2 缺失致Alagille 综合征患儿临床和肝脏病理分析[J]. 临床儿科杂志, 2019, 37(5): 388-.
[13]	杨赛，张晓，冯枚，等. 儿童抗-NMDA 受体脑炎的临床特征和预后因素分析[J]. 临床儿科杂志, 2019, 37(4): 250-.
[14]	吴小英，许红梅，赵瑞秋. 先天性结核病20 例临床分析[J]. 临床儿科杂志, 2019, 37(3): 196-.
[15]	邓燕，苏阳娜，张慧华，等. 儿童吞气症35 例临床特征及治疗分析[J]. 临床儿科杂志, 2019, 37(10): 749-.