Abstract
Fungal infections are emerging as a major problem in part due to high mortality associated with systemic infections, especially in the case of immunocompromised patients. With the development of new treatments for diseases such as cancer and the acquired immune deficiency syndrome pandemic, the number of immunosuppressed patients has increased and, as a consequence, also the number of invasive fungal infections has increased. Several studies have proposed new strategies for the development of effective fungal vaccines. In addition, better understanding of how the immune system works against fungal pathogens has improved the further development of these new vaccination strategies. As a result, some fungal vaccines have advanced through clinical trials. However, there are still many challenges that prevent the clinical development of fungal vaccines that can efficiently immunise subjects at risk of developing invasive fungal infections. In this review, we will discuss these new vaccination strategies and the challenges that they present. In the future with proper investments, fungal vaccines may soon become a reality.
Highlights
Fungal infections are emerging as a major problem in part due to high mortality associated with systemic infections, especially in the case of immunocompromised patients
It is estimated that patients undergoing treatment for haematologic malignancies, such as leukaemia, have a mortality rate of 35% due to systemic fungal infections (Bhatt et al 2011) while human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) patients are significantly affected by opportunistic fungi as Cryptococcus neoformans, accounting for 650,000 deaths/year (Del Poeta & Casadevall 2012)
This review will cover how the immune system works against fungal infections, the importance of the development of new strategies, the efforts made and challenges that still need to be solved for the advance in this area of fungal vaccines
Summary
Humans are constantly exposed to many species of fungi; those that can survive at human body temperature can establish different interactions - from symbiotic to pathogenic (Iannitti et al 2012). Despite efforts to avoid secondary infections, such as the development of combined antiretroviral therapy and the use of antifungal agents for prophylaxis in cancer patients (Staber et al 2007, Armstrong-James et al 2014, Brown et al 2014), the immune dysregulation in such cases can be extremely dramatic and even the species known for its equilibrated relation with the host, such as C. albicans, can become a life-threatening pathogen (Romani 2011). In this case, it is important to know how the immune system regulates the relation between host and fungi
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