Chronic Disseminated Candidiasis During Hematological Malignancies: An Immune Reconstitution Inflammatory Syndrome With Expansion of Pathogen-Specific T Helper Type 1 Cells.

Autor:	Candon S; Université Paris-Descartes, Faculté de Médecine, INSERM U1151-CNRS UMR 8253, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Necker-Enfants Malades, APHP, Immunologie Biologique, Paris, France.; Université de Rouen Normandie, INSERM U1234, CHU de Rouen Normandie, Rouen, France., Rammaert B; Université Paris Descartes, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Paris, France.; Université de Poitiers, Faculté de Médecine et Pharmacie, Poitiers, France.; CHU de Poitiers, Service de Maladies Infectieuses et Tropicales, Poitiers, France., Foray AP; Université Paris-Descartes, Faculté de Médecine, INSERM U1151-CNRS UMR 8253, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Necker-Enfants Malades, APHP, Immunologie Biologique, Paris, France., Moreira B; Université Paris-Descartes, Faculté de Médecine, INSERM U1151-CNRS UMR 8253, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Necker-Enfants Malades, APHP, Immunologie Biologique, Paris, France., Gallego Hernanz MP; CHU de Poitiers, Service d'Hématologie, Poitiers, France., Chatenoud L; Université Paris-Descartes, Faculté de Médecine, INSERM U1151-CNRS UMR 8253, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Necker-Enfants Malades, APHP, Immunologie Biologique, Paris, France., Lortholary O; Université Paris Descartes, Faculté de Médecine, APHP, Hôpital Necker-Enfants Malades, Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Paris, France.; Institut Pasteur, Unité de Mycologie Moléculaire, Paris, France.
Jazyk:	angličtina
Zdroj:	The Journal of infectious diseases [J Infect Dis] 2020 May 11; Vol. 221 (11), pp. 1907-1916.
DOI:	10.1093/infdis/jiz688
Abstrakt:	Background: Chronic disseminated candidiasis (CDC) is a rare disease that mostly occurs after chemotherapy-induced prolonged neutropenia in patients with hematological malignancies. It is believed to ensue from Candida colonization, breach of the intestinal epithelial barrier, and venous translocation to organs. Fungal blood or liver biopsy cultures are generally negative, suggesting the absence of an ongoing invasive fungal disease. Methods: To unravel the contribution of the immune system to CDC pathogenesis, we undertook a prospective multicentric exploratory study in 44 CDC patients at diagnosis and 44 matched controls. Results: Analysis of Candida-specific T-cell responses using enzyme-linked immunospot assays revealed higher numbers of interferon (IFN)γ-producing T cells reactive to mp65 or candidin in 27 CDC cases compared with 33 controls. Increased plasma levels of soluble CD25, interleukin (IL)-6, IL-1β, tumor necrosis factor-α, and IL-10 and lower levels of IL-2 were observed in CDC patients versus controls. Neutrophilia and higher levels of CD4 and CD8 T-cell activation were found in CDC patients as well as increased proportions of CXCR3-expressing TCRγδ +Vδ2+ cells. Conclusions: The expansion of Candida-specific IFNγ-producing T cells together with features of T-cell activation and systemic inflammation identified here support the view that CDC belongs to the broad spectrum of fungal-associated immune reconstitution inflammatory syndromes. (© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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