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Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients

Diagnosis, treatment, and management of invasive mould infections (IMI) are challenged by several risk factors, including local epidemiological characteristics, the emergence of fungal resistance and the innate resistance of emerging pathogens, the use of new immunosuppressants, as well as off-targe...

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Autores principales: Vehreschild, Jörg Janne, Koehler, Philipp, Lamoth, Frédéric, Prattes, Juergen, Rieger, Christina, Rijnders, Bart J A, Teschner, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779224/
https://www.ncbi.nlm.nih.gov/pubmed/32898264
http://dx.doi.org/10.1093/mmy/myaa079
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author Vehreschild, Jörg Janne
Koehler, Philipp
Lamoth, Frédéric
Prattes, Juergen
Rieger, Christina
Rijnders, Bart J A
Teschner, Daniel
author_facet Vehreschild, Jörg Janne
Koehler, Philipp
Lamoth, Frédéric
Prattes, Juergen
Rieger, Christina
Rijnders, Bart J A
Teschner, Daniel
author_sort Vehreschild, Jörg Janne
collection PubMed
description Diagnosis, treatment, and management of invasive mould infections (IMI) are challenged by several risk factors, including local epidemiological characteristics, the emergence of fungal resistance and the innate resistance of emerging pathogens, the use of new immunosuppressants, as well as off-target effects of new oncological drugs. The presence of specific host genetic variants and the patient's immune system status may also influence the establishment of an IMI and the outcome of its therapy. Immunological components can thus be expected to play a pivotal role not only in the risk assessment and diagnosis, but also in the treatment of IMI. Cytokines could improve the reliability of an invasive aspergillosis diagnosis by serving as biomarkers as do serological and molecular assays, since they can be easily measured, and the turnaround time is short. The use of immunological markers in the assessment of treatment response could be helpful to reduce overtreatment in high risk patients and allow prompt escalation of antifungal treatment. Mould-active prophylaxis could be better targeted to individual host needs, leading to a targeted prophylaxis in patients with known immunological profiles associated with high susceptibility for IMI, in particular invasive aspergillosis. The alteration of cellular antifungal immune response through oncological drugs and immunosuppressants heavily influences the outcome and may be even more important than the choice of the antifungal treatment. There is a need for the development of new antifungal strategies, including individualized approaches for prevention and treatment of IMI that consider genetic traits of the patients. LAY ABSTRACT: Anticancer and immunosuppressive drugs may alter the ability of the immune system to fight invasive mould infections and may be more important than the choice of the antifungal treatment. Individualized approaches for prevention and treatment of invasive mold infections are needed.
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spelling pubmed-77792242021-01-07 Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients Vehreschild, Jörg Janne Koehler, Philipp Lamoth, Frédéric Prattes, Juergen Rieger, Christina Rijnders, Bart J A Teschner, Daniel Med Mycol Original Article Diagnosis, treatment, and management of invasive mould infections (IMI) are challenged by several risk factors, including local epidemiological characteristics, the emergence of fungal resistance and the innate resistance of emerging pathogens, the use of new immunosuppressants, as well as off-target effects of new oncological drugs. The presence of specific host genetic variants and the patient's immune system status may also influence the establishment of an IMI and the outcome of its therapy. Immunological components can thus be expected to play a pivotal role not only in the risk assessment and diagnosis, but also in the treatment of IMI. Cytokines could improve the reliability of an invasive aspergillosis diagnosis by serving as biomarkers as do serological and molecular assays, since they can be easily measured, and the turnaround time is short. The use of immunological markers in the assessment of treatment response could be helpful to reduce overtreatment in high risk patients and allow prompt escalation of antifungal treatment. Mould-active prophylaxis could be better targeted to individual host needs, leading to a targeted prophylaxis in patients with known immunological profiles associated with high susceptibility for IMI, in particular invasive aspergillosis. The alteration of cellular antifungal immune response through oncological drugs and immunosuppressants heavily influences the outcome and may be even more important than the choice of the antifungal treatment. There is a need for the development of new antifungal strategies, including individualized approaches for prevention and treatment of IMI that consider genetic traits of the patients. LAY ABSTRACT: Anticancer and immunosuppressive drugs may alter the ability of the immune system to fight invasive mould infections and may be more important than the choice of the antifungal treatment. Individualized approaches for prevention and treatment of invasive mold infections are needed. Oxford University Press 2020-09-08 /pmc/articles/PMC7779224/ /pubmed/32898264 http://dx.doi.org/10.1093/mmy/myaa079 Text en © The Author(s) 2020. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Vehreschild, Jörg Janne
Koehler, Philipp
Lamoth, Frédéric
Prattes, Juergen
Rieger, Christina
Rijnders, Bart J A
Teschner, Daniel
Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients
title Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients
title_full Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients
title_fullStr Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients
title_full_unstemmed Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients
title_short Future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients
title_sort future challenges and chances in the diagnosis and management of invasive mould infections in cancer patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779224/
https://www.ncbi.nlm.nih.gov/pubmed/32898264
http://dx.doi.org/10.1093/mmy/myaa079
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