Fungi are microorganisms that are ubiquitous in the environment. To establish themselves in the host, they employ a broad variety of virulence strategies. Fungi are an important source of morbidity in humans. However, despite millions of species, only about a hundred cause disease, owing to a remarkable collaboration of the innate and adaptive immune systems. In individuals who have immunocompromised cellular immunity, fungi readily cause invasive disease. Our knowledge of how the immune system prevents invasive fungal disease has been greatly aided by the study of acquired or inherited immune defects. However, much remains to be known in order to improve our ability to treat fungal infections, and our ability to control endemic disease in many areas of the world remains limited, warranting more research towards immunomodulatory interventions.
Key Concepts
Fungi readily colonise the environment including our skin and mucosal surfaces.
Invasive fungal infections largely occur in individuals with impaired immunity, although infections are endemic in many areas of the world in immunocompetent hosts.
T cells and neutrophils are essential in preventing invasive fungal disease.
In immunocompromised hosts, fungi frequently cause disease by direct invasion, and also indirectly (i.e. through exaggerated host immune responses).
Fungal infections are a major cause of morbidity and mortality worldwide.