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Abstract：
The global burden of fungal diseases has been increasing, as a result of the expanding number of susceptible individuals including people living with human immunodeficiency virus (HIV), hematopoietic stem cell or organ transplant recipients, patients with malignancies or immunological conditions receiving immunosuppressive treatment, premature neonates, and the elderly. Opportunistic fungal pathogens such as Aspergillus, Candida, Cryptococcus, Rhizopus, and Pneumocystis jiroveci are distributed worldwide and constitute the majority of invasive fungal infections (IFIs). Dimorphic fungi such as Histoplasma capsulatum, Coccidioides spp., Paracoccidioides spp., Blastomyces dermatiditis, Sporothrix schenckii, Talaromyces (Penicillium) marneffei, and Emmonsia spp. are geographically restricted to their respective habitats and cause endemic mycoses. Disseminated histoplasmosis, coccidioidomycosis, and T. marneffei infection are recognized as acquired immunodeficiency syndrome (AIDS)-defining conditions, while the rest also cause high rate of morbidities and mortalities in patients with HIV infection and other immunocompromised conditions. In the past decade, a growing number of monogenic immunodeficiency disorders causing increased susceptibility to fungal infections have been discovered. In particular, defects of the IL-12/IFN-γ pathway and T-helper 17-mediated response are associated with increased susceptibility to endemic mycoses. In this review, we put together the various forms of endemic mycoses on the map and take a journey around the world to examine how cellular and molecular defects of the immune system predispose to invasive endemic fungal infections, including primary immunodeficiencies, individuals with autoantibodies against interferon-γ, and those receiving biologic response modifiers. Though rare, these conditions provide importance insights to host defense mechanisms against endemic fungi, which can only be appreciated in unique climatic and geographical regions.
摘要：
真菌疾病的全球负担一直在增加，由于包括人类免疫缺陷病毒（HIV）感染者在内的易感人群数量不断增加，造血干细胞或器官移植受者，患有恶性肿瘤或免疫疾病的患者接受免疫抑制治疗，早产儿,和老人。机会性真菌病原体，如曲霉，念珠菌,隐球菌,根霉,和jiroveci肺孢子虫分布在世界各地，构成了大多数侵袭性真菌感染（IFIs）。异形真菌，如荚膜组织胞浆，球虫属。,副球菌属。,胚芽炎，申克氏孢子虫,马尔尼菲塔拉菌(青霉属)，和Emmonsiaspp.在地理上被限制在各自的栖息地，并导致地方性真菌病。播散性组织胞浆菌病,球孢子菌病,和马尔尼菲感染被认为是获得性免疫缺陷综合征（AIDS）定义的条件，而其余的也会导致HIV感染和其他免疫功能低下的患者的高发病率和死亡率。在过去的十年里,已经发现越来越多的单基因免疫缺陷性疾病导致对真菌感染的易感性增加。特别是,IL-12/IFN-γ途径的缺陷和T辅助细胞17介导的应答与对地方性真菌病的易感性增加相关.在这次审查中,我们将各种形式的地方性真菌病放在地图上，并环游世界，以检查免疫系统的细胞和分子缺陷如何易患侵袭性地方性真菌感染，包括原发性免疫缺陷,具有抗干扰素-γ自身抗体的个体，和那些接受生物反应修饰的人。虽然罕见，这些条件为宿主对地方性真菌的防御机制提供了重要的见解，只有在独特的气候和地理区域才能欣赏。
