Conclusions

The discovery of TLR, DC, and Treg cells have been major breakthroughs in the field of fungal immunology, which may offer new grounds for a better comprehension of the cells and immune pathways that are amenable to manipulation in patients with or at risk of fungal infections. A variety of cytokines, including chemokines and growth factors proved to be beneficial in experimental and human fungal infections (Mencacci et al., 2000; Kawakami, 2003). The Th1/Th2 balance itself can be the target of immunotherapy (Koguchi & Kawakami, 2002; Mencacci et al., 2000). It now appears that a combination of different types of Treg cells controls the Th1, as well as the Th2 inflammatory responses. Consequently, manipulation of Treg cells is thought of as a promising therapeutic approach devoid of risks associated with interference with homeostatic mechanisms of the immune system. Further understanding of the cooperation of various multiple innate immune receptors in fungal recognition potentially provides a basis for novel therapeutic strategies for immunomodulation, which will very likely contribute to successfully coping with the threat of severe fungal infections. Notwithstanding the redundancy and overlapping repertoire of antifungal effector mechanisms, the deliberate targeting of cells and pathways of antifungal CMI may represent a useful strategy in developing fungal vaccines capable of both sterilizing immunity and protecting against fungal reactivation.

Acknowledgments I thank Dr. Silvia Moretti for editorial assistance. This study was supported by the Specific Targeted Research Project 'EURAPS' (LSHM-CT-2005), contract number 005223 (FP6).

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