Host immune reactivity and antifungal chemotherapy: The power of being together

Fungal infections, particularly those in immunocompromised hosts, have been a major therapeutic challenge over recent decades. The difficulty in diagnosing invasive infections, together with the emergence of unusual opportunistic pathogens and a pathogen shift in the spectrum of the causative organisms, have greatly hampered the effectiveness of antifungal therapy. Knowledge of the immunoregulation of fungal infections may provide new insights for therapeutic interventions. The appreciation of the importance of T helper cells and cytokines in the overall coordination of the effector immune response to fungi has offered novel opportunities to manipulate these processes and to alter the outcome of fungal infections while improving the therapeutic efficacy of antifungal drugs. Cytokine and cytokine antagonists, alone or in combination with antifungals, have the potential to overcome the specific defects of host immune reactivity predisposing to fungal infections. The current challenge lies in translating much of the information obtained in experimental and preclinical studies into therapeutic strategies providing prospects for the ultimate treatment of fungal infections.