Pathogenic fungi have emerged as significant causes of infectious morbidity and death in patients with acquired immunodeficiency conditions such as HIV/AIDS and following receipt of chemotherapy, immunosuppressive agents or targeted biologics for neoplastic or autoimmune diseases, or transplants for end organ failure. Furthermore, in recent years, the spread of multidrug-resistant Candida auris has caused life-threatening outbreaks in health-care facilities worldwide and raised serious concerns for global public health. Rapid progress in the discovery and functional characterization of inborn errors of immunity that predispose to fungal disease and the development of clinically relevant animal models have enhanced our understanding of fungal recognition and effector pathways and adaptive immune responses. In this Review, we synthesize our current understanding of the cellular and molecular determinants of mammalian antifungal immunity, focusing on observations that show promise for informing risk stratification, prognosis, prophylaxis and therapies to combat life-threatening fungal infections in vulnerable patient populations.

病原真菌已成为艾滋病毒/艾滋病等获得性免疫缺陷患者在接受化疗、免疫抑制剂或针对肿瘤或自身免疫性疾病的靶向生物制剂或针对终末器官衰竭的移植后感染发病和死亡的重要原因。此外，近年来，多重耐药耳念珠菌的传播已在全球卫生保健机构中造成危及生命的疫情，引发了全球公共卫生的严重担忧。易患真菌疾病的先天性免疫缺陷的发现和功能表征的快速进展以及临床相关动物模型的开发增强了我们对真菌识别和效应途径以及适应性免疫反应的理解。在这篇综述中，我们综合了目前对哺乳动物抗真菌免疫的细胞和分子决定因素的理解，重点关注那些有望为风险分层、预后、预防和治疗提供信息的观察结果，以对抗脆弱患者群体中危及生命的真菌感染。