Although the commensal stage is frequently described as “harmless” to the host, it is likely that this stage is highly regulated and the fungus is continuously or transiently interacting with the host immune system [64]. It is also likely

that the human host has evolved to recognize and deal with a potential fungal invader so that the evolved state is one of commensalism. Treg cells seem to act in tuning this equilibrium by preventing inappropriate immune responses that can be damaging to host tissues. Bacher et al. [65] found that Treg cells specific for A. fumigatus and C. albicans — both of which inhabit or are in contact with our mucosae 5-Fluoracil ic50 — exceeded in number and functionally suppressed specific memory T cells. In patients with severe allergic reactions, the Ag-specific memory T-cell response dominated the immune environment [65]. Thus, expansion of fungus-specific Treg-cell populations is important for preventing pathological immune responses. Indeed, while early inflammation prevents or limits infection, an uncontrolled response may eventually oppose disease eradication. Bortezomib order Counteracting exaggerated effector immune responses and dysregulated inflammation requires a specific environment in which not only Treg cells but also

tolerogenic DCs play an essential role. The shift between the inflammatory and anti-inflammatory states of DCs is strictly controlled heptaminol by the kynurenine pathway of tryptophan

catabolism, and it has been shown to involve IDO [66]. IDO activates the aryl hydrocarbon receptor (AhR) in lymphoid tissues [67] and promotes Treg-cell development [68]. In the gastrointestinal (GI) tract, diet-derived AhR ligands promote local IL-22 production by innate lymphoid type 3 cells (ILC3s) [69]. In combination with IL-17A, IL-22 mediates a pivotal innate antifungal resistance in mice [70] and humans [71]. Zelante et al. [72] showed that the intestinal microbiota regulates these cytokines, and in particular a subset of commensal Lactobacilli — L. reuteri in the stomach and L. acidophilus in the vaginal tract — produce the metabolite indole-3-aldeyde by tryptophan metabolism, and indole-3-aldeyde activates AhR in ILCs. This Ahr activation results in an induced IL-22-mediated antimicrobial response, which in turn reduces colonization by opportunistic fungi, such as Candida, providing mucosal protection from inflammation. In the complex host–pathogen interaction used by both parties to evaluate the environmental milieu in the ongoing battle for survival, Candida in turn has been shown to produce immunomodulatory compounds, such as oxylipins from the conversion of polyunsaturated fatty acids [73]. Those molecules interfere with the metabolism, perception, and signaling processes of cell immune response.