Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2026
The impact of toll-like receptor polymorphisms on susceptibility to fungal infections: a systematic review of genetic and clinical data.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Staiger Martha Fabielle Pereira, Souza Gleyce Hellen de Almeida, Venturini James, Peres Nalu Teixeira de Aguiar, Lucini Fabíola, Santos Daniel Assis, Bastos Rafael Wesley, Carvalho Agostinho, Rossato Luana
Аннотация
BACKGROUND: Fungal infections affect over 1.5 billion people, with invasive diseases posing a significant threat to immunocompromised individuals. Toll-like receptors (TLRs) are critical components of innate immunity. Single nucleotide polymorphisms (SNPs) in TLR genes are associated with altered immune responses to fungal infections.
OBJECTIVES: To summarize and critically appraise the available evidence on TLR gene variants reported in patients with invasive fungal infections.
DATA SOURCES: Studies were identified in Embase, PubMed, Scopus, and Google Scholar.
STUDY ELIGIBILITY CRITERIA: Observational studies published up to July 2025 reporting TLR gene variants in patients with fungal infections were included.
PARTICIPANTS: Data from studies involving patients with fungal infections.
ASSESSMENT OF RISK OF BIAS: Joanna Briggs Institute critical appraisal tools, applied according to study design.
METHODS OF DATA SYNTHESIS: Data were synthesized descriptively, and a random-effects meta-analysis was performed when sufficient homogeneous data were available.
RESULTS: Data from 1611 patients across ten countries were included, revealing 70 distinct TLR variants across TLR1-TLR10. Polymorphisms in TLR2, TLR4, and TLR9 were most frequently reported among patients with invasive aspergillosis and candidiasis. The most common studied variants were rs5743708 (TLR2), rs4986790/rs4986791 (TLR4), and rs5743836 (TLR9). Underlying conditions such as malignancies and transplantation were frequently reported. China, the Netherlands, and the United Kingdom accounted for the highest number of cases. A meta-analysis of seven studies yielded a pooled odds ratio of 1.90 (95% CI: 1.24-2.90) for fungal infection in patients with TLR polymorphisms compared with those without these variants.
CONCLUSIONS: Variants in TLR2, TLR4, and TLR9 have been frequently reported in patients with invasive fungal infections, particularly among immunocompromised individuals. However, the available evidence remains largely descriptive, highlighting the need for comparative studies with appropriate control populations.
OBJECTIVES: To summarize and critically appraise the available evidence on TLR gene variants reported in patients with invasive fungal infections.
DATA SOURCES: Studies were identified in Embase, PubMed, Scopus, and Google Scholar.
STUDY ELIGIBILITY CRITERIA: Observational studies published up to July 2025 reporting TLR gene variants in patients with fungal infections were included.
PARTICIPANTS: Data from studies involving patients with fungal infections.
ASSESSMENT OF RISK OF BIAS: Joanna Briggs Institute critical appraisal tools, applied according to study design.
METHODS OF DATA SYNTHESIS: Data were synthesized descriptively, and a random-effects meta-analysis was performed when sufficient homogeneous data were available.
RESULTS: Data from 1611 patients across ten countries were included, revealing 70 distinct TLR variants across TLR1-TLR10. Polymorphisms in TLR2, TLR4, and TLR9 were most frequently reported among patients with invasive aspergillosis and candidiasis. The most common studied variants were rs5743708 (TLR2), rs4986790/rs4986791 (TLR4), and rs5743836 (TLR9). Underlying conditions such as malignancies and transplantation were frequently reported. China, the Netherlands, and the United Kingdom accounted for the highest number of cases. A meta-analysis of seven studies yielded a pooled odds ratio of 1.90 (95% CI: 1.24-2.90) for fungal infection in patients with TLR polymorphisms compared with those without these variants.
CONCLUSIONS: Variants in TLR2, TLR4, and TLR9 have been frequently reported in patients with invasive fungal infections, particularly among immunocompromised individuals. However, the available evidence remains largely descriptive, highlighting the need for comparative studies with appropriate control populations.