Despite recent additions to our antifungal
drug armamentarium, success rates for many
mycoses remain unacceptably low and antifungal
drug therapy is often limited by toxicity, resistance and high cost. To circumvent these difficulties, alternative approaches to prevention and treatment are being developed, including
vaccines and passive immunotherapy. Here, we review the progress of current research in this field, discuss some of the potential obstacles to developing and marketing a protective antifungal
vaccine, and summarize two clinical trials of
monoclonal antibodies as adjunctive treatment of established
mycoses. In animal models of
fungal infections, protective responses have been elicited with
vaccines composed of whole organisms, soluble cell free fractions, purified
proteins,
glycans and
nucleic acids. Methods to boost the immune response to vaccination include the use of adjuvants and
antigen-loaded dendritic cells (DCs). A significant challenge to the development of effective
vaccines will be to elicit immune responses in immunocompromised individuals who are most at risk for
invasive fungal infections.