Complement Component C5a Provides a Critical Innate Defense Against Candida

Extrahepatic phagocyte production of C5a may explain why systemic candidiasis is a complication of anti-complement–C5a monoclonal antibody therapy.

Anti-complement–C5a monoclonal antibody therapy with eculizumab is used to treat patients with atypical hemolytic uremic syndrome and other autoimmune diseases. Although eculizumab is known to raise risk for meningococcal disease, systemic candidiasis and other severe Candida infections recently have emerged as additional complications (Blood 2020; 135:1049).

Desai et al. found that complement gene transcription is the chief biological pathway induced in candidemic patients, and this transcription predicts candidemia. C5a complexed to its receptor mediates candida clearance and survival in a murine model, highlighting the relevance of this innate immune component against Candida infections. Local tissue production of C5a by phagocytes provid…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases