Candida Infection Associated with Anti-IL-17 Medication: A Systematic Analysis and Review of the Literature

Am J Clin Dermatol. 2022 Jul;23(4):469-480. doi: 10.1007/s40257-022-00686-z. Epub 2022 Apr 15.

Abstract

Anti-interleukin (IL)-17 agents have shown excellent therapeutic efficacy in patients with psoriasis and are expected to be expanded to other chronic inflammatory diseases. However, patients receiving anti-IL-17 agents are at an increased risk of developing Candida infection, with some agents reported to increase the incidence in a dose-dependent manner. Interleukin-17 is secreted by the Th17 subset of CD4+ lymphocytes, CD8+ T cells, and innate cells, including natural killer T cells, lymphoid tissue inducer cells, innate lymphoid cells, and γδ-T cells, and plays an important role in antifungal defense. Genetic defects in the IL-17-signaling pathway in both humans and animal models render susceptibility to candidiasis caused by Candida albicans. The purpose of this narrative review is to evaluate the literature on the role of IL-17 in protection against candidiasis, the prevalence of candidiasis in anti-IL-17 agent use, and to offer clinical recommendations on the diagnosis and management of anti-IL-17 medication-associated candidiasis.

Publication types

  • Review

MeSH terms

  • Animals
  • Candida albicans / metabolism
  • Candidiasis* / drug therapy
  • Candidiasis* / epidemiology
  • Humans
  • Immunity, Innate
  • Interleukin-17* / genetics
  • Th17 Cells

Substances

  • Interleukin-17