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Chronic Mucocutaneous Candidiasis in Humans with Inborn Errors of Interleukin-17 Immunity
Open accessAbstract
Chronic yeast infections in the absence of other infections result from genetic deficiencies in proinflammatory host responses.
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In the citing paper
“IL-17-mediated immunity is central to mucocutaneous host defense against fungi such as C. albicans and Malassezia [10,99,100].”
From Host–Candida auris interactions in the skin (2026) · cites this paper as [99]
Experimental — accuracy not yet measuredIn the citing paper
“analysis of Th17 cells in different tissue sites has revealed that Th17 cells may exhibit distinct transcriptional profiles associated with either homeostatic or pathogenic functions”
From TH17 cell heterogeneity and its role in tissue inflammation (2023) · cites this paper as [43]
In the citing paper
“intestinal non-pathogenic/homeostatic Th17 cells specific for segmented filamentous bacteria (SFB) have a transcriptome that differs markedly from the pro-inflammatory Th17 cells elicited by Helicobacter hepaticus (H. hepaticus) in mice defective for induced intestinal Treg cells”
From TH17 cell heterogeneity and its role in tissue inflammation (2023) · cites this paper as [43]
In the citing paper
“In the Il10−/− model of colitis, in which IL-10-deficient mice develop spontaneous microbiota-dependent colitis, Th17 cells were identified as the main immune population mediating the inflammatory immune response [43, 133].”
From TH17 cell heterogeneity and its role in tissue inflammation (2023) · cites this paper as [43]
In the citing paper
“In Helicobacter hepaticus- dependent colitis, pathobiont-specific inflammatory Th17 cells are major mediators of intestinal inflammation [43].”
From TH17 cell heterogeneity and its role in tissue inflammation (2023) · cites this paper as [43]
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“In 2011, the identification of inborn errors of IL-17F or IL-17RA in patients with isolated chronic mucocutaneous candidiasis (CMC) revealed the crucial role of IL-17A–IL-17F in mucocutaneous protection against Candida albicans and to some extent S. aureus 137 .”
Self-citationHost genetics and opportunistic fungal infections
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“The identification of complete autosomal recessive IL-17RA and partial autosomal dominant IL-17F deficiencies in pedigrees suffering from CMCD provided direct genetic evidence for the role of IL-17 immunity in human susceptibility to CMC [52].”
BackgroundAnti-IL-17 mAbs herald new options in psoriasis
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Therapeutic potential of targeting IL‐17 and IL‐23 in sepsis
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“In other forms of chronic mucocutaneous candidiasis disease, presenting with recurrent or persistent infections with Candida albicans, associations with either an autosomal recessive deficiency in the IL-17 receptor A (IL-17RA) or autosomal dominant deficiency in IL-17 F have been described [30].”
BackgroundTargeting the IL-23/IL-17 axis for the treatment of psoriasis and psoriatic arthritis
Alunno, A., Carubbi, F., Cafaro, G., Pucci, G., Battista, F., Bartoloni, E., Giacomelli, R., Schillaci, G., & Gerli, R. (2015) · Expert Opinion on Biological Therapy · doi:10.1517/14712598.2015.1084284 · Cited by 41
“In particular, subjects with reduced capability to build a Th17 response, as demonstrated by studies in patients with genetic disorders affecting this arm of the immune system, are more susceptible to recurrent mucocutaneous infections caused by Candida albicans and Staphylococcus aureus [74].”
BackgroundPatient Susceptibility to Candidiasis—A Potential for Adjunctive Immunotherapy
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“cassiicola stimulation, and on IL-17A, which was produced normally by the patient’s PBMCs but promotes mucocutaneous antifungal immunity in other settings (Figure 2B and Supplemental Figure 7) (31, 32).”
BackgroundEmerging clinical phenotypes associated with anti-cytokine autoantibodies
Vincent, T., Plawecki, M., Goulabchand, R., Guilpain, P., & Eliaou, J. F. (2015) · Autoimmunity Reviews · doi:10.1016/j.autrev.2015.01.015 · Cited by 43
Toll-Like Receptor 5 Engagement Induces Interleukin-17C Expression in Intestinal Epithelial Cells
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“IL-17 plays an important role in immunity toward yeast, with defects in IL17RA and IL17F genes causally involved in the heritable disorder chronic mucocutaneous candidiasis [69].”
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“Patients with deficiencies in IL-17 signaling, either due to inborn errors in IL-17 signaling (14) or autoantibodies against IL-17 cytokines, develop chronic”
BackgroundWiesner, D. L., Smith, K. D., Kashem, S. W., Bohjanen, P. R., & Nielsen, K. (2017) · The Journal of Immunology · doi:10.4049/jimmunol.1600821 · Cited by 38
“Although true in some cases, as evidenced by enhanced susceptibility to mucocutaneous candidiasis in humans with IL-17 deficiencies (52), there are instances where IL-17 responses to fungal infection are deleterious, particularly in the lungs (53).”
BackgroundAkarcan, S. E., Severcan, E. U., Karaca, N. E., Işık, E., Aksu, G., Migaud, M., Gürkan, F., Azarsız, E., Puel, A., Casanova, J., et al. (2017) · Case Reports in Immunology · doi:10.1155/2017/2846928 · Cited by 39
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“In the patient’s body, mutations in STAT1 prevent T cells from differentiating into Th17 cells and thus fail to secrete immune effectors such as IL-17, which are the key to skin resistance to Candida infection.(65,68,113) Moreover, patients with autoimmune disease produce antibodies to IL-17, which impair immunity and…”
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C-Type Lectin Receptors Orchestrate Antifungal Immunity
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“Indeed, patients with Th17 pathway deficiency are prone to develop these infections [13].”
BackgroundFunctional and phenotypic heterogeneity of Th17 cells in health and disease
Byström, J., Clanchy, F. I. L., Taher, T. E. I., Al-Bogami, M. M., Ong, V. H., Abraham, D., Williams, R. O., & Mageed, R. A. (2018) · European Journal of Clinical Investigation · doi:10.1111/eci.13032 · Cited by 39
“The importance of Th17 cells in maintaining antimicrobial immunity is underscored by the fact that patients with loss‐of‐function mutations in genes coding for IL‐17, IL‐17 receptor or RORγt experience recurrent infections (eg, Candida albicans and Staphylococcus aureus) of the skin, nails and oral and genital mucosae…”
BackgroundNew Insights into Asthma Inflammation: Focus on iNKT, MAIT, and γδT Cells
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Innate lymphoid cells in the defense against infections
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Treatment options for chronic mucocutaneous candidiasis
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Interferon signature in patients with STAT1 gain‐of‐function mutation is epigenetically determined
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“Interestingly, genetic defects affecting the IL-17 signaling pathway have been associated with occurrence of chronic mucocutaneous candidosis [99].”
BackgroundBoll, E. J., Lopez, D. V., Terne, M., Hessing, S., Parschat, K., & Jensen, S. R. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1359499 · Cited by 37
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“The IL-17 secreted by activated TH17 T cells has been shown to play a critical role in protecting against mucosal infections, and particularly against mucosal candidiasis (Pietrella et al., 2011; Puel et al., 2011).”
BackgroundSystematic analysis of the IL‐17 receptor signalosome reveals a robust regulatory feedback loop
Draberova, H., Janusova, S., Knizkova, D., Šemberová, T., Přibíková, M., Ujevic, A., Harant, K., Knápková, S., Hrdinka, M., Fanfani, V., et al. (2020) · The EMBO Journal · doi:10.15252/embj.2019104202 · Cited by 35
“In accord, patients impaired in IL-17 signaling suffer from chronic mucocutaneous candidiasis (Puel et al , 2011; Conti & Gaffen, 2015).”
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“In human, mutations in the IL-17 signaling (IL17RA, IL17RC, ACT1, IL17F) and type17 master-regulating (signal transducer and activator of transcription 3 (STAT3), RAR Related Orphan Receptor C (RORC) genes have been linked to chronic mucocutaneous candidiasis (17,18).”
BackgroundInfluentialTangye, S. G., Pelham, S. J., Deenick, E. K., & Ma, C. S. (2017) · The Journal of Immunology · doi:10.4049/jimmunol.1700842 · Cited by 34
“Thus, mutations in IL17F (78), IL17RA (78), IL17RC (79), or TRAF3IP2 (encoding ACT1, downstream of IL-17R) (80)”
BackgroundInfluentialOrgan-specific mechanisms linking innate and adaptive antifungal immunity
Drummond, R. A., & Lionakis, M. S. (2018) · Seminars in Cell and Developmental Biology · doi:10.1016/j.semcdb.2018.01.008 · Cited by 33
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CX 3 CR1 Is Dispensable for Control of Mucosal Candida albicans Infections in Mice and Humans
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Immune deficiency and autoimmunity
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“Interestingly, the decrease in absolute CD4 T-lymphocyte count characteristic of HIV patients, inborn errors in the IL-17 pathway (eg, IL-17RA, IL-17F), or mutations in STAT1, STAT3, and AIRE [24, 25], resulting in chronic mucocutaneous candidiasis, hyper IgE syndrome, and autoimmune polyendocrinopathy-candidiasis-ect…”
BackgroundTwo functionally distinct subsets of IL‐17 producing γδ T cells
O’Brien, R. L., & Born, W. K. (2020) · Immunological Reviews · doi:10.1111/imr.12905 · Cited by 35
Galectin-3, Possible Role in Pathogenesis of Periodontal Diseases and Potential Therapeutic Target
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“Examination of animal models and the patients with genetic defects in IL-17 signaling indicate the key role for IL-17 in oral antifungal immunity (Puel et al., 2011; Lionakis et al., 2014).”
BackgroundOral Fungal Infections: Past, Present, and Future
Cannon, R. D. (2022) · Frontiers in Oral Health · doi:10.3389/froh.2022.838639 · Cited by 34
“The protective role of IL-17 is evidenced by uncontrolled fungal growth on mucosal surfaces in individuals with defects in Th17 cells and IL-17 signaling [62].”
BackgroundBasic Genetics and Immunology of Candida Infections
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“IL17 is involved in the local control of barrier integrity and defense against extracellular pathogens, such as fungi and bacteria (55).”
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“Previous studies have shown that IL-6 and IL-10 play essential roles for the maintenance of intestinal homeostasis and the prevention of colitis (17, 18), while proinflammatory cytokines, such as IL-17 and IL-15 promote intestinal dysbiosis associated with increased susceptibility to colitis (19, 20).”
BackgroundTNF overproduction impairs epithelial staphylococcal response in hyper IgE syndrome
Myles, I. A., Anderson, E. D., Earland, N. J., Zarember, K. A., Sastalla, I., Williams, K. W., Gough, P., Moore, I. N., Ganesan, S., Fowler, C., et al. (2018) · Journal of Clinical Investigation · doi:10.1172/jci121486 · Cited by 32
Transcriptional Programs Underlying Cd4 T Cell Differentiation and Functions
Chalmin, F., Humblin, É., Ghiringhelli, F., & Végran, F. (2018) · International review of cytology · doi:10.1016/bs.ircmb.2018.07.002 · Cited by 33
Lehman, H. K., & Gordon, C. J. (2019) · The Journal of Allergy and Clinical Immunology In Practice · doi:10.1016/j.jaip.2018.11.026 · Cited by 33
Lionakis, M. S. (2019) · Current Opinion in Infectious Diseases · doi:10.1097/qco.0000000000000593 · Cited by 32
MYO1F regulates antifungal immunity by regulating acetylation of microtubules
Sun, W., Ma, X., Wang, H., Du, Y., Chen, J., Hu, H., Gao, R., He, R.-R., Peng, Q., Cui, Z., et al. (2021) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2100230118 · Cited by 31
Risk of candidiasis associated with interleukin-17 inhibitors: Implications and management
Bilal, H., Khan, M. N., Khan, S., Fang, W., Chang, W., Yin, B., Song, N., Liu, Z., Zhang, D., Yao, F., et al. (2023) · Mycology: An International Journal on Fungal Biology · doi:10.1080/21501203.2023.2265664 · Cited by 31
“Due to the functions of both cytokines in antifungal host defence, double neutralisation was also linked with a higher incidence of mild to moderate oral candidiasis compared to secukinumab and ixekizumab (Puel et al. 2011; Ling and Puel 2014; Gordon et al. 2021).”
BackgroundSelf-citationNatarajan, M., Hsu, A. P., Weinreich, M. A., Zhang, Y., Niemela, J. E., Butman, J. A., Pittaluga, S., Sugui, J. A., Collar, A. L., Lim, J. K., et al. (2018) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2018.05.009 · Cited by 31
DOCK2 regulates antifungal immunity by regulating RAC GTPase activity
Ma, X., Tan, X., Yu, B., Sun, W., Wang, H., Hu, H., Du, Y., He, R., Gao, R., Peng, Q., et al. (2022) · Cellular and Molecular Immunology · doi:10.1038/s41423-021-00835-0 · Cited by 31
Shao, T., Kakade, P., Witchley, J. N., Frazer, C., Murray, K. L., Ene, I. V., Haslam, D. B., Hagan, T., Noble, S. M., Bennett, R. J., et al. (2022) · Cell Reports · doi:10.1016/j.celrep.2022.110837 · Cited by 31
“This symbiotic relationship is consistent with neutropenia, CD4+ T cell deficiency, or genetic defects in the Th17 axis representing primary risk factors for severe fungal infection (Boisson et al., 2013; Desai and Lionakis, 2018; Lionakis et al., 2014; Puel et al., 2011).”
CMTM4 is a subunit of the IL-17 receptor and mediates autoimmune pathology
Knizkova, D., Přibíková, M., Draberova, H., Šemberová, T., Trivić, T., Synackova, A., Ujevic, A., Stefanovic, J., Drobek, A., Huranová, M., et al. (2022) · Nature Immunology · doi:10.1038/s41590-022-01325-9 · Cited by 31
Defects in innate and adaptive immunity in patients with sepsis and health care associated infection
Ryan, T., Coakley, J. D., & Martín‐Loeches, I. (2017) · Annals of Translational Medicine · doi:10.21037/atm.2017.09.21 · Cited by 31
Abdel‐Rahman, S. M., & Preuett, B. L. (2012) · Journal of Dermatological Science · doi:10.1016/j.jdermsci.2012.05.003 · Cited by 31
“STAT1 and 3, CARD9, AIRE, CLEC4E and 7A, CD209, IL-17) were not represented among the preliminary 275 genes identified by WGG in this study [55–60].”
BackgroundIL-17 in the Rheumatologist’s Line of Sight
Truchetet, M., Mossalayi, M. D., & Boniface, K. (2013) · BioMed Research International · doi:10.1155/2013/295132 · Cited by 31
“Recent genetic studies revealed disease susceptibility association with IL-17RA autosomal recessive deficiency [68].”
BackgroundBrodalumab for the treatment of psoriasis
Galluzzo, M., D’Adamio, S., Bianchi, L., & Talamonti, M. (2016) · Expert Review of Clinical Immunology · doi:10.1080/1744666x.2016.1246957 · Cited by 30
Invasive candidiasis: future directions in non-culture based diagnosis
Posch, W., Heimdörfer, D., Wilflingseder, D., & Lass‐Flörl, C. (2017) · Expert Review of Anti-infective Therapy · doi:10.1080/14787210.2017.1370373 · Cited by 29
Spondyloarthritis, Acute Anterior Uveitis, and Fungi: Updating the Catterall–King Hypothesis
Laurence, M., Asquith, M. J., & Rosenbaum, J. T. (2018) · Frontiers in Medicine · doi:10.3389/fmed.2018.00080 · Cited by 29
Infections in the monogenic autoimmune syndrome APECED
Oikonomou, V., Break, T. J., Gaffen, S. L., Moutsopoulos, N. M., & Lionakis, M. S. (2021) · Current Opinion in Immunology · doi:10.1016/j.coi.2021.07.011 · Cited by 31
Basso, P., Dang, E. V., Urisman, A., Cowen, L. E., Madhani, H. D., & Noble, S. M. (2022) · Cell Host & Microbe · doi:10.1016/j.chom.2022.10.004 · Cited by 32
“CMC has been linked to independent mutations affecting IL-17F (Puel et al., 2011), a component of IL-17 cytokines, as well as IL-17RA and IL-17RC (Lévy et al.”
BackgroundPrimary immunodeficiency update
Pichard, D. C., Freeman, A. F., & Cowen, E. W. (2015) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2015.01.055 · Cited by 30
Monaci, E., Mancini, F., Lofano, G., Bacconi, M., Tavarini, S., Sammicheli, C., Arcidiacono, L., Giraldi, M., Galletti, B., Paccani, S. R., et al. (2015) · Frontiers in Immunology · doi:10.3389/fimmu.2015.00439 · Cited by 30
Genetic Predictors of Susceptibility to Dermatophytoses
Abdel‐Rahman, S. M. (2016) · Mycopathologia · doi:10.1007/s11046-016-0046-z · Cited by 32
“Of note, the IL-17F mutation was also identified in two putatively healthy familial relations suggesting incomplete clinical penetrance [112].”
InfluentialNaglik, J. R. (2014) · New Journal of Science · doi:10.1155/2014/390241 · Cited by 29
Native human and mouse skin infection models to study Candida auris-host interactions
Seiser, S., Arzani, H., Ayub, T., Phan-Canh, T., Staud, C., Worda, C., Kuchler, K., & Elbe-Bürger, A. (2024) · Microbes and Infection · doi:10.1016/j.micinf.2023.105234 · Cited by 29
Kalarikkal, S. P., Kumar, M. N., Rajendran, S., Bethi, C. M. S., Ravilla, J., Janakiraman, N., & Sundaram, G. M. (2025) · iScience · doi:10.1016/j.isci.2025.112556 · Cited by 31
Moutsopoulos, N. M., Lionakis, M. S., & Hajishengallis, G. (2015) · Journal of Dental Research · doi:10.1177/0022034515583533 · Cited by 30
Therapeutic potential of interleukin-17 in inflammation and autoimmune diseases
Yan, J.-W., Wang, Y., Peng, W., Tao, J., Wan, Y.-N., Li, B., Mei, B., Chen, B., Yao, H. C., Yang, G., et al. (2013) · Expert Opinion on Therapeutic Targets · doi:10.1517/14728222.2013.843669 · Cited by 29
Candidiasis vulvovaginal: una antigua enfermedad con nuevos desafíos
Miró, M. S., Rodríguez, E., Vigezzi, C., Icely, P. A., Araújo, M. G. D. F., Riera, F. O., Vargas, L., Abiega, C. D., Caeiro, J. P., & Sotomayor, C. E. (2017) · Revista Iberoamericana de Micología · doi:10.1016/j.riam.2016.11.006 · Cited by 34
Shen, F., Verma, A. H., Volk, A. L., Jones, B. H., Coleman, B. M., Loza, M. J., Malaviya, R., Moore, B. A., Weinstock, D., Elloso, M. M., et al. (2019) · The Journal of Immunology · doi:10.4049/jimmunol.1801436 · Cited by 30
“albicans, is a major infectious consequence of a full IL-17R deficiency in mice and humans (20, 28).”
BackgroundPrimary Immunodeficiencies With Defects in Innate Immunity: Focus on Orofacial Manifestations
Jung, S., Gies, V., Korganow, A., & Guffroy, A. (2020) · Frontiers in Immunology · doi:10.3389/fimmu.2020.01065 · Cited by 31
“However, several other PIDs of intrinsic and innate immunity (Category 6; Table 1) are also characterized by specific oral manifestations such as oral candidiasis in chronic mucocutaneous candidiasis (CMC) disease for example.”
BackgroundInfluentialJohnson, M. (2012) · Materials and Methods · doi:10.13070/mm.en.2.117 · Cited by 29
Ferreira-Gomes, M., Wich, M., Böde, S., Hube, B., Jacobsen, I. D., & Jungnickel, B. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.698849 · Cited by 29
The Differential Regulation of Human ACT1 Isoforms by Hsp90 in IL-17 Signaling
Wu, L., Wang, C., Boisson, B., Misra, S., Rayman, P. A., Finke, J. H., Puel, A., Casanova, J., & Li, X. (2014) · The Journal of Immunology · doi:10.4049/jimmunol.1400715 · Cited by 28
Self-citation
Metadata
- Authors
- Puel, A., Cypowyj, S., Bustamante, J., Wright, J. F., Liu, L., Lim, H. K., Migaud, M., Israel, L., Chrabieh, M., Audry, M., Gumbleton, M., Toulon, A., Bodemer, C., El-Baghdadi, J., Whitters, M., Paradis, T., Brooks, J., Collins, M., Wolfman, N. M., Al-Muhsen, S., Galicchio, M., Abel, L., Picard, C., & Casanova, J.-L.
- Affiliations
- Inserm (FR)
- Rockefeller University (US)
- Pfizer (United States) (US)
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale, U980, and University Paris Descartes, Necker Medical School, 75015 Paris, France.
- SUNY Upstate Medical University (US)
- Hôpital Necker-Enfants Malades (FR)
- Unit of Genetics, Military Hospital of Instruction Mohamed V, Rabat 10000, Morocco.
- Prince Naif Center for Immunology Research, Department of Pediatrics, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia.
- Victor J. Vilela Children’s Hospital, Rosario, Santa Fe 2000, Argentina.
- Corresponding author
- Puel, Anne
- Cypowyj, Sophie
- Abel, Laurent
- Casanova, Jean-Laurent
- ORCID
- Venue
- Science
- Published
- 2011-04
- Volume
- 332
- Issue
- 6025
- Pages
- 65-68
- ISSN
- 0036-8075 (ISSN-L)
- 1095-9203
- PMC
- PMC3070042
- OpenAlex
- W2034453891
- Cited by
- 1,056
- References
- 30
- Citations by year
- 2026: 26 · 2025: 35 · 2024: 29 · 2023: 54 · 2022: 52 · 2021: 64 · 2020: 76 · 2019: 57 · 2018: 67 · 2017: 84 · 2016: 81 · 2015: 76 · 2014: 94 · 2013: 95 · 2012: 103
- FWCI
- 49.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Science (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Research Resources (UL1RR024143)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Immunodeficiency and Autoimmune Disorders
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Keywords
- chronic mucocutaneous candidiasis, IL-17A, Candida albicans, primary immunodeficiency, autosomal recessive inheritance, autosomal dominant inheritance
- MeSH terms
- Candida albicans, Candidiasis, Chronic Mucocutaneous, Child, Child, Preschool, Female, Genes, Dominant, Genes, Recessive, Humans, Male, Molecular Sequence Data, Mutation, Pedigree, Signal Transduction, Interleukin-17, Receptors, Interleukin-17, Th17 Cells
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