Resposta imune de neonatos prematuros frente a infecções por fungos do gênero Candida: revisão de escopo

Abstract

Prematurity is considered a serious global public health problem. In this context, premature newborns are more vulnerable to numerous infectious conditions due to the weaknesses of their immune system. In this sense, among the pathogens that can affect this public, fungi of the genus Candida stand out, in view of their prevalence in hospital infections, generating high neonatal morbidity and mortality. Thus, the objective was to map the scientific production on the mechanisms involved in the innate and adaptive immune response of premature neonates against infections by fungi of the genus Candida. This is a scoping review, based on the recommendations of the Joanna Briggs Institute. Searches were performed in MEDLINE databases via PubMed, CINHAHL, SCOPUS, Embase, Web of Science and LILACS, and in gray literature via Google Scholar and ProQuest Dissertation and Theses. The descriptors in health sciences used for the research were Infant, premature, Immunity and Candida, combined using the Boolean AND operator. Studies in English, Portuguese and Spanish were considered, with no time frame. Data were extracted, tabulated and analyzed by two researchers independently. A total of 35,567 studies were retrieved from all databases and portals analyzed, of which 18 made up the final sample of this study. The articles included compared components of the immune system of premature and/or full-term neonates, or addressed aspects of the immune system of premature neonates against fungal infections based on data obtained from the current literature. Among the actions performed by the innate system, the physical barrier, phagocytosis and the production of pro-inflammatory cytokines are the ones that stood out the most. In turn, regarding adaptive immune responses, the action developed by cellular immunity stands out to the detriment of humoral immunity. Studies have also shown that there are significant differences between the innate and adaptive immune response of neonates depending on gestational age, and in premature infants they are potentially more fragile. Thus, the studies included in this review compete with the understanding of the action of the innate and adaptive immune systems for the protection of premature neonates against infections caused by fungi of the genus Candida.