{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T21:36:51Z","timestamp":1779313011595,"version":"3.51.4"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100004484","name":"Tehran University of Medical Sciences","doi-asserted-by":"publisher","award":["1400-3-154-55\u00a0897"],"award-info":[{"award-number":["1400-3-154-55\u00a0897"]}],"id":[{"id":"10.13039\/501100004484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The considerable number of the 2019 coronavirus disease (COVID-19) patients who developed mucormycosis infections in West and Central Asia urged a need to investigate the underlying causes of this fatal complication. It was hypothesized that an immunocompromised state secondary to the excessive administration of anti-inflammatory drugs was responsible for the outburst of mucormycosis in COVID-19 patients. Therefore, we aimed to study the implication of two major subsets of adaptive immunity T helper (Th)-1 and Th17 cells in disease development. Thirty patients with COVID-19-associated mucormycosis, 38 with COVID-19 without any sign or symptom of mucormycosis, and 26 healthy individuals were included. The percentage of Th1 and Th17 cells in peripheral blood, as well as the serum levels of interleukin (IL)-17 and interferon-gamma (IFN-\u03b3), were evaluated using flow cytometry and ELISA techniques, respectively. Th17 cell percentage in patients with COVID-19-associated mucormycosis was significantly lower than in COVID-19 patients (P-value: &amp;lt;0.001) and healthy subjects (P-value: 0.01). In addition, the serum level of IL-17 in COVID-19 patients was significantly higher than that of healthy individuals (P-value: 0.01). However, neither the frequency of Th1 cells nor the serum level of IFN-\u03b3 was different between the study groups. Given the critical role of Th17 cells in the defense against mucosal fungal infections, these findings suggest that low numbers of Th17 and insufficient levels of IL-17 might be a predisposing factor for the development of mucormycosis during or after COVID-19 infection.<\/jats:p>","DOI":"10.1093\/mmy\/myad090","type":"journal-article","created":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T02:45:52Z","timestamp":1692672352000},"source":"Crossref","is-referenced-by-count":4,"title":["Percentage of Th1 and Th17 cells and serum level of IL-17 and IFN-\u03b3 cytokines in COVID-19-associated mucormycosis"],"prefix":"10.1093","volume":"61","author":[{"given":"Narjes","family":"Soleimanifar","sequence":"first","affiliation":[{"name":"Molecular Immunology Research Center, Tehran University of Medical Sciences , Tehran , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5244-3127","authenticated-orcid":false,"given":"Sara","family":"Assadiasl","sequence":"additional","affiliation":[{"name":"Molecular Immunology Research Center, Tehran University of Medical Sciences , Tehran , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdolrahman","family":"Rostamian","sequence":"additional","affiliation":[{"name":"Rheumatology Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences , Tehran , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alireza","family":"Abdollahi","sequence":"additional","affiliation":[{"name":"Department of pathology, school of medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences , Tehran , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammadreza","family":"Salehi","sequence":"additional","affiliation":[{"name":"Research center for antibiotic stewardship and antimicrobial resistance, Infectious diseases department, Tehran University of medical sciences , Tehran , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohsen","family":"Abdolmaleki","sequence":"additional","affiliation":[{"name":"Department of medical sciences, Aligudarz branch, Islamic Azad University , Aligudarz , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeed","family":"Barzegari","sequence":"additional","affiliation":[{"name":"Department of Paramedicine, Amol School of Paramedical Sciences, Mazandaran University of Medical Sciences , Amol , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abolfazl","family":"Sobati","sequence":"additional","affiliation":[{"name":"Department of nursing and midwifery, Tehran University of Medical Sciences , Tehran , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Sadr","sequence":"additional","affiliation":[{"name":"Molecular Immunology Research Center, Tehran University of Medical Sciences , Tehran , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7219-9923","authenticated-orcid":false,"given":"Bahareh","family":"Mohebbi","sequence":"additional","affiliation":[{"name":"Molecular Immunology Research Center, Tehran University of Medical Sciences , Tehran , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanieh","family":"Mojtahedi","sequence":"additional","affiliation":[{"name":"Molecular Immunology Research Center, Tehran University of Medical Sciences , Tehran , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Hossein","family":"Nicknam","sequence":"additional","affiliation":[{"name":"Molecular Immunology Research Center, Tehran University of Medical Sciences , Tehran , Iran"},{"name":"Department of Immunology, Medicine School, Tehran University of Medical Sciences , Tehran , Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,8,21]]},"reference":[{"key":"2023083120071730800_bib1","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1186\/s12939-022-01767-5","article-title":"The world health organization COVID-19 surveillance database","volume":"21","author":"Allan","year":"2022","journal-title":"Int J Equity Health"},{"issue":"suppl_1","key":"2023083120071730800_bib2","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1093\/cid\/cir864","article-title":"Taxonomy of fungi causing mucormycosis and entomophthoramycosis (zygomycosis) and nomenclature of the disease: molecular mycologic perspectives","volume":"54","author":"Kwon-Chung","year":"2012","journal-title":"Clin Infect Dis"},{"key":"2023083120071730800_bib3","doi-asserted-by":"crossref","first-page":"3728","DOI":"10.4103\/ijo.IJO_1316_21","article-title":"Mucormycosis in COVID-19 patients","volume":"69","author":"Sundaram","year":"2021","journal-title":"Indian J Ophthalmol"},{"key":"2023083120071730800_bib4","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1111\/myc.13334","article-title":"Mucormycosis in patients with COVID-19: a cross-sectional descriptive multicentre study from iran","volume":"64","author":"Pakdel","year":"2021","journal-title":"Mycoses"},{"key":"2023083120071730800_bib5","first-page":"1","article-title":"Innate and adaptive immunity to mucorales","volume":"3","author":"Ghuman","year":"2017","journal-title":"J Fungi (Basel)"},{"key":"2023083120071730800_bib6","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/myc.12431","article-title":"Natural killer cell-mediated damage of clinical isolates of mucormycetes","volume":"59","author":"Schmidt","year":"2016","journal-title":"Mycoses"},{"key":"2023083120071730800_bib7","doi-asserted-by":"crossref","first-page":"5416","DOI":"10.1182\/blood-2011-07-366526","article-title":"Mucorales-specific t cells emerge in the course of invasive mucormycosis and may be used as a surrogate diagnostic marker in high-risk patients","volume":"118","author":"Potenza","year":"2011","journal-title":"Blood"},{"issue":"Suppl_2","key":"2023083120071730800_bib8","doi-asserted-by":"crossref","first-page":"S634","DOI":"10.1093\/ofid\/ofz360.1594","article-title":"1731. Immune dysregulation in mucormycosis","volume":"6","author":"Gupta","year":"2019","journal-title":"Open Forum Infect Dis"},{"issue":"5","key":"2023083120071730800_bib9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/IAI.00040-21","article-title":"In vivo and in vitro impairments in t helper cell and neutrophil responses against mucor irregularis in card9 knockout mice","volume":"89","author":"Sun","year":"2021","journal-title":"Infect Immun"},{"key":"2023083120071730800_bib10","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s11046-021-00598-2","article-title":"IFN-\u03b3 mediated signaling improves fungal clearance in experimental pulmonary mucormycosis","volume":"187","author":"dos\u00a0Santos","year":"2022","journal-title":"Mycopathologia"},{"key":"2023083120071730800_bib11","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/S1473-3099(16)30541-2","article-title":"Nivolumab plus interferon-\u03b3 in the treatment of intractable mucormycosis","volume":"17","author":"Grimaldi","year":"2017","journal-title":"Lancet Infect Dis"},{"key":"2023083120071730800_bib12","doi-asserted-by":"crossref","first-page":"5794","DOI":"10.3390\/ijms22115794","article-title":"The role of IL-17-producing cells in cutaneous fungal infections","volume":"22","author":"Sawada","year":"2021","journal-title":"Int J Mol Sci"},{"key":"2023083120071730800_bib13","doi-asserted-by":"crossref","first-page":"551889","DOI":"10.3389\/fpubh.2020.551889","article-title":"Iran's approach to COVID-19: evolving treatment protocols and ongoing clinical trials","volume":"8","author":"Rahmanzade","year":"2020","journal-title":"Front Public Health"},{"key":"2023083120071730800_bib14","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1016\/j.ejrnm.2018.01.001","article-title":"Imaging features of rhinocerebral mucormycosis: a study of 43 patients","volume":"49","author":"Therakathu","year":"2018","journal-title":"Egypt J Radiol Nucl Med"},{"key":"2023083120071730800_bib15","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.mib.2012.06.003","article-title":"Unravelling fungal immunity through primary immune deficiencies","volume":"15","author":"Lilic","year":"2012","journal-title":"Curr Opin Microbiol"},{"key":"2023083120071730800_bib16","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/1-4020-5492-0_11","article-title":"Recognition of fungal pathogens by Toll-like receptors","author":"Netea","year":"2007","journal-title":"Immunology of Fungal Infections"},{"key":"2023083120071730800_bib17","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1056\/NEJMoa0901053","article-title":"Human dectin-1 deficiency and mucocutaneous fungal infections","volume":"361","author":"Ferwerda","year":"2009","journal-title":"N Engl J Med"},{"key":"2023083120071730800_bib18","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1038\/nri2939","article-title":"Immunity to fungal infections","volume":"11","author":"Romani","year":"2011","journal-title":"Nat Rev Immunol"},{"key":"2023083120071730800_bib19","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1002\/eji.200839102","article-title":"IL-17\/Th17 in anti-fungal immunity: what's new?","volume":"39","author":"Zelante","year":"2009","journal-title":"Eur J Immunol"},{"key":"2023083120071730800_bib20","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.3390\/cells10061550","article-title":"The role of Th17 response in COVID-19","volume":"10","author":"Martonik","year":"2021","journal-title":"Cells"},{"key":"2023083120071730800_bib21","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s40009-022-01123-9","article-title":"Th1\/Th2\/Th17 cytokine profile among different stages of COVID-19 infection","volume":"45","author":"Gupta","year":"2022","journal-title":"Natl Acad Sci Lett"},{"key":"2023083120071730800_bib22","doi-asserted-by":"crossref","first-page":"3434","DOI":"10.1038\/s41467-020-17292-4","article-title":"Marked t cell activation, senescence, exhaustion and skewing towards TH17 in patients with COVID-19 pneumonia","volume":"11","author":"De\u00a0Biasi","year":"2020","journal-title":"Nat Commun"},{"key":"2023083120071730800_bib23","doi-asserted-by":"crossref","first-page":"205873842096649","DOI":"10.1177\/2058738420966497","article-title":"Immune system changes during COVID-19 recovery play key role in determining disease severity","volume":"34","author":"Fathi","year":"2020","journal-title":"Int J Immunopathol Pharmacol"},{"key":"2023083120071730800_bib24","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s12663-021-01604-2","article-title":"Current understanding in the pathophysiology of SARS-CoV-2-associated rhino-orbito-cerebral mucormycosis: a comprehensive review","volume":"20","author":"Jose","year":"2021","journal-title":"J Oral Maxillofac Surg"},{"key":"2023083120071730800_bib25","first-page":"100971","article-title":"Invasive Fungal Diseases during COVID-19: We Should Be Prepared","volume-title":"J mycol med","author":"Gangneux","year":"2020"},{"key":"2023083120071730800_bib26","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1111\/myc.13542","article-title":"T-cell dysfunction as a potential contributing factor in post-COVID-19 mucormycosis","volume":"66","author":"Dandu","year":"2023","journal-title":"Mycoses"},{"key":"2023083120071730800_bib27","first-page":"243","article-title":"COVID-19 associated mucormycosis: a review","volume-title":"World Journal of Pharmaceutical Research","author":"Roy","year":"2021"}],"container-title":["Medical Mycology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mmy\/advance-article-pdf\/doi\/10.1093\/mmy\/myad090\/51204014\/myad090.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mmy\/article-pdf\/61\/8\/myad090\/51318839\/myad090.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mmy\/article-pdf\/61\/8\/myad090\/51318839\/myad090.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T20:15:55Z","timestamp":1693512955000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mmy\/article\/doi\/10.1093\/mmy\/myad090\/7246887"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8]]},"references-count":27,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8,2]]}},"URL":"https:\/\/doi.org\/10.1093\/mmy\/myad090","relation":{},"ISSN":["1369-3786","1460-2709"],"issn-type":[{"value":"1369-3786","type":"print"},{"value":"1460-2709","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,8]]},"published":{"date-parts":[[2023,8]]},"article-number":"myad090"}}