隐球菌是一种机会性真菌病原体，可在免疫力受损的患者中引起主要累及中枢神经系统的播散性感染。生物制剂越来越多地用于治疗肿瘤和自身免疫/炎症性疾病以及预防移植排斥，这可能会影响人类针对隐球菌病的防御机制。在这篇综述中，我们全面调查了隐球菌病与各种生物制剂之间的关联，强调了它们的感染风险、临床表现和临床结果。临床医生应对接受影响 Th1/巨噬细胞激活途径的生物制剂的患者保持警惕，如肿瘤坏死因子 α 拮抗剂、布鲁顿酪氨酸激酶抑制剂、芬戈莫德、JAK/STAT 抑制剂（Janus 激酶/信号转导器和激活剂）患者发生隐球菌病的风险。转录）和抗 CD52 的单克隆抗体。在风险分层过程中，还应考虑其他风险因素，例如年龄、基础疾病和同时使用的免疫抑制剂，尤其是皮质类固醇。© 作者 2024。由牛津大学出版社代表美国传染病学会出版。

Cryptococcus is an opportunistic fungal pathogen that can cause disseminated infection with predominant central nervous system involvement in patients with compromised immunity. Biologics are increasingly used in the treatment of neoplasms and autoimmune/inflammatory conditions and the prevention of transplant rejection, which may affect human defense mechanisms against cryptococcosis. In this review, we comprehensively investigate the association between cryptococcosis and various biologics, highlighting their risks of infection, clinical manifestations, and clinical outcomes. Clinicians should remain vigilant for the risk of cryptococcosis in patients receiving biologics that affect the Th1/macrophage activation pathways, such as tumor necrosis factor α antagonists, Bruton tyrosine kinase inhibitors, fingolimod, JAK/STAT inhibitors (Janus kinase/signal transducer and activator of transcription), and monoclonal antibody against CD52. Other risk factors-such as age, underlying condition, and concurrent immunosuppressants, especially corticosteroids-should also be taken into account during risk stratification.© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.