The Goldilocks model of immune symbiosis withMycobacteriaandCandidacolonizers

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Mycobacteria and Candida species include significant human pathogens that can cause localized or disseminated infections. Although these organisms may appear to have little in common, several shared pathways of immune recognition and response are important for both control and infection-related pathology. In this article, we compare and contrast the innate and adaptive components of the immune system that pertain to these infections in humans and animal models. We also explore a relatively new concept in the mycobacterial field: biological commensalism. Similar to the well-established model of Candida infection, Mycobacteria species colonize their human hosts in equilibrium with the immune response. Perturbations in the immune response permit the progression to pathologic disease at the expense of the host. Understanding the immune factors required to maintain commensalism may aid with the development of diagnostic and treatment strategies for both categories of pathogens.Graphical abstractHighlightsMycobacteria and Candida spp. are best described as commensals of most humans.Immune responses maintain Mycobacteria and Candida spp. in a commensal state.Mycobacteria and Candida spp. share pathways of immune recognition and response.Hypo-responsiveness leads Mycobacteria & Candida spp. to become human exploiters.Hyper-responsiveness also leads Mycobacteria & Candida spp. to become human exploiters.

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