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Chapter 33 : Acquired Antibody-Mediated Immunity to Fungi
Category: Fungi and Fungal Pathogenesis
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The importance of antibody-mediated immunity (AMI) for resistance to fungal disease has not been rigorously examined for most clinically relevant fungi. Information from the fungi that have been studied suggests that AMI can play an immunoregulatory role. Despite uncertainty about the importance of AMI in natural resistance to fungi, the efficacy of antibody (Ab) against Cryptococcus neoformans, Candida albicans, Histoplasma capsulatum, and Pneumocystis jiroveci is now established in experimental models. The demonstration that Ab can mediate protection against these fungi provides proof of the principle that AMI can be effective against medically relevant fungi. A human monoclonal Ab (MAb) to glucuronoxylomannan (GXM) produced from lymphocytes of a volunteer GXM-tetanus toxoid (TT) recipient reacted with all four GXM serotypes, albeit better with serotypes D and A. MAbs produced from human immunoglobulin (Ig) transgenic mice were largely specific for serotype D GXM but were reactive with serotype A C. neoformans cells, suggesting differential expression of the epitope(s) they recognize. Proof of the principle that AMI can prolong survival and enhance host immune mechanisms against experimental cryptococcosis fueled a paradigm shift that has resulted in reconsideration of Ab-based therapies for many infectious diseases. Protective and nonprotective Abs to Candida represent another system in which anti-fungal Abs can be distinguished by their structure and specificity and further clarifies the basis of historical difficulties in establishing the efficacy of sera against fungi.
Key Concept Ranking
- Fungal Infections