Chapter 28 : Acquired Humoral Immunity to

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Acquired Humoral Immunity to , Page 1 of 2

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Research initiated in the late 1980s has been the driving force behind a major expansion of one's knowledge about Ab immunity (AI) to cryptococcal disease (cryptococcosis) and a sea change in the understanding of mechanisms of AI to and other microbes for which AI is not thought to be the predominant protective host defense mechanism. This chapter highlights this information, placing emphasis on how new knowledge about AI to has advanced one's understanding of pathogenesis, virulence, and mechanisms of Ab action. Levels of IgG to glucuronoxylomannan (GXM) were higher in human immunodeficiency virus (HIV)-infected than HIV-uninfected individuals in studies using a direct GXM capture enzyme-linked immunosorbent assay (ELISA), but lower in studies using different ELISA methods. The major effect of monoclonal Ab (MAb) to GXM on effector cell function is achieved by enhancing expression of costimulatory molecules, cytokine receptors, and cytokines that polarize the cellular response toward a Th1-like response. A long-recognized mechanism that is central to AI to cryptococcal disease is Ab-mediated clearance of GXM. The remarkable expansion of knowledge about AI to cryptococcal disease since the late 1980s has already translated into potential therapies to ameliorate human cryptococcal disease. The study of AI to has provided precedents that have informed and influenced one's views on Ab immunity in general and the efficacy of Abs against other microbes.

Citation: Pirofski L, Casadevall A. 2011. Acquired Humoral Immunity to , p 397-428. In Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555816858.ch28

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Damage-response curve depicting host damage ( axis) in the setting of HIV-associated cryptococcal disease as a function of the host inflammatory response ( axis). The open circles depict points on the curve at which host damage is maximal, and the black circles depict points on the curve at which host damage is below the disease threshold. The arrows depict the potential for the Ab-mediated processes noted under each disease heading to reduce host damage. Note that Ab functions associated with reduction of damage in the setting of a weak immune response involve micro-bial clearance, and functions associated with reduction of damage in the setting of a strong immune response involve a reduction in the inflammatory response. Abbreviations: HIV, human immunode-ficiency virus; CN, ; SOT, solid organ transplant; IRIS, immune reconstitution inflammatory syndrome; Th-1, T helper cell type 1.

Citation: Pirofski L, Casadevall A. 2011. Acquired Humoral Immunity to , p 397-428. In Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555816858.ch28
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Mechanisms of AI to cryptococcosis

Citation: Pirofski L, Casadevall A. 2011. Acquired Humoral Immunity to , p 397-428. In Heitman J, Kozel T, Kwon-Chung K, Perfect J, Casadevall A (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555816858.ch28

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