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Chapter 9 : Tissue Responses and Special Topics in Immunity

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Abstract:

This chapter explores the host response to infection, with emphasis on integrating clinical observations with those from animal studies and in vitro observations. The chapter describes the host response to infection for lung, brain, and skin, since these are the organs for which most information is available. The inflammatory response to infection has four unusual features. First, the inflammatory response can range in intensity from florid, intense granulomatous inflammation to the virtual absence of inflammatory cells. The variables responsible for differences in the magnitude and intensity of the inflammatory response include the immune status of the host and poorly defined characteristics of strains. Second, can be found in tissue as both an intracellular pathogen and an extracellular pathogen. Third, the type of inflammatory response is a function, in part, of the organ tissue where the infection occurs. Fourth, there is considerable variation in the type of effector cells found in inflammatory responses. A study compared the inflammatory response to pulmonary infection in CBA/J mice using two strains of , and strongly suggested that some of the differences observed in the human inflammatory response may be the result of unique strain differences in host inflammatory cell recruitment. In summary, the literature strongly supports the view that impairment of cell-mediated immunity is associated with enhanced susceptibility to infection.

Citation: Casadevall A, Perfect J. 1998. Tissue Responses and Special Topics in Immunity, p 271-324. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch9

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Figure 1

Electron micrograph of -infected mouse lung tissue at day 7 of infection. The photomicrograph shows an area of lung with cryptococci filling the airspace, whereas other fungal cells are found in the intracellular space. Open arrows indicate extracellular cryptococci. Closed arrows indicate intracellular cryptococci. Most intracellular cryptococci are inside alveolar macrophages. The tissue comes from C57BL/6 mice, and the cryptococcal strain is ATCC 24067. For details of experimental infection and microscopy, see references and . Micrograph obtained at a magnification of ×3,000. Figure courtesy of Marta Feldmesser (Bronx, N.Y.).

Citation: Casadevall A, Perfect J. 1998. Tissue Responses and Special Topics in Immunity, p 271-324. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch9
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Figure 2

Temporal inflammatory changes in three organs following intracisternal infection in rats. Rats given infection thorough the intracisternal route controlled the infection and seldom died ( ). Histopathological sections of rat brain, lung, and spleen tissue on days 7, 15, and 30 after infection with are shown. (A) Brain tissue on day 7 reveals extracellular yeast forms (arrows) within the subarachnoid space. Original magnification, ×540. (B) Lung tissue on day 7 shows cryptococci surrounded by mononuclear cells. Original magnification, ×540. Cryptococci in lung tissue presumably are a result of hematogenous dissemination from brain tissue. (C) Spleen tissue on day 7 reveals no inflammation or cryptococci. Original magnification, ×335. (D) By day 15 the brain infection has changed histopathologically such that there are increased numbers of lymphocytes and macrophages in the subarachnoid space. Original magnification, ×335. (E) In the lung on day 15, inflammation has progressed to granuloma formation. Arrows point to cryptococci within Langerhans giant cells. Original magnification, ×335. (F) Spleen tissue on day 15 reveals discrete granulomas. Original magnification, ×335. (G) By day 30, inflammation has progressed in the subarachnoid space to include a large infiltration of lymphocytes, monocytes, and epithelioid cells. By this time, several layers of lymphocytes coat the pial surface. Original magnification, ×540. (H) In the lung on day 30, the inflammatory response continues with the formation of foamy macrophages. Original magnification, ×540. (I) In spleen tissue on day 30, inflammation is resolving, paralleling the resolution of infection in other organs. The figure, courtesy of David Goldman (Bronx, N.Y.), originally appeared in reference 94 and is reproduced here with permission.

Citation: Casadevall A, Perfect J. 1998. Tissue Responses and Special Topics in Immunity, p 271-324. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch9
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References

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1. Amundson, D. E. 1992. Cavitary pulmonary cryptococcosis complicating Churg-Strauss vasculitis. South. Med. J. 85: 700 702.
2. Anderson, D. M.,, and M. A. Dykstra. 1984. Pulmonary cell response in mice following intranasal instillation with Cryptococcus neoformans. Mycopathologia 86: 179 184.
3. Aronson, M.,, and J. Kletter. 1973. Aspects of the defense against a large-sized parasite, the yeast, Cryptococcus neoformans. Isr. J. Med. Sci. 1: 132 162.
4. Asherton, G. L.,, V. Colizzi,, and M. Zembala. 1986. An overview of T-suppressor cell circuits. Annu. Rev. Immunol. 4: 37 68.
5. 4a. Atkinson, A. J.,, and J. E. B. Bennett 1968. Experience with a new skin test antigen prepared from Cryptococcus neoformans. Am. Rev. Respir. Dis. 97: 637 643.
5. Attal, H. C.,, S. Grover,, M. P. Bansai,, B. S. Chaubey,, and V. K. Joglekar. 1983. Capsule deficient Cryptococcus neoformans an unusual clinical presentation. J. Assoc. Physicians India 31: 49 51.
6. Baird, R. W.,, and A. S. Garfield. 1994. Cavitation and rupture of a pulmonary cryptococcoma in an immunocompetent man. Am. J. Med. 97: 309 311.
7. Baker, P. J. 1990. Regulation of magnitude of antibody response to bacterial polysaccharide antigens by thymus-derived lymphocytes. Infect. Immun. 58: 3465 3468.
8. Baker, R. D. 1952. Resectable mycotic lesions and acutely fatal mycoses. JAMA 159: 1579 1581.
9. Baker, R. D. 1976. The primary pulmonary lymph node complex of cryptococcosis. Am. J. Clin. Pathol. 65: 83 92.
10. Baker, R. D.,, and R. K. Haugen. 1955. Tissue changes and tissue diagnosis in cryptococcosis. A study of 26 cases. Am. J. Clin. Pathol. 25: 14 24.
11. Bennett, J. E.,, and H. F. Hasenclever. 1965. Cryptococcus neoformans polysaccharide: studies of serologic properties and role in infection. J. Immunol. 94: 916 920.
12. Bergman, F. 1961. Pathology ofexperimental cryptococcosis. A study of course and tissue response in subcutaneously inducedinfection in mice. Acta Pathol. Microbiol. Scand. 147( Suppl.): l 163.
13. Berk, M.,, and B. Gerstl. 1952. Torulosis (Cryptococcosis) producing a solitary pulmonary lesion. JAMA 149: 1310 1312.
14. Bird, D. C.,, J. N. Sheagren,, and J. E. Bennett 1969. Reticuloendothelial phagocytic function during systemic mycotic infections in man. J. Lab. Clin. Med. 74: 340 345.
15. Blackstock, R. 1996. Cryptococcal capsular polysaccharide utilizes an antigen-presenting cell to induce a T-suppressor cell to secrete TsF. J. Med. Vet. Mycol. 34: 19 30.
16. Blackstock, R.,, and A. Casadevall. 1997. Presentation of cryptococcal capsular polysaccharide (GXM) on activated antigen presenting cells inhibits the T-suppressor response and enhances delayed-type hypersensitivity and survival. Immunology 92: 334 339.
17. Blackstock, R.,, and N. K. Hall. 1982. Immunosuppression by avirulent, pseudohyphal forms of Cryptococcus neoformans. Mycopathologia 80: 95 99.
18. Blackstock, R.,, and N. K. Hall. 1984. Non-specific immunosuppression by Cryptococcus neoformans infection. Mycopathologia 86: 35 43.
19. Blackstock, R.,, N. K. Hall,, and N. C. Hernandez. 1989. Characterization of a suppressor factor that regulates phagocytosis by macrophages in murine cryptococcosis. Infect. Immun. 57: 1773 1779.
20. Blackstock, R.,, and N. C. Hernandez. 1988. Inhibition of macrophage phagocytosis in cryptococcosis: phenotypic analysis of the suppressor cell. Cell. Immunol. 114: 174 187.
21. Blackstock, R.,, and N. C. Hernandez. 1989. Characterization of the macrophage subset affected and its response to a T suppressor factor (TsFmp) found in cryptococcosis. Infect. Immun. 57: 2931 2937.
22. Blackstock, R.,, J. M. McCormack,, and N. K. Hall. 1987. Induction of a macrophage-suppressive lymphokine by soluble cryptococcal antigens and its association with models of immunologic tolerance. Infect. Immun. 55: 233 239.
23. Blackstock, R.,, M. Zembala,, and G. L. Asherson. 1991. Functional equivalence of cryptococcal and haptene-specific T suppressor factor (TsF). I. Picryl and oxazolone-specific TsF, which inhibit transfer of contact sensitivity, also inhibit phagocytosis by a subset of macrophages. Cell. Immunol. 136: 435 447.
24. Blackstock, R.,, M. Zembala,, and G. L. Asherson. 1991. Functional equivalence of cryptococcal and haptene-specific T suppressor factor (TsF). II. Monoclonal anti-cryptococcal TsF inhibits both phagocytosis by a subset of macrophages and transfer of contact sensitivity. Cell. Immunol. 136: 448 461.
25. Blasi, E.,, R. Barluzzi,, R. Mazzola,, F. Mosci,, and F. Bistoni. 1992. Experimental model of intracerebral infection with Cryptococcus neoformans: roles of phagocytes and opsonization. Infect. Immun. 60: 3682 3688.
26. Blasi, E.,, R. Barluzzi,, R. Mazzola,, L. Pitzurra,, M. Puliti,, S. Saleppico,, and F. Bistoni. 1995. Biomolecular events involved in anticryptococcal resistance in the brain. Infect. Immun. 63: 1218 1222.
27. Blasi, E.,, R. Mazzola,, R. Barluzzi,, P. Mosci,, A. Bartoli,, and F. Bistoni. 1991. Intracerebral transfer of an in vitro established microglial cell line: local induction of a protective state against lethal challenge with Candida albicans. J. Neuroimmunol. 32: 249 257.
28. Blasi, E.,, R. Mazzola,, R. Barluzzi,, P. Mosci,, and F. Bistoni. 1994. Anticryptococcal resistance in the mouse brain: beneficial effects of local administration of heat-inactivated yeast cells. Infect. Immun. 62: 3189 3196.
29. Brajtburg, J.,, W. G. Powderly,, G. Kobayashi,, and G. Medoff. 1993. Amphotericin B: current understanding of mechanisms of action. Antimicrob. Agents Chemother. 34: 183 188.
30. Brodie, S. J.,, V. G. Sasseville,, K. A. Reinmann,, M. A. Simon,, P. K. Sehgal,, and D. J. Ringler. 1994. Macrophage function in simian AIDS. Killing defects in vivo are independent of macrophage function, associated with alterations in Th phenotype, and reversible with IFN-gamma. J. Immunol. 153: 5790.
31. Brueske, C. H. 1986. Proteolytic activity of a clinical isolate of Cryptococcus neoformans. J. Clin. Microbiol. 23: 631 633.
32. Brummer, E.,, and D. A. Stevens. 1994. Macrophage colony-stimulating factor induction of enhanced macrophage anticryptococcal activity: synergy with fluconazole for killing. J. Infect. Dis. 170: 173 179.
33. Buchanan, K. L.,, P. L. Fidel,, and J. W. Murphy. 1991. Effects of Cryptococcus neoformans-specific suppressor T cells on the amplified anticryptococcal delayed-type hypersensitivity response. Infect. Immun. 59: 29 35.
34. Bulmer, G. S.,, and J. R. Tacker. 1975. Phagocytosis of Cryptococcus neoformans by alveolar macrophages. Infect. Immun. 11: 73 79.
35. Cameron, M. L.,, J. A. Bartlett,, H. A. Gallis,, and H. A. Waskin. 1991. Manifestations of pulmonary cryptococcosis in patients with acquired immunodeficiency syndrome. Rev. Infect. Dis. 13: 64 67.
36. Cameron, M. L.,, D. L. Granger,, T. J. Matthews,, and J. B. Weinberg. 1994. Human immunodeficiency virus (HIV)-infected human blood monocytes and peritoneal macrophages have reduced anticryptococcal activity whereas HIV-infected alveolar macraphages retain normal activity. J. Infect. Dis. 170: 60 70.
37. Carton, C. A.,, and L. A. Mount. 1951. Neurosurgical aspects of cryptococcosis. J. Neurosurg. 8: 143 156.
38. Casadevall, A. 1993. Cryptococcosis: the case for immunotherapy. Cliniguide to Fungal Infections 4: 1 5.
39. Casadevall, A.,, D. L. Goldman,, and M. Feldmesser. 1997. Antibody-based therapies for infectious diseases: renaissance for an abandoned arsenal? Bull. Inst. Pasteur 95: 247 257.
40. Casadevall, A.,, J. Mukherjee,, Y. RuiRong,, and J. Perfect. 1994. Management of Cryptococcus neoformans contaminated needle injuries. Clin. Infect. Dis. 19: 951 953.
41. Cauley, L. K.,, and J. W. Murphy. 1979. Response of congenitally athymic (nude) and phenotypically normal mice to Cryptococcus neoformans infection. Infect. Immun. 23: 644 651.
42. Cawley, E. P.,, R. H. Grekin,, and A. C. Curtis. 1950. Torulosis. A review of the cutaneous and adjoining mucous membrane manifestations. J. Invest Dermatol. 14: 327 344.
43. Chatuverdi, V.,, B. Wong,, and S. L. Newman. 1996. Oxidative killing of Cryptococcus neoformans by human leukocytes. Evidence that fungal mannitol protects by scavenging reactive oxygen intermediates. J. Immunol. 156: 3836 3840.
44. Chen, L. -C.,, E. Blank,, and A. Casadevall. 1996. Extracellular proteinase activity of Cryptococcus neoformans. Clin. Diagn. Lab. Immunol. 3: 570 574.
45. Cherniak, R.,, and J. B. Sundstrom. 1994. Polysaccharide antigens of the capsule of Cryptococcus neoformans. Infect. Immun. 62: 1507 1512.
46. Clemons, K. V.,, R. Azzi,, and D. A. Stevens. 1996. Experimental systemic cryptococcosis in SCID mice. J. Med. Vet. Mycol. 34: 331 335.
47. Clemons, K. V.,, E. Drummer,, and D. A. Stevens. 1994. Cytokine treatment of central nervous system infection: efficacy of interleukin-12 alone and synergy with conventional antifungal therapy in experimental cryptococcosis. Antimicrob. Agents Chemother. 38: 460 464.
49. Collins, H. L.,, and G. J. Bancroft. 1991. Encapsulation of Cryptococcus neoformans impairs antigen-specific T-cell responses. Infect. Immun. 59: 3883 3888.
50. Curtis, J. L.,, G. B. Huffnagle,, G. H. Chen,, M. L. Warnock,, M. Gyetko,, R. McDonald,, P. Scott,, and G. B. Toews. 1994. Experimental murine pulmonary cryptococcosis. Lab. Invest. 71: 113 126.
51. Cusini, M.,, P. Cagliani,, R. Grimalt,, G. Tadini,, E. Alessi,, and M. Fasan. 1991. Primary cutaneous cryptococcosis in a patient with the Acquired Immunodeficiency Syndrome. Arch. Dermatol. 127: 1848 1849.
52. Daniel, P. M.,, F. Shiller,, and R. L. Vollum. 1949. Torulosis of the central nervous system. Report of two cases. Lancet i: 53 56.
53. DeShaw, M.,, and L.-A. Pirofski. 1995. Antibodies to the Cryptococcus neoformans capsular glucuronoxylomannan are ubiquitous in serum from HIV+ and HIV— individuals. Clin. Exp. Immunol. 99: 425 432.
54. Diamond, R. D. 1977. Effects of stimulation and suppression of cell-mediated immunity on experimental cryptococcosis. Infect. Immun. 17: 187 194.
55. Diamond, R. D.,, and J. E. Bennett. 1973. Disseminated cryptococcosis in man: decreased lymphocyte transformation in response to Cryptococcus neoformans. J. Infect. Dis. 127: 694 697.
56. Diamond, R.D.,, and J. E. Bennett 1973. Growth of Cryptococcus neoformans within human macrophages in vitro. Infect. Immun. 7: 231 2360.
57. Diamond, R. D.,, and N. F. Erickson III. 1982. Chemotaxis of human neutrophils and monocytes induced by Cryptococcus neoformans. Infect. Immun. 38: 380 382.
58. Diamond, R. D.,, J. E. May,, M. Kane,, M. M. Frank,, and J. E. Bennett 1973. The role of late complement component and the alternate complement pathway in experimental cryptococcosis (37580). Proc. Soc. Exp. Biol. Med. 144: 312 315.
59. Diamond, R. D.,, J. E. May,, M. C. Kane,, M. M. Frank,, and J. E. Bennett 1974. The role of the classical and alternate complement pathways in host defenses against Cryptococcus neoformans infection. J. Immunol. 112: 2260 2270.
60. Dixon, D. M.,, and A. Polak. 1986. In vivo and in vitro studies with an atypical, rhinotrophic isolate of Cryptococcus neoformans. Mycopathologia 96: 33 40.
61. Dobiick, P.,, K. Miksits,, and H. Hahn. 1995. L3T4(CD4)-, Lyt-2(CD8)- and Mac-1(CD11b)-phenotypic leukocytes in murine cryptococcal meningoencephalitis. Mycopathologia 131: 159 166.
62. Dong, Z. M.,, and J. W. Murphy. 1993. Mobility of human neutrophils in response to Cryptococcus neoformans cells, culture filtrate antigen, and individual components of the antigen. Infect. Immun. 61: 5067 5077.
63. Dong, Z. M.,, and J. W. Murphy. 1995. Intravascular cryptococcal culture filtrate (CneF) and its major component, glucuronoxylomannan, are potent inhibitors of leukocyte accumulation. Infect. Immun. 63: 770 778.
64. Dong, Z. M.,, and J. W. Murphy. 1995. Effects of the two varieties of Cryptococcus neoformans cells and culture filtrate antigens on neutrophil locomotion. Infect. Immun. 63: 2632 2644.
65. Dong, Z. M.,, and J. W. Murphy. 1996. Cryptococcal polysaccharides induce L-selectin shedding and tumor necrosis receptor loss from the surface of human neutrophils. J. Clin. Invest. 97: 689 698.
66. Dong, Z. M.,, and J. W. Murphy. 1997. Cryptococcal polysaccharide bind to CD18 on human neutrophils. Infect. Immun. 65: 557 563.
67. Dorf, M.,, and B. Benacerraf. 1984. Suppressor cells and immunoregulation. Annu. Rev. Immunol. 2: 127 158.
68. Dormer, B. A.,, J. Friedlander,, F. J. Wiles,, and F. W. Simson. 1945. Tumor of the lung due to Cryptococcus histolyticus (blastomycosis). J. Thoracic Surg. 14: 322 329.
69. Dromer, E.,, and J. Charreire. 1991. Improved amphotericin B activity by a monoclonal anti- Cryptococcus neoformans antibody: study during murine cryptococcosis and mechanisms of action. J. Infect. Dis. 163: 1114 1120.
70. Drouhet, E.,, and G. Segretain. 1951. Inhibition de la migration leucocytaire in vitro par un polyoside capsulaire de Torulopsis (Cryptococcus) neoformans. Ann. Inst. Pasteur 81: 674.
71. Duke, S. S.,, and R. A. Fromtling. 1984. Effects of diethylstilbestrol and cyclophosphamide on the pathogenesis of experimental Cryptococcus neoformans infections. J. Med. Vet. Mycol. 22: 125 135.
72. Durden, F. M.,, and B. Elewski. 1994. Cutaneous involvement with Cryptococcus neoformans in AIDS. J. Am. Acad. Dermatol. 30: 844 848.
73. Dystra, M. A.,, and L. Friedman. 1978. Pathogenesis, lethality, and immunizing effect of experimental cutaneous cryptococcosis. Infect. Immun. 20: 446 455.
74. Epstein, R.,, R. Cole, and K. K. Hunt. 1972. Pleural effusion secondary to pulmonary cryptococcosis. Chest 61: 296 298.
75. Farmer, S. G.,, and R. A. Komorowski. 1973. Histologic response to capsule-deficient Cryptococcus neoformans. Arch. Pathol. 96: 383 387.
76. Feldmesser, M.,, and A. Casadevall. 1997. Effect of serum IgG1 against murine pulmonary infection with Cryptococcus neoformans. J. Immunol. 158: 790 799.
77. Feldmesser, M.,, A. Casadevall,, Y. Kress,, G. Spira,, and A. Orlofski. 1997. Eosinophil- Cryptococcus neoformans interactions in vivo and in vitro. Infect. Immun. 65: 1899 1907.
78. Feldmesser, M.,, J. Mukherjee,, and A. Casadevall. 1996. Combination of 5-flucytosine and capsule binding monoclonal antibody in therapy of murine Cryptococcus neoformans infections and in vitro. J. Antimicrob. Chemother. 37: 617 622.
79. Ferry, J. A.,, C. K. Pettit,, A. E. Rosenberg,, and N. L. Harris. 1991. Fungi in megakaryocytes. An unusual manisfestation of fungal infection in the bone marrow. Am. J. Clin. Pathol. 96: 577 581.
80. Fidel, P. L.,, and J. W. Murphy. 1988. Characterization of an in vitro-stimulated, Cryptococcus neoformans-specific second-order suppressor T cell and its precursor. Infect. Immun. 56: 1267 1272.
81. Freeman, W. 1930. Torula meningo-encephalitis. Comparative histopathology in seventeen cases. Trans. Am. Neurol. Assoc. 56: 203 217.
82. Freeman, W. 1931. Torula infection of the central nervous system. J. Psychol. Neurol. 43: 236 245.
83. Friedman, E. P.,, R. F. Miller,, A. Severn,, I. G. Williams,, and P. J. Shaw. 1995. Cryptococcal pneumonia in patients with the acquired immunodeficiency syndrome. Clin. Radiol. 50: 756 760.
84. Frisch, M.,, and D. R. Gnepp. 1995. Primary cryptococcal infection of the larynx: report of a case. Otolaryngol. Head Neck Surg. 113: 477 480.
85. Fromtling, R. A.,, G. K. Abruzzo,, and A. Ruiz. 1988. Cryptococcus neoformans: a central nervous system isolate from an AIDS patient that is rhinotropic in a normal mouse model. Mycopathologia 102: 79 86.
86. Fromtling, R. A.,, and H. J. Shadomy. 1982. Immunity in cryptococcosis: an overview. Mycopathologia 77: 183 190.
87. Gadebusch, H. H. 1961. Natural host resistance to infection with Cryptococcus neoformans. The effect of the properdin system on the experimental disease. J. Infect. Dis. 109: 147 153.
88. Gadebusch, H. H. 1972. Mechanisms of native and acquired resistance to infection with Cryptococcus neoformans. Crit. Rev. Microbiol 1: 311 320.
89. Gal, A. A.,, M. N. Koss,, J. Hawkins,, S. Evans,, and H. Einstein. 1986. The pathology of pulmonary cryptococcal infections in the acquired immunodeficiency syndrome. Arch. Pathol. Lab. Med. 110: 502 507.
90. Ghigliotti, G.,, G. Carrega,, A. Farris,, A. Burroni,, A. Nigra,, G. Pagano,, and R. De Marchi. 1992. Cutaneous cryptococcosis resembling molluscum contagiosum in a homosexual man with AIDS. Acta Dermatol. Venereol. 72: 182 184.
91. Glaser, J. B.,, and A. Garden. 1985. Inoculation of cryptococcosis without transmission of the acquired immunodeficiency syndrome. N. Engl J. Med. 313: 266.
92. Goldman, D.,, Y. Cho,, M.-L. Zhao,, A. Casadevall,, and S. C. Lee. 1996. Expression of inducible nitric oxide synthase in rat pulmonary Cryptococcus neoformans granulomas. Am. J. Pathol. 148: 1275 1282.
93. Goldman, D.,, S. C. Lee,, and A. Casadevall. 1994. Pathogenesis of pulmonary Cryptococcus neoformans infection in the rat. Infect. Immun. 62: 4755 4761.
94. Goldman, D. L.,, A. Casadevall,, Y. Cho,, and S. C. Lee. 1996. Cryptococcus neoformans meningitis in the rat. Lab. Invest. 75: 759 770.
95. Goodman, J. S.,, L. Kaufman,, and G. Koenig. 1971. Diagnosis of cryptococcal meningitis. N. Engl. J. Med. 285: 434 436.
96. Gordon, M. A.,, and A. Casadevall. 1995. Serum therapy of cryptococcal meningitis. Clin. Infect. Dis. 21: 1477 1479.
97. Gordon, M. A.,, and E. Lapa. 1964. Serum protein enhancement of antibiotic therapy in cryptococcosis. J. Infect. Dis. 114: 373 378.
98. Gordon, S. M.,, A. A. Gal,, and J. R. Amerson. 1994. Granulomatous peritoneal cryptococcomas. An unusual sequela of disseminated cryptococcosis. Arch. Pathol. Lab. Med. 118: 194 195.
99. Graybill, J. R.,, J. Ahrens,, T. Nealon,, and R. Paque. 1983. Pulmonary cryptococcosis in the rat. Am. Rev. Respir. Dis. 127: 636 640.
100. Graybill, J. R.,, and R. H. Alford. 1974. Cell-mediated immunity in cryptococcosis. Cell. Immunol. 14: 12 21.
101. Graybill, J. R.,, R. Bocanegra,, C. Lambros,, and M. F. Luther. 1997. Granulocyte colony stimulating factor therapy of experimental cryptococcal meningitis. J. Med. Vet. Mycol. 35: 243 247.
102. Graybill, J. R.,, and D. J. Drutz. 1978. Host defense in cryptococcosis. II. Cryptococcosis in the nude mouse. Cell. Immunol. 40: 263 274.
103. Griffin, F. M. 1980. Roles of macrophage Fc and C3b receptors in phagocytosis of immunologically coated Cryptococcus neoformans. Proc. Natl Acad. Sci. USA 78: 3853 3857.
104. Gutierrez, F.,, Y. S. Fu,, and H. I. Lurie. 1975. Cryptococcosis histologically resembling histoplasmosis. Arch. Pathol 99: 347 353.
105. Gyetko, M. R.,, G.-H. Chen,, R. A. McDonald,, R. Goodman,, G. B. Huffnagle,, C. C. Wilkinson,, J. A. Fuller,, and G. B. Toews. 1996. Urokinase is required for the pulmonary inflammatory response to Cryptococcus neoformans. J. Clin. Invest. 97: 1818 1826.
106. Harrison, T. S.,, H. Kornfeld,, and S. M. Levitz. 1995. The effect of infection with human immunodeficiency virus on the anticryptococcal activity of lymphocytes and monocytes. J. Infect. Dis. 172: 665 671.
107. Haugen, R. K.,, and R. D. Baker. 1954. The pulmonary lesions in cryptococcosis with special reference to subpleural nodules. Am. J. Clin. Pathol. 24: 1381 1390.
108. Heere, L. J.,, T. A. Mahvi,, and M. M. Annable. 1975. Effect of temperature on growth and macromolecular biosynthesis in Cryptococcus species. Mycopathologia 55: 105 113.
109. Henderson, D. K.,, J. E. Bennett,, and M. A. Huben 1982. Long-lasting, specific immunologic unresponsiveness associated with cryptococcal meningitis. J. Clin. Invest. 69: 1185 1190.
110. Henderson, D.K.,, V. L. Kan,, and J. E. Bennett. 1986. Tolerance to cryptococcal polysaccharide in cured cryptococcosis patients: failure of antibody secretion in vitro. Clin. Exp. Immunol. 65: 639 646.
112. Hill, J. 0. 1992. CD4 + T cells cause multinucleated giant cells to form around Cryptococcus neoformans and confine the yeast within the primary site of infection in the respiratory tract. J. Exp. Med. 175: 1685 1695.
113. Hill, J. O.,, and K. M. Aguirre. 1994. CD4 + T cell-dependent acquired state of immunity that protects the brain against Cryptococcus neoformans. J. Immunol. 152: 2344 2350.
114. Hill, J. O.,, and R L. Dunn. 1993. A T cell-independent protective response against Cryptococcus neoformans expressed at the primary site of infection in the lung. Infect. Immun. 61: 5302 5308.
115. Hino, H.,, K. Takizawa,, and G. Asboe-Hansen. 1982. Ultrastmcture of Cryptococcus neoformans. Acta Dermatol. Venereol. 62: 113 117.
116. Hinrichs, J.,, D. Kitz,, G. Kobayashi,, and J. R. Little. 1983. Immune enhancement in mice by Ara-A. J. Immunol. 130: 829 833.
117. Hirano, A.,, H. M. Zimmerman,, and S. Levine. 1964. Fine structure of cerebral fluid accumulation. V. Transfer of fluid from extracellular compartments in acute phase of cryptococcal polysaccharide lesions. Arch. Neurol. 11: 632 641.
118. Hirano, A.,, H. M. Zimmerman,, and S. Levine. 1964. Fine structure of cerebral fluid accumulation. III. Extracellular spread of cryptococcal polysaccharides in the acute stage. Am. J. Pathol. 46: 1 11.
119. Hirano, A.,, H. M. Zimmerman,, and S. Levine. 1965. Fine structure of cerebral fluid accumulation. VI. Intracellular accumulation of fluid and cryptococcal polysaccharide in oligodendria. Arch. Neurol. 12: 189 196.
120. Hirano, A.,, H. M. Zimmerman,, and S. Levine. 1965. Fine structure of cerebral fluid accumulation. VII. Reactions of astrocytes to cryptococcal polysaccharide implantation. J. Neuropathol. Exp. Neurol. 24: 386 396.
121. Hobbs, M. M.,, J. R. Perfect,, D. L. Granger,, and D. T. Durack. 1990. Opsonic activity of cerebrospinal fluid in experimental cryptococcal meningitis. Infect. Immun. 58: 2115 2119.
122. Hoff, C. L. 1942. Immunity studies of Cryptococcus hominis ( Torula histolytica) in mice. J. Lab. Clin. Med. 27: 751 754.
123. Horn, C. A.,, and R. G. Washburn. 1995. Anticryptococcal activity of NK cell-enriched peripheral blood lymphocytes from human immunodeficiency virus-infected subjects: responses to interleukin-2, interferon-gamma, and interleukin-12. J. Infect. Dis. 172: 1023 1027.
124. Huffnagle, G. B.,, G.-H. Chen,, J. L. Curtis,, R. A. McDonald,, R. M. Strieter,, and G. B. Toews. 1995. Down-regulation of the afferent phase of T cell-mediated pulmonary inflammation and immunity by a high melanin-producing strain of Cryptococcus neoformans. J. Immunol. 155: 3507 3516.
125. Huffnagle, G. B.,, and M. F. Lipscomb. 1992. Animal model of human disease: pulmonary cryptococcosis. Am. J. Pathol. 141: 1517 1520.
126. Huffnagle, G.B.,, M. F. Lipscomb,, J. A. Lovchik,, K. A. Hoag,, and N. E. Street. 1994. The role of CD4 + and CD8 + T-cells in protective inflammatory response to a pulmonary cryptococcal infection. J. Leukocyte Biol 55: 35 42.
127. Huffnagle, G. B.,, N. E. Street,, and M. Lipscomb. 1992. In contrast to Balb/c mice, a Cryptococcus neoformans infection in C57BL/6 mice generates protective T cell immunity in the periphery and non-protective T-cell mediated eosinophilia in the lungs. FASEB J. 6:A1689. (Abstract.)
128. Huffnagle, G. B.,, R. M. Strieter,, T. J. Standiford,, R. A. McDonald,, M. D. Burdick,, S. L. Kunkel,, and G. B. Toews. 1995. The role of monocyte chemotactic protein-1 (MCP-1) in the recruitment of monocytes and CD4 + T cells during a pulmonary Cryptococcus neoformans infection. J. Immunol. 155: 4790 4797.
129. Huffnagle, G. B.,, J. L. Yates,, and M. F. Lipscomb. 1991. T cell-mediated immunity in the lung: a Cryptococcus neoformans pulmonary infection model using SOD and athymic nude mice. Infect. Immun. 59: 1423 1433.
130. Huffnagle, G. B.,, J. L. Yates,, and M. F. Lipscomb. 1991. Immunity to pulmonary Cryptococcus neoformans infection requires both CD4 + and CD8 + T cells. J. Exp. Med. 173: 793 800.
131. Iarobellis, F. W.,, M. I. Jacobs,, and R. P. Cohen. 1984. Primary cutaneous cryptococcosis. Arch. Dermatol. 23: 673 675.
132. Jacobson, E.S.,, and S. B. TinnelL1993. Antioxidant function of fungal melanin. J. Bacteriol. 175: 7102 7104.
133. Joly, V.,, L. Saint-Julien,, C. Carbon,, and P. Yeni. 1994. In vivo activity of interferon-gamma in combination with amphotericin B in the treatment of experimental cryptococcosis. J. Infect. Dis. 170: 1331 1334.
134. Kagaya, K.,, T. Yamada,, Y. Miyakawa,, Y. Fukazawa,, and S. Saito. 1985. Characterization of pathogenic constituents of Cryptococcus neoformans strains. Microbiol. Immunol. 29: 517 532.
135. Kahn, F. W.,, D. N. England,, and J. M. Jones. 1985. Solitary pulmonary nodule due to Cryptococcus neoformans and Mycobacterium tuberculosis. Am. J. Med. 78: 677 681.
136. Kalina, M.,, Y. Kletter,, and M. Aronson. 1974. The interaction of phagocytes and the large-sized parasite Cryptococcus neoformans: cytochemical and ultrastructural study. Cell Tissue Res. 152: 165 174.
137. Kawakami, K.,, S. Kohno,, J. -I. Kadota,, M. Tohyama,, K. Teruya,, N. Kedeken,, A. Saito,, and K. Hara. 1995. T cell-dependent activation of macrophages and enhancement of their phagocytic activity in the lungs of mice inoculated with heat-killed Cryptococcus neoformans: involvement of IFN-gamma and its protective effect against cryptococcal infection. Microbiol. Immunol. 39: 135 143.
138. Kawakami, K.,, S. Kohno,, N. Morikawa,, J. Kadota,, A. Saito,, and K. Hara. 1994. Activation of macrophages and expansion of specific T lymphocytes in the lungs of mice intratracheally inoculated with Cryptococcus neoformans. Clin. Exp. Immunol. 96: 230 237.
139. Kent T. H.,, and J. M. Layton. 1962. Massive pulmonary cryptococcosis. Am. J. Clin. Pathol. 38: 596 604.
140. Kerkering, T. M.,, R. J. Duma,, and S. Shadomy. 1981. The evolution of pulmonary cryptococcosis. Ann. Intern. Med. 94: 611 616.
141. Kessel, J. E.,, and F. Holtzwart. 1935. Experimental studies with torula from a knee infection in man. Am. J. Trop. Med. 15: 467 481.
142. Khakpour, F. R.,, and J. W. Murphy. 1987. Characterization of a third-order suppressor T cell (Ts3) induced by cryptococcal antigen. Infect. Immun. 55: 1657 1662.
143. Kitchen, L. W. 1996. Adjunctive immunologic therapy for Cryptococcus neoformans infections. Clin. Infect. Dis. 23: 209 210.
144. Kitchen, L. W.,, J. A. Ross,, J. E. Hernandez,, A. L. Zarraga,, and F. J. Mather. 1992. Effect of administration of diethylcarbamazine on experimental bacterial and fungal infections in mice. Int. J. Antimicrob. Agents 1: 259 268.
145. Kitchen, L. W.,, J. A. Ross,, B. S. Turner,, J. E. Hernandez,, and F. J. Mather. 1995. Diethylcarbamazine enhances blood microbicidal activity. Adv. Therapy 12: 22 29.
146. Kobayashi, T.,, I. Nakashima,, and N. Kato. 1975. Factors affecting experimental infection with Cryptococcus neoformans in mice with special reference to an endotoxic substance of C. neoformans. Mycopathologia 55: 17 22.
147. Kozel, T. R. 1993. Opsonization and phagocytosis of Cryptococcus neoformans. Arch. Med. Res. 24: 211 218.
148. Kozel, T. R. 1996. Activation of the complement system by pathogenic fungi. Clin. Microbiol. Rev. 9: 34 46.
149. Kozel, T. R.,, and J. Cazin, Jr. 1972. Immune response to Cryptococcus neoformans soluble polysaccharide. Infect. Immun. 5: 35 41.
150. Kozel, T. R.,, and E. Gotschlich. 1982. The capsule of Cryptococcus neoformans passively inhibits phagocytosis of the yeast by macrophages. J. Immunol. 129: 1675 1680.
151. Kozel, T. R.,, W. F. Gulley,, and J. Cazin, Jr. 1977. Immune response to Cryptococcus neoformans soluble polysaccharide: immunological unresponsiveness. Infect. Immun. 18: 701 707.
152. Kozel, T. R.,, and G. S. T. Pfrommer. 1986. Activation of the complement system by Cryptococcus neoformans leads to binding of iC3b to the yeast. Infect. Immun. 52: 1 5.
153. Kozel, T. R.,, E. Reiss,, and R. Cherniak. 1980. Concomitant but not causal association between surface charge and inhibition of phagocytosis by cryptococcal polysaccharide. Infect. Immun. 29: 295 300.
154. Krainer, L.,, J. M. Small,, A. B. Hewlitt,, and T. Deness. 1946. A case of systemic torula infection with tumour formation in the meninges. J. Neurol. Neurosurg. Psychiatr. 9: 158 162.
155. Kuhn, L. R. 1939. Experimental cryptococcic infection. Arch. Pathol. 27: 803.
156. Laxalt, K. A.,, and T. R. Kozel. 1979. Chemotoxigenesis and activation of the alternative complement pathway by encapsulated and non-encapsulated Cryptococcus neoformans. Infect. Immun. 26: 435 440.
157. Lee, S. C.,, and A. Casadevall. 1996. Polysaccharide antigen in brain tissue of AIDS patients with cryptococcal meningitis. Clin. Infect. Dis. 23: 194 195.
158. Lee, S. C.,, A. Casadevall,, and D. W. Dickson. 1996. Immunohistochemical localization of capsular polysaccharide antigen in the central nervous system cells in cryptococcal meningoencephalitis. Am.J. Pathol. 148: 1267 1274.
159. Lee, S. C.,, D. W. Dickson,, and A. Casadevall. 1996. Pathology of cryptococcal meningoencephalitis: analysis of 27 patients with pathogenetic implications. Hum. Pathol. 27: 839 847.
161. Lee, S. L.,, Y. Kress,, M.-L. Zhao,, D. W. Dickson,, and A. Casadevall. 1995. Cryptococcus neoformans survive and replicate in spacious phagosomes in human microglia. Lab. Invest. 73: 871 879.
162. Lehrer, R. I.,, A. K. Lichenstein,, and T. Ganz. 1993. Defensins: antimicrobial and cytotoxic peptides of mammalian cells. Annu. Rev. Immunol. 11: 105 128.
163. Levine, S.,, H. M. Zimmerman,, and A. Scorza. 1957. Experimental cryptococcosis (torulosis). Am. J. Pathol. 33: 385 409.
164. Levitz, S. M. 1992. Overview of host defenses in fungal infections. Clin. Infect. Dis. 14( Suppl. 1): S37BS42.
165. Levitz, S. M.,, and T. P. Farrell. 1990. Growth inhibition of Cryptococcus neoformans by cultured human monocytes: role of the capsule, opsonins, the culture surface and cytokines. Infect. Immun. 58: 1201 1209.
166. Levitz, S.M.,, A. Tabumi,, H. Komfeld,, C. C. Reardon,, and D. T. Golenbock. 1994. Production of tumornecrosis factor alpha in human leukocytes stimulated by Cryptococcus neoformans. Infect. Immun. 62: 1975 1981.
167. Levitz, S. M.,, A. Tabuni,, and C. Treseler. 1993. Effect of mannose-binding protein on binding of Cryptococcus neoformans to human phagocytes. Infect. Immun. 61: 4891 4893.
168. Ley, A.,, R. Jacas,, and C. Oliveras. 1951. Torula granuloma of the cervical spinal cord. J. Neurosurg. 8: 327 335.
169. Lim, T. S.,, J. W. Murphy,, and L. K. Cauley. 1980. Host-etiological agent interactions in intranasally and intraperitoneally induced cryptococcosis in mice. Infect. Immun. 29: 633 641.
170. Linell, F.,, B. Magnusson,, and A. Norden. 1953. Cryptococcosis. Review and report of a case. Acta Dermatol. Venereol. 33: 103 122.
171. Lipscomb, M. F. 1989. Lung defenses against opportunistic infections. Chest 96: 1393 1399.
172. Lipscomb, M. F.,, G. B. Huffnagle,, J. A. Lovchik,, C. R. Lyons,, A. M. Pollard,, and J. L. Yates. 1993. The role of T lymphocytes in pulmonary microbial defense mechanisms. Arch. Pathol. Lab. Med. 117: 1225 1232.
172a. Liu, C. T. 1953. Intracerebral cryptococdc granuloma. J. Neurosurg. 10: 686 689.
173. Louie, A.,, A. L. Baltch,, M. A. Franke,, R. P. Smith,, and M. A. Gordon. 1994. Comparative efficacy of four antifungal agents to stimulate murine macrophages to produce tumour necrosis factor alpha: an effect that is attenuated by pentoxifylline, liposomal vesicles, and dexamethasone. J. Antimicrob. Chemother. 34: 975 987.
174. Lovchik, J.A.,, and M. F. Lipscomb. 1993. Role for C5 and neutrophils in the pulmonary intravascular clearance of circulating Cryptococcus neoformans. Am. J. Respir. Cell. Mol. Biol. 9: 617 627.
175. Lovchik, J.A.,, C. R. Lyons,, and M. F. Lipscomb. 1995. A role for gamma interferon-induced nitric oxide in pulmonary clearance of Cryptococcus neoformans. Am.J. Respir. Cell. Mol. Biol. 13: 116 124.
176. Love, G.L.,, G. D. Boyd,, and D. L. Green 1985. Large Cryptococcusneoformans isolated from brain abscess. J. Clin.Microbiol. 22: 1068 1070.
177. Lurie, H. L.,, and H. J. Shadomy. 1971. Morphological variations of a hypha-forrning strain of Cryptococcus neoformans (Coward strain) in tissues of mice. Sabouraudia 9: 10 14.
178. Macher, A., M. J. E. Bennett,, J. E. Gadek,, and M. M. Frank. 1978. Complement depletion in cryptococcal sepsis. J. Immunol. 120: 1686 1690.
179. Manfredi, R.,, A. Mazzoni,, A. Nanetti,, A. Mastroianni,, O. Coronado,, and F. Chiodo. 1996. Morphologic features and clinical significance of skin involvement in patients with AIDS-related cryptococcosis. Acta Dermatol. Venereol. 76: 72 76.
180. Manrique, P.,, J. Mayo,, J. A. Alvarez,, X. Ganchegui,, I. Zabalza,, and M. Flores. 1992. Polymorphous cutaneous cryptococcosis: nodular, herpes-like, and molluscum-like lesions in a patient with the acquired immunodeficiency syndrome. J. Am. Acad. Dermatol. 26: 122 124.
181. Marquis, G.,, S. Montplaisir,, M. Pelletier,, S. Mousseau,, and P. Auger. 1985. Genetic resistance to murine cryptococcosis: increased susceptibility in the CBA/N XID mutant strain of mice. Infect. Immun. 47: 282 287.
182. Martinez, A. J.,, M. Sell,, T. Mitrovics,, G. Stoltenburg-Didinger,, J. R. Iglesias-Rozas,, M. A. Giraldo-Velasquez,, G. Gosztonyi,, V. Schneider,, and J. Cervos-Navarro. 1995. The neuropathology and epidemiology of AIDS. A Berlin experience. A review of 200 cases. Pathol. Res. Pract. 191: 427 443.
183. Masih, D. T.,, C. E. Sotomayor,, L. A. Cervi,, C. M. Riera,, and H. R. Rubinstein. 1991. Inhibition of I-A expression in rat peritoneal macrophages due to T-suppressor cells induced by Cryptococcus neoformans. J. Med. Vet. Mycol. 29: 125 128.
184. Masih, D. T.,, C. E. Sotomayor,, H. R. Rubinstein,, and C. M. Riera. 1991. Immunosuppression in experimental cryptococcosis in rats. Induction of efferent T suppressor cells to a non-related antigen. Mycopathologia 114: 179 186.
185. Mazzola, R.,, R. Barluzzi,, A. Brozzetti,, J. R. Boelaert,, T. Luna,, S. Saleppico,, F. Bistoni,, and E. Blasi. 1997. Enhanced resistance to Cryptococcus neoformans infection induced by chloroquine in a murine model of meningoencephalitis. Antimicrob. Agents Chemother. 41: 802 807.
186. McDonnell, J. M.,, and G. M. Hutchins. 1985. Pulmonary cryptococcosis. Hum. Pathol. 16: 121 128.
187. Megson, G. M.,, D. A. Stevens,, J. R. Hamilton,, and D. W. Denning. 1996. D-Mannitol in cerebrospinal fluid of patients with AIDS and cryptococcal meningitis. J. Clin. Microbiol. 34: 218 221.
187a. Meighan, J. W. 1972. Pulmonary cryptococcosis mimicking carcinoma of the lung. Radiology 103: 61 62.
188. Meyohas, M.-G.,, P. Roux,, D. Bollens,, C. Chouaid,, W. Rozenbaum,, J.-L. Meynard,, J.-L. Poirot,, J. Frottier,, and C. Mayaud. 1995. Pulmonary cryptococcosis: localized and disseminated infections in 27 patients with AIDS. Clin. Infect. Dis. 21: 628 633.
189. Miller, G. P. G. 1986. The immunology of cryptococcal disease. Semin. Respir. Infect. 1: 45 52.
190. Miyaji, M.,, and K. Nishimura. 1981. Studies on organ specificity in experimental murine cryptococcosis. Mycopathologia 76: 145 154.
191. Mody, C. H.,, G.-H. Chen,, C. Jackson,, J. L. Curtis,, and G. B. Toews. 1993. Depletion of murine CD8+ T-cells in vivo decreases pulmonary clearance of a moderately virulent strain of Cryptococcus neoformans. J. Lab. Clin. Med. 121: 765 773.
192. Mody, C. H.,, and R. M. Syme. 1993. Effect of polysaccharide capsule and methods of preparation on human lymphocyte proliferation in response to Cryptococcus neoformans. Infect. Immun. 61: 464 469.
193. Mook, W. H.,, and M. Moore. 1936. Cutaneous torulosis. Arch. Dermatol. Syph. 33: 951 962.
194. Morgan, M. A.,, R. A. Blackstock,, G. S. Bulmer,, and N. K. Hall. 1983. Modification of macrophage phagocytosis in murine cryptococcosis. Infect. Immun. 40: 493 500.
195. Moser, S. A.,, F. L. Lyon,, J. E. Domer,, and J. E. Williams. 1982. Immunization of mice by intracutaneous inoculation with viable virulent Cryptococcus neoformans: immunological and histopathological parameters. Infect. Immun. 35: 685 696.
196. Mosley, R. L.,, J. W. Murphy,, and R. A. Cox. 1986. Immunoadsorption of Cryptococcus-specific suppressor T-cell factors. Infect. Immun. 51: 844 850.
197. Mukherjee, J.,, M. Feldmesser,, M. D. Scharff,, and A. Casadevall. 1995. Monoclonal antibodies to Cryptococcus neoformans glucuronoxylomannan enhance fluconazole activity. Antimicrob. Agents Chemother. 39: 1398 1405.
198. Mukherjee, J.,, L. Pirofski,, M. D. Scharff,, and A. Casadevall. 1993. Antibody mediated protection in mice with lethal intracerebral Cryptococcus neoformans infection. Proc. Natl. Acad. Sci. USA 90: 3636 3640.
199. Mukherjee, J.,, L. Zuckier,, M. D. Scharff,, and A. Casadevall. 1994. Therapeutic efficacy of monoclonal antibodies to Cryptococcus neoformans glucuronoxylomannan alone and in combination with amphotericin B. Antimicrob. Agents Chemother. 38: 580 587.
200. Mukherjee, S.,, S. Lee,, J. Mukherjee,, M. D. Scharff,, and A. Casadevall. 1994. Monoclonal antibodies to Cryptococcus neoformans capsular polysaccharide modify the course of intravenous infection in mice. Infect. Immun. 62: 1079 1088.
201. Mulanovich, V. E.,, W. E. Dismukes,, and N. Markowitz. 1995. Cryptococcal empyema: case report and review. Clin. Infect. Dis. 20: 1396 1398.
202. Muller, W.,, W. Schorre,, R. Suchenwirth,, H. M. Zitz,, and G. Konorza. 1978. A case of fatal cryptococcus meningitis with intracerebral granuloma. Acta Neurochirur. 44: 223 235.
203. Murakawa, G. J.,, R. Kerschmann,, and T. Berger. 1996. Cutaneous Cryptococcus infection and AIDS. Arch. Dermatol. 132: 545 548.
204. Murphy, J. W. 1985. Effects of first-order Cryptococcus-specific T-suppressor cells on induction of cells responsible for delayed-type hypersensitivity. Infect. Immun. 48: 439 445.
205. Murphy, J. W. 1988. Influence of cryptococcal antigens on cell-mediated immunity. Rev. Infect. Dis. 10( Suppl. 2): S432BS435.
206. Murphy, J. W. 1989. Clearance of Cryptococcus neoformans from immunologically suppressed mice. Infect. Immun. 57: 1946 1952.
207. Murphy, J. W. 1992. Cryptococcal immunity and immunostimulation. Adv. Exp. Med. Biol. 319: 225 230.
208. Murphy, J. W.,, and R. A. Cox. 1988. Induction of antigen-specific suppression by circulating Cryptococcus neoformans antigen Clin. Exp. Immunol 73: 174 180.
209. Murphy, J. W.,, and G. C. Cozad. 1972. Immunological unresponsiveness induced by cryptococcal polysaccharide assayed by the hemolytic plaque technique. Infect. Immun. 5: 896 901.
210. Murphy, J. W.,, and J. W. Moorhead. 1982. Regulation of cell-mediated immunity in cryptococcosis. I. Induction of specific afferent T suppressor cells by cryptococcal antigen. J. Immunol. 126: 276 283.
211. Murphy, J. W.,, and R. L. Mosley. 1985. Regulation of cell-mediated immunity in cryptococcosis. III. Characterization of second-order T suppressor cells (Ts2). J. Immunol. 134: 577 583.
212. Murphy, J. W.,, R. L. Mosley,, and J. W. Moorhead. 1983. Regulation of cell- immunity in cryptococcosis. II. Characterization of first-order T suppressor cells (Tsl) and induction of second-order suppressor cells. J. Immunol. 30: 2876 2880.
213. Narisawa, Y.,, T. Kojima,, A. Iriki,, J. Masaki,, and H. Kohda. 1986. Tissue changes in cryptococcosis: histologic alteration from gelatinous to suppurative granulomatous tissue response with asteroid body. Mycopathologia 126: 65 73.
214. Naslund, R K.,, W. C. Miller,, and D. L. Granger. 1995. Cryptococcus neoformans fails to induce nitric oxide synthase in primed murine macrophage-like cells. Infect. Immun. 63: 1298 1304.
215. Nathan, C. 1992. Nitric oxide as a secretary product of mammalian cells. FASEB J. 6: 3051 3064.
216. Nathan, C. E.,, and J. B. Hibbs, Jr. 1991. Role of nitric oxide synthesis in macrophage antimicrobial activity. Curr. Opin. Immunol. 3: 65 70.
217. Neilson, J. B.,, R. A. Fromtling,, and G. S. Bulmer. 1981. Pseudohyphal forms of Cryptococcus neoformans: decreased survival in vivo. Mycopathologia 73: 57 59.
218. Nishimura, K.,, and M. Miyaji. 1979. Histopathological studies on experimental cryptococcosis in nude mice. Mycopathologia 68: 145 153.
219. Noble, R. C.,, and L. F. Fajardo. 1971. Primary cutaneous cryptococcosis: review and morphologic study. Am. J. Clin. Pathol 57: 13 22.
220. Ostrosky-Zeichner, L.,, J. L. Soto-Hernandez,, A. Angeles-Morales,, F. Teixeira,, C. Nava-Ruiz,, C. Rios,, F. Solis,, and J. Sotelo. 1996. Effects of pentoxifylline or dexamethasone in combination with amphotericin B in experimental murine cerebral cryptococcosis: evidence of neuroexcitatory pathogenic mechanisms. Antimicrob. Agents Chemother. 40: 1194 1197.
221. Pema, K.,, J. Diaz,, L. G. Guerra,, D. Nabhan,, and A. Verghese. 1994. Disseminated cutaneous cryptococcosis. Comparison of clinical manifestations in the pre-AIDS and AIDS eras. Arch. Intern. Med. 154: 1032 1034.
222. Perfect, J. R.,, and D. T. Durack. 1985. Chemotactic activity of cerebrospinal fluid in experimental cryptococcal meningitis. Sabouraudia 23: 37 45.
223. Perfect, J. R.,, D. T. Durack,, and H. A. Gallis. 1983. Cryptococcemia. Medicine 62: 98 109.
224. Perfect, J. R.,, D. L. Granger,, and D. T. Durack. 1987. Effects of antifungal agents and gamma-interferon on macrophage cytotoxicity for fungi and tumor cells. J. Infect. Dis. 156: 316 323.
225. Perfect, J. R.,, S. D. R. Lang,, and D. T. Durack. 1980. Chronic cryptococcal meningitis. Am. J. Pathol. 101: 177 193.
226. Pettoello-Mantovani, M.,, A. Casadevall,, and H. Goldstein. 1992. The presence of cryptococcal capsular polysaccharide increases the sensitivity of HIV-1 coculture in children. In Proc. Pediatric AIDS: Clinical, Pathologic and Basic Science Perspectives, Washington, D.C. (Abstract.)
227. Pettoello-Mantovani, M.,, A. Casadevall,, and H. Goldstein. 1993. The presence of cryptococcal capsular polysaccharide increases the sensitivity of HIV-1 coculture in children. Ann. NY. Acad. Sci. 693: 281 283.
228. Pettoello-Mantovani, M.,, A. Casadevall,, T. R. Kollman,, A. Rubinstein,, and H. Goldstein. 1992. Enhancement of HIV-1 infection by the capsular polysaccharide of Cryptococcus neoformans. Lancet 339: 21 23.
229. Pettoello-Mantovani, M.,, A. Casadevall,, P. Smarnworawong,, and H. Goldstein. 1994. HIV-1 infectivity is increased in vitro by the presence of the capsular polysaccharide of Cryptococcus neoformans and Haemophilus influenzae. AIDS Res. Hum. Retroviruses 10: 1079 1087.
230. Picon, L.,, L. Vaillant,, T. Duong,, G. Lorette,, Y. Bacq,, J. M. Besnier,, and P. Choutet. 1989. Cutaneous cryptococcosis resembling molluscum contagiosum: a first manifestation of AIDS. Acta Dermatol. Venereol. 69: 365 367.
231. Porter, K. G.,, D. G. Sinnamon,, and R. R. Gillies. 1977. Cryptococcus neoformans-specific oligoclonal immunoglobulins in the cerebrospinal fluid in cryptococcal meningitis. Lancet i: 1262.
232. Procknow, J. J.,, J. R. Benfield,, J. W. Rippon,, C. F. Diener,, and F. L. Archer. 1965. Cryptococcal hepatitis presenting as a surgical emergency. First isolation of Cryptococcus neoformans from point source in Chicago. JAMA 191: 93 98.
233. Radhakrishnan, V. V.,, A. Mathai,, J. Shanmugham,, and G. J. Mathews. 1982. The role of hyaluronidase in experimental cryptococcal infections. Surg. Neurol. 17: 239 244.
234. Randall, R. E.,, W. K. Stacy,, E. C. Toone,, G. R. Prout,, G. E. Madge,, H. J. Shadomy,, S. Shadomy,, and J. P. Utz. 1968. Cryptococcal pyelonephritis. N. Engl. J. Med. 27: 60 65.
235. Rappaport, B. Z.,, and B. Kaplan. 1926. Generalized torula mycosis. Arch. Pathol. 1: 720 741.
236. Retini, C.,, A. Vecchiarelli,, C. Monari,, C. Tascini,, F. Bistoni,, and T. R. Kozel. 1996. Capsular polysaccharide of Cryptococcus neoformans induces proinflammatory cytokine release by human neutrophils. Infect. Immun. 64: 2897 2903.
237. Rhodes, J. C. 1985. Contribution of complement component C5 to the pathogenesis of experimental murine cryptococcosis. J. Med. Vet. Mycol. 23: 225 234.
238. Rhodes, J. C.,, L. S. Wicker,, and W. Urba. 1980. Genetic control of susceptibility to Cryptococcus neoformans in mice. Infect. Immun. 29: 494 499.
239. Robinson, B. E.,, N. K. Hall,, G. S. Bulmer,, and R. Blackstock. 1982. Suppression of responses to cryptococcal antigen in murine cryptococcosis. Mycopathologia 80: 157 163.
240. Rubinstein, H. R.,, C. E. Sotomayor,, L. A. Cervi,, C. M. Riera,, and D. T. Masih. 1993. Modulation of I-A and I-E expression in macrophages by T-suppressor cells induced in Cryptococcus neoformans infected rats. Mycopathologia 123: 141 148.
241. Sakaguchi, N.,, T. Baba,, M. Fukuzawa,, and S. Ohno. 1993. Ultrastructural study of Cryptococcus neoformans by quick-freezing and deep-etching method. Mycopathologia 121: 133 141.
242. Salkowski, C.A.,, and E. Balish. 1991. Cutaneous cryptococcosis in athymic and beige-athymic mice. Infect. Immun. 59: 1785 1789.
244. Salyer, W. R.,, and D. C. Salyer. 1974. Pleural involvement in cryptococcosis. Chest 66: 139 140.
245. Salyer, W. R.,, D. C. Salyer,, and R. D. Baker. 1974. Primary complex of Cryptococcus and pulmonary lymph nodes. J. Infect Dis. 130: 74 77.
246. Sarosi, G. A.,, P. M. Silberfarb,, and F. E. Tosh. 1971. Cutaneous cryptococcosis: a sentinel of disseminated disease. Arch. Dermatol. 104: 1 3.
247. Schimpff, S. C.,, and J. E. Bennett. 1975. Abnormalities in cell-mediated immunity in patients with Cryptococcus neoformans infection. J. Allergy Clin. Immunol. 55: 430 441.
248. Schneerson-Porat, S.,, A. Sharar,, and M. Aronson. 1965. Formation of histiocyte rings in response to Cryptococcus neoformans infection. RES J. Reticuloendothel. Soc. 2: 249 255.
249. Schupbach, C. W.,, C. E. Wheeler,, R. A. Briggaman,, N. A. Warner,, and E. P. Kanof. 1976. Cutaneous manifestations of disseminated cryptococcosis. Arch. Dermatol. 112: 1734 1740.
250. Schwartz, D. A. 1988. Characterization of the biological activity of Cryptococcus infections in surgical pathology. The budding index and the carminophilic index. Ann. Clin. Lab. Sci. 18: 388 397.
251. Selby, R. C.,, and N. M. Lopes. 1973. Torulomas (cryptococcal granulomata) of the central nervous system. J. Neurosurg. 38: 40 46.
252. Sethi, K. K.,, K. Salfelder,, and J. Schwarz. 1965. Experimental cutaneous primary infection with Cryptococcus neoformans (Sanfelice) Vuillemin. Mycopathol. Mycol. Appl. 27: 357 368.
253. Shadomy, H. J.,, and H. I. Lurie. 1971. Histopathological observations in experimental cryptococcosis caused by hypha-producing strain of Cryptococcus neoformans in mice. Sabouraudia 9: 6 9.
254. Shahar, A.,, Y. Kletter,, and M. Aronson. 1969. Granuloma formation in cryptococcosis. Isr. J. Med. Sci. 5: 1164 1172.
255. Sokolowski, J. W.,, R. F. Schillaci,, and T. E. Motley. 1969. Disseminated cryptococcosis complicating sarcoidosis. Am. Rev. Respir. Dis. 100: 717 722.
256. Song, M. M. 1971. Experimental cryptococcosis of the skin. Sabouraudia 12: 133 137.
257. Sotomayor, C.E.,, H. R. Rubinstein,, L. Cervi,, C. M. Riera,, and D. T. Masih. 1989. Immunosuppression in experimental cryptococcosis in rats. Induction of thymic suppressor cells. Mycopathologia 108: 5 10.
258. Sotomayor, C.E.,, H. R. Rubinstein,, L. Cervi,, C. M. Riera,, and D. T. Masih. 1987. Immunosuppression in experimental cryptococcosis in rats. Induction of afferent T suppressor cells to a non-related antigen. J. Med. Vet. Mycol. 25: 67 75.
259. Sotomayor, C.E.,, H. R. Rubinstein,, L. Cervi,, C. M. Riera,, and D. T. Masih. 1995. Immunosuppression in experimental cryptococcosis: variation of splenic and thymic populations and expression of class II major histocompatibility complex gene products. Clin. Immunol. Immunopathol. 77: 19 26.
260. Speed, B.,, and D. Dunt. 1995. Clinical and host differences between infections with the two varieties of Cryptococcus neoformans. Clin. Infect. Dis. 21: 28 34.
261. Speed, B. R.,, J. Kaldor,, B. Cairns,, and M. Pegorer. 1995. Serum antibody response to active infection with Cryptococcus neoformans and its varieties in immunocompetent hosts. J. Med. Vet Mycol. 34: 187 193.
262. Stevens, D. A.,, J. E. Domer,, R. B. Ashman,, R. Blackstock,, and E. Brummer. 1994. Immunomodulation in the mycoses. J. Med. Vet. Mycol. 32( Suppl. l): 253 265.
263. Sundstrom, J. B.,, and R. Cherniak. 1992. A glucuronoxylomannan of Cryptococcus neoformans serotype A is a type 2 T-cell-independent antigen. Infect Immun. 60: 4080 4087.
264. Sundstrom, J. B.,, and R. Cherniak. 1993. T-cell dependent and T-cell-independent mechanisms of tolerance to glucuronoxylomannan of Cryptococcus neoformans serotype A. Infect Immun. 61: 1340 1345.
265. Swanson, H.,, and W. A. Smith. 1944. Torular granulomas simulating cerebral tumor. Report of two cases. Arch. Neurol. Psychiatr. 51: 426 431.
266. Tang, T.,, R S. Frenette,, R. O. Hynes,, D. D. Wagner,, and T. N. Mayadas. 1996. Cytokine-induced meningitis is dramatically attenuated in mice deficient in enothelial selectins. J. Clin. Invest. 97: 2485 2490.
267. Taylor, E. R. 1970. Pulmonary cryptococcosis. Analysis of 15 cases from the Columbia area. Ann. Thorac. Surg. 10: 309 316.
268. Terplan, K. 1948. Pathogenesis of cryptococcic (Torula) meningitis. Am. J. Pathol. 24: 711 712.
269. Tohyama, M.,, K. Kawakami,, and A. Saito. 1996. Anticryptococcal effect of amphotericin B is mediated through macrophage production of nitric oxide. Antimicrob. Agents Chemother. 40: 1919 1923.
270. Torre, D.,, R. Martegani,, F. Speranza,, C. Zeroli,, and G. P. Fiori. 1995. Pulmonary cryptococcosis presenting as pneumothorax in a patient with AIDS. Clin. Infect. Dis. 21: 1524 1525.
271. Truelsen, K.,, T. Young,, and T. R. Kozel. 1992. In vivo complement activation and binding of C3 to encapsulated Cryptococcus neoformans. Infect. Immun. 60: 3937 3939.
272. Turner, S.H.,, and R. Chemiak,. 1990. Multiplicity in the structure of the glucuronoxylomannan of Cryptococcus neoformans, p. 123 142. In J. P. Latge, and D. Boucias (ed.), Fungal Cell Wall and Immune Response. Springer-Verlag, Berlin.
273. Twonley-Price, J.,, and G. S. Bulmer. 1972. Tumor induction by Cryptococcus neoformans. Infect. Immun. 6: 199 205.
274. Vanbreuseghem, R. 1967. White mice sensitivity to Cryptococcus neoformans. Production of resistance against a cerebral infection. Ann. Soc. Belg. Med. Trop. 47: 281 294.
275. Van Cutsem, J.,, J. Fransen,, F. Van Gerven,, and P. A. J. Janssen. 1986. Experimental cryptococcosis: cUssernination of Cryptococcus neoformans and dermatropism in guinea pigs. Mykosen 29: 561 575.
276. Vartivarian, S. E. 1992. Virulence properties and nonimmune pathogenetic mechansims of fungi. Clin. Infect. Dis. 14( Suppl. 1): S30BS36.
277. Vecchiarelli, A.,, C. Monari,, C. Retini,, D. Pietrella,, B. Palazzetti,, L. Pitzurra,, and A. Casadevall. 1997. Cryptococcus neoformans differently regulates B7-1 (CD80) and B7-2 (CD86) expression on human monocytes. Eur. J. Immunol. 28: 114 121.
278. Vecchiarelli, A.,, D. Pietrella,, M. Dottorini, C. Monari,, C. Retini,, and T. Todisco. 1995. Encapsulation of Cryptococcus neoformans regulates fungicidal activity and the antigen presentation process in human alveolar macrophages. Clin. Exp. Immunol. 98: 217 223.
279. Vecchiarelli, A.,, C. Retini,, C. Monari,, C. Tascini,, F. Bistoni,, and T. R. Kozel. 1996. Purified capsular polysaccharide of Cryptococcus neoformans induces interleukin-10 secretion by human monocytes. Infect. Immun. 64: 2846 2849.
280. Vecchiarelli, A.,, C. Retini,, D. Pietrella,, C. Monari,, C. Tascini,, T. Beccari,, and T. R. Kozel. 1995. Downregulation by cryptococcal polysaccharide of tumor necrosis factor alpha and interleukin-1beta secretion from human monocytes. Infect. Immun. 63: 2919 2923.
281. Wang, Y.,, P. Aisen,, and A. Casadevall. 1995. Cryptococcus neoformans melanin and virulence: mechanism of action. Infect. Immun. 63: 3131 3136.
282. Wang, Y.,, and A. Casadevall. 1994. Susceptibility of melanized and nonmelanized Cryptococcus neoformans to nitrogen- and oxygen-derived oxidants. Infect. Immun. 64: 3004 3007.
283. Watabe, T.,, M. Miyaji,, and K. Nishimura. 1984. Studies on the relationship between cysts and granulomas in murine cryptococcosis. Mycopathologia 86: 113 120.
284. Weidman, F. D. 1933. Cutaneous torulosis. The identification of yeast cells in general in histologic sections. South. Med. J. 26: 851 863.
285. Wile, U. J. 1935. Cutaneous torulosis. Arch. Dermatol. Syph. 31: 58 66.
286. Wilson, E.,, L. Thorson,, and D. P. Speert. 1991. Enhancement of macrophage superoxide anion production by amphotericin B. Antimicrob. Agents Chemother. 35: 796 800.
287. Wolf, J. E.,, and S. E. Massof. 1990. In vivo activation of macrophage oxidative burst activity by cytokines and amphotericin B. Infect. Immun. 58: 1296 1200.
288. Wong, B.,, J. R. Perfect,, S. Beggs,, and K. A. Wright 1990. Production of the hexitol D-mannitol by Cryptococcus neoformans in vitro and in rabbits with experimental meningitis. Infect. Immun. 58: 1664 1670.
289. Yamaoka, H.,, N. Sakaguchi,, K. Sano,, and M. Ito. 1996. Intravascular granuloma induced by intravenous inoculation of Cryptococcus neoformans. Mycopathologia 133: 149 158.
290. Yao, J. D. C.,, C. F. Arkin,, J. P. Doweiko,, and S. M. Hammer. 1990. Disseminated cryptococcosis diagnosed on peripheral blood smear in a patient with acquired immunodeficiency syndrome. Am. J. Med. 89: 100 102.
291. Yuan, R.,, A. Casadevall,, J. Oh,, and M. D. Scharff. 1997. T cells cooperate with passive antibody to modify Cryptococcus neoformans infection in mice. Proc. Natl. Acad. Sci. USA 94: 2483 2488.

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