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Chapter 4 : Cryptococcosis

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Abstract:

In patients with recognizable disease, the symptoms of pulmonary cryptococcosis may be mild and are typically chronic. It is likely that both reactivation of previous infection and primary progressive infection can cause CNS cryptococcosis in patients with AIDS. Given the frequent lack of inflammatory responses in patients with cryptococcosis and the possibility of enhancing the immune response by adjuvant type therapy, the factors involved in regulating the production of TH1 immunity to infection have received a great deal of study. Natural killer (NK) cells are also important in promoting the development of TH1 cells from naive TH cells during pulmonary cryptococcosis, primarily via the production of IFN- γ. Administration of IL-12 to wild-type mice enhances IFN- production, promotes clearance of , and prevents dissemination to the brain. In this study, pulmonary cryptococcosis was associated with almost no expression of TH1 mRNAs, but some TH2 mRNAs. Production of TNF-α in mice with pulmonary cryptococcosis occurs early during infection and also appears necessary for the development of protective TH1 immunity and macrophage activation. Nevertheless, neutralization of either MCP1 or MIP-1α in mice with pulmonary cryptococcosis results in reduced macrophage and leukocyte recruitment and impaired fungal clearance. Since control of cryptococcosis is associated with strong granulomatous responses, immune therapeutic approaches have focused on measures that stimulate cellular-mediated immunity.

Citation: Goldman D, Casadevall A. 2003. Cryptococcosis, p 85-116. In Boros D (ed), Granulomatous Infections and Inflammations. ASM Press, Washington, DC. doi: 10.1128/9781555817879.ch4
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Figure 1

India ink stain of CSF from rat with experimental meningitis. Note large capsules of organisms.

Citation: Goldman D, Casadevall A. 2003. Cryptococcosis, p 85-116. In Boros D (ed), Granulomatous Infections and Inflammations. ASM Press, Washington, DC. doi: 10.1128/9781555817879.ch4
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Image of Figure 2
Figure 2

(A) Granulomatous inflammation in the meninges of rat with experimental cryptococcal meningitis. Arrows point to iNOS-expressing cells. (B) Rat lung, 1 year after pulmonary infection with (mucin stain). Lung contains small granulomatous foci with organisms. (C) Lung from NOS2 mouse infected with Intense granulomatous inflammation is present. Arrow points to (Photo courtesy of J. Rivera.) (D) Lung from wild-type (parental) mouse infected with A large number of organisms are present and form collections that distend alveoli. Minimal organized inflammation is present. (Photo courtesy of J. Rivera.)

Citation: Goldman D, Casadevall A. 2003. Cryptococcosis, p 85-116. In Boros D (ed), Granulomatous Infections and Inflammations. ASM Press, Washington, DC. doi: 10.1128/9781555817879.ch4
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Tables

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Table 1

Activities of capsular polysaccharides that affect immune response

Citation: Goldman D, Casadevall A. 2003. Cryptococcosis, p 85-116. In Boros D (ed), Granulomatous Infections and Inflammations. ASM Press, Washington, DC. doi: 10.1128/9781555817879.ch4

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