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      Cryptococcus neoformans infections: aspartyl protease potential to improve outcome in susceptible hosts

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          ABSTRACT

          Though a confined or a broad population is exposed respectively to endemic or pandemic infections, in the same environment, some individuals resist the development of infections. The attributed reason is the inheritance of a set of immune system genes that can efficiently deal with the pathogens. In this study, we show how outbred mice differentially respond to Cryptococcus neoformans, a fungal pathogen, and the mechanism through which the surviving mice mount a protective immune defense. We identified that those mice developing antibodies specifically against Pep1p, an aspartic protease secreted by C. neoformans, had significantly improved survival. Vaccination (either prophylactic or therapeutic) with a recombinant Pep1p significantly increased the survival of the mice by decreasing the fungal load and stimulating a protective immune response. Passive immunization of C. neoformans-infected mice with monoclonal antibodies developed against Pep1p also improves the survival of the mice by increasing phagocytosis of C. neoformans and decreasing the multiplication of this fungus. Together, these data demonstrate the prophylactic and therapeutic potentials of the C. neoformans antigenic protein Pep1p or Pep1p-specific antibodies against this fungal infection. Also, this study suggests that the immunological interaction and thereby the responses developed against a pathogen guide the hosts to behave differentially against microbial pathogenicity.

          IMPORTANCE

          Vaccination and immunotherapies against fungal pathogens still remain a challenge. Here, we show using an in vivo model based on outbred mice that development of antibodies against Pep1p, an antigenic protein of the fungal pathogen Cryptococcus neoformans, confers resistance to this fungal infection. In support of this observation, prophylactic or therapeutic immunization of the mice with recombinant Pep1p could improve their survival when infected with a lethal dose of C. neoformans. Moreover, passive therapy with monoclonal anti-Pep1p antibodies also enhanced survival of the mice from C. neoformans infection. The associated antifungal mechanisms were mounting of a protective immune response and the development of fungal specific antibodies that decrease the fungal burden due to an increase in their phagocytosis and/or inhibit the fungal multiplication. Together, our study demonstrates (a) the mode of host–fungal interaction and the immune response developed thereby play a crucial role in developing resistance against C. neoformans; (b) Pep1p, an aspartic protease as well as an antigenic protein secreted by C. neoformans, can be exploited for vaccination (both prophylactic and therapeutic) or immunotherapy to improve the host defense during this fungal infection.

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          Most cited references57

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          Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america.

          Cryptococcosis is a global invasive mycosis associated with significant morbidity and mortality. These guidelines for its management have been built on the previous Infectious Diseases Society of America guidelines from 2000 and include new sections. There is a discussion of the management of cryptococcal meningoencephalitis in 3 risk groups: (1) human immunodeficiency virus (HIV)-infected individuals, (2) organ transplant recipients, and (3) non-HIV-infected and nontransplant hosts. There are specific recommendations for other unique risk populations, such as children, pregnant women, persons in resource-limited environments, and those with Cryptococcus gattii infection. Recommendations for management also include other sites of infection, including strategies for pulmonary cryptococcosis. Emphasis has been placed on potential complications in management of cryptococcal infection, including increased intracranial pressure, immune reconstitution inflammatory syndrome (IRIS), drug resistance, and cryptococcomas. Three key management principles have been articulated: (1) induction therapy for meningoencephalitis using fungicidal regimens, such as a polyene and flucytosine, followed by suppressive regimens using fluconazole; (2) importance of early recognition and treatment of increased intracranial pressure and/or IRIS; and (3) the use of lipid formulations of amphotericin B regimens in patients with renal impairment. Cryptococcosis remains a challenging management issue, with little new drug development or recent definitive studies. However, if the diagnosis is made early, if clinicians adhere to the basic principles of these guidelines, and if the underlying disease is controlled, then cryptococcosis can be managed successfully in the vast majority of patients.
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            Cryptococcosis.

            Cryptococcosis is an invasive mycosis caused by pathogenic encapsulated yeasts in the genus Cryptococcus. Cryptococcus gained prominence as a pathogen capable of widespread disease outbreaks in vulnerable populations. We have gained insight into the pathobiology of Cryptococcus, including the yeast' s capacity to adapt to environmental pressures, exploit new geographic environments, and cause disease in both immunocompromised and apparently immunocompetent hosts. Inexpensive, point-of-care testing makes diagnosis more feasible than ever. The associated worldwide burden and mortality remains unacceptably high. Novel screening strategies and preemptive therapy offer promise at making a sustained and much needed impact on this sugar-coated opportunistic mycosis.
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              Passive antibody therapy for infectious diseases.

              Antibody-based therapies are currently undergoing a renaissance. After being developed and then largely abandoned in the twentieth century, many antibody preparations are now in clinical use. However, most of the reagents that are available target non-infectious diseases. Interest in using antibodies to treat infectious diseases is now being fuelled by the wide dissemination of drug-resistant microorganisms, the emergence of new microorganisms, the relative inefficacy of antimicrobial drugs in immunocompromised hosts and the fact that antibody-based therapies are the only means to provide immediate immunity against biological weapons. Given the need for new antimicrobial therapies and many recent technological advances in the field of immunoglobulin research, there is considerable optimism regarding renewed applications of antibody-based therapy for the prevention and treatment of infectious diseases.
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                Author and article information

                Contributors
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – review and editing
                Role: InvestigationRole: Methodology
                Role: InvestigationRole: MethodologyRole: Writing – review and editing
                Role: InvestigationRole: MethodologyRole: Writing – review and editing
                Role: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – original draftRole: Writing – review and editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review and editing
                Role: Editor
                Journal
                mBio
                mBio
                mbio
                mBio
                American Society for Microbiology (1752 N St., N.W., Washington, DC )
                2150-7511
                November 2024
                23 October 2024
                23 October 2024
                : 15
                : 11
                : e02733-24
                Affiliations
                [1 ]Institut Pasteur, Université Paris Cité, CNRS, Molecular Mycology Unit, UMR 2000; , Paris, France
                [2 ]Institut Pasteur, Université Paris Cité, CNRS UAR 2024, Mass Spectrometry for Biology Unit, Proteomics platform; , Paris, France
                [3 ]Institut Pasteur, Human Histopathology and Animal Models Unit; , Paris, France
                Texas Christian University; , Fort Worth, Texas, USA
                Author notes
                Address correspondence to Vishukumar Aimanianda, vkumar@ 123456pasteur.fr
                Address correspondence to Françoise Dromer, francoise.dromer@ 123456pasteur.fr

                Present address: Institut Pasteur, Biology and Genetics of the Bacterial Wall Unit, Paris, France, Paris, France

                Present address: Veranex PCS France, Paris, France

                Present address: Institut Pasteur, Université Paris Cité, Fungal Pathogens and RNA Biology Unit, Paris, France

                Present address: Institut Pasteur, Immunobiology of Aspergillus group, Mycology Department, Paris, France

                Present address: Institut Pasteur, Scientific Careers and Evaluation Department, Paris, France

                The authors declare no conflict of interest.

                Author information
                https://orcid.org/0000-0001-5813-7497
                https://orcid.org/0000-0003-1671-1475
                Article
                mbio02733-24 mbio.02733-24
                10.1128/mbio.02733-24
                11559057
                39440979
                2fb2c923-5beb-4e7f-8483-56fd44e914ef
                Copyright © 2024 Vernel-Pauillac et al.

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

                History
                : 04 September 2024
                : 25 September 2024
                Page count
                supplementary-material: 0, authors: 6, Figures: 8, Tables: 1, References: 57, Pages: 20, Words: 11362
                Funding
                Funded by: Institut Pasteur;
                Award ID: recurrent funding,Technology Transfer and Industrial Partnership Department
                Award Recipient :
                Funded by: Labex IBEID;
                Award ID: IBEID
                Award Recipient :
                Funded by: Merieux Foundation;
                Award ID: Merieux Research grant
                Award Recipient :
                Categories
                Research Article
                host-microbial-interactions, Host-Microbial Interactions
                Custom metadata
                November 2024

                Life sciences
                cryptococcus neoformans,aspartic protease pep1p,vaccination,prophylaxis,passive therapy,monoclonal antibodies

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