Cryptococcus neoformans is a major fungal pathogen for individuals with impaired immunity, including thosewith advanced HIV infection, organ transplants, and on immunosuppressive regimens. Furthermore, there isincreasing evidence that this fungus can establish latent infection in humans that could have profoundconsequences for the development of other chronic diseases, including possibly asthma. C, neoformans hasseveral well-characterized virulence factors, among which a polysaccharide capsule is considered to be themost important. The capsule is composed of at least three components known as Glucuronoxylomannan(GXM), galactoxylomannan (GalXM) and highly mannosylated proteins known as mannoproteins. Antibodyresponses to the capsular GXM elicit protective and non-protedive antibodies. Given the seriousness ofcryptococcal infections there has been great interest in harnessing humoral immunity for therapy andprevention of disease. A monoclonal antibody (mAb) has completed preliminary clinical studies andcontinues in development. Immunization with GXM conjugated to protein carriers elicits protectiveantibodies. The mechanism of antibody action Is multifactorial and includes opsonization, modulation oftheinflammatory response, and abrogation of GXM release from yeast cells. Remari^ably, protective and non-protective mAbs can be distinguished by their ability to affect GXM release and block biofilm formation invitro. Although much is now known about the mechanism of antibody action in vivo, and in vitro, themolecular nature ofthe GXM epitopes recognized by protective and non-protective mAbs is unknown.Furthermore, the mechanisms of action of antibodies at the level of the yeast cell that abrogatepolysaccharide release are not understood. This application proposes to continue the study ofthe interactionof antibodies with the capsule of C. neofomnans. In contrast to the prior funding cycles when the effort wasfocused on molecular analysis of the antibody molecule, this proposal refocuses the research program onthe polysaccharide antigen and the capsule. In addition to continuing to study antibodies to GXM thisapplication proposes to explore the role of GalXM in capsule structure.
Three specific Aims are proposed: 1)To define the polysaccharide molecular structure(s) that bind protective and non-protective mAbs; 2) Todetermine the mechanism and consequences of antibody-mediated changes in C. neoformans metabolism:3) To determine the protective efficacy of GalXM-congugate vaccines and GatXM-binding antibodies in hostdefense.

Public Health Relevance

The research program is focused on a fungal pathogen known as Cryptococcus neoformans that is a majorproblem for patients with AIDS. Over a million people woridwide suffer life-threatening infections with thisfungus and as many as 600,000 die each year in Africa alone. This fungus has a capsule that allows it tocause disease. Hence, understanding this structure is important for knowing how the fungus protects itselfagainst the immune system. We hope that this information will lead to new immune therapies and vaccines.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Method to Extend Research in Time (MERIT) Award (R37)
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Special Emphasis Panel (NSS)
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Duncan, Rory A
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Albert Einstein College of Medicine
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