PMID- 30761136
OWN - NLM
STAT- MEDLINE
DCOM- 20191231
LR  - 20200309
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 10
DP  - 2019
TI  - Resistance and Tolerance to Cryptococcal Infection: An Intricate Balance That 
      Controls the Development of Disease.
PG  - 66
LID - 10.3389/fimmu.2019.00066 [doi]
LID - 66
AB  - Cryptococcus neoformans is a ubiquitous environmental yeast and a leading cause 
      of invasive fungal infection in humans. The most recent estimate of global 
      disease burden includes over 200,000 cases of cryptococcal meningitis each year. 
      Cryptococcus neoformans expresses several virulence factors that may have 
      originally evolved to protect against environmental threats, and human infection 
      may be an unintended consequence of these acquired defenses. Traditionally, C. 
      neoformans has been viewed as a purely opportunistic pathogen that targets 
      severely immune compromised hosts; however, during the past decade the spectrum 
      of susceptible individuals has grown considerably. In addition, the closely 
      related strain Cryptococcus gattii has recently emerged in North America and 
      preferentially targets individuals with intact immunity. In parallel to the 
      changing epidemiology of cryptococcosis, an increasing role for host immunity in 
      the pathogenesis of severe disease has been elucidated. Initially, the HIV/AIDS 
      epidemic revealed the capacity of C. neoformans to cause host damage in the 
      absence of adaptive immunity. Subsequently, the development and clinical 
      implementation of highly active antiretroviral treatment (HAART) led to 
      recognition of an immune reconstitution inflammatory syndrome (IRIS) in a subset 
      of HIV+ individuals, demonstrating the pathological role of host immunity in 
      disease. A post-infectious inflammatory syndrome (PIIRS) characterized by 
      abnormal T cell-macrophage activation has also been documented in HIV-negative 
      individuals following antifungal therapy. These novel clinical conditions 
      illustrate the highly complex host-pathogen relationship that underlies severe 
      cryptococcal disease and the intricate balance between tolerance and resistance 
      that is necessary for effective resolution. In this article, we will review 
      current knowledge of the interactions between cryptococci and mammalian hosts 
      that result in a tolerant phenotype. Future investigations in this area have 
      potential for translation into improved therapies for affected individuals.
FAU - Shourian, Mitra
AU  - Shourian M
AD  - Translational Research in Respiratory Diseases Program, Meakins-Christie 
      Laboratories, Research Institute of the McGill University Health Centre, 
      Montreal, QC, Canada.
AD  - Division of Experimental Medicine, Department of Medicine, McGill University 
      Health Centre, Montreal, QC, Canada.
FAU - Qureshi, Salman T
AU  - Qureshi ST
AD  - Translational Research in Respiratory Diseases Program, Meakins-Christie 
      Laboratories, Research Institute of the McGill University Health Centre, 
      Montreal, QC, Canada.
AD  - Division of Experimental Medicine, Department of Medicine, McGill University 
      Health Centre, Montreal, QC, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20190129
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (IL10 protein, human)
RN  - 0 (Virulence Factors)
RN  - 130068-27-8 (Interleukin-10)
SB  - IM
MH  - Adaptation, Physiological
MH  - Animals
MH  - CD4-Positive T-Lymphocytes/immunology
MH  - Cryptococcus gattii/immunology
MH  - Cryptococcus neoformans/*immunology/*pathogenicity
MH  - Dendritic Cells/immunology
MH  - Disease Resistance/*immunology
MH  - Host-Pathogen Interactions
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/microbiology
MH  - Immune Tolerance/*immunology
MH  - Interleukin-10/metabolism
MH  - Meningitis, Cryptococcal/*microbiology
MH  - Mice
MH  - Virulence Factors/metabolism
PMC - PMC6361814
OTO - NOTNLM
OT  - Cryptococcus
OT  - asymptomatic infection
OT  - damage response framework
OT  - disease tolerance
OT  - host-pathogen interaction
OT  - immunoregulation
EDAT- 2019/02/15 06:00
MHDA- 2020/01/01 06:00
PMCR- 2019/01/01
CRDT- 2019/02/15 06:00
PHST- 2018/09/17 00:00 [received]
PHST- 2019/01/11 00:00 [accepted]
PHST- 2019/02/15 06:00 [entrez]
PHST- 2019/02/15 06:00 [pubmed]
PHST- 2020/01/01 06:00 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2019.00066 [doi]
PST - epublish
SO  - Front Immunol. 2019 Jan 29;10:66. doi: 10.3389/fimmu.2019.00066. eCollection 
      2019.