Are macrophages the heroes or villains during cryptococcosis?

•Macrophages feature heavily during the progression of Cryptococcus infection.•Immunotherapy will need to either enhance or inhibit macrophage function.•Macrophages are critical for cryptococcal control and adaptive immunity.•Macrophages also aid cryptococcal dissemination and fail to clear yeast ce...

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Bibliographic Details
Published in:Fungal genetics and biology 2019-11, Vol.132, p.103261-103261, Article 103261
Main Authors: Rudman, Jacob, Evans, Robert J., Johnston, Simon Andrew
Format: Article
Language:English
Subjects:
Animals
Clinical
Cryptococcosis - immunology
Cryptococcosis - therapy
Cryptococcus
Cryptococcus neoformans - immunology
Cryptococcus neoformans - pathogenicity
Host-Pathogen Interactions - immunology
Humans
Immunity, Innate
Immunocompromised Host
Immunology
Immunotherapy
Macrophage
Macrophages - immunology
Macrophages - microbiology
Mice
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Summary:•Macrophages feature heavily during the progression of Cryptococcus infection.•Immunotherapy will need to either enhance or inhibit macrophage function.•Macrophages are critical for cryptococcal control and adaptive immunity.•Macrophages also aid cryptococcal dissemination and fail to clear yeast cells.•There are major questions still to be answered about cryptococcal infection. Cryptococcus infections represents a major healthcare burden, with over 200,000 cases globally a year and even with treatment, mortality remains as high as 80%. There is a clear need for new classes of treatment, especially with the global threat of antifungal resistance. Several groups are investigating the potential of immunotherapy – circumventing many of the issues with current treatments. Macrophages are a cell type known to be heavily associated with cryptococcal infection, from the innate immune response through to the later stage chronic adaptive response – making these an ideal target for manipulation. However, it is currently debated whether macrophage activity is positive or negative for host outcomes. Here, we discuss the current literature surrounding the role of macrophages during Cryptococcus infection, and makes cases for and against macrophage enhancement. Finally, we discuss which pressing questions in the field still remain that require answers in order to safely design an immunotherapeutic with high efficacy.
ISSN:1087-1845
1096-0937
DOI:10.1016/j.fgb.2019.103261