cryptococcal capsule and iris
DESCRIPTION
Cryptococcal Capsule and IRIS. Darin L Wiesner. Healthy Response To Cryptococcus. Normal. Adapted from Wiesner and Boulware , Curr Fungal Infect Rep 2011. Healthy Response To Cryptococcus. Normal. Adapted from Wiesner and Boulware , Curr Fungal Infect Rep 2011. - PowerPoint PPT PresentationTRANSCRIPT
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Cryptococcal Capsule and IRIS
Darin L Wiesner
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Healthy Response To Cryptococcus
Normal
Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011
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Healthy Response To Cryptococcus
Normal
Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011
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Healthy Response To Cryptococcus
Normal
Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011
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Theory of CM-IRIS Pathogenesis
Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011
Pathologic
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Hypothesis:
• CM Patients that mount an ineffective ex vivo cytokine response to cryptococcal capsular antigen are at increased risk for death or IRIS.
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45%
20%
35%
Patient Characteristics
CM Only
CM-IRIS
Death
Ineffective Response
Normal Response
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45%
20%
35%
Patient Characteristics
CM Only
CM-IRIS
Death
Ineffective Response
Normal Response
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Cytokine Response to Capsular Antigen
Equivalent
Significantly Elevated
Cytokine Response Relativeto Negative Control:
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Multivariate Model of IRIS/Death Risk
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Theory of CM-IRIS Pathogenesis
Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011
Pathologic
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Acknowledgements• Mentorship:
– David Boulware, U of MN– Paul Bohjanen, U of MN– Kirsten Nielsen, U of MN
• Reagents and/or Discussion:– Stu Levitz, U of MA– Nielsen Lab, U of MN– Mellissa Rolfes, U of MN
• Clinic:– David Meya, IDI - Kampala– Andrew Kumbugu, IDI – Kampala
• Laboratory:– Henry Kajambula, Makerere U– Andrew Akampurira, Makerere U– Beatrice Achan, Makerere U