Mody C H, Toews G B, Lipscomb M F
Department of Internal Medicine, University of Texas Health Science Center, Dallas 75235.
Infect Immun. 1988 Jan;56(1):7-12. doi: 10.1128/iai.56.1.7-12.1988.
Cryptococcus neoformans is a frequent opportunistic infectious agent in patients with decreased T-lymphocyte-mediated immune function, including those with acquired immune deficiency syndrome. Cyclosporin A (CsA), a potent inhibitor of T-lymphocyte function, was administered subcutaneously to mice to study the pathogenesis of C. neoformans infections in the setting of impaired T-cell function. Surprisingly, survival was prolonged indefinitely in animals that received immunosuppressive doses of CsA following either intratracheal or intravenous inoculations of C. neoformans. Furthermore, following intratracheal inoculation, mice treated with CsA cleared C. neoformans from their lungs more rapidly than did control mice. CsA directly inhibited the growth of C. neoformans when it was added to cultures in vitro at concentrations comparable to the blood levels achieved in experimental mice. Thus, CsA inhibited both in vitro and in vivo growth of C. neoformans. While these results must be extended to studies in humans, these data suggest that patients who now receive CsA-immunosuppressive therapy may be fortuitously protected against infections with C. neoformans. Furthermore, research into cyclosporin derivatives may yield compounds with less immunosuppressive properties and enhanced antifungal activity.
新型隐球菌是T淋巴细胞介导的免疫功能降低患者(包括获得性免疫缺陷综合征患者)中常见的机会性感染病原体。环孢素A(CsA)是一种强效的T淋巴细胞功能抑制剂,将其皮下注射给小鼠,以研究在T细胞功能受损情况下新型隐球菌感染的发病机制。令人惊讶的是,在经气管内或静脉内接种新型隐球菌后接受免疫抑制剂量CsA的动物中,生存期无限延长。此外,经气管内接种后,用CsA治疗的小鼠比对照小鼠更快地从肺部清除新型隐球菌。当以与实验小鼠中达到的血药浓度相当的浓度添加到体外培养物中时,CsA直接抑制新型隐球菌的生长。因此,CsA在体外和体内均抑制新型隐球菌的生长。虽然这些结果必须扩展到人体研究,但这些数据表明,目前接受CsA免疫抑制治疗的患者可能会幸运地免受新型隐球菌感染。此外,对环孢素衍生物的研究可能会产生免疫抑制特性较低且抗真菌活性增强的化合物。