Shi Zoe W, Chen Yanli, Ogoke Krystal M, Strickland Ashley B, Shi Meiqing
Division of Immunology, Virginia-Maryland College of Veterinary Medicine and Maryland Pathogen Research Institute, University of Maryland, College Park, MD 20742, USA.
Department of Chemistry and Biochemistry, University of Maryland, College Park, MD 20742, USA.
Microorganisms. 2022 Dec 7;10(12):2419. doi: 10.3390/microorganisms10122419.
is an encapsulated pathogenic fungus that initially infects the lung but can migrate to the central nervous system (CNS), resulting in meningoencephalitis. The organism causes the CNS infection primarily in immunocompromised individuals including HIV/AIDS patients, but also, rarely, in immunocompetent individuals. In HIV/AIDS patients, limited inflammation in the CNS, due to impaired cellular immunity, cannot efficiently clear a infection. Antiretroviral therapy (ART) can rapidly restore cellular immunity in HIV/AIDS patients. Paradoxically, ART induces an exaggerated inflammatory response, termed immune reconstitution inflammatory syndrome (IRIS), in some HIV/AIDS patients co-infected with . A similar excessive inflammation, referred to as post-infectious inflammatory response syndrome (PIIRS), is also frequently seen in previously healthy individuals suffering from cryptococcal meningoencephalitis. Cryptococcal IRIS and PIIRS are life-threatening complications that kill up to one-third of affected people. In this review, we summarize the inflammatory responses in the CNS during HIV-associated cryptococcal meningoencephalitis. We overview the current understanding of cryptococcal IRIS developed in HIV/AIDS patients and cryptococcal PIIRS occurring in HIV-uninfected individuals. We also describe currently available animal models that closely mimic aspects of cryptococcal IRIS observed in HIV/AIDS patients.
是一种有包膜的致病真菌，最初感染肺部，但可迁移至中枢神经系统（CNS），导致脑膜脑炎。该病原体主要在包括艾滋病毒/艾滋病患者在内的免疫功能低下个体中引起中枢神经系统感染，但在免疫功能正常的个体中也很少见。在艾滋病毒/艾滋病患者中，由于细胞免疫受损，中枢神经系统的炎症有限，无法有效清除感染。抗逆转录病毒疗法（ART）可迅速恢复艾滋病毒/艾滋病患者的细胞免疫。矛盾的是，ART在一些合并感染的艾滋病毒/艾滋病患者中会引发过度的炎症反应，称为免疫重建炎症综合征（IRIS）。在患有隐球菌性脑膜脑炎的既往健康个体中也经常出现类似的过度炎症，称为感染后炎症反应综合征（PIIRS）。隐球菌性IRIS和PIIRS是危及生命的并发症，可导致多达三分之一的患者死亡。在本综述中，我们总结了艾滋病毒相关隐球菌性脑膜脑炎期间中枢神经系统的炎症反应。我们概述了目前对艾滋病毒/艾滋病患者中发生的隐球菌性IRIS和未感染艾滋病毒个体中发生的隐球菌性PIIRS的理解。我们还描述了目前可用的动物模型，这些模型密切模拟了在艾滋病毒/艾滋病患者中观察到的隐球菌性IRIS的各个方面。
