The role of these antibodies in the pathogenesis of human cryptococcosis is unknown. Sera from GXM-TT vaccinees promote phagocytosis of C. neoformans by human mononuclear cells. This phenomenon is mediated by human Fcg RIIa and IgG2 antibodies. Enhancement of effector cell antifungal activity by human GXM antibodies suggests that some antibodies might alter the course of human cryptococcosis. Taken together, these observations indicate that human antibodies might play a role in preventing infection in immunocompetent hosts, and represent useful therapeutic reagents to add to our armamentarium against cryptococcosis in immunocompromised patients.
Recommendations Define the adjuvant properties of fungal agents and their products.
Efforts should be directed toward gaining a more detailed understanding of the cells, cytokines, chemokines and costimulatory molecules involved in protective and non-protective immune responses against each of the fungal pathogens. Establish how genetics of the host and genetics of the organism influence the protective responses. Acquire knowledge of how the host recognizes or responds to various fungal proteins, glycoproteins, polysaccharides and glycolipids. Relate findings from normal host to the compromised host. Define how fungal pathogens evade the immune responses.