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Guess TE, Rosen J, Castro-Lopez N, Wormley FL, McClelland EE. An inherent T cell deficit in healthy males to C. neoformans infection may begin to explain the sex susceptibility in incidence of cryptococcosis. Biol Sex Differ 2019; 10:44. [PMID: 31477151 PMCID: PMC6720413 DOI: 10.1186/s13293-019-0258-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/16/2019] [Indexed: 02/07/2023] Open
Abstract
Background Cryptococcus neoformans, the causative agent of cryptococcosis, causes ~ 181,000 deaths annually, with males having a higher incidence of disease than females (7M:3F). The reason for this sex bias remains unclear. We hypothesized that this disparity was due to biological differences between the male and female immune response. Methods Peripheral blood mononuclear cells (PBMCs) from healthy donors were isolated and infected with C. neoformans ± exogenous testosterone or 17-β-estradiol. C. neoformans, B, T, and NK cell proliferation was quantified by flow cytometry. Cytokine analysis was conducted via protein array or ELISA. Serological testing was conducted to determine previous exposure to C. neoformans. Results C. neoformans proliferated more in male PBMCs. T cell percentages in both sexes were lower in infected versus uninfected cells. Male PBMCs had lower CD3+, CD4+, and CD8+ T cells percentages during infection compared to females. Cytokine profiles showed differences in uninfected male and female PBMCs, which subsided during infection. Only one donor was sero-negative for prior C. neoformans exposure. There was an effect of estrogen in one dataset. Conclusions These results suggest that males show an inherent deficit in T cell response during infection, which may contribute to the increased incidence of disease in males. Electronic supplementary material The online version of this article (10.1186/s13293-019-0258-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tiffany E Guess
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Joseph Rosen
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN, USA
| | - Natalia Castro-Lopez
- Department of Biology, The University of Texas at San Antonio, San Antonio, TX, USA.,South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Floyd L Wormley
- Department of Biology, The University of Texas at San Antonio, San Antonio, TX, USA.,South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Erin E McClelland
- Department of Biology, Middle Tennessee State University, Murfreesboro, TN, USA.
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Li Y, Fang W, Jiang W, Hagen F, Liu J, Zhang L, Hong N, Zhu Y, Xu X, Lei X, Deng D, Xu J, Liao W, Boekhout T, Chen M, Pan W. Cryptococcosis in patients with diabetes mellitus II in mainland China: 1993-2015. Mycoses 2017; 60:706-713. [PMID: 28857298 DOI: 10.1111/myc.12645] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 12/13/2022]
Abstract
Diabetes mellitus II (DM II) is a newly defined independent factor contributing to the morbidity and mortality of cryptococcosis. This retrospective case analysis aims to explore the epidemiology, clinical profile and strain characteristics of cryptococcosis in Chinese DM II patients. This study included 30 cases of cryptococcosis with DM II occurring from 1993 to 2015 in mainland China. The hospital-based prevalence of cryptococcosis in DM II was 0.21%. The mean age of the patients was 56.1 years (95% confidence interval: 51.5, 60.6), and 93% of the patients were older than 40 years. Sixty-two per cent of the patients experienced untreated or poorly controlled blood glucose before infection. Multilocus sequence typing analysis categorised all cultured strains as Cryptococcus neoformans and sequence type 5. Sixty-nine per cent of pulmonary cryptococcosis patients experienced misdiagnoses and treatment delays. Sixty per cent of cryptococcal meningitis patients received substandard antifungal therapy. The overall death rate was 33%. Considering the large population size of DM II patients in China, improved attention should be paid to the high prevalence of cryptococcosis as revealed by us. We also emphasised the importance of blood glucose control for infection prevention, especially among the elderly.
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Affiliation(s)
- Yingfang Li
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Wenjie Fang
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Weiwei Jiang
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Ferry Hagen
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands
| | - Jia Liu
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Lei Zhang
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Nan Hong
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yu Zhu
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xiaoguang Xu
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Xia Lei
- Department of Dermatology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Danqi Deng
- Department of Dermatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jianping Xu
- Department of Biology, McMaster University, Hamilton, ON, Canada
| | - Wanqing Liao
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Teun Boekhout
- Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, the Netherlands.,Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands
| | - Min Chen
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands
| | - Weihua Pan
- Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, China.,Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China
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5
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Cogliati M, D'Amicis R, Zani A, Montagna MT, Caggiano G, De Giglio O, Balbino S, De Donno A, Serio F, Susever S, Ergin C, Velegraki A, Ellabib MS, Nardoni S, Macci C, Oliveri S, Trovato L, Dipineto L, Rickerts V, McCormick-Smith I, Akcaglar S, Tore O, Mlinaric-Missoni E, Bertout S, Mallié M, Martins MDL, Vencà ACF, Vieira ML, Sampaio AC, Pereira C, Criseo G, Romeo O, Ranque S, Al-Yasiri MHY, Kaya M, Cerikcioglu N, Marchese A, Vezzulli L, Ilkit M, Desnos-Ollivier M, Pasquale V, Korem M, Polacheck I, Scopa A, Meyer W, Ferreira-Paim K, Hagen F, Theelen B, Boekhout T, Lockhart SR, Tintelnot K, Tortorano AM, Dromer F, Varma A, Kwon-Chung KJ, Inácio J, Alonso B, Colom MF. Environmental distribution of Cryptococcus neoformans and C. gattii around the Mediterranean basin. FEMS Yeast Res 2016; 16:fow045. [PMID: 27188887 DOI: 10.1093/femsyr/fow045] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2016] [Indexed: 11/15/2022] Open
Abstract
In order to elucidate the distribution of Cryptococcus neoformans and C. gattii in the Mediterranean basin, an extensive environmental survey was carried out during 2012-2015. A total of 302 sites located in 12 countries were sampled, 6436 samples from 3765 trees were collected and 5% of trees were found to be colonized by cryptococcal yeasts. Cryptococcus neoformans was isolated from 177 trees and C. gattii from 13. Cryptococcus neoformans colonized 27% of Ceratonia, 10% of Olea, Platanus and Prunus trees and a lower percentage of other tree genera. The 13 C. gattii isolates were collected from five Eucalyptus, four Ceratonia, two Pinus and two Olea trees. Cryptococcus neoformans was distributed all around the Mediterranean basin, whereas C. gattii was isolated in Greece, Southern Italy and Spain, in agreement with previous findings from both clinical and environmental sources. Among C. neoformans isolates, VNI was the prevalent molecular type but VNII, VNIV and VNIII hybrid strains were also isolated. With the exception of a single VGIV isolate, all C. gattii isolates were VGI. The results confirmed the presence of both Cryptococcus species in the Mediterranean environment, and showed that both carob and olive trees represent an important niche for these yeasts.
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Affiliation(s)
- Massimo Cogliati
- Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy
| | - Roberta D'Amicis
- Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy
| | - Alberto Zani
- Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy
| | - Maria Teresa Montagna
- Dip. Scienze Biomediche ed Oncologia Umana, Università degli Studi di Bari 'Aldo Moro', Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Giuseppina Caggiano
- Dip. Scienze Biomediche ed Oncologia Umana, Università degli Studi di Bari 'Aldo Moro', Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Osvalda De Giglio
- Dip. Scienze Biomediche ed Oncologia Umana, Università degli Studi di Bari 'Aldo Moro', Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Stella Balbino
- Dip. Scienze Biomediche ed Oncologia Umana, Università degli Studi di Bari 'Aldo Moro', Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Antonella De Donno
- Dip. di Scienze e Tecnologie Biologiche ed Ambientali, Università del Salento, Via Monteroni, 73100 Lecce, Italy
| | - Francesca Serio
- Dip. di Scienze e Tecnologie Biologiche ed Ambientali, Università del Salento, Via Monteroni, 73100 Lecce, Italy
| | - Serdar Susever
- Dept. of Nutrition and Dietetics, Cyprus Near East University, Near East Boulevard, 99138 Nicosia, Cyprus
| | - Cagri Ergin
- Medical School, Pamukkale University, Kliniki Kampusu, 20160 Denizli, Turkey
| | - Aristea Velegraki
- Medical School National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece
| | - Mohamed S Ellabib
- Medical College, University of Tripoli, Tripoli University Road, Tripoli, Libya
| | - Simona Nardoni
- Dip. Scienze Veterinarie, Università di Pisa, Via delle Piagge 2, 56124 Pisa, Italy
| | - Cristina Macci
- Istituto per lo Studio degli Ecosistemi (ISE), National Research Council (CNR), Via Moruzzi 1, 56124 Pisa, Italy
| | - Salvatore Oliveri
- Dip. di Scienze Microbiologiche e Scienze Ginecologiche, Università degli Studi di Catania, Via Androne 81, 95124 Catania, Italy
| | - Laura Trovato
- Dip. di Scienze Microbiologiche e Scienze Ginecologiche, Università degli Studi di Catania, Via Androne 81, 95124 Catania, Italy
| | - Ludovico Dipineto
- Dip. di Medicina Veterinaria e Produzioni Animali, University of Napoli Federico II, C.so Umberto I 40, 80138 Napoli, Italy
| | - Volker Rickerts
- Dept. of Infeciuos Diseases, Robert-Koch Institute, D-13302 Berlin, Germany
| | | | - Sevim Akcaglar
- School of Medicine, Uludag University, Gorukle Kampusu, 16059 Bursa, Turkey
| | - Okan Tore
- School of Medicine, Uludag University, Gorukle Kampusu, 16059 Bursa, Turkey
| | | | - Sebastien Bertout
- Unité Mixte Internationale 'Recherches Translationnelles sur l'infection à VIH et les Maladies Infectieuses', Université de Montpellier, 15 Avenue Charles Flahault, 34093 Montpellier, France
| | - Michele Mallié
- Unité Mixte Internationale 'Recherches Translationnelles sur l'infection à VIH et les Maladies Infectieuses', Université de Montpellier, 15 Avenue Charles Flahault, 34093 Montpellier, France
| | - Maria da Luz Martins
- Instituto de Higiene e Medicina Tropical, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Ana C F Vencà
- Instituto de Higiene e Medicina Tropical, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Maria L Vieira
- Instituto de Higiene e Medicina Tropical, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Ana C Sampaio
- CITAB, Universidade de Trás-os-Montes e Alto Douro, Quinta dos Prados, 5000-801 Vila Real, Portugal
| | - Cheila Pereira
- CITAB, Universidade de Trás-os-Montes e Alto Douro, Quinta dos Prados, 5000-801 Vila Real, Portugal
| | - Giuseppe Criseo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Piazza Pugliatti 1, 98122 Messina, Italy
| | - Orazio Romeo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Piazza Pugliatti 1, 98122 Messina, Italy
| | - Stéphane Ranque
- IP-TPT Infections Parasitaires Transmission Pphysiopathologie et Therapeutiques, Aix-Marseille University, 27 Blv. Jean Moulin, 13005 Marseille, France
| | - Mohammed H Y Al-Yasiri
- IP-TPT Infections Parasitaires Transmission Pphysiopathologie et Therapeutiques, Aix-Marseille University, 27 Blv. Jean Moulin, 13005 Marseille, France
| | - Meltem Kaya
- School of Medicine, Marmara University, MÜ Göztepe Kampüsü, 34722 Istanbul, Turkey
| | - Nilgun Cerikcioglu
- School of Medicine, Marmara University, MÜ Göztepe Kampüsü, 34722 Istanbul, Turkey
| | - Anna Marchese
- Sezione di Microbiologia del DISC, Università di Genova-IRCCS San Martino IST Genova, Largo Benzi 10, 16132 Genova, Italy
| | - Luigi Vezzulli
- Dipartimento di Scienze della Terra, dell'Ambiente e della Vita (DISTAV), Università di Genova, C.so europa 26, 16132 Genova, Italy
| | - Macit Ilkit
- Dept. of Microbiology, University of Çukurova Sariçam, Çukurova Üniversitesi Rektörlüğü, 01330 Adana, Turkey
| | - Marie Desnos-Ollivier
- Institut Pasteur, CNRS, Unité de Mycologie Moléculaire, 25-28 Rue du Dr Roux, 75015 Paris, France
| | - Vincenzo Pasquale
- Dip. di Scienze e Tecnologie, Università degli Studi di Napoli Parthenope, Via Amm. F. Acton 38, 80133 Napoli, Italy
| | - Maya Korem
- Div. of Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, P.O. Box 12271 Jerusalem, Israel
| | - Itzhack Polacheck
- Div. of Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein Kerem, P.O. Box 12271 Jerusalem, Israel
| | - Antonio Scopa
- Facoltà di Scienze Agrarie, Forestali e Ambientali, Università degli Studi della Basilicata, Via Nazario Sauro 85, 85100 Potenza, Italy
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, CIDM, MBI, Sydney Medical School-Westmead Hospital, University of Sydney/Westmead Millennium Institute, 176 Hawkesbury Rd, NSW 2145 Westmead, NSW, Australia
| | - Kennio Ferreira-Paim
- Molecular Mycology Research Laboratory, CIDM, MBI, Sydney Medical School-Westmead Hospital, University of Sydney/Westmead Millennium Institute, 176 Hawkesbury Rd, NSW 2145 Westmead, NSW, Australia
| | - Ferry Hagen
- Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6532 SZ Nijmegen, The Netherlands
| | - Bart Theelen
- CBS-KNAW Fungal Biodiversity Centre, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands
| | - Teun Boekhout
- CBS-KNAW Fungal Biodiversity Centre, Uppsalalaan 8, 3584 CT Utrecht, The Netherlands
| | - Shawn R Lockhart
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333 Atlanta, USA
| | - Kathrin Tintelnot
- Dept. of Infeciuos Diseases, Robert-Koch Institute, D-13302 Berlin, Germany
| | - Anna Maria Tortorano
- Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133 Milano, Italy
| | - Françoise Dromer
- Institut Pasteur, CNRS, Unité de Mycologie Moléculaire, 25-28 Rue du Dr Roux, 75015 Paris, France
| | - Ashok Varma
- National Institute of Allergy and Infectious Diseases, 31 Center Dr, Bethesda, MD 20892 Bethesda, USA
| | - Kyung J Kwon-Chung
- National Institute of Allergy and Infectious Diseases, 31 Center Dr, Bethesda, MD 20892 Bethesda, USA
| | - Joäo Inácio
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Lewes Road, BN2 4GJ Brighton, UK
| | - Beatriz Alonso
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Lewes Road, BN2 4GJ Brighton, UK
| | - Maria F Colom
- Medical School, Universidad Miguel Hernández, Avenida de la Universidad, 03202 Alicante, Spain
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