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Barker BM, Thompson GR, Ampel NM. Challenges to Implementing a Vaccine for Coccidioidomycosis. Open Forum Infect Dis 2024; 11:ofae095. [PMID: 38887487 PMCID: PMC11181188 DOI: 10.1093/ofid/ofae095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/20/2024] [Indexed: 06/20/2024] Open
Abstract
A vaccine for coccidioidomycosis is likely to undergo trials in the near future. In this paper, we raise 4 questions that should be answered before its use and offer our solutions to these questions. These include defining the goals of vaccination, determining who should be vaccinated, how to measure vaccine immunity and protection, and how to address vaccine hesitancy and denial.
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Affiliation(s)
- Bridget M Barker
- Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona, USA
| | - George R Thompson
- Department of Medical Microbiology and Immunology, University of California at Davis, Davis, California, USA
| | - Neil M Ampel
- Departments of Medicine and Immunobiology, University of Arizona, Tucson, Arizona, USA
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Chechi JL, da Costa FAC, Figueiredo JM, de Souza CM, Valdez AF, Zamith-Miranda D, Camara AC, Taborda CP, Nosanchuk JD. Vaccine development for pathogenic fungi: current status and future directions. Expert Rev Vaccines 2023; 22:1136-1153. [PMID: 37936254 DOI: 10.1080/14760584.2023.2279570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/01/2023] [Indexed: 11/09/2023]
Abstract
INTRODUCTION Fungal infections are caused by a broad range of pathogenic fungi that are found worldwide with different geographic distributions, incidences, and mortality rates. Considering that there are relatively few approved medications available for combating fungal diseases and no vaccine formulation commercially available, multiple groups are searching for new antifungal drugs, examining drugs for repurposing and developing antifungal vaccines, in order to control deaths, sequels, and the spread of these complex infections. AREAS COVERED This review provides a summary of advances in fungal vaccine studies and the different approaches under development, such as subunit vaccines, whole organism vaccines, and DNA vaccines, as well as studies that optimize the use of adjuvants. We conducted a literature search of the PubMed with terms: fungal vaccines and genus of fungal pathogens (Cryptococcus spp. Candida spp. Coccidioides spp. Aspergillus spp. Sporothrix spp. Histoplasma spp. Paracoccidioides spp. Pneumocystis spp. and the Mucorales order), a total of 177 articles were collected from database. EXPERT OPINION Problems regarding the immune response development in an immunocompromised organism, the similarity between fungal and mammalian cells, and the lack of attention by health organizations to fungal infections are closely related to the fact that, at present, there are no fungal vaccines available for clinical use.
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Affiliation(s)
- Jéssica L Chechi
- Laboratório de Fungos Dimórficos Patogênicos, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, SP, SP, Brazil
| | - Felipe A C da Costa
- Laboratório de Fungos Dimórficos Patogênicos, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, SP, SP, Brazil
- Laboratório de Micologia Médica (LIM-53), Departamento de Dermatologia, Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, SP, SP, Brazil
| | - Julia M Figueiredo
- Laboratório de Fungos Dimórficos Patogênicos, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, SP, SP, Brazil
| | - Cássia M de Souza
- Laboratório de Fisiologia e Biologia Molecular de Fungos, Departamento de Microbiologia, Universidade Estadual de Londrina, Londrina, Brazil
- Instituto Carlos Chagas, Fundação Oswaldo, Cruz (Fiocruz), Curitiba, Paraná, Brazil
| | - Alessandro F Valdez
- Departments of Medicine (Division of Infectious Diseases) and Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Daniel Zamith-Miranda
- Departments of Medicine (Division of Infectious Diseases) and Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Aline C Camara
- Laboratório de Fungos Dimórficos Patogênicos, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, SP, SP, Brazil
- Laboratório de Micologia Médica (LIM-53), Departamento de Dermatologia, Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, SP, SP, Brazil
| | - Carlos P Taborda
- Laboratório de Fungos Dimórficos Patogênicos, Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, SP, SP, Brazil
- Laboratório de Micologia Médica (LIM-53), Departamento de Dermatologia, Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de São Paulo, SP, SP, Brazil
| | - Joshua D Nosanchuk
- Departments of Medicine (Division of Infectious Diseases) and Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA
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Gorris ME, Caballero Van Dyke MC, Carey A, Hamm PS, Mead HL, Uehling JK. A Review of Coccidioides Research, Outstanding Questions in the Field, and Contributions by Women Scientists. CURRENT CLINICAL MICROBIOLOGY REPORTS 2021; 8:114-128. [PMID: 34367880 PMCID: PMC8327307 DOI: 10.1007/s40588-021-00173-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 12/19/2022]
Abstract
Purpose of Review Coccidioidomycosis is an infectious disease that gained clinical significance in the early 20th century. Many of the foundational contributions to coccidioidomycosis research, including the discovery of the fungal disease agent, Coccidioides spp., were made by women. We review recent progress in Coccidioides research and big questions remaining in the field, while highlighting some of the contributions from women. Recent Findings New molecular-based techniques provide a promising method for detecting Coccidioides, which can help determine the dominate reservoir host and ideal environmental conditions for growth. Genetic and genomic analyses have allowed an understanding of population structure, species level diversity, and evolutionary histories. We present a current, comprehensive genome list, where women contributed many of these entries. Several efforts to develop a coccidioidomycosis vaccine are underway. Summary Women continue to pioneer research on Coccidioides, including the relationships between the fungi and the environment, genetics, and clinical observations. Significant questions remain in the field of Coccidioides, including the main host reservoir, the relationships between genotypic and phenotypic variation, and the underlying cause for chronic clinical coccidioidomycosis cases.
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Affiliation(s)
- Morgan E Gorris
- Los Alamos National Laboratory, Information Systems and Modeling & Center for Nonlinear Studies, Los Alamos, NM USA
| | | | - Adrienne Carey
- Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Paris S Hamm
- Department of Biology, University of New Mexico, Albuquerque, NM USA
| | - Heather L Mead
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ USA
| | - Jessie K Uehling
- Department of Botany and Plant Pathology, Oregon State University, Corvallis, OR USA
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Diep AL, Hoyer KK. Host Response to Coccidioides Infection: Fungal Immunity. Front Cell Infect Microbiol 2020; 10:581101. [PMID: 33262956 PMCID: PMC7686801 DOI: 10.3389/fcimb.2020.581101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/15/2020] [Indexed: 12/22/2022] Open
Abstract
Coccidioidomycosis is a fungal, respiratory disease caused by Coccidioides immitis and Coccidioides posadasii. This emerging infectious disease ranges from asymptomatic to pulmonary disease and disseminated infection. Most infections are cleared with little to no medical intervention whereas chronic disease often requires life-long medication with severe impairment in quality of life. It is unclear what differentiates hosts immunity resulting in disease resolution versus chronic infection. Current understanding in mycology-immunology suggests that chronic infection could be due to maladaptive immune responses. Immunosuppressed patients develop more severe disease and mouse studies show adaptive Th1 and Th17 responses are required for clearance. This is supported by heightened immunosuppressive regulatory responses and lowered anti-fungal T helper responses in chronic Coccidioides patients. Diagnosis and prognosis is difficult as symptoms are broad and overlapping with community acquired pneumonia, often resulting in misdiagnosis and delayed treatment. Furthermore, we lack clear biomarkers of disease severity which could aid prognosis for more effective healthcare. As the endemic region grows and population increases in endemic areas, the need to understand Coccidioides infection is becoming urgent. There is a growing effort to identify fungal virulence factors and host immune components that influence fungal immunity and relate these to patient disease outcome and treatment. This review compiles the known immune responses to Coccidioides spp. infection and various related fungal pathogens to provide speculation on Coccidioides immunity.
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Affiliation(s)
- Anh L. Diep
- Quantitative and Systems Biology, Graduate Program, University of California Merced, Merced, CA, United States
| | - Katrina K. Hoyer
- Quantitative and Systems Biology, Graduate Program, University of California Merced, Merced, CA, United States
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California Merced, Merced, CA, United States
- Health Sciences Research Institute, University of California Merced, Merced, CA, United States
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Mead HL, Van Dyke MCC, Barker BM. Proper Care and Feeding of Coccidioides: A Laboratorian's Guide to Cultivating the Dimorphic Stages of C. immitis and C. posadasii. CURRENT PROTOCOLS IN MICROBIOLOGY 2020; 58:e113. [PMID: 32894648 PMCID: PMC9976608 DOI: 10.1002/cpmc.113] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Coccidioidomycosis ("Valley fever") is caused by Coccidioides immitis and C. posadasii. These fungi are thermally dimorphic, cycling between mycelia and arthroconidia in the environment and converting into spherules and endospores within a host. Coccidioides can cause a broad spectrum of disease that can be difficult to treat. There has been a steady increase in disease, with an estimated 350,000 new infections per year in the United States. With the increase in disease and difficulty in treatment, there is an unmet need to increase research in basic biology and identify new treatments, diagnostics, and vaccine candidates. Here, we describe protocols required in any Coccidioides laboratory, such as growing, harvesting, and storing the different stages of this dimorphic fungal pathogen. © 2020 Wiley Periodicals LLC. Basic Protocol 1: Growth and harvest of liquid mycelia cultures for extractions Alternate Protocol 1: Large-volume growth and harvest of liquid mycelia cultures Basic Protocol 2: Mycelial growth on solid medium Alternate Protocol 2: Maintaining mycelial growth on solid medium Basic Protocol 3: Harvesting and quantification of arthroconidia Alternate Protocol 3: Long-term storage of arthroconidia Basic Protocol 4: Parasitic spherule growth and harvest Alternate Protocol 4: Obtaining endospores from spherules Basic Protocol 5: Intranasal infection of murine models.
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Affiliation(s)
- Heather L. Mead
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, Arizona
| | | | - Bridget M. Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, Arizona,Corresponding author:
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Hayden CA, Landrock D, Hung CY, Ostroff G, Fake GM, Walker JH, Kier A, Howard JA. Co-Administration of Injected and Oral Vaccine Candidates Elicits Improved Immune Responses over Either Route Alone. Vaccines (Basel) 2020; 8:E37. [PMID: 31973150 PMCID: PMC7157212 DOI: 10.3390/vaccines8010037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 12/22/2022] Open
Abstract
Infectious diseases continue to be a significant cause of morbidity and mortality, and although efficacious vaccines are available for many diseases, some parenteral vaccines elicit little or no mucosal antibodies which can be a significant problem since mucosal tissue is the point of entry for 90% of pathogens. In order to provide protection for both serum and mucosal areas, we have tested a combinatorial approach of both parenteral and oral administration of antigens for diseases caused by a viral pathogen, Hepatitis B, and a fungal pathogen, Coccidioides. We demonstrate that co-administration by the parenteral and oral routes is a useful tool to increase the overall immune response. This can include achieving an immune response in tissues that are not elicited when using only one route of administration, providing a higher level of response that can lead to fewer required doses or possibly providing a better response for individuals that are considered poor or non-responders.
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Affiliation(s)
- Celine A. Hayden
- Applied Biotechnology Institute, Cal Poly Tech Park, San Luis Obispo, CA 93407, USA; (C.A.H.); (G.M.F.)
| | - Danilo Landrock
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A & M University, College Station, TX 77843, USA; (D.L.); (A.K.)
| | - Chiung Yu Hung
- Department of Biology, University of Texas San Antonio, One UTSA Circle, San Antonio, TX 78249, USA;
| | - Gary Ostroff
- Program in Molecular Medicine, University of Massachusetts Medical School, 373 Plantation St. Biotech 2, Suite 113, Worcester, MA 01605, USA;
| | - Gina M. Fake
- Applied Biotechnology Institute, Cal Poly Tech Park, San Luis Obispo, CA 93407, USA; (C.A.H.); (G.M.F.)
| | - John H. Walker
- Department of Statistics, California Polytechnic State University, San Luis Obispo, CA 93407, USA;
| | - Ann Kier
- Department of Veterinary Pathobiology, College of Veterinary Medicine, Texas A & M University, College Station, TX 77843, USA; (D.L.); (A.K.)
| | - John A. Howard
- Applied Biotechnology Institute, Cal Poly Tech Park, San Luis Obispo, CA 93407, USA; (C.A.H.); (G.M.F.)
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Van Dyke MCC, Thompson GR, Galgiani JN, Barker BM. The Rise of Coccidioides: Forces Against the Dust Devil Unleashed. Front Immunol 2019; 10:2188. [PMID: 31572393 PMCID: PMC6749157 DOI: 10.3389/fimmu.2019.02188] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 08/30/2019] [Indexed: 12/13/2022] Open
Abstract
Coccidioidomycosis (Valley fever) is a fungal disease caused by the inhalation of Coccidioides posadasii or C. immitis. This neglected disease occurs in the desert areas of the western United States, most notably in California and Arizona, where infections continue to rise. Clinically, coccidioidomycosis ranges from asymptomatic to severe pulmonary disease and can disseminate to the brain, skin, bones, and elsewhere. New estimates suggest as many as 350,000 new cases of coccidioidomycosis occur in the United States each year. Thus, there is an urgent need for the development of a vaccine and new therapeutic drugs against Coccidioides infection. In this review, we discuss the battle against Coccidioides including the development of potential vaccines, the quest for new therapeutic drugs, and our current understanding of the protective host immune response to Coccidioides infection.
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Affiliation(s)
| | - George R Thompson
- Department of Medical Microbiology and Immunology, University of California, Davis, Davis, CA, United States.,Division of Infectious Diseases, Department of Internal Medicine, University of California Davis Medical Center, Sacramento, CA, United States
| | - John N Galgiani
- Valley Fever Center for Excellence, Department of Medicine, University of Arizona College of Medicine-Tucson, Tucson, AZ, United States
| | - Bridget M Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, United States
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