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Cryptococcal Capsule and IRIS Darin L Wiesner. Healthy Response To Cryptococcus Normal Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011.

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Presentation on theme: "Cryptococcal Capsule and IRIS Darin L Wiesner. Healthy Response To Cryptococcus Normal Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011."— Presentation transcript:

1 Cryptococcal Capsule and IRIS Darin L Wiesner

2 Healthy Response To Cryptococcus Normal Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011

3 Healthy Response To Cryptococcus Normal Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011

4 Healthy Response To Cryptococcus Normal Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011

5 Theory of CM-IRIS Pathogenesis Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011 Pathologic

6 Hypothesis: CM Patients that mount an ineffective ex vivo cytokine response to cryptococcal capsular antigen are at increased risk for death or IRIS.

7 45% 20% 35% Patient Characteristics CM Only CM-IRIS Death Ineffective Response Normal Response

8 45% 20% 35% Patient Characteristics CM Only CM-IRIS Death Ineffective Response Normal Response

9 Cytokine Response to Capsular Antigen Equivalent Significantly Elevated Cytokine Response Relative to Negative Control:

10 Multivariate Model of IRIS/Death Risk

11 Theory of CM-IRIS Pathogenesis Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011 Pathologic

12 Acknowledgements Mentorship: – David Boulware, U of MN – Paul Bohjanen, U of MN – Kirsten Nielsen, U of MN Reagents and/or Discussion: – Stu Levitz, U of MA – Nielsen Lab, U of MN – Mellissa Rolfes, U of MN Clinic: – David Meya, IDI - Kampala – Andrew Kumbugu, IDI – Kampala Laboratory: – Henry Kajambula, Makerere U – Andrew Akampurira, Makerere U – Beatrice Achan, Makerere U


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