ABSTRACTCryptococcus neoformanscauses deadly mycosis primarily in AIDS patients, whereasCryptococcus gattiiinfects mostly non-HIV patients, even in regions with high burdens of HIV/AIDS and an established environmental presence ofC. gattii. As HIV induces type I IFN (t1IFN), we hypothesized that t1IFN would differentially affect the outcome ofC. neoformansandC. gattiiinfections. Exogenous t1IFN induction using stabilized poly(I·C) (pICLC) improved murine outcomes in either cryptococcal infection. InC. neoformans-infected mice, pICLC activity was associated withC. neoformanscontainment and classical Th1 immunity. In contrast, pICLC activity againstC. gattiidid not require any immune factors previously associated withC. neoformansimmunity: T, B, and NK cells, IFN-γ, and macrophages were all dispensable. Interestingly,C. gattiipICLC activity depended on β-2-microglobulin, which impacts iron levels among other functions. Iron supplementation reversed pICLC activity, suggestingC. gattiipICLC activity requires iron limitation. Also, pICLC induced a set of iron control proteins, some of which were directly inhibitory to cryptococcusin vitro, suggesting t1IFN regulates iron availability in the pulmonary air space fluids. Thus, exogenous induction of t1IFN significantly improves the outcome of murine infection byC. gattiiandC. neoformansbut by distinct mechanisms; theC. gattiieffect was mediated by iron limitation, while the effect onC. neoformansinfection was through induction of classical T-cell-dependent immunity. Together this difference in types of T-cell-dependent t1IFN immunity for differentCryptococcusspecies suggests a possible mechanism by which HIV infection may select againstC. gattiibut notC. neoformans.IMPORTANCECryptococcus neoformansandCryptococcus gattiicause fatal infection in immunodeficient and immunocompetent individuals. While these fungi are sibling species,C. gattiiinfects very few AIDS patients, whileC. neoformansinfection is an AIDS-defining illness, suggesting that the host response to HIV selectsC. neoformansoverC. gattii. We used a viral mimic molecule (pICLC) to stimulate the immune response, and pICLC treatment improved mouse outcomes from both species. pICLC-induced action againstC. neoformanswas due to activation of well-defined immune pathways known to deterC. neoformans, whereas these immune pathways were dispensable for pICLC treatment ofC. gattii. Since these immune pathways are eventually destroyed by HIV/AIDS, our data help explain why the antiviral immune response in AIDS patients is unable to controlC. neoformansinfection but is protective againstC. gattii. Furthermore, pICLC induced tighter control of iron in the lungs of mice, which inhibitedC. gattii, thus suggesting an entirely new mode of nutritional immunity activated by viral signals.
A Multiplex Real-Time PCR Assay for Identification of Pneumocystis jirovecii, Histoplasma capsulatum, and Cryptococcus neoformans/Cryptococcus gattii in Samples from AIDS Patients with Opportunistic Pneumonia