Novel Treatment of Cryptococcal Meningitis via Neurapheresis Therapy
| Autor: | John R. Perfect, Gordon Smilnak, Laura Zitella Verbick, Andrew Bartuska, Drew Cutshaw, Shivanand P. Lad, Tiffany Ejikeme, Charles Giamberardino, Aaron McCabe, Alykhan Premji, Lefko T Charalambous, Huaxin Sheng, Blake Hedstrom, Promila Pagadala, Christi Ballard |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Fungal meningitis Antigens Fungal 030106 microbiology Meningitis Cryptococcal Extracorporeal Microbiology Major Articles and Brief Reports 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Antigen In vivo medicine Animals Immunology and Allergy 030212 general & internal medicine Cryptococcus neoformans biology business.industry Fungal Polysaccharides medicine.disease biology.organism_classification Disease Models Animal Regimen Infectious Diseases Blood Component Removal Rabbits business Meningitis |
| Zdroj: | The Journal of Infectious Diseases. 218:1147-1154 |
| ISSN: | 1537-6613 0022-1899 |
| Popis: | Cryptococcal meningitis (CM) has emerged as the most common life-threatening fungal meningitis worldwide. Current management involves a sequential, longitudinal regimen of antifungals; despite a significant improvement in survival compared with uniform mortality without treatment, this drug paradigm has not led to a consistent cure. Neurapheresis therapy, extracorporeal filtration of yeasts from cerebrospinal fluid (CSF) in infected hosts, is presented here as a novel, one-time therapy for CM. In vitro filtration of CSF through this platform yielded a 5-log reduction in concentration of the yeast and a 1-log reduction in its polysaccharide antigen over 24 hours. Additionally, an analogous closed-loop system achieved 97% clearance of yeasts from the subarachnoid space in a rabbit model over 4–6 hours. This is the first publication demonstrating the direct ability to rapidly clear, both in vitro and in vivo, the otherwise slowly removed fungal pathogen that directly contributes to the morbidity and mortality seen in CM. |
| Databáze: | OpenAIRE |
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