Next Article in Journal
Special Issue: Mycorrhizal Fungi in Sensitive Environments
Next Article in Special Issue
Application of Culture-Independent Rapid Diagnostic Tests in the Management of Invasive Candidiasis and Cryptococcosis
Previous Article in Journal
Effective Single Photodynamic Treatment of ex Vivo Onychomycosis Using a Multifunctional Porphyrin Photosensitizer and Green Light
Article Menu

Export Article

Correction published on 5 July 2016, see J. Fungi 2016, 2(3), 20.

Open AccessReview
J. Fungi 2015, 1(2), 154-167;

Is Cryptococcus gattii a Primary Pathogen?

Molecular Microbiology Section, Laboratory of Clinical Infectious Diseases, National Institutes of Allergy and Infectious Diseases, NIH, Bethesda, MD 20892, USA.
Second Department of Internal Medicine, Nagasaki University Hospital, Sakamoto 1-7-1, Nagasaki-city, 851-8501, Japan
Author to whom correspondence should be addressed.
Academic Editor: John R. Perfect
Received: 27 May 2015 / Revised: 8 July 2015 / Accepted: 9 July 2015 / Published: 29 July 2015
(This article belongs to the Special Issue Yeasts Are Beasts)
Full-Text   |   PDF [783 KB, uploaded 5 July 2016]   |  


The two etiologic agents of cryptococcal meningoencephalitis, Cryptococcus neoformans and C. gattii, have been commonly designated as either an opportunistic pathogen for the first species or as a primary pathogen for the second species. Such a distinction has been based on epidemiological findings that the majority of patients presenting meningoencephalitis caused by C. neoformans are immunocompromised while C. gattii infection has been reported more often in immunocompetent patients. A recent report, however, showed that GM-CSF (granulocyte-macrophage colony-stimulating factor) neutralizing antibodies were prevalent in the plasma of “apparently immunocompetent” C. gattii patients with meningoencephalitis. Because GM-CSF is essential for differentiation of monocytes to macrophages and modulating the immune response, it is not surprising that the lack of GM-CSF function predisposes otherwise healthy individuals to infection via inhalation of environmental pathogens such as C. gattii. Since the test for anti-GM-CSF autoantibodies is not included in routine immunological profiling at most hospitals, healthy patients with GM-CSF neutralizing antibodies are usually categorized as immunocompetent. It is likely that a comprehensive immunological evaluation of patients with C. gattii meningoencephalitis, who had been diagnosed as immunocompetent, would reveal a majority of them had hidden immune dysfunction. This paper reviews the relationship between GM-CSF neutralizing antibodies and the risk for C. gattii infection with CNS involvement. View Full-Text
Keywords: Cryptococcosis; Cryptococcus gattii; anti-GM-CSF autoantibodies; immune dysfunction Cryptococcosis; Cryptococcus gattii; anti-GM-CSF autoantibodies; immune dysfunction

Graphical abstract

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Share & Cite This Article

MDPI and ACS Style

Kwon-Chung, K.J.; Saijo, T. Is Cryptococcus gattii a Primary Pathogen? J. Fungi 2015, 1, 154-167.

Show more citation formats Show less citations formats

Related Articles

Article Metrics

Article Access Statistics



[Return to top]
J. Fungi EISSN 2309-608X Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top