ArticleThe Journal of infectious diseases2014
Cryptococcus neoformans ex vivo capsule size is associated with intracranial pressure and host immune response in HIV-associated cryptococcal meningitis.
Article in The Journal of infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01075152 (Trial for the Optimal Timing of HIV Therapy After Cryptococcal Meningitis), which is not on this map. Cited by 74 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Trial for the Optimal Timing of HIV Therapy After Cryptococcal Meningitis
Who cites it
74 citing papers in PubMed, 122 citations in OpenAlex.
- Efficient phagocytosis and laccase activity affect the outcome of HIV-associated cryptococcosis.The Journal of clinical investigation · 2014Trial
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- Iturin A disruptsNpj fungal science · 2026Article
- Pathogenicity and virulence of Cryptococcus neoformans from an environmental perspective.Virulence · 2025Review
- Intrinsic and extrinsic factors affecting the evolution of virulence in the HIV-associated opportunistic human fungal pathogenVirulence · 2025Article
- Target product profile and discovery and development path for novel cryptococcal disease treatments.The Journal of infection · 2025Review
- The Hidden Fortress: A Comprehensive Review of Fungal Biofilms with Emphasis onJournal of fungi (Basel, Switzerland) · 2025Review
- Article
- Elements of dissemination in cryptococcosis.mBio · 2024Review
- Is Cryptococcus neoformans a pleomorphic fungus?Current opinion in microbiology · 2024Review
- IL-6 deficiency accelerates cerebral cryptococcosis and alters glial cell responses.Journal of neuroinflammation · 2024Article
- Evolution of Laboratory Diagnostics for Cryptococcosis and Missing Links to Optimize Diagnosis and Outcomes in Resource-Constrained Settings.Open forum infectious diseases · 2024Review
- Severe CSF immune cell alterations in cryptococcal meningitis gradually resolve during antifungal therapy.BMC neurology · 2024Article
- Chelation of Mitochondrial Iron as an Antiparasitic Strategy.ACS infectious diseases · 2024Article
- BIOMOLECULAR ACTIVITY OF CRYPTOCOCCUS DURING CRYPTOCOCCOSIS: A REVIEW OF MOLECULAR INTERACTIONS OF CRYPTOCOCCUS WITH HUMAN IMMUNE SYSTEM AND BLOOD-BRAIN-BARRIER.African journal of infectious diseases · 2024Article
- Persistently elevated intracranial pressure in cryptococcal meningitis- 76 therapeutic lumbar punctures.Medical mycology case reports · 2023Article
- Phospholipase B Is Critical for Cryptococcus neoformans Survival in the Central Nervous System.mBio · 2023Article
- Importance of Clinical Isolates inJournal of fungi (Basel, Switzerland) · 2023Review
- Review
14 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundThe Cryptococcus neoformans polysaccharide capsule is a well-characterized virulence factor with immunomodulatory properties. The organism and/or shed capsule is postulated to raise intracranial pressure (ICP) in cryptococcal meningitis (CM) by mechanical obstruction of cerebrospinal fluid (CSF) outflow. Little is known regarding capsule phenotype in human cryptococcosis. We investigated the relationship of ex vivo CSF capsular phenotype with ICP and CSF immune response, as well as in vitro phenotype.
methodsIn total, 134 human immunodeficiency virus (HIV)-infected Ugandan adults with CM had serial lumbar punctures with measurement of CSF opening pressures, quantitative cultures, ex vivo capsule size and shedding, viscosity, and CSF cytokines; 108 had complete data. Induced capsular size and shedding were measured in vitro for 48 C. neoformans isolates.
resultsCryptococcal strains producing larger ex vivo capsules in the baseline (pretreatment) CSF correlated with higher ICP (P = .02), slower rate of fungal clearance (P = .02), and paucity of CSF inflammation, including decreased CSF white blood cell (WBC) count (P < .001), interleukin (IL)-4 (P = .02), IL-6 (P = .01), IL-7 (P = .04), IL-8 (P = .03), and interferon γ (P = .03). CSF capsule shedding did not correlate with ICP. On multivariable analysis, capsule size remained independently associated with ICP. Ex vivo capsular size and shedding did not correlate with that of the same isolates grown in vitro.
conclusionsCryptococcal capsule size ex vivo is an important contributor to virulence in human cryptococcal meningitis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.