Evidence map›Paper›PMID 29788431›Full record

ArticleThe Journal of infectious diseases2018

Novel Treatment of Cryptococcal Meningitis via Neurapheresis Therapy.

Gordon J Smilnak, Lefko T Charalambous, Drew Cutshaw, Alykhan M Premji, Charles D Giamberardino, Christi G Ballard, Andrew P Bartuska, Tiffany U Ejikeme, Huaxin Sheng, Laura Zitella Verbick and 5 more

Open access · bronzeAbstract read
In one paragraph

Article in The Journal of infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
3.2field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 35 citations in OpenAlex.

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  11. Present and Future Therapy ofJournal of fungi (Basel, Switzerland) · 2018
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 3 institutions in 1 country.

Gordon J SmilnakDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
Lefko T CharalambousDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
Drew CutshawDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
Alykhan M PremjiDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
Charles D GiamberardinoDepartment of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina.
Christi G BallardDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
Andrew P BartuskaDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
Tiffany U EjikemeDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
Huaxin ShengDepartment of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
Laura Zitella VerbickMinnetronix, Inc, Saint Paul, Minnesota.
Blake A HedstromMinnetronix, Inc, Saint Paul, Minnesota.
Promila C PagadalaDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
Aaron R McCabeMinnetronix, Inc, Saint Paul, Minnesota.
John R PerfectDepartment of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina.
Shivanand P LadDepartment of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
Duke Medical Center · USDuke University Hospital · USMinnetronix (United States) · US

Funding

Pathobiology of C. neoformans in the Central Nervous SystemR01AI073896 · NIAID · DUKE UNIVERSITY · PI PERFECT, JOHN R. · 2008 to 2018
$4.4M
Evolution of Cryptococcus neoformans Strains from Patients with HIV/AIDSR01AI093257 · NIAID · DUKE UNIVERSITY · PI PERFECT, JOHN R. · 2011 to 2022
$3.8M
Validation of Novel Therapeutic Approach for Cryptococcal MeningitisR42AI120304 · NIAID · MINNETRONIX, INC. · PI LAD, SHIVANAND P, MCCABE, AARON RICHARD · 2017 to 2018
$1.5M
NIAID NIH HHS R01 AI073896NIAID NIH HHS R01 AI093257NIAID NIH HHS R42 AI120304
6 · The paper itself

Abstract

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.

Indexed as

Blood Component RemovalAnimalsAntigens, FungalCryptococcus neoformansDisease Models, AnimalFungal PolysaccharidesMeningitis, CryptococcalRabbitsAntigens, FungalFungal Polysaccharides

Identifiers

PMID29788431
PMCPMC6107745
OpenAlexW2803416912

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.