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Cryptococcal Capsule and IRIS

Cryptococcal Capsule and IRIS. Darin L Wiesner. Healthy Response To Cryptococcus. Normal. Adapted from Wiesner and Boulware , Curr Fungal Infect Rep 2011. Healthy Response To Cryptococcus. Normal. Adapted from Wiesner and Boulware , Curr Fungal Infect Rep 2011.

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Cryptococcal Capsule and IRIS

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  1. Cryptococcal Capsule and IRIS Darin L Wiesner

  2. Healthy Response To Cryptococcus Normal Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011

  3. Healthy Response To Cryptococcus Normal Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011

  4. Healthy Response To Cryptococcus Normal Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011

  5. Theory of CM-IRIS Pathogenesis Pathologic Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011

  6. Hypothesis: • CM Patients that mount an ineffective ex vivo cytokine response to cryptococcal capsular antigen are at increased risk for death or IRIS.

  7. Patient Characteristics Normal Response CM Only CM-IRIS 45% Death 20% Ineffective Response 35%

  8. Patient Characteristics Normal Response CM Only CM-IRIS 45% Death 20% Ineffective Response 35%

  9. Cytokine Response to Capsular Antigen Cytokine Response Relative to Negative Control: Significantly Elevated Equivalent

  10. Multivariate Model of IRIS/Death Risk

  11. Theory of CM-IRIS Pathogenesis Pathologic Adapted from Wiesner and Boulware, Curr Fungal Infect Rep 2011

  12. Acknowledgements • Mentorship: • David Boulware, U of MN • Paul Bohjanen, U of MN • Kirsten Nielsen, U of MN • Reagents and/or Discussion: • Stu Levitz, U of MA • Nielsen Lab, U of MN • Mellissa Rolfes, U of MN • Clinic: • David Meya, IDI - Kampala • Andrew Kumbugu, IDI – Kampala • Laboratory: • Henry Kajambula, Makerere U • Andrew Akampurira, Makerere U • Beatrice Achan, MakerereU

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