Overcoming Hurdles to Development of a Vaccine against Pneumocystis jirovecii

Garvy, Beth A.

doi:10.1128/iai.00035-17

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…The development of a vaccine for the prevention of PCP has long been a goal of the field [80]. Several antigenic components have been evaluated in murine models and the roles of CD4 T cells and antibodies have been clearly established [18,[81][82][83][84][85][86][87][88][89][90][91].…”

Section: Development Of Pneumocystis Prevention and Treatment Strategiesmentioning

confidence: 99%

Pneumocystis as a Co-Factor in Pulmonary Diseases

Rabacal¹,

Rayens²,

Norris³

2018

obm genet

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Pneumocystis causes life-threatening pneumonia in immunocompromised populations. More recently it has been implicated as a co-factor in a number of chronic lung diseases including chronic obstructive pulmonary disease (COPD), severe asthma, and cystic fibrosis (CF). In this review, we will examine the current literature regarding Pneumocystis and lung diseases in the HIV-infected patients and non-HIV immunocompromised populations, and the barriers to prophylaxis and treatment in these patients. Trimethoprim sulfamethoxazole (TMP-SMX) is an effective therapeutic against Pneumocystis but this approach remains problematic due to drug interactions, treatment-limiting adverse events, and breakthrough Pneumocystis pneumonia (PCP) despite prophylaxis. This review summarizes the shortcomings of current prophylaxis and treatment strategies, and the advances that have been made toward the development of novel diagnostics and therapeutics, with a focus on vaccine development.

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Section: Development Of Pneumocystis Prevention and Treatment Strategiesmentioning

confidence: 99%

Pneumocystis as a Co-Factor in Pulmonary Diseases

Rabacal¹,

Rayens²,

Norris³

2018

obm genet

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Fungal vaccines, mechanism of actions and immunology: A comprehensive review

Nami

Mohammadi

Vakili

et al. 2019

Biomedicine & Pharmacotherapy

106

105

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Pneumocystis jiroveci in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

Fishman

Gans

2019

Clinical Transplantation

197

207

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These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of Pneumocystis jiroveci fungal infection transplant recipients. Pneumonia (PJP) may develop via airborne transmission or reactivation of prior infection. Nosocomial clusters of infection have been described among transplant recipients. PJP should not occur during prophylaxis with trimethoprim‐sulfamethoxazole (TMP‐SMX). Without prophylaxis, PJP risk is greatest in the first 6 months after organ transplantation but may develop later. Risk factors include low lymphocyte counts, cytomegalovirus infection (CMV), hypogammaglobulinemia, treated graft rejection or corticosteroids, and advancing patient age (>65). Presentation typically includes fever, dyspnea with hypoxemia, and cough. Chest radiographic patterns generally reveal diffuse interstitial processes best seen by CT scans. Patients generally have PO2 < 60 mm Hg, elevated serum lactic dehydrogenase (LDH), and elevated serum (1 → 3) β‐d‐glucan assay. Specific diagnosis uses respiratory specimens with direct immunofluorescent staining; invasive procedures may be required. Quantitative PCR is a useful adjunct to diagnosis. TMP‐SMX is the drug of choice for therapy; drug allergy should be documented before resorting to alternative therapies. Adjunctive corticosteroids may be useful early. Routine PJP prophylaxis is recommended for at least 6‐12 months post–transplant, preferably with TMP‐SMX.

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Overcoming Hurdles to Development of a Vaccine against Pneumocystis jirovecii

Cited by 3 publications

References 27 publications

Pneumocystis as a Co-Factor in Pulmonary Diseases

Pneumocystis as a Co-Factor in Pulmonary Diseases

Fungal vaccines, mechanism of actions and immunology: A comprehensive review

Pneumocystis jiroveci in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

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