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Measurement of Cellular Immunity in Human Coccidioidomycosis

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Abstract

Measurement of cellular immune response in human coccidioidomycosis, a diseaseof the Western Hemisphere caused by the soil-dwelling fungus Coccidioides,began more than 75 years ago. Numerous studies have shown that measurement ofcoccidioidal cellular immunity is a useful epidemiologic and clinical tool. The firstwidely used coccidioidal skin-test reagent, coccidioidin, was derived from a filtrateof cultured mycelia of Coccidioides by Smith and colleagues in the 1940's. Itremained the standard until the 1970's, when spherulin, obtained from the spheruleform of the fungus, was found to be more sensitive. Both reagents are specificindicators of coccidioidal cellular immunity. Since then, other coccidioidal antigenshave been identified and in vitro tests of cellular immunity have been shown to yieldcomparable results to skin testing. In vitro assays have also begun to open a windowon the specific immunologic events of coccidioidal cellular immunity. Persistentexpression of coccidioidal cellular immune response appears to augur an improvedclinical outcome. Despite this, a study of a coccidioidal vaccine failed to demonstrateefficacy. Current and future studies are focused on modulating the coccidioidal immune response in vitro and in vivo and on developing an improved vaccine.

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    Neil M. Ampel

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Ampel, N.M. Measurement of Cellular Immunity in Human Coccidioidomycosis. Mycopathologia 156, 247–262 (2003). https://doi.org/10.1023/B:MYCO.0000003580.93839.71

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