Development of a heat-killed fbp1 mutant strain as a therapeutic agent to treat invasive Cryptococcus infection

In previous studies we determined that the F-box protein Fbp1, a subunit of the SCF(Fbp1) E3 ligase in Cryptococcus neoformans, is essential for fungal pathogenesis. Heat-killed fbp1Δ cells (HK-fbp1) can confer vaccine-induced immunity against lethal challenge with clinically important invasive fungal pathogens, e.g., C. neoformans, C. gattii, and Aspergillus fumigatus. In this study, we found that either CD4+ T cells or CD8+ T cells are sufficient to confer protection against lethal challenge of C. neoformans in HK-fbp1 induced-immunity. Given the potent effect of HK-fbp1 as a preventative vaccine, we further tested the potential efficacy of administering HK-fbp1 cells as a therapeutic agent for treating animals after infection. Remarkably, administration of HK-fbp1 provided robust host protection against pre-existing C. neoformans infection. The mice infected with wild type H99 cells and then treated with HK-fbp1 showed significant reduction of fungal CFU in the infected lung, and no dissemination of fungal cells to the brain and spleen. we find that early treatment is critical for the effective use of HK-fbp1 as a therapeutic agent. Immune analysis revealed that early treatment with HK-fbp1 cells elicited Th1 biased protective immune responses that help block fungal dissemination and promote better host protection. Our data thus suggest that HK-fbp1 is both an effective prophylactic vaccine candidate against C. neoformans infection in both immunocompetent and immunocompromised populations, as well as a potential novel therapeutic strategy to treat early stage cryptococcosis. Importance Invasive fungal infections, e.g., cryptococcosis, are often life threatening and difficult to treat with very limited therapeutic options. There is no vaccine available in clinical use to prevent or treat fungal infections. Our previous studies demonstrated that heat-killed fbp1Δ cells (HK-fbp1) in Cryptococcus neoformans can be harnessed to confer protection against a challenge by the virulent parental strain, even in immunocompromised animals, such as the ones lacking CD4+ T cells. In this study, we further determined that T cells are required for vaccine-induced protection against homologous challenge and that either CD4+ or CD8+ cells are sufficient. This finding is particularly important for the potential utility of this vaccine candidate in the context of HIV/AIDS-induced immune deficiency, the main risk factor for cryptococcosis in humans. Furthermore, in addition to the utility of HK-fbp1 as a prophylactic vaccine, we found that HK-fbp1 administration can inhibit disease dissemination when animals are treated at an early-stage during Cryptococcus infection. Our findings could significantly expand the utility of HK-fbp1 not only as prophylactic vaccine but also as a novel therapy against cryptococcosis. Conceptually, therapeutic administration of HK-fbp1 could have an advantage over small molecule antifungal drugs in that it is expected to have minimal side effects and lower cost. In all, our studies showed that HK-fbp1 strain can be used both preventively and therapeutically to elicit robust host protection against cryptococcosis.