Liise-anne Pirofski, M.D.
The focus of our laboratory is immunity to encapsulated pathogens, specifically Cryptococcus and Pneumococcus, which are acquired by inhalation. Pneumococus is the leading cause of pneumonia in the United States and globally, causing more than one million deaths annually in children under the age of five years. It also occurs widely in the elderly and in those with compromised antibody immunity. Cryptococcus is the leading cause of fungal meningitis globally, causing more than 900,000 cases of disease and 600,000 deaths annually, primarily in sub-Saharan Africa. Cryptococcal disease occurs primarily in patients with AIDS and those with solid organ transplants.
Antimicrobial therapy for both microbes suffers from limitations, stemming from antimicrobial resistance for Pneumococcus and an inability to eradicate the organism in immunocompromised patients for Cryptococcus. Pneumococcal vaccines are in use, but their efficacy is limited in immunocompromised patients. There is no vaccine for Cryptococcus. The main virulence factor of both is a polysaccharide capsule, which surrounds the organism. These capsules inhibit cellular and antibody immunity, enhancing susceptibility to disease. We seek to identify the mechanisms that govern immunity to encapsulated microbes. We hope to better predict disease susceptibility and to improve therapies and vaccines. Much of our work is based on the Damage-response framework, a theory of microbial pathogenesis.
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