title: PARACOCCIDIOIDOMYCOSIS: CHALLENGES IN THE DEVELOPMENT OF A VACCINE AGAINST AN ENDEMIC MYCOSIS IN THE AMERICAS.
abstract: Paracoccidioidomycosis (PCM), caused by Paracoccidioides spp, is an important endemic mycosis in Latin America. There are two recognized Paracoccidioides species, P. brasiliensis and P. lutzii, based on phylogenetic differences; however, the pathogenesis and disease manifestations of both are indistinguishable at present. Approximately 1,853 (~51,2%) of 3,583 confirmed deaths in Brazil due to systemic mycoses from 1996-2006 were caused by PCM. Antifungal treatment is required for patients with PCM. The initial treatment lasts from two to six months and sulfa derivatives, amphotericin B, azoles and terbinafine are used in clinical practice; however, despite prolonged therapy, relapses are still a problem. An effective Th1-biased cellular immune response is essential to control the disease, which can be induced by exogenous antigens or modulated by prophylactic or therapeutic vaccines. Stimulation of B cells or passive transference of monoclonal antibodies are also important means that may be used to improve the efficacy of paracoccidioidomycosis treatment in the future. This review critically details major challenges facing the development of a vaccine to combat PCM.
authors.affiliation: Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Carlos P
authors.initials: CP
authors.lastname: Taborda
authors.affiliation: Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: M E
authors.initials: ME
authors.lastname: Urán
authors.affiliation: Departments of Medicine, Division of Infectious Diseases and Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, U.S.A.
authors.forename: J D
authors.initials: JD
authors.lastname: Nosanchuk
authors.affiliation: Departmento de Microbiologia, Imunologia e Parasitologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: L R
authors.initials: LR
authors.lastname: Travassos
mesh_terms: D000818:Animals; D000946:Antigens, Fungal / Q000276:immunology*; D000951:Antigens, Neoplasm / Q000276:immunology; D005657:Fungal Vaccines / Q000276:immunology*; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D051379:Mice; D010228:Paracoccidioides / Q000276:immunology*; D010229:Paracoccidioidomycosis / Q000276:immunology / Q000628:therapy*; D010446:Peptide Fragments / Q000276:immunology; D019444:Vaccines, DNA / Q000276:immunology*
chemical_list: D000946:Antigens, Fungal; D000951:Antigens, Neoplasm; D005657:Fungal Vaccines; D006023:Glycoproteins; C550731:P10 peptide, Paracoccidioides brasiliensis; D010446:Peptide Fragments; D019444:Vaccines, DNA; C107095:tumor-associated antigen, gp43