bioRxiv2019
Cryptococcus neoformans is an opportunistic human pathogen, which causes serious disease in immunocompromised hosts. Infection with this pathogen is particularly relevant in HIV+ patients, where it leads to around 200,000 deaths per annum. A key feature of cryptococcal pathogenesis is the ability of the fungus to survive and replicate within the phagosome of macrophages, as well as its ability to escape via a novel non-lytic mechanism known as vomocytosis. We have been exploring whether viral infection affects the interaction between C. neoformans and macrophages. Here we show that viral infection enhances cryptococcal vomocytosis without altering phagocytosis or intracellular proliferation of the fungus. This effect occurs with distinct, unrelated human viral pathogens and is recapitulated when macrophages are stimulated with the anti-viral cytokine interferon alpha (IFN). Importantly, the effect is abrogated when type-I interferon signalling is blocked, thus underscoring the importance of type-I interferons in this phenomenon. Our results highlight the importance of incorporating specific context cues while studying host-pathogen interactions. By doing so, we found that acute viral infection may trigger the release of latent cryptococci from intracellular compartments, with significant consequences for disease progression.\n\nNon-Technical Author SummaryInfectious diseases are typically studied in the laboratory in isolation, but in real life people often encounter multiple infections simultaneously. Here we investigate how the innate immune response to the fatal fungus Cryptococcus neoformans is influenced by viral coinfection. Whilst virally-infected macrophages retain a normal capacity to engulf and kill Cryptococci, they demonstrate a dramatically enhanced propensity to expel them via the process known as non-lytic expulsion or vomocytosis. Activation of vomocytosis is independent of the type of virus encountered, since both HIV and measles (two entirely unrelated viral pathogens) trigger the same effect. Instead it is driven by interferon-, a generic antiviral response, which signals back to the infected macrophage, triggering expulsion of the fungus. We propose that this hitherto unobserved phenomenon represents a reprioritisation pathway for innate immune cells, by which they can alter the frequency with which they expel one pathogen (Cryptococcus) depending on the level of threat from a secondary viral infection.