Antibodies to the Cryptococcus neoformans capsular glucuronoxylomannan are ubiquitous in serum from HIV⁺ and HIV^- individuals

Murine MoAbs to the Cryptococcus neoformans capsular glucuronoxylomannan (GXM) polysaccharide are protective in mice in vivo and in vitro. The prevalence of protective anti-GXM antibodies in human serum is unknown. To provide further insight into the human antibody response to C. neoformans we determined the prevalence, isotype, and IgG subclass utilization of human anti-GXM antibodies in HIV⁺ and HIV^- sera by a sensitive antigen capture ELISA assay. One hundred and twenty-three sera from the Bronx Municipal Hospital Centre serum bank were studied retrospectively. Seventy were from HIV⁺ individuals, 10 with a history of cryptococcal meningitis (CM), and 53 were from HIV^- individuals. Serum GXM determinations were also performed on 61 HIV⁺ sera. Our results demonstrated that anti-GXM IgG, IgA,and IgM are ubiquitous in both HIV⁺ (including those with CM), and HIV^- sera. Anti-GXM IgA titres and total serum IgA concentration were elevated in HIV⁺ sera. Anti-GXM IgG antibodies were almost exclusively isotype-restricted to the IgG2 subclass. Our data also demonstrated elevations of antibovine serum albumin (BSA) titres in HIV⁺ sera. Taken together, our findings confirm hypergammaglobulinaemia and expansion of anti-protein (BSA) antibodies in HIV⁺ individuals and isotype restriction of human anti-carbohydrate (GXM) antibodies to the IgG2 subclass. Our report of ubiquitous anti-GXM antibodies of the IgG and IgA isotypes suggests that anti-GXM antibodies exist before HIV infection.