Mucormycosis or ‘black fungus’, is a fungal infection affecting the sinuses, lungs, brain, and skin. The fungal infection is rare but can be fatal for those with a weakened immune system. Those that contract black fungus unknowingly inhale spores from different molds, including Rhizopus, Mucor, and others. Patients can also get the infection through contact with contaminated surfaces or open wounds. Fortunately, black fungus is not contagious and cannot be spread between people. Symptoms are dependent on location of the infection, but may include fever, swelling, vision loss, congestion, black lesions, and others. Since symptoms are not specific to this disease, it may resemble other infections and be difficult to diagnose. Treatment usually involves antifungal medication and, if necessary, surgery to remove the infected tissue. Unfortunately, it is much harder to treat immunocompromised patients because they lack a fully functional immune system. Scientists are currently working to provide alternatives for patients with weakened immune responses.
While anti-fungal medication is the standard-of-care treatment, other therapies are being tested to improve immune response. One therapy that scientists are testing for black fungus includes antibody treatment. Antibodies are proteins generated in the body by cells, known as B cells. Once the immune system comes into contact with an invading pathogen, B cells generate antibodies to neutralize the infection. Antibodies are shaped like a “Y” that can bind to pathogens and signal other immune cells to eliminate infectious biomaterial. Interestingly, antibodies can be created in the lab to treat various diseases, including cancer. This lab-based approach provides an alternative treatment for immunocompromised patients with black fungus. Scientists at the Lundquist Institute have recently reported breakthroughs in antibody-based therapy for black fungal-infected patients.
A recent article in Science Translational Medicine, by Dr. Ashraf Ibrahim and others, demonstrate how targeting a fungal surface protein with antibody treatment can significantly reduce infection and improve patient outcomes. Ibrahim is a scientists and professor in the Lundquist Institute for Biomedical Innovation at the Harbor -UCLA Medical Center. His work investigates fungal and bacterial infections and how the immune system responds. Specifically, Ibrahim’s work has focused on novel immunotherapies to redirect the immune system toward infection.
Ibrahim and his team have developed an antibody treatment that stops the fungal infection from spreading throughout the body. In this treatment antibodies are tailored to target a fungal surface protein: Mucorales spore coat protein (CotH). The antibody, known as VX-01, has strong binding affinity to the fungus compared to other antibody treatments. Additionally, not only does the antibody protect from further infection, but also enhances therapeutic efficacy by activating a robust immune response. Early tests have shown that VX-01 is safe and could be used in immunocompromised patients.
Further investigation hopes to provide insight into combining the VX-01 antibody with standard of care or other immunotherapies to provide optimal treatment response. Overall, the team has developed an effective antibody treatment for black fungus which has identified novel targets for treatment and will provide clinicians with an alternative therapy for their patients. Ibrahim and others are also planning to move this therapy forward in the clinic and improve patient survival.
Article, Science Translational Medicine, Ashraf Ibrahim, Lundquist Institute, Harbor -UCLA Medical Center
