Cryptococcus infections represents a major healthcare burden, with over 200,000 cases globally a year and even with treatment, mortality remains as high as 80%. There is a clear need for new classes of treatment, especially with the global threat of antifungal resistance. Several groups are investigating the potential of immunotherapy - circumventing many of the issues with current treatments. Macrophages are a cell type known to be heavily associated with cryptococcal infection, from the innate immune response through to the later stage chronic adaptive response - making these an ideal target for manipulation. However, it is currently debated whether macrophage activity is positive or negative for host outcomes. Here, we discuss the current literature surrounding the role of macrophages during Cryptococcus infection, and makes cases for and against macrophage enhancement. Finally, we discuss which pressing questions in the field still remain that require answers in order to safely design an immunotherapeutic with high efficacy.

中文翻译：

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隐球菌病中巨噬细胞是英雄还是反派？

隐球菌感染是主要的医疗保健负担，全球每年有200,000例病例，即使进行治疗，死亡率仍高达80％。显然需要新的治疗方法，尤其是在全球范围内抗真菌药耐药的情况下。几个小组正在研究免疫疗法的潜力-规避当前疗法的许多问题。从先天免疫反应到后期慢性适应性反应，巨噬细胞是一种与隐球菌感染密切相关的细胞类型-使它们成为理想的操纵靶标。但是，目前正在辩论巨噬细胞活动对宿主结局是阳性还是阴性。在这里，我们讨论有关巨噬细胞在隐球菌感染过程中的作用的现有文献，并提出支持和反对增强巨噬细胞的理由。最后，我们讨论了该领域中仍然存在哪些迫切需要解决的紧迫问题，以便安全地设计具有高功效的免疫疗法。