Neutrophils license antifungal monocyte responses via carbonic anhydrase 4 modulation

Abstract

Abstract Neutropenia is a significant risk factor for life threatening invasive fungal infections (IFI). Neutrophils are well known as important innate cells that promote the direct eradication of fungal pathogens but whether they mediate antifungal defense beyond their role as effectors is unclear. Here we demonstrate that a pulmonary infection with the clinically relevant fungal pathogen Aspergillus fumigatus induces the diversification of specialized antifungal neutrophils that are required for antifungal CCR2+ monocyte-derived dendritic cell (mo-DC) function. Selective depletion of neutrophils resulted in global transcriptional alterations of the antifungal CCR2+ monocyte response, limited mo-DC differentiation, and diminished conidiacidal activity. Impaired mo-DC antifungal activity in neutropenic mice was accompanied by significant upregulation of carbonic anhydrase 4 (Car4) expression in CCR2+ monocyte precursors. Pharmacological inhibition of Car4 with the FDA-approved drug methazolamide (MZ) rescued the antifungal response of mo-DC and protected neutropenic mice from invasive apergillosis. Thus, beyond their role as effectors, antifungal neutrophils facilitate antifungal mo-DC functions by regulating Car4 activity. Moreover, our data provide proof-of-principle evidence for the importance of carbonic anhydrases in shaping innate cell differentiation as well as for the off-label therapeutic benefit of carbonic anhydrase inhibitors to boost antifungal immunity in susceptible patient populations.