The problem

When evaluating the risks for invasive fungal infections in a patient, physicians today rely mostly on the absolute neutrophil count. However, absolute neutrophil count as a biomarker is imprecise and often misleading in patients with liver diseases (e.g., cirrhosis). 

The approach

We designed functional assays for neutrophils that replicate essential aspects of the interaction between neutrophils and invasive fungi in vitro. The key feature that is absent in any of the existing assays is the neutrophil–neutrophil communication aka ‘neutrophil swarming’, an essential activity against invasive fungi.   

Main discoveries and innovations

  • Chronic liver failure neutrophils swarm less and are less able to control Candida albicans growth compared to healthy neutrophils
  • Neurophil recruitment towards growing Candida albicans is enhanced five-fold in the presence of albumin
  • The addition of albumin during chronic liver failure neutrophil swarming against live Candida albicans restricts fungal growth in a concentration dependent manner


Massachusetts General Hospital, MA,USA
Principal Investigator (2002–present)

Shriners Hospitals for Children, FL, USA
Senior Investigator (2006–present)