Antiidiotypic monoclonal antibodies (MAbs) representing the internal image of a yeast killer toxin (KT)have therapeutic potential against several fungal infections. The efficacy of KT MAbs against Aspergillus fumigatus was investigated in a mouse model of T-cell-depleted allogeneic bone marrow transplantation (BMT) with invasive pulmonary aspergillosis. Mice were highly susceptible to infection at 3 days post-BMT, when profound neutropenia was observed both in the periphery and in the lungs. Treatment with KT MAbs protected the mice from infection, as judged by the long-term survival and decreased pathology associated with inhibition of fungal growth and hyphal development in the lungs. In vitro, similar to polymorphonuclear neutrophils, KT MAbs significantly inhibited the hyphal development and metabolic activity of germinated Aspergillus conidia. These results indicate that mimicking the action of neutrophils could be a strategy through which KT MAbs exert therapeutic efficacy in A. fumigatus infections.Invasive fungal infections remain a major problem for bone marrow (BM) transplant (BMT) recipients (35,45). Mortality from opportunistic fungal infections exceeds 50% in most studies and has been reported to be as high as 95% in allogeneic BMT recipients with Aspergillus sp. infection, despite aggressive antifungal therapy (4).Studies in vitro and in animal models have indicated that the innate defenses are primarily responsible for the elimination of inhaled conidia from the lungs (10,13,19,38). Early fungal clearance is mediated by a dual phagocytic system involving both alveolar macrophages and recruited polymorphonuclear leukocytes capable of efficiently opposing fungal infectivity at the level of conidia or hyphal forms (37). However, the killing of phagocytosed conidia by mononuclear cells is a slow process that occurs with a low killing rate and depends on the immunocompetence of effector monocytes (19). Moreover, the finding that the conidiocidal activity of monocytes in both clinical disease and experimental chronic granulomatous disease is largely unaffected (26) reveals the unique importance of neutrophil activity against germinating conidia and hyphae in the control of aspergillosis.Human studies have shown that prolonged neutropenia is one of the most important factors predisposing to invasive aspergillosis (35,45). However, the efficacy of immunotherapies aimed at both shortening the duration of neutropenia and restoring neutrophil antifungal activity has been limited by problems associated with the transfusion therapy, including the still uncertain efficacy of colony-stimulating factors (34) and the limited persistence of the transfused cells (16). It appears that strategies aimed at keeping the infection in check until the recovery of adequate innate antifungal activity are needed for prompt handling of the fungus by the host.Recent studies have highlighted the therapeutic potential of killer antiidiotypic antibodies in several fungal infections (23). Antiidiotypes to a monoclonal antibody (MAb)...