John Robert Perfect, MD

Professor of Medicine
James B. Duke Professor of Medicine
Chief, Division of Infectious Diseases
Professor in Molecular Genetics and Microbiology
Campus mail Duke Box 102359, Durham, NC 27710
Phone (919) 684-4016
Email address perfe001@mc.duke.edu

Research in my laboratory focuses around several aspects of medical mycology. We are investigating antifungal agents (new and old) in animal models of candida and cryptococcal infections. We have examined clinical correlation of in vitro antifungal susceptibility testing and with in vivo outcome. Our basic science project examines the molecular pathogenesis of cryptococcal infections. We have developed a molecular foundation for C. neoformans, including transformation systems, gene disruptions, differential gene expression screens, and cloning pathogenesis genes. The goal of this work is to use C. neoformans as a model yeast system to identify molecular targets for antifungal drug development. There are a series of clinical trials in fungal infections which are being coordinated through this laboratory and my work also includes a series of antibiotic trials in various aspects of infections. Finally, we have now been awarded a NIH sponsored Mycology Unit for 5 years with 6 senior investigators which is focused on C. neoformans as a pathogenic model system, but will include multiple areas of medical mycology from diagnosis to treatment.

Education and Training

  • Fellow, Infectious Diseases, Duke University School of Medicine, 1977 - 1980
  • Resident, University of Michigan at Ann Arbor, 1975 - 1977
  • Intern, Riverside Methodist Hospital, 1974 - 1975
  • M.D., University of Toledo, 1974

Publications

Horan, J. L., and J. R. Perfect. “Fungal meningitis.” In Infections of the Central Nervous System: Fourth Edition, 2014.

Scholars@Duke

Al Thaqafi, Abdul Hakeem O., Fayssal M. Farahat, Maher I. Al Harbi, Abdul Fattah W. Al Amri, and John R. Perfect. “Predictors and outcomes of Candida bloodstream infection: eight-year surveillance, western Saudi Arabia..” International Journal of Infectious Diseases : Ijid : Official Publication of the International Society for Infectious Diseases 21 (April 2014): 5–9. https://doi.org/10.1016/j.ijid.2013.12.012.

PMID
24468816
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Inoue, Makoto, Tomohiro Arikawa, Yu-Hsun Chen, Yasuhiro Moriwaki, Michael Price, Michael Brown, John R. Perfect, and Mari L. Shinohara. “T cells down-regulate macrophage TNF production by IRAK1-mediated IL-10 expression and control innate hyperinflammation..” Proceedings of the National Academy of Sciences of the United States of America 111, no. 14 (April 2014): 5295–5300. https://doi.org/10.1073/pnas.1321427111.

PMID
24706909
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Janbon, Guilhem, Kate L. Ormerod, Damien Paulet, Edmond J. Byrnes, Vikas Yadav, Gautam Chatterjee, Nandita Mullapudi, et al. “Analysis of the genome and transcriptome of Cryptococcus neoformans var. grubii reveals complex RNA expression and microevolution leading to virulence attenuation..” Plos Genet 10, no. 4 (April 2014). https://doi.org/10.1371/journal.pgen.1004261.

PMID
24743168
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Jarvis, J. N., T. Bicanic, A. Loyse, G. Meintjes, L. Hogan, C. H. Roberts, S. Shoham, J. R. Perfect, N. Govender, and T. S. Harrison. “Vitamin D deficiency in HIV-infected South Africans: Common, and not associated with susceptibility, immune response, or outcome in HIV-associated cryptococcal meningitis.” International Journal of Infectious Diseases 21 (April 2014): 284–284. https://doi.org/10.1016/j.ijid.2014.03.1010.

Full Text

Alexander, B. D., M. D. Johnson, C. D. Pfeiffer, C. Jiménez-Ortigosa, J. Catania, and R. Booker. “Erratum: Increasing echinocandin resistance in Candida glabrata: Clinical failure correlates with presence of FKS mutations and elevated minimum inhibitory concentrations (Clinical Infectious Diseases (2013) 56 (1724-32)).” Clinical Infectious Diseases 58, no. 5 (March 1, 2014). https://doi.org/10.1093/cid/cit956.

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Chen, Yuan, Dena L. Toffaletti, Jennifer L. Tenor, Anastasia P. Litvintseva, Charles Fang, Thomas G. Mitchell, Tami R. McDonald, et al. “The Cryptococcus neoformans transcriptome at the site of human meningitis..” Mbio 5, no. 1 (February 4, 2014): e01087–e01013. https://doi.org/10.1128/mBio.01087-13.

PMID
24496797
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Chen, Y., D. L. Toffaletti, J. L. Tenor, A. P. Litvintseva, C. Fang, T. G. Mitchell, T. R. McDonald, et al. “The Cryptococcus neoformans transcriptome at the site of human meningitis.” Mbio 5, no. 1 (February 4, 2014). https://doi.org/10.1128/mBio.01087-13.

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Holmer, S. M., K. S. Evans, Y. G. Asfaw, D. Saini, W. A. Schell, J. G. Ledford, R. Frothingham, et al. “Impact of surfactant protein d, interleukin-5, and eosinophilia on cryptococcosis..” Infection and Immunity 82, no. 2 (February 2014): 683–93. https://doi.org/10.1128/iai.00855-13.

PMID
24277798
Full Text

Holmer, Stephanie M., Kathy S. Evans, Yohannes G. Asfaw, Divey Saini, Wiley A. Schell, Julie G. Ledford, Richard Frothingham, Jo Rae Wright, Gregory D. Sempowski, and John R. Perfect. “Impact of surfactant protein D, interleukin-5, and eosinophilia on Cryptococcosis..” Infection and Immunity 82, no. 2 (February 2014): 683–93. https://doi.org/10.1128/IAI.00855-13.

PMID
24478083
Full Text

Pages