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Wong SSW, Dellière S, Schiefermeier-Mach N, Lechner L, Perkhofer S, Bomme P, Fontaine T, Schlosser AG, Sorensen GL, Madan T, Kishore U, Aimanianda V. Surfactant protein D inhibits growth, alters cell surface polysaccharide exposure and immune activation potential of Aspergillus fumigatus. Cell Surf 2022; 8:100072. [PMID: 35118215 PMCID: PMC8792412 DOI: 10.1016/j.tcsw.2022.100072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/05/2022] [Accepted: 01/05/2022] [Indexed: 10/25/2022] Open
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2
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Abstract
Coronavirus disease 2019 (COVID-19)-associated invasive fungal infections are an important complication in a substantial number of critically ill, hospitalized patients with COVID-19. Three groups of fungal pathogens cause co-infections in COVID-19: Aspergillus, Mucorales and Candida species, including Candida auris. Here we review the incidence of COVID-19-associated invasive fungal infections caused by these fungi in low-, middle- and high-income countries. By evaluating the epidemiology, clinical risk factors, predisposing features of the host environment and immunological mechanisms that underlie the pathogenesis of these co-infections, we set the scene for future research and development of clinical guidance. Hoenigl and colleagues review the epidemiology, immunology and clinical risk factors contributing to COVID-19-associated fungal infections.
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3
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Ortiz SC, Pennington K, Thomson DD, Bertuzzi M. Novel Insights into Aspergillus fumigatus Pathogenesis and Host Response from State-of-the-Art Imaging of Host-Pathogen Interactions during Infection. J Fungi (Basel) 2022; 8:264. [PMID: 35330266 PMCID: PMC8954776 DOI: 10.3390/jof8030264] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/21/2022] [Accepted: 03/01/2022] [Indexed: 12/03/2022] Open
Abstract
Aspergillus fumigatus spores initiate more than 3,000,000 chronic and 300,000 invasive diseases annually, worldwide. Depending on the immune status of the host, inhalation of these spores can lead to a broad spectrum of disease, including invasive aspergillosis, which carries a 50% mortality rate overall; however, this mortality rate increases substantially if the infection is caused by azole-resistant strains or diagnosis is delayed or missed. Increasing resistance to existing antifungal treatments is becoming a major concern; for example, resistance to azoles (the first-line available oral drug against Aspergillus species) has risen by 40% since 2006. Despite high morbidity and mortality, the lack of an in-depth understanding of A. fumigatus pathogenesis and host response has hampered the development of novel therapeutic strategies for the clinical management of fungal infections. Recent advances in sample preparation, infection models and imaging techniques applied in vivo have addressed important gaps in fungal research, whilst questioning existing paradigms. This review highlights the successes and further potential of these recent technologies in understanding the host-pathogen interactions that lead to aspergillosis.
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Affiliation(s)
- Sébastien C. Ortiz
- Manchester Academic Health Science Centre, Core Technology Facility, Manchester Fungal Infection Group, Faculty of Biology, Medicine and Health, The University of Manchester, Grafton Street, Manchester M13 9NT, UK; (S.C.O.); (K.P.)
| | - Katie Pennington
- Manchester Academic Health Science Centre, Core Technology Facility, Manchester Fungal Infection Group, Faculty of Biology, Medicine and Health, The University of Manchester, Grafton Street, Manchester M13 9NT, UK; (S.C.O.); (K.P.)
| | - Darren D. Thomson
- Medical Research Council Centre for Medical Mycology, University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter EX4 4QD, UK;
| | - Margherita Bertuzzi
- Manchester Academic Health Science Centre, Core Technology Facility, Manchester Fungal Infection Group, Faculty of Biology, Medicine and Health, The University of Manchester, Grafton Street, Manchester M13 9NT, UK; (S.C.O.); (K.P.)
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4
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Abstract
Respiratory fungal infection is a severe clinical problem, especially in patients with compromised immune functions. Aspergillus, Cryptococcus, Pneumocystis, and endemic fungi are major pulmonary fungal pathogens that are able to result in life-threatening invasive diseases. Growing data being reported have indicated that multiple cells and molecules orchestrate the host's response to a fungal infection in the lung. Upon fungal challenge, innate myeloid cells including macrophages, dendritic cells (DC), and recruited neutrophils establish the first line of defense through the phagocytosis and secretion of cytokines. Natural killer cells control the fungal expansion in the lung via the direct and indirect killing of invading organisms. Adaptive immune cells including Th1 and Th17 cells confer anti-fungal activity by producing their signature cytokines, interferon-γ, and IL-17. In addition, lung epithelial cells (LEC) also participate in the resistance against fungal infection by internalization, inflammatory cytokine production, or antimicrobial peptide secretion. In the host cells mentioned above, various molecules with distinct functions modulate the immune defense signaling: Pattern recognition receptors (PRRs) such as dectin-1 expressed on the cell surface are involved in fungal recognition; adaptor proteins such as MyD88 and TRAF6 are required for transduction of signals to the nucleus for transcriptional regulation; inflammasomes also play crucial roles in the host's defense against a fungal infection in the lung. Furthermore, transcriptional factors modulate the transcriptions of a series of genes, especially those encoding cytokines and chemokines, which are predominant regulators in the infectious microenvironment, mediating the cellular and molecular immune responses against a fungal infection in the lung.
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Affiliation(s)
- Zhi Li
- The Joint Center for Infection and Immunity, Guangzhou Women and Children's Medical Center, Guangzhou Institute of Pediatrics, Guangzhou, China
- The Joint Center for Infection and Immunity, Institute Pasteur of Shanghai, Chinese Academy of Science, Shanghai, China
| | - Gen Lu
- The Joint Center for Infection and Immunity, Guangzhou Women and Children's Medical Center, Guangzhou Institute of Pediatrics, Guangzhou, China
| | - Guangxun Meng
- The Joint Center for Infection and Immunity, Institute Pasteur of Shanghai, Chinese Academy of Science, Shanghai, China
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5
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Amarsaikhan N, Tsoggerel A, Hug C, Templeton SP. The Metabolic Cytokine Adiponectin Inhibits Inflammatory Lung Pathology in Invasive Aspergillosis. THE JOURNAL OF IMMUNOLOGY 2019; 203:956-963. [PMID: 31253725 DOI: 10.4049/jimmunol.1900174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 06/12/2019] [Indexed: 12/11/2022]
Abstract
Systemic immunity and metabolism are coregulated by soluble factors, including the insulin-regulating adipose tissue cytokine adiponectin. How these factors impact detrimental inflammatory responses during fungal infection remains unknown. In this study, we observed that mortality, fungal burden, and tissue histopathology were increased in adiponectin-deficient mice in a neutropenic model of invasive aspergillosis. Lung RNA sequencing, quantitative RT-PCR, and subsequent pathway analysis demonstrated activation of inflammatory cytokine pathways with upstream regulation by IL-1 and TNF in adiponectin-deficient mice with decreased/inhibited anti-inflammatory genes/pathways, suggesting broad cytokine-mediated pathology along with ineffective fungal clearance. Quantitative RT-PCR analysis confirmed increased transcription of IL-1a, IL-6, IL-12b, IL-17A/F, and TNF in adiponectin-deficient mice at early time points postinfection, with a specific increase in intracellular TNF in alveolar macrophages. Although eosinophil recruitment and activation were increased in adiponectin-deficient mice, mortality was delayed, but not decreased, in mice deficient in both adiponectin and eosinophils. Interestingly, neutrophil depletion was required for increased inflammation in adiponectin-deficient mice in response to swollen/fixed conidia, suggesting that immune suppression enhances detrimental inflammation, whereas invasive fungal growth is dispensable. Our results suggest that adiponectin inhibits excessive lung inflammation in invasive aspergillosis. Our study has therefore identified the adiponectin pathway as a potential source for novel therapeutics in immune-compromised patients with detrimental immunity to invasive fungal infection.
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Affiliation(s)
- Nansalmaa Amarsaikhan
- Department of Microbiology and Immunology, Indiana University School of Medicine-Terre Haute, Terre Haute, IN 47809; and
| | - Angar Tsoggerel
- Department of Microbiology and Immunology, Indiana University School of Medicine-Terre Haute, Terre Haute, IN 47809; and
| | | | - Steven P Templeton
- Department of Microbiology and Immunology, Indiana University School of Medicine-Terre Haute, Terre Haute, IN 47809; and
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6
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Herrera S, Gohir W, Foroutan F, Aguilar C, Juvet S, Martinu T, Kumar D, Humar A, Rotstein C, Keshavjee S, Singer LG, Husain S. Cytokine profile in lung transplant recipients with Aspergillus spp colonization. Transpl Infect Dis 2019; 21:e13060. [PMID: 30753747 DOI: 10.1111/tid.13060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 01/31/2019] [Accepted: 02/07/2019] [Indexed: 01/05/2023]
Abstract
We studied cytokine profiles in BAL of LTRs with Aspergillus spp colonization who did not progress to IPA in the absence of antifungal prophylaxis. This was a retrospective, single center case-control study. BAL samples were analyzed for cytokines. Patients with Aspergillus spp in BAL who did not receive prophylaxis and did not develop IPA were compared to LTRs with Aspergillus spp that received prophylaxis, LTRs with IPA and controls. Twenty-one patients with Aspergillus colonization who did not develop IPA, seven patients with suspected IPA who received prophylaxis, 4 IPA and 19 controls were included. IPA group had significantly higher levels (median [IQR]) of MIP-1 beta compared to the Suspected IPA group (5 vs 5 P: 0.03). The Suspected IPA group had significantly higher levels of IL-12 (11.38 vs 1 P: 0.0001), IL-1 RA (86.11 vs 23.98 P: 0.0118), IP-10 (22.47 vs 0.86 P: 0.0151), HGF (40.92 vs 16.82 P: 0.0055), and MIG (169.62 vs 5 P: 0.0005) than Colonization group. We have identified a unique cytokine signature in patients with Aspergillus colonization that do not develop IPA. Our study forms basis for a larger study to use these cytokines profile to identify patients at a lower risk of developing IPA.
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Affiliation(s)
- Sabina Herrera
- Transplant Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Wajiha Gohir
- Transplant Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Farid Foroutan
- Ted Rogers Centre of Excellence in Heart Function, Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
| | - Claire Aguilar
- Transplant Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Stephen Juvet
- Lung Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Tereza Martinu
- Lung Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Deepali Kumar
- Transplant Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Atul Humar
- Transplant Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Coleman Rotstein
- Transplant Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Shaf Keshavjee
- Lung Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Lianne G Singer
- Lung Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Shahid Husain
- Transplant Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
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7
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Luo XL, Li JX, Huang HR, Duan JL, Dai RX, Tao RJ, Yang L, Hou JY, Jia XM, Xu JF. LL37 Inhibits Aspergillus fumigatus Infection via Directly Binding to the Fungus and Preventing Excessive Inflammation. Front Immunol 2019; 10:283. [PMID: 30842778 PMCID: PMC6391356 DOI: 10.3389/fimmu.2019.00283] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 02/04/2019] [Indexed: 12/13/2022] Open
Abstract
The incidence of Aspergillus fumigatus infection and the rate of resistance to antifungal drugs have sharply increased in recent years. LL37 has been reported as a host defense peptide with broad-spectrum antibacterial activities. However, the role of LL37 during A. fumigatus infection remains unclear. Here, we examined the interaction between LL37 and A. fumigatus and found that synthetic LL37 could directly bind to the surface of A. fumigatus, disrupting the integrity of the cell wall in vitro. LL37 inhibited mycelial growth in a concentration-dependent manner, rather than fungicidal effect even at high concentration (e.g., 20 μM). Interestingly, low concentrations of LL37 (e.g., 4 μM) significantly attenuated mycelial adhesion and prevented the invasion and destruction of epithelial cells. Following LL37 treatment, the levels of proinflammatory cytokines released by A. fumigatus-stimulated macrophages decreased significantly, accompanied by downregulation of M1 type markers. In a mouse model of pulmonary A. fumigatus infection, LL37-treated mice showed lower amounts of fungi load, moderate pathological damage, and reduced proinflammatory cytokines. Further, LL37 transgenic mice (LL37+/+) were examined to investigate the effects of endogenous LL37 in an A. fumigatus infection model and showed lower susceptibility to A. fumigatus infection in comparison with wild-type mice. In addition, LL37 also played a protective role in an immunosuppressed mouse model of A. fumigatus infection. Thus, LL37 inhibits A. fumigatus infection via directly binding to mycelia and reducing excessive inflammation. LL37 or its analogs may therefore constitute potential drug components for A. fumigatus infection.
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Affiliation(s)
- Xiao-Li Luo
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jian-Xiong Li
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hua-Rong Huang
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jie-Lin Duan
- Clinical Translational Research Center, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ruo-Xuan Dai
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ru-Jia Tao
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ling Yang
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jia-Yun Hou
- Zhongshan Hospital Institute of Clinical Science, Shanghai Institute of Clinical Bioinformatics, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xin-Ming Jia
- Clinical Translational Research Center, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jin-Fu Xu
- Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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8
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Gago S, Overton NLD, Ben-Ghazzi N, Novak-Frazer L, Read ND, Denning DW, Bowyer P. Lung colonization by Aspergillus fumigatus is controlled by ZNF77. Nat Commun 2018; 9:3835. [PMID: 30237437 PMCID: PMC6147781 DOI: 10.1038/s41467-018-06148-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 07/27/2018] [Indexed: 01/21/2023] Open
Abstract
Aspergillus fumigatus is a critical pathogen of humans. Exposure to A. fumigatus conidia occurs frequently but is normally cleared from the respiratory airways. In contrast, individuals with respiratory diseases are often highly colonized by fungi. Here, we use genome-edited epithelial cells to show that the genetic variant rs35699176 in ZNF77 causes loss of integrity of the bronchial epithelium and increases levels of extracellular matrix proteins. These changes promote A. fumigatus conidial adhesion, germination and growth. RNA-seq and LC/MS-MS analysis reveal rs35699176 upregulates vesicle trafficking leading to an increment of adhesion proteins. These changes make cells carrying rs35699176 more receptive to A. fumigatus in the early stages of infection. Moreover, patients with fungal asthma carrying rs35699176+/- have higher A. fumigatus loads in their respiratory airway. Our results indicate ZNF77 as a key controller of Aspergillus colonization and suggest its utility as a risk-marker for patient stratification.
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Affiliation(s)
- Sara Gago
- Manchester Fungal Infection Group, Division of Infection, Immunity and Respiratory Medicine, University of Manchester, CTF Building, 46 Grafton Street, Manchester, M13 9NT, UK
| | - Nicola L D Overton
- Manchester Fungal Infection Group, Division of Infection, Immunity and Respiratory Medicine, University of Manchester, CTF Building, 46 Grafton Street, Manchester, M13 9NT, UK.,Clinical & Experimental Pharmacology Group, CRUK Manchester Institute, University of Manchester, Manchester, M20 4GJ, UK
| | - Nagwa Ben-Ghazzi
- Manchester Fungal Infection Group, Division of Infection, Immunity and Respiratory Medicine, University of Manchester, CTF Building, 46 Grafton Street, Manchester, M13 9NT, UK
| | - Lilyann Novak-Frazer
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester NHS Foundation Trust, Manchester, M23 9LT, UK.,Mycology Reference Centre, ECMM Excellence Centre of Medical Mycology, Manchester University NHS Foundation Trust, Manchester, M23 9LT, UK
| | - Nick D Read
- Manchester Fungal Infection Group, Division of Infection, Immunity and Respiratory Medicine, University of Manchester, CTF Building, 46 Grafton Street, Manchester, M13 9NT, UK
| | - David W Denning
- National Aspergillosis Centre, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, M23 9LT, UK
| | - Paul Bowyer
- Manchester Fungal Infection Group, Division of Infection, Immunity and Respiratory Medicine, University of Manchester, CTF Building, 46 Grafton Street, Manchester, M13 9NT, UK.
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9
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Hyperbaric Oxygen Reduces Aspergillus fumigatus Proliferation In Vitro and Influences In Vivo Disease Outcomes. Antimicrob Agents Chemother 2018; 62:AAC.01953-17. [PMID: 29229641 DOI: 10.1128/aac.01953-17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/06/2017] [Indexed: 12/23/2022] Open
Abstract
Recent estimates suggest that more than 3 million people have chronic or invasive fungal infections, causing more than 600,000 deaths every year. Aspergillus fumigatus causes invasive pulmonary aspergillosis (IPA) in patients with compromised immune systems and is a primary contributor to increases in human fungal infections. Thus, the development of new clinical modalities as stand-alone or adjunctive therapy for improving IPA patient outcomes is critically needed. Here we tested the in vitro and in vivo impacts of hyperbaric oxygen (HBO) (100% oxygen, >1 atmosphere absolute [ATA]) on A. fumigatus proliferation and murine IPA outcomes. Our findings indicate that HBO reduces established fungal biofilm proliferation in vitro by over 50%. The effect of HBO under the treatment conditions was transient and fungistatic, with A. fumigatus metabolic activity rebounding within 6 h of HBO treatment being removed. In vivo, daily HBO provides a dose-dependent but modest improvement in murine IPA disease outcomes as measured by survival analysis. Intriguingly, no synergy was observed between subtherapeutic voriconazole or amphotericin B and HBO in vitro or in vivo with daily HBO dosing, though the loss of fungal superoxide dismutase genes enhanced HBO antifungal activity. Further studies are needed to optimize the HBO treatment regimen and better understand the effects of HBO on both the host and the pathogen during a pulmonary invasive fungal infection.
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10
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Zhang P, Xin X, Fang L, Jiang H, Xu X, Su X, Shi Y. HMGB1 mediates Aspergillus fumigatus -induced inflammatory response in alveolar macrophages of COPD mice via activating MyD88/NF-κB and syk/PI3K signalings. Int Immunopharmacol 2017; 53:125-132. [DOI: 10.1016/j.intimp.2017.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 09/23/2017] [Accepted: 10/05/2017] [Indexed: 12/20/2022]
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11
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Innate and Adaptive Immune Defects in Chronic Pulmonary Aspergillosis. J Fungi (Basel) 2017; 3:jof3020026. [PMID: 29371544 PMCID: PMC5715918 DOI: 10.3390/jof3020026] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 05/04/2017] [Accepted: 05/08/2017] [Indexed: 12/17/2022] Open
Abstract
We evaluated the expression of biomarkers of innate and adaptive immune response in correlation with underlying conditions in 144 patients with chronic pulmonary aspergillosis (CPA). Patients with complete medical and radiological records, white cell counts, and a complete panel of CD3, CD4, CD8, CD19, and CD56 lymphocyte subsets were included. Eighty-four (58%) patients had lymphopenia. Six (4%) patients had lymphopenia in all five CD variables. There were 62 (43%) patients with low CD56 and 62 (43%) patients with low CD19. Ten (7%) patients had isolated CD19 lymphopenia, 18 (13%) had isolated CD56 lymphopenia, and 15 (10%) had combined CD19 and CD56 lymphopenia only. Forty-eight (33%) patients had low CD3 and 46 (32%) had low CD8 counts. Twenty-five (17%) patients had low CD4, 15 (10%) of whom had absolute CD4 counts <200/μL. Multivariable logistic regression showed associations between: low CD19 and pulmonary sarcoidosis (Odds Ratio (OR), 5.53; 95% Confidence Interval (CI), 1.43–21.33; p = 0.013), and emphysema (OR, 4.58; 95% CI; 1.36–15.38; p = 0.014), low CD56 and no bronchiectasis (OR, 0.27; 95% CI, 0.10–0.77; p = 0.014), low CD3 and both multicavitary CPA disease (OR, 2.95; 95% CI, 1.30–6.72; p = 0.010) and pulmonary sarcoidosis (OR, 4.94; 95% CI, 1.39–17.57; p = 0.014). Several subtle immune defects are found in CPA.
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12
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Männ L, Kochupurakkal N, Martin C, Verjans E, Klingberg A, Sody S, Kraus A, Dalimot J, Bergmüller E, Jung S, Voortman S, Winterhager E, Brandau S, Garbi N, Kurrer M, Eriksson U, Gunzer M, Hasenberg M. CD11c.DTR mice develop a fatal fulminant myocarditis after local or systemic treatment with diphtheria toxin. Eur J Immunol 2016; 46:2028-42. [PMID: 27184067 DOI: 10.1002/eji.201546245] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/05/2016] [Accepted: 05/11/2016] [Indexed: 12/21/2022]
Abstract
To assess the role of alveolar macrophages (AMs) during a pulmonary Aspergillus fumigatus infection AMs were depleted by intratracheal application of diphtheria toxin (DTX) to transgenic CD11c.DTR mice prior to fungal infection. Unexpectedly, all CD11c.DTR mice treated with DTX died within 4-5 days, whether being infected with A. fumigatus or not. Despite measurable impact of DTX on lung functional parameters, these constrictions could not explain the high mortality rate. Instead, DTX-treated CD11c.DTR animals developed fulminant myocarditis (FM) characterized by massive leukocyte infiltration and myocardial cell destruction, including central parts of the heart's stimulus transmission system. In fact, standard limb lead ECG recordings of diseased but not healthy mice showed a "Brugada"-like pattern with an abnormally high ST segment pointing to enhanced susceptibility for potential lethal arrhythmias. While CD11c.DTR mice are extensively used for the characterization of CD11c(+) cells, including dendritic cells, several studies have already mentioned adverse side effects following DTX treatment. Our results demonstrate that this limitation is based on severe myocarditis but not on the expected lung constrictions, and has to be taken into consideration if this animal model is used. Based on these properties, however, the CD11c.DTR mouse might serve as useful animal model for FM.
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Affiliation(s)
- Linda Männ
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Nora Kochupurakkal
- Department of Research, Experimental Critical Care Medicine, University Hospital, Basel, Switzerland
| | - Christian Martin
- Institute of Pharmacology and Toxicology, University Hospital Aachen, Aachen, Germany
| | - Eva Verjans
- Institute of Pediatrics, University Hospital Aachen, Aachen, Germany
| | - Anika Klingberg
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Simon Sody
- Department of Otorhinolaryngology, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Andreas Kraus
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Jill Dalimot
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Eileen Bergmüller
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Steffen Jung
- Department of Immunology, Weizmann Institute of Science, Rehovot, Israel
| | - Sylvia Voortman
- Imaging Center Essen, Electron Microscopy Unit, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Elke Winterhager
- Imaging Center Essen, Electron Microscopy Unit, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Sven Brandau
- Department of Otorhinolaryngology, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Natalio Garbi
- Institute of Experimental Immunology, Rheinische Friedrich Wilhelms University, Bonn, Germany
| | | | - Urs Eriksson
- Division of Cardioimmunology, Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.,Department of Medicine, GZO-Zurich Regional Health Center, Wetzikon, Switzerland
| | - Matthias Gunzer
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, Essen, Germany
| | - Mike Hasenberg
- Institute for Experimental Immunology and Imaging, University Hospital, University Duisburg-Essen, Essen, Germany
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13
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Hopke A, Nicke N, Hidu EE, Degani G, Popolo L, Wheeler RT. Neutrophil Attack Triggers Extracellular Trap-Dependent Candida Cell Wall Remodeling and Altered Immune Recognition. PLoS Pathog 2016; 12:e1005644. [PMID: 27223610 PMCID: PMC4880299 DOI: 10.1371/journal.ppat.1005644] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 04/28/2016] [Indexed: 01/09/2023] Open
Abstract
Pathogens hide immunogenic epitopes from the host to evade immunity, persist and cause infection. The opportunistic human fungal pathogen Candida albicans, which can cause fatal disease in immunocompromised patient populations, offers a good example as it masks the inflammatory epitope β-glucan in its cell wall from host recognition. It has been demonstrated previously that β-glucan becomes exposed during infection in vivo but the mechanism behind this exposure was unknown. Here, we show that this unmasking involves neutrophil extracellular trap (NET) mediated attack, which triggers changes in fungal cell wall architecture that enhance immune recognition by the Dectin-1 β-glucan receptor in vitro. Furthermore, using a mouse model of disseminated candidiasis, we demonstrate the requirement for neutrophils in triggering these fungal cell wall changes in vivo. Importantly, we found that fungal epitope unmasking requires an active fungal response in addition to the stimulus provided by neutrophil attack. NET-mediated damage initiates fungal MAP kinase-driven responses, particularly by Hog1, that dynamically relocalize cell wall remodeling machinery including Chs3, Phr1 and Sur7. Neutrophil-initiated cell wall disruptions augment some macrophage cytokine responses to attacked fungi. This work provides insight into host-pathogen interactions during disseminated candidiasis, including valuable information about how the C. albicans cell wall responds to the biotic stress of immune attack. Our results highlight the important but underappreciated concept that pattern recognition during infection is dynamic and depends on the host-pathogen dialog. Opportunistic fungal infections, including those caused by C. albicans, have emerged as a significant global health burden and the disseminated form of these infections still have unacceptably high mortality rates despite modern antifungal treatments. The fungal cell wall controls its interaction with the host environment and immune recognition, although cell wall dynamics during infection are poorly understood. C. albicans organizes its cell wall to mask the inflammatory β-glucan as a form of immune evasion and it is known that during infection this β-glucan becomes exposed. Here, we investigated how β-glucan becomes exposed and discovered a dynamic interaction where host NETs provoke an active fungal response that disrupts cell wall architecture and unmasks β-glucan. We revealed an unexpected level of local fungal cell wall dynamics in response to immune mediated stress, suggesting this may represent a model that can be leveraged to identify novel drug targets. Our results highlight the understudied concept that the cell wall is a dynamic landscape during infection and can be influenced by the host.
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Affiliation(s)
- Alex Hopke
- Molecular and Biomedical Sciences, University of Maine, Orono, Maine, United States of America
| | - Nadine Nicke
- Molecular and Biomedical Sciences, University of Maine, Orono, Maine, United States of America
| | - Erica E. Hidu
- Molecular and Biomedical Sciences, University of Maine, Orono, Maine, United States of America
| | - Genny Degani
- Department of Biosciences, University of Milan, Milan, Italy
| | - Laura Popolo
- Department of Biosciences, University of Milan, Milan, Italy
| | - Robert T. Wheeler
- Molecular and Biomedical Sciences, University of Maine, Orono, Maine, United States of America
- Graduate School of Biomedical Sciences and Engineering, University of Maine, Orono, Maine, United States of America
- * E-mail:
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14
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Gresnigt MS, Rekiki A, Rasid O, Savers A, Jouvion G, Dannaoui E, Parlato M, Fitting C, Brock M, Cavaillon JM, van de Veerdonk FL, Ibrahim-Granet O. Reducing hypoxia and inflammation during invasive pulmonary aspergillosis by targeting the Interleukin-1 receptor. Sci Rep 2016; 6:26490. [PMID: 27215684 PMCID: PMC4877709 DOI: 10.1038/srep26490] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/04/2016] [Indexed: 01/05/2023] Open
Abstract
Hypoxia as a result of pulmonary tissue damage due to unresolved inflammation during invasive pulmonary aspergillosis (IPA) is associated with a poor outcome. Aspergillus fumigatus can exploit the hypoxic microenvironment in the lung, but the inflammatory response required for fungal clearance can become severely disregulated as a result of hypoxia. Since severe inflammation can be detrimental to the host, we investigated whether targeting the interleukin IL-1 pathway could reduce inflammation and tissue hypoxia, improving the outcome of IPA. The interplay between hypoxia and inflammation was investigated by in vivo imaging of hypoxia and measurement of cytokines in the lungs in a model of corticosteroid immunocompromised and in Cxcr2 deficient mice. Severe hypoxia was observed following Aspergillus infection in both models and correlated with development of pulmonary inflammation and expression of hypoxia specific transcripts. Treatment with IL-1 receptor antagonist reduced hypoxia and slightly, but significantly reduced mortality in immunosuppressed mice, but was unable to reduce hypoxia in Cxcr2(-/-) mice. Our data provides evidence that the inflammatory response during invasive pulmonary aspergillosis, and in particular the IL-1 axis, drives the development of hypoxia. Targeting the inflammatory IL-1 response could be used as a potential immunomodulatory therapy to improve the outcome of aspergillosis.
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Affiliation(s)
- Mark S Gresnigt
- Unité de recherche Cytokines &Inflammation, Institut Pasteur, Paris.,Department of Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Orhan Rasid
- Unité de recherche Cytokines &Inflammation, Institut Pasteur, Paris
| | - Amélie Savers
- Fungal Genetics and Biology, School of Life Sciences, University of Nottingham, UK
| | - Grégory Jouvion
- Unité Histopathologie Humaine et Modèles Animaux, Institut Pasteur, Paris France
| | - Eric Dannaoui
- Paris-Descartes University, Faculty of Medicine, APHP, European Georges Pompidou Hospital, Parasitology-Mycology Unit, Microbiology department, Paris, France
| | - Marianna Parlato
- INSERM UMR S1163 Institut Imagine, Laboratoire d'Immunité Intestinale, Paris France
| | | | - Matthias Brock
- Fungal Genetics and Biology, School of Life Sciences, University of Nottingham, UK
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15
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Rieber N, Singh A, Öz H, Carevic M, Bouzani M, Amich J, Ost M, Ye Z, Ballbach M, Schäfer I, Mezger M, Klimosch SN, Weber ANR, Handgretinger R, Krappmann S, Liese J, Engeholm M, Schüle R, Salih HR, Marodi L, Speckmann C, Grimbacher B, Ruland J, Brown GD, Beilhack A, Loeffler J, Hartl D. Pathogenic fungi regulate immunity by inducing neutrophilic myeloid-derived suppressor cells. Cell Host Microbe 2015; 17:507-14. [PMID: 25771792 PMCID: PMC4400268 DOI: 10.1016/j.chom.2015.02.007] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/17/2014] [Accepted: 01/26/2015] [Indexed: 01/19/2023]
Abstract
Despite continuous contact with fungi, immunocompetent individuals rarely develop pro-inflammatory antifungal immune responses. The underlying tolerogenic mechanisms are incompletely understood. Using both mouse models and human patients, we show that infection with the human pathogenic fungi Aspergillus fumigatus and Candida albicans induces a distinct subset of neutrophilic myeloid-derived suppressor cells (MDSCs), which functionally suppress T and NK cell responses. Mechanistically, pathogenic fungi induce neutrophilic MDSCs through the pattern recognition receptor Dectin-1 and its downstream adaptor protein CARD9. Fungal MDSC induction is further dependent on pathways downstream of Dectin-1 signaling, notably reactive oxygen species (ROS) generation as well as caspase-8 activity and interleukin-1 (IL-1) production. Additionally, exogenous IL-1β induces MDSCs to comparable levels observed during C. albicans infection. Adoptive transfer and survival experiments show that MDSCs are protective during invasive C. albicans infection, but not A. fumigatus infection. These studies define an innate immune mechanism by which pathogenic fungi regulate host defense. Pathogenic fungi induce myeloid-derived suppressor cells (MDSCs) MDSC induction involves Dectin-1/CARD9, ROS, caspase-8, and IL-1 MDSCs dampen T and NK cell immune responses Adoptive transfer of MDSCs improves survival in Candida infection in vivo
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Affiliation(s)
- Nikolaus Rieber
- Department of Pediatrics I, University of Tübingen, 72076 Tübingen, Germany.
| | - Anurag Singh
- Department of Pediatrics I, University of Tübingen, 72076 Tübingen, Germany
| | - Hasan Öz
- Department of Pediatrics I, University of Tübingen, 72076 Tübingen, Germany
| | - Melanie Carevic
- Department of Pediatrics I, University of Tübingen, 72076 Tübingen, Germany
| | - Maria Bouzani
- Department of Medicine II, University of Würzburg, 97080 Würzburg, Germany
| | - Jorge Amich
- IZKF Research Group for Experimental Stem Cell Transplantation, Department of Medicine II, 97080 Würzburg, Germany
| | - Michael Ost
- Department of Pediatrics I, University of Tübingen, 72076 Tübingen, Germany
| | - Zhiyong Ye
- Department of Pediatrics I, University of Tübingen, 72076 Tübingen, Germany; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
| | - Marlene Ballbach
- Department of Pediatrics I, University of Tübingen, 72076 Tübingen, Germany
| | - Iris Schäfer
- Department of Pediatrics I, University of Tübingen, 72076 Tübingen, Germany
| | - Markus Mezger
- Department of Pediatrics I, University of Tübingen, 72076 Tübingen, Germany
| | - Sascha N Klimosch
- Institute of Cell Biology, Department of Immunology, University of Tübingen, 72076 Tübingen, Germany
| | - Alexander N R Weber
- Institute of Cell Biology, Department of Immunology, University of Tübingen, 72076 Tübingen, Germany
| | | | - Sven Krappmann
- Microbiology Institute - Clinical Microbiology, Immunology and Hygiene, University Hospital of Erlangen and Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Johannes Liese
- Department of Pediatrics, University of Würzburg, 97080 Würzburg, Germany
| | - Maik Engeholm
- Department of Neurology, University of Tübingen, 72076 Tübingen, Germany
| | - Rebecca Schüle
- Department of Neurology, University of Tübingen, 72076 Tübingen, Germany
| | | | - Laszlo Marodi
- Department of Infectious and Pediatric Immunology, Medical and Health Science Center, University of Debrecen, 4032 Debrecen, Hungary
| | - Carsten Speckmann
- Centre of Chronic Immunodeficiency (CCI), University Medical Center Freiburg and University of Freiburg, 79106 Freiburg, Germany
| | - Bodo Grimbacher
- Centre of Chronic Immunodeficiency (CCI), University Medical Center Freiburg and University of Freiburg, 79106 Freiburg, Germany
| | - Jürgen Ruland
- Institut für Klinische Chemie und Pathobiochemie, Klinikum rechts der Isar, Technische Universität München, 81675 Munich, Germany
| | - Gordon D Brown
- Aberdeen Fungal Group, Section of Immunology and Infection, University of Aberdeen, AB24 3FX Aberdeen, UK
| | - Andreas Beilhack
- IZKF Research Group for Experimental Stem Cell Transplantation, Department of Medicine II, 97080 Würzburg, Germany
| | - Juergen Loeffler
- Department of Medicine II, University of Würzburg, 97080 Würzburg, Germany
| | - Dominik Hartl
- Department of Pediatrics I, University of Tübingen, 72076 Tübingen, Germany.
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16
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Bozza S, Campo S, Arseni B, Inforzato A, Ragnar L, Bottazzi B, Mantovani A, Moretti S, Oikonomous V, De Santis R, Carvalho A, Salvatori G, Romani L. PTX3 Binds MD-2 and Promotes TRIF-Dependent Immune Protection in Aspergillosis. THE JOURNAL OF IMMUNOLOGY 2014; 193:2340-8. [DOI: 10.4049/jimmunol.1400814] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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17
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Moretti S, Bozza S, Massi-Benedetti C, Prezioso L, Rossetti E, Romani L, Aversa F, Pitzurra L. An immunomodulatory activity of micafungin in preclinical aspergillosis. J Antimicrob Chemother 2013; 69:1065-74. [DOI: 10.1093/jac/dkt457] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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