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Ross RL, Santiago-Tirado FH. Advanced genetic techniques in fungal pathogen research. mSphere 2024; 9:e0064323. [PMID: 38470131 PMCID: PMC11036804 DOI: 10.1128/msphere.00643-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Although fungi have been important model organisms for solving genetic, molecular, and ecological problems, recently, they are also becoming an important source of infectious disease. Despite their high medical burden, fungal pathogens are understudied, and relative to other pathogenic microbes, less is known about how their gene functions contribute to disease. This is due, in part, to a lack of powerful genetic tools to study these organisms. In turn, this has resulted in inappropriate treatments and diagnostics and poor disease management. There are a variety of reasons genetic studies were challenging in pathogenic fungi, but in recent years, most of them have been overcome or advances have been made to circumvent these barriers. In this minireview, we highlight how recent advances in genetic studies in fungal pathogens have resulted in the discovery of important biology and potential new antifungals and have created the tools to comprehensively study these important pathogens.
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Affiliation(s)
- Robbi L. Ross
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, USA
| | - Felipe H. Santiago-Tirado
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, USA
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, Indiana, USA
- Warren Center for Drug Discovery, University of Notre Dame, Notre Dame, Indiana, USA
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2
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Kong X, Cheng L, Dong Z, Huang Y, Xue X, Wang Z, Wang Y, Zang X, Qian H, Chang L, Wang Y. Rapid Cryptococcus electroporated-lysis and sensitive detection on a miniaturized platform. Biosens Bioelectron 2024; 250:116096. [PMID: 38316089 DOI: 10.1016/j.bios.2024.116096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 02/07/2024]
Abstract
Fast and accurate detection of Cryptococcus and precise differentiation of its subtypes is of great significance in protecting people from cryptococcal disease and preventing its spread in populations. However, traditional Cryptococcus identification and detection techniques still face significant challenges in achieving high analysis speed as well as high sensitivity. In this work, we report an electric microfluidic biochip. Compared to conventional methods that take several hours or even a day, this chip can detect Cryptococcus within 20 min, and achieve its maximum detection limit within 1 h, with the ability to differentiate between the Cryptococcus neoformans (NEO) and rare Cryptococcus gattii (GAT) efficiently, which accounts for nearly 100%. This device integrated two functional zones of an electroporation lysis (EL) zone for rapid cell lysis (<30 s) and an electrochemical detection (ED) zone for sensitive analysis of the released nucleic acids. The EL zone adopted a design of microelectrode arrays, which obtains a large electric field intensity at the constriction of the microchannel, addressing the safety concerns associated with high-voltage lysis. The device enables a limit of detection (LOD) of 60 pg/mL for NEO and 100 pg/mL for GAT through the modification of nanocomposites and specific probes. In terms of the detection time and sensitivity, the integrated microfluidic biochip demonstrates broad potential in Cryptococcus diagnosis and disease prevention.
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Affiliation(s)
- Xiangzhu Kong
- School of Biomedical Engineering, Anhui Medical University, Hefei, 230032, China
| | - Long Cheng
- School of Biomedical Engineering, Anhui Medical University, Hefei, 230032, China
| | - Zaizai Dong
- School of Engineering Medicine, Beihang University, Beijing, 100191, China; Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
| | - Yemei Huang
- Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
| | - Xinying Xue
- Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China; Affiliated Hospital of Weifang Medical University, Weifang, 261000, China
| | - Zhiying Wang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Yusen Wang
- Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Xuelei Zang
- Department of Respiratory and Critical Care, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
| | - Haisheng Qian
- School of Biomedical Engineering, Anhui Medical University, Hefei, 230032, China; School of Basic Medical Sciences, Anhui Provincial Institute of Translational Medicine, Anhui Medical University, Hefei, 230032, China.
| | - Lingqian Chang
- School of Biomedical Engineering, Anhui Medical University, Hefei, 230032, China; Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China.
| | - Yang Wang
- School of Engineering Medicine, Beihang University, Beijing, 100191, China.
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Palmucci JR, Sells BE, Giamberardino CD, Toffaletti DL, Dai B, Asfaw YG, Dubois LG, Li Z, Theriot B, Schell WA, Hope W, Tenor JL, Perfect JR. A ketogenic diet enhances fluconazole efficacy in murine models of systemic fungal infection. mBio 2024:e0064924. [PMID: 38619236 DOI: 10.1128/mbio.00649-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/16/2024] Open
Abstract
Invasive fungal infections are a significant public health concern, with mortality rates ranging from 20% to 85% despite current treatments. Therefore, we examined whether a ketogenic diet could serve as a successful treatment intervention in murine models of Cryptococcus neoformans and Candida albicans infection in combination with fluconazole-a low-cost, readily available antifungal therapy. The ketogenic diet is a high-fat, low-carbohydrate diet that promotes fatty acid oxidation as an alternative to glycolysis through the production of ketone bodies. In this series of experiments, mice fed a ketogenic diet prior to infection with C. neoformans and treated with fluconazole had a significant decrease in fungal burden in both the brain (mean 2.66 ± 0.289 log10 reduction) and lung (mean 1.72 ± 0.399 log10 reduction) compared to fluconazole treatment on a conventional diet. During C. albicans infection, kidney fungal burden of mice in the keto-fluconazole combination group was significantly decreased compared to fluconazole alone (2.37 ± 0.770 log10-reduction). Along with higher concentrations of fluconazole in the plasma and brain tissue, fluconazole efficacy was maximized at a significantly lower concentration on a keto diet compared to a conventional diet, indicating a dramatic effect on fluconazole pharmacodynamics. Our findings indicate that a ketogenic diet potentiates the effect of fluconazole at multiple body sites during both C. neoformans and C. albicans infection and could have practical and promising treatment implications.IMPORTANCEInvasive fungal infections cause over 2.5 million deaths per year around the world. Treatments for fungal infections are limited, and there is a significant need to develop strategies to enhance antifungal efficacy, combat antifungal resistance, and mitigate treatment side effects. We determined that a high-fat, low-carbohydrate ketogenic diet significantly potentiated the therapeutic effect of fluconazole, which resulted in a substantial decrease in tissue fungal burden of both C. neoformans and C. albicans in experimental animal models. We believe this work is the first of its kind to demonstrate that diet can dramatically influence the treatment of fungal infections. These results highlight a novel strategy of antifungal drug enhancement and emphasize the need for future investigation into dietary effects on antifungal drug activity.
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Affiliation(s)
- Julia R Palmucci
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Blake E Sells
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Charles D Giamberardino
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Dena L Toffaletti
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Baodi Dai
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Yohannes G Asfaw
- Department of Laboratory Animal Resources, Duke University Medical Center, Durham, North Carolina, USA
| | - Laura G Dubois
- Duke Proteomics and Metabolomics Core Facility, Duke University, Durham, North Carolina, USA
| | - Zhong Li
- Duke Proteomics and Metabolomics Core Facility, Duke University, Durham, North Carolina, USA
| | - Barbara Theriot
- Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA
| | - Wiley A Schell
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - William Hope
- Antimicrobial Pharmacodynamics and Therapeutics, University of Liverpool, Liverpool Health Partners, Liverpool, United Kingdom
| | - Jennifer L Tenor
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - John R Perfect
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
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Patel K, Twohig P, Peeraphatdit T, Stohs EJ, Samson K, Smith L, Patel J, Manatsathit W. Outcomes and factors associated with cryptococcal disease among cirrhotics: A study of the national inpatient sample 2005 to 2014. Clin Res Hepatol Gastroenterol 2024; 48:102337. [PMID: 38609048 DOI: 10.1016/j.clinre.2024.102337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/29/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Cryptococcal disease (CD) confers a higher mortality in cirrhotic patients compared to non-cirrhotic patients. Factor association for CD in cirrhotic patients is poorly understood. Our aim was to determine the incidence, demographic, and comorbidities associated with CD among cirrhotic patients in the United States (US). METHOD Retrospective analysis of admissions of cirrhotic patients, with or without CD, using the National Inpatient Sample (NIS) database from 2005 to 2014. The number of admissions were reported in raw and weighted frequencies. The trends of CD among cirrhotic patients and overall CD were evaluated. Rao-Scott chi-square, t-tests, and multivariate logistic regressions were performed to evaluate variables and CD among cirrhotic patients. RESULTS There were 886,962 admissions for cirrhosis, and 164 of these with CD. By adjusted odds ratio (AOR), CD was more often associated with cirrhosis in Southern (2.95; 95 % CI 1.24, 7.02) and Western regions (4.45; 95 % CI 1.91, 10.37), Hispanic patients (1.80; 95 % CI 1.01, 3.20), and patients with chronic kidney disease (CKD) (3.13; 95 % CI 2.09, 4.69). Of note, CD in cirrhotic patients was associated with higher inpatient mortality (AOR of 3.89, 95 % CI 2.53, 5.99), longer length of stay (9.87 vs. 4.88 days), and a higher total charge ($76,880 vs. $ 37,227) when compared to cirrhotic patients without CD. DISCUSSION Patients with cirrhosis admitted with CD have a high inpatient mortality. The geographical location and CKD were important factors associated with CD among cirrhotic patients. Autoimmune liver diseases and immunosuppression did not appear to increase the risk of CD.
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Affiliation(s)
- Kishan Patel
- Division of Gastroenterology and Nutrition, Loyola University Medical Center, Maywood, IL 60153, USA
| | - Patrick Twohig
- Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Thoetchai Peeraphatdit
- Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Erica J Stohs
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Kaeli Samson
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Lynette Smith
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Jay Patel
- Department of Internal Medicine, University of Connecticut Medical Center, Farmington, CA 06030, USA
| | - Wuttiporn Manatsathit
- Division of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE 68198, USA.
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Castelli RF, Pereira A, Honorato L, Valdez A, de Oliveira HC, Bazioli JM, Garcia AWA, Klimeck TDF, Reis FCG, Camillo-Andrade AC, Santos MDM, Carvalho PC, Zaragoza O, Staats CC, Nimrichter L, Fill TP, Rodrigues ML. Corrected and republished from: "Extracellular Vesicle Formation in Cryptococcus deuterogattii Impacts Fungal Virulence". Infect Immun 2024; 92:e0003724. [PMID: 38470135 PMCID: PMC11003230 DOI: 10.1128/iai.00037-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 03/13/2024] Open
Abstract
Small molecules are components of fungal extracellular vesicles (EVs), but their biological roles are only superficially known. NOP16 is a eukaryotic gene that is required for the activity of benzimidazoles against Cryptococcus deuterogattii. In this study, during the phenotypic characterization of C. deuterogattii mutants expected to lack NOP16 expression, we observed a reduced EV production. Whole-genome sequencing, RNA-Seq, and cellular proteomics revealed that, contrary to our initial findings, these mutants expressed Nop16 but exhibited altered expression of 14 genes potentially involved in sugar transport. Based on this observation, we designated these mutant strains as Past1 and Past2, representing potentially altered sugar transport. Analysis of the small molecule composition of EVs produced by wild-type cells and the Past1 and Past2 mutant strains revealed not only a reduced number of EVs but also an altered small molecule composition. In a Galleria mellonella model of infection, the Past1 and Past2 mutant strains were hypovirulent. The hypovirulent phenotype was reverted when EVs produced by wild-type cells, but not mutant EVs, were co-injected with the mutant cells in G. mellonella. These results connect EV biogenesis, cargo, and cryptococcal virulence.
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Affiliation(s)
- Rafael F. Castelli
- Instituto Carlos Chagas, Fundação Oswaldo Cruz (Fiocruz), Curitiba, Brazil
- Programa de Pós-Graduação em Biologia Parasitária, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | - Alana Pereira
- Instituto de Química, Universidade de Campinas, São Paulo, Brazil
| | - Leandro Honorato
- Instituto de Microbiologia Paulo de Góes (IMPG), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alessandro Valdez
- Instituto de Microbiologia Paulo de Góes (IMPG), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Jaqueline M. Bazioli
- Instituto de Química, Universidade de Campinas, São Paulo, Brazil
- Faculty of Pharmaceutical Sciences, State University of Campinas, Campinas, São Paulo, Brazil
| | - Ane W. A. Garcia
- Programa de Pós-graduação em Biologia Celular e Molecular, Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Flavia C. G. Reis
- Instituto Carlos Chagas, Fundação Oswaldo Cruz (Fiocruz), Curitiba, Brazil
- Centro de Desenvolvimento Tecnológico em Saúde (CDTS), Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | - Marlon D. M. Santos
- Instituto Carlos Chagas, Fundação Oswaldo Cruz (Fiocruz), Curitiba, Brazil
- Analytical Biochemistry and Proteomics Unit. IIBCE/Institut Pasteur de Montevideo, Montevideo, Uruguay
| | - Paulo C. Carvalho
- Instituto Carlos Chagas, Fundação Oswaldo Cruz (Fiocruz), Curitiba, Brazil
| | - Oscar Zaragoza
- Mycology Reference Laboratory. National Centre for Microbiology. Instituto de Salud Carlos III, Madrid, Spain
- Center for Biomedical Research in Network in Infectious Diseases, CB21/13/00105, Instituto de Salud Carlos III, Madrid, Spain
| | - Charley C. Staats
- Programa de Pós-graduação em Biologia Celular e Molecular, Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Leonardo Nimrichter
- Instituto de Microbiologia Paulo de Góes (IMPG), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Taícia P. Fill
- Instituto de Química, Universidade de Campinas, São Paulo, Brazil
| | - Marcio L. Rodrigues
- Instituto Carlos Chagas, Fundação Oswaldo Cruz (Fiocruz), Curitiba, Brazil
- Instituto de Microbiologia Paulo de Góes (IMPG), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Guha S, Cristy SA, Buda De Cesare G, Cruz MR, Lorenz MC, Garsin DA. Optimization of the antifungal properties of the bacterial peptide EntV by variant analysis. mBio 2024:e0057024. [PMID: 38587425 DOI: 10.1128/mbio.00570-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024] Open
Abstract
Fungal resistance to commonly used medicines is a growing public health threat, and there is a dire need to develop new classes of antifungals. We previously described a peptide produced by Enterococcus faecalis, EntV, that restricts Candida albicans to a benign form rather than having direct fungicidal activity. Moreover, we showed that one 12-amino acid (aa) alpha helix of this peptide retained full activity, with partial activity down to the 10aa alpha helix. Using these peptides as a starting point, the current investigation sought to identify the critical features necessary for antifungal activity and to screen for new variants with enhanced activity using both biofilm and C. elegans infection assays. First, the short peptides were screened for residues with critical activity by generating alanine substitutions. Based on this information, we used synthetic molecular evolution (SME) to rationally vary the specific residues of the 10aa variant in combination to generate a library that was screened to identify variants with more potent antifungal activity than the parent template. Five gain-of-function peptides were identified. Additionally, chemical modifications to the peptides to increase stability, including substitutions of D-amino acids and hydrocarbon stapling, were investigated. The most promising peptides were additionally tested in mouse models of oropharyngeal and systemic candidiasis where their efficacy in preventing infection was demonstrated. The expectation is that these discoveries will contribute to the development of new therapeutics in the fight against antimicrobial resistant fungi. IMPORTANCE Since the early 1980s, the incidence of disseminated life-threatening fungal infections has been on the rise. Worldwide, Candida and Cryptococcus species are among the most common agents causing these infections. Simultaneously, with this rise of clinical incidence, there has also been an increased prevalence of antifungal resistance, making treatment of these infections very difficult. For example, there are now strains of Candida auris that are resistant to all three classes of currently used antifungal drugs. In this study, we report on a strategy that allows for the development of novel antifungal agents by using synthetic molecular evolution. These discoveries demonstrate that the enhancement of antifungal activity from naturally occurring peptides is possible and can result in clinically relevant agents that have efficacy in multiple in vivo models as well as the potential for broad-spectrum activity.
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Affiliation(s)
- Shantanu Guha
- Department of Microbiology and Molecular Genetics, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Shane A Cristy
- Department of Microbiology and Molecular Genetics, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Giuseppe Buda De Cesare
- Department of Microbiology and Molecular Genetics, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Melissa R Cruz
- Department of Microbiology and Molecular Genetics, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Michael C Lorenz
- Department of Microbiology and Molecular Genetics, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Danielle A Garsin
- Department of Microbiology and Molecular Genetics, The University of Texas Health Science Center at Houston, Houston, Texas, USA
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Fathallah A, Chouaieb H, Saief MB, Ismaïl S, Said MB, Denning DW. The incidence and prevalence of serious fungal diseases in Tunisia. J Mycol Med 2024; 34:101479. [PMID: 38604083 DOI: 10.1016/j.mycmed.2024.101479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/08/2024] [Accepted: 04/02/2024] [Indexed: 04/13/2024]
Abstract
With increasing concern about the negative health impact of fungal disease, there is a need to survey what is and is not known about the epidemiology of these infections in Tunisia. We have estimated the incidence and prevalence of the most serious fungal diseases in Tunisia for the first time. Using published literature from Tunisia, or if absent other countries, we have estimated the burden of life-threatening fungal infections and those causing significant morbidity, using deterministic modeling, based on populations at greatest risk. An estimated 250,494 (2.12% of the Tunisian population) are affected by a serious fungal disease annually. Invasive and chronic pulmonary aspergillosis are relatively common with 708 and 2090 patients affected, partly linked to the prevalence of chronic obstructive pulmonary disease (COPD). Fungal asthma (allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitization) have an estimated prevalence of 38,264 (5.8% of the adult asthma population). Fungal keratitis probably affects 1,761 eyes annually, often leading to uniocular blindness. Candidaemia and Candida peritonitis probably affect at least 680 people annually, with a high mortality. Recurrent vulvovaginal candidiasis probably affects over 200,000 women. While fungal diseases are regularly diagnosed in Tunisia, epidemiological studies with denominators are uncommon. Some fungal diseases are poorly addressed with the current diagnostic portfolio, and surveillance is lacking. Studies on these diseases and the implementation of a national program of surveillance are required.
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Affiliation(s)
- Akila Fathallah
- Laboratory of Parasitology - Mycology, Farhat Hached Hospital, Sousse, Tunisia; Department of Parasitology-Mycology, Faculty of Medicine of Sousse, University of Sousse Mohamed El Karoui Street, Bp 126,4002 Sousse, Tunisia
| | - Hamed Chouaieb
- Laboratory of Parasitology - Mycology, Farhat Hached Hospital, Sousse, Tunisia; Department of Parasitology-Mycology, Faculty of Medicine of Sousse, University of Sousse Mohamed El Karoui Street, Bp 126,4002 Sousse, Tunisia
| | - Moadh Ben Saief
- Laboratory of Parasitology - Mycology, Farhat Hached Hospital, Sousse, Tunisia
| | - Samar Ismaïl
- Laboratory of Parasitology - Mycology, Farhat Hached Hospital, Sousse, Tunisia; Department of Parasitology-Mycology, Faculty of Medicine of Sousse, University of Sousse Mohamed El Karoui Street, Bp 126,4002 Sousse, Tunisia
| | - Moncef Ben Said
- Laboratory of Parasitology - Mycology, Farhat Hached Hospital, Sousse, Tunisia; Department of Parasitology-Mycology, Faculty of Medicine of Sousse, University of Sousse Mohamed El Karoui Street, Bp 126,4002 Sousse, Tunisia
| | - David W Denning
- Manchester Fungal Infection Group, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
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Ortiz SC, Hull CM. Biogenesis, germination, and pathogenesis of Cryptococcus spores. Microbiol Mol Biol Rev 2024; 88:e0019623. [PMID: 38440970 DOI: 10.1128/mmbr.00196-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024] Open
Abstract
SUMMARYSpores are primary infectious propagules for the majority of human fungal pathogens; however, relatively little is known about their fundamental biology. One strategy to address this deficiency has been to develop the basidiospores of Cryptococcus into a model for pathogenic spore biology. Here, we provide an update on the state of the field with a comprehensive review of the data generated from the study of Cryptococcus basidiospores from their formation (sporulation) and differentiation (germination) to their roles in pathogenesis. Importantly, we provide support for the presence of basidiospores in nature, define the key characteristics that distinguish basidiospores from yeast cells, and clarify their likely roles as infectious particles. This review is intended to demonstrate the importance of basidiospores in the field of Cryptococcus research and provide a solid foundation from which researchers who wish to study sexual spores in any fungal system can launch their studies.
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Affiliation(s)
- Sébastien C Ortiz
- Department of Biomolecular Chemistry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Christina M Hull
- Department of Biomolecular Chemistry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Medical Microbiology and Immunology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
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9
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Hallas-Mølle M, Burow M, Henrissat B, Johansen KS. Cryptococcus neoformans: plant-microbe interactions and ecology. Trends Microbiol 2024:S0966-842X(24)00059-3. [PMID: 38519353 DOI: 10.1016/j.tim.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/24/2024]
Abstract
While the opportunistic human pathogens Cryptococcus neoformans and Cryptococcus gattii are often isolated from plants and plant-related material, evidence suggests that these Cryptococcus species do not directly infect plants. Studies find that plants are important for Cryptococcus mating and dispersal. However, these studies have not provided enough detail about how plants and these fungi interact, especially in ways that could show the fungi are capable of causing disease. This review synthesizes recent findings from studies utilizing different plant models associated with the ecology of C. neoformans and C. gattii. Unanswered questions about their environmental role are highlighted. Overall, current research indicates that Cryptococcus utilizes plants as a substrate rather than harming them, arguing against Cryptococcus as a genuine plant pathogen. We hypothesize that plants represent reservoirs that aid dispersal, not hosts vulnerable to infection.
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Affiliation(s)
- Magnus Hallas-Mølle
- Department of Geoscience and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
| | - Meike Burow
- Department of Plant and Environmental Sciences, University of Copenhagen, Thorvaldsensvej 40, 1871 Frederiksberg C, Denmark
| | - Bernard Henrissat
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Søltofts Plads 224, 2800 Kgs, Lyngby, Denmark
| | - Katja Salomon Johansen
- Department of Geoscience and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark.
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10
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Onyishi CU, Jeon Y, Fejer G, Mukhopadhyay S, Gordon S, May RC. Loss of the scavenger receptor MARCO results in uncontrolled vomocytosis of fungi from macrophages. Eur J Immunol 2024:e2350771. [PMID: 38494423 DOI: 10.1002/eji.202350771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 03/03/2024] [Accepted: 03/05/2024] [Indexed: 03/19/2024]
Abstract
Vomocytosis, also known as nonlytic exocytosis, is a process whereby fully phagocytosed microbes are expelled from phagocytes without discernible damage to either the phagocyte or microbe. Although this phenomenon was first described in the opportunistic fungal pathogen Cryptococcus neoformans in 2006, to date, mechanistic studies have been hampered by an inability to reliably stimulate or inhibit vomocytosis. Here we present the fortuitous discovery that macrophages lacking the scavenger receptor MAcrophage Receptor with COllagenous domain (MARCO), exhibit near-total vomocytosis of internalised cryptococci within a few hours of infection. Marco-/- macrophages also showed elevated vomocytosis of a yeast-locked C. albicans strain, suggesting this to be a broadly relevant observation. We go on to show that MARCO's role in modulating vomocytosis is independent of its role as a phagocytic receptor, suggesting that this protein may play an important and hitherto unrecognised role in modulating macrophage behaviour.
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Affiliation(s)
- Chinaemerem U Onyishi
- Institute of Microbiology & Infection and School of Biosciences, University of Birmingham, Edgbaston, Birmingham, UK
- Molecular Mycology and Immunity Section, Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health, Bethesda, MD, USA
| | - Yusun Jeon
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Gyorgy Fejer
- School of Biomedical Sciences, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Subhankar Mukhopadhyay
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Siamon Gordon
- Department of Microbiology and Immunology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Sir William Dunn School of Pathology, University of Oxford, Oxford, UK
| | - Robin C May
- Institute of Microbiology & Infection and School of Biosciences, University of Birmingham, Edgbaston, Birmingham, UK
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11
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Puumala E, Fallah S, Robbins N, Cowen LE. Advancements and challenges in antifungal therapeutic development. Clin Microbiol Rev 2024; 37:e0014223. [PMID: 38294218 PMCID: PMC10938895 DOI: 10.1128/cmr.00142-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Over recent decades, the global burden of fungal disease has expanded dramatically. It is estimated that fungal disease kills approximately 1.5 million individuals annually; however, the true worldwide burden of fungal infection is thought to be higher due to existing gaps in diagnostics and clinical understanding of mycotic disease. The development of resistance to antifungals across diverse pathogenic fungal genera is an increasingly common and devastating phenomenon due to the dearth of available antifungal classes. These factors necessitate a coordinated response by researchers, clinicians, public health agencies, and the pharmaceutical industry to develop new antifungal strategies, as the burden of fungal disease continues to grow. This review provides a comprehensive overview of the new antifungal therapeutics currently in clinical trials, highlighting their spectra of activity and progress toward clinical implementation. We also profile up-and-coming intracellular proteins and pathways primed for the development of novel antifungals targeting their activity. Ultimately, we aim to emphasize the importance of increased investment into antifungal therapeutics in the current continually evolving landscape of infectious disease.
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Affiliation(s)
- Emily Puumala
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Sara Fallah
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Robbins
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Leah E. Cowen
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
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12
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Zhang A, Lao X, Liang J, Xia X, Ma L, Liang J. Case Report: Pneumonia Caused by Chlamydia Psittaci and Cryptococcus Co-Infection. Infect Drug Resist 2024; 17:845-849. [PMID: 38463387 PMCID: PMC10924924 DOI: 10.2147/idr.s445920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/28/2024] [Indexed: 03/12/2024] Open
Abstract
This study presents a rare case of pneumonia caused by a co-infection of Chlamydia psittaci and Cryptococcus, confirmed by metagenomic next-generation sequencing (mNGS). The patient, who had underlying chronic hepatitis B, had adopted a stray pigeon before the onset of the disease. The primary symptoms were fever, and a productive cough. The patient recovered following treatment with moxifloxacin and itraconazole. C. psittaci and Cryptococcus infections may both have been transmitted from the stray pigeon. This report highlights the potential for infections caused by multiple zoonotic pathogens and the value of mNGS for making the diagnosis of these infections.
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Affiliation(s)
- Anbing Zhang
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, People’s Republic of China
| | - Xiaoli Lao
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, People’s Republic of China
- Guangdong Medical University, Zhanjiang, Guangdong, People’s Republic of China
| | - Jinguang Liang
- Department of Respiratory and Critical Care Medicine, Zhongshan Huangpu People’s Hospital, Zhongshan, People’s Republic of China
| | - Xiuqiong Xia
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, People’s Republic of China
| | - Lei Ma
- Department of Respiratory and Critical Care Medicine, Fuyang Second People’s Hospital, Fuyang, People’s Republic of China
| | - Jianping Liang
- Department of Respiratory and Critical Care Medicine, Zhongshan People’s Hospital, Zhongshan, People’s Republic of China
- Guangdong Medical University, Zhanjiang, Guangdong, People’s Republic of China
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13
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Liu R, Li X, Liu Y, Du L, Zhu Y, Wu L, Hu B. A high-speed microscopy system based on deep learning to detect yeast-like fungi cells in blood. Bioanalysis 2024; 16:289-303. [PMID: 38334080 DOI: 10.4155/bio-2023-0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Background: Blood-invasive fungal infections can cause the death of patients, while diagnosis of fungal infections is challenging. Methods: A high-speed microscopy detection system was constructed that included a microfluidic system, a microscope connected to a high-speed camera and a deep learning analysis section. Results: For training data, the sensitivity and specificity of the convolutional neural network model were 93.5% (92.7-94.2%) and 99.5% (99.1-99.5%), respectively. For validating data, the sensitivity and specificity were 81.3% (80.0-82.5%) and 99.4% (99.2-99.6%), respectively. Cryptococcal cells were found in 22.07% of blood samples. Conclusion: This high-speed microscopy system can analyze fungal pathogens in blood samples rapidly with high sensitivity and specificity and can help dramatically accelerate the diagnosis of fungal infectious diseases.
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Affiliation(s)
- Ruiqi Liu
- Guangxi Key Laboratory of Special Biomedicine, School of Medicine, Guangxi University, Nanning, Guangxi, P.R. China
| | - Xiaojie Li
- Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
| | - Yingyi Liu
- Guangxi Key Laboratory of Special Biomedicine, School of Medicine, Guangxi University, Nanning, Guangxi, P.R. China
| | - Lijun Du
- Department of Clinical Laboratory, Huadu District People's Hospital of Guangzhou, Guangdong, China
| | - Yingzhu Zhu
- Guangzhou Waterrock Gene Technology, Guangdong, China
| | - Lichuan Wu
- Guangxi Key Laboratory of Special Biomedicine, School of Medicine, Guangxi University, Nanning, Guangxi, P.R. China
| | - Bo Hu
- Department of Laboratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P.R. China
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14
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Hester MM, Carlson D, Lodge JK, Levitz SM, Specht CA. Immune evasion by Cryptococcus gattii in vaccinated mice coinfected with C. neoformans. Front Immunol 2024; 15:1356651. [PMID: 38469300 PMCID: PMC10925662 DOI: 10.3389/fimmu.2024.1356651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/05/2024] [Indexed: 03/13/2024] Open
Abstract
Cryptococcus neoformans and C. gattii, the etiologic agents of cryptococcosis, cause over 100,000 deaths worldwide every year, yet no cryptococcal vaccine has progressed to clinical trials. In preclinical studies, mice vaccinated with an attenuated strain of C. neoformans deleted of three cryptococcal chitin deacetylases (Cn-cda1Δ2Δ3Δ) were protected against a lethal challenge with C. neoformans strain KN99. While Cn-cda1Δ2Δ3Δ extended the survival of mice infected with C. gattii strain R265 compared to unvaccinated groups, we were unable to demonstrate fungal clearance as robust as that seen following KN99 challenge. In stark contrast to vaccinated mice challenged with KN99, we also found that R265-challenged mice failed to induce the production of protection-associated cytokines and chemokines in the lungs. To investigate deficiencies in the vaccine response to R265 infection, we developed a KN99-R265 coinfection model. In unvaccinated mice, the strains behaved in a manner which mirrored single infections, wherein only KN99 disseminated to the brain and spleen. We expanded the coinfection model to Cn-cda1Δ2Δ3Δ-vaccinated mice. Fungal burden, cytokine production, and immune cell infiltration in the lungs of vaccinated, coinfected mice were indicative of immune evasion by C. gattii R265 as the presence of R265 neither compromised the immunophenotype established in response to KN99 nor inhibited clearance of KN99. Collectively, these data indicate that R265 does not dampen a protective vaccine response, but rather suggest that R265 remains largely undetected by the immune system.
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Affiliation(s)
- Maureen M. Hester
- Department of Medicine, The University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Diana Carlson
- Department of Medicine, The University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Jennifer K. Lodge
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC, United States
| | - Stuart M. Levitz
- Department of Medicine, The University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Charles A. Specht
- Department of Medicine, The University of Massachusetts Chan Medical School, Worcester, MA, United States
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15
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Roosen L, Maes D, Musetta L, Himmelreich U. Preclinical Models for Cryptococcosis of the CNS and Their Characterization Using In Vivo Imaging Techniques. J Fungi (Basel) 2024; 10:146. [PMID: 38392818 PMCID: PMC10890286 DOI: 10.3390/jof10020146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/24/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
Infections caused by Cryptococcus neoformans and Cryptococcus gattii remain a challenge to our healthcare systems as they are still difficult to treat. In order to improve treatment success, in particular for infections that have disseminated to the central nervous system, a better understanding of the disease is needed, addressing questions like how it evolves from a pulmonary to a brain disease and how novel treatment approaches can be developed and validated. This requires not only clinical research and research on the microorganisms in a laboratory environment but also preclinical models in order to study cryptococci in the host. We provide an overview of available preclinical models, with particular emphasis on models of cryptococcosis in rodents. In order to further improve the characterization of rodent models, in particular the dynamic aspects of disease manifestation, development, and ultimate treatment, preclinical in vivo imaging methods are increasingly used, mainly in research for oncological, neurological, and cardiac diseases. In vivo imaging applications for fungal infections are rather sparse. A second aspect of this review is how research on models of cryptococcosis can benefit from in vivo imaging methods that not only provide information on morphology and tissue structure but also on function, metabolism, and cellular properties in a non-invasive way.
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Affiliation(s)
- Lara Roosen
- Biomedical MRI, Department of Imaging and Pathology, KU Leuven, 3000 Leuven, Belgium
| | - Dries Maes
- Biomedical MRI, Department of Imaging and Pathology, KU Leuven, 3000 Leuven, Belgium
| | - Luigi Musetta
- Biomedical MRI, Department of Imaging and Pathology, KU Leuven, 3000 Leuven, Belgium
| | - Uwe Himmelreich
- Biomedical MRI, Department of Imaging and Pathology, KU Leuven, 3000 Leuven, Belgium
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16
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de Sena ACVP, de Arruda JAA, Oliveira SR, Pereira NM, Faria LDS, Travassos DV, Silva TA. Orofacial Cryptococcosis: A Challenging Clinical Report and a Systematic Analysis of the Literature. Int J Surg Pathol 2024; 32:165-181. [PMID: 37143300 DOI: 10.1177/10668969231169048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Cryptococcosis is a neglected fungal disease. The scarcity of studies on oral cryptococcosis is certainly due to rarity and/or underreporting of the disease, especially in Brazil. We describe an example of orofacial cryptococcosis affecting a 57-year-old man after heart transplantation, who presented with multiple erythematous ulcers and erosions distributed in the chin, nasal cavity, labial mucosa, hard palate, and buccal vestibule. Computed tomography revealed opacities and micronodules in the lungs. Histopathological features of the oral and pulmonary lesions were compatible with Cryptococcus spp. Amphotericin B and fluconazole were used for treatment during hospitalization and itraconazole for prolonged therapy after hospital discharge. The patient has been under follow up for 6 months without signs of disease. According to a review conducted in PubMed, Web of Science, Scopus, Embase, and LILACS for data analysis of oral cryptococcosis, 26 reports were described in the literature. Predilection for men was observed (85%), with a male:female ratio of 5.5:1. The mean age of the individuals was 49 ± 15.3 years. Oral cryptococcosis mostly presented as an ulcer (n = 17). The palate and tongue were the most affected sites (n = 9 for each). Amphotericin B was the primary therapy utilized in most patients. Seventeen (65%) individuals survived. Knowledge of the clinicodemographic aspects of oral cryptococcosis is important for clinicians in decision making and surveillance.
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Affiliation(s)
- Ana Carolina Velasco Pondé de Sena
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sicília Rezende Oliveira
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Nickolas Mendes Pereira
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Dos Santos Faria
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Denise Vieira Travassos
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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17
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Nielson JA, Jezewski AJ, Wellington M, Davis JM. Survival in macrophages induces enhanced virulence in Cryptococcus. mSphere 2024; 9:e0050423. [PMID: 38073033 PMCID: PMC10826345 DOI: 10.1128/msphere.00504-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/31/2023] [Indexed: 01/31/2024] Open
Abstract
Cryptococcus is a ubiquitous environmental fungus and frequent colonizer of human lungs. Colonization can lead to diverse outcomes, from clearance to long-term colonization to life-threatening meningoencephalitis. Regardless of the outcome, the process starts with an encounter with phagocytes. Using the zebrafish model of this infection, we have noted that cryptococcal cells first spend time inside macrophages before they become capable of pathogenic replication and dissemination. What "licensing" process takes place during this initial encounter, and how are licensed cryptococcal cells different? To address this, we isolated cryptococcal cells after phagocytosis by cultured macrophages and found these macrophage-experienced cells to be markedly more virulent in both zebrafish and mouse models. Despite producing a thick polysaccharide capsule, they were still subject to phagocytosis by macrophages in the zebrafish. Analysis of antigenic cell wall components in these licensed cells demonstrated that components of mannose and chitin are more available for staining than they are in culture-grown cells or cells with capsule production induced in vitro. Cryptococcus is capable of exiting or transferring between macrophages in vitro, raising the likelihood that this fungus alternates between intracellular and extracellular life during growth in the lungs. Our results raise the possibility that intracellular life has its advantages over time, and phagocytosis-induced alteration in mannose and chitin exposure is one way that makes subsequent rounds of phagocytosis more beneficial to the fungus.IMPORTANCECryptococcosis begins in the lungs and can ultimately travel through the bloodstream to cause devastating infection in the central nervous system. In the zebrafish model, small amounts of cryptococcus inoculated into the bloodstream are initially phagocytosed and become far more capable of dissemination after they exit macrophages. Similarly, survival in the mouse lung produces cryptococcal cell types with enhanced dissemination. In this study, we have evaluated how phagocytosis changes the properties of Cryptococcus during pathogenesis. Macrophage-experienced cells (MECs) become "licensed" for enhanced virulence. They out-disseminate culture-grown cells in the fish and out-compete non-MECs in the mouse lung. Analysis of their cell surface demonstrates that MECs have increased availability of cell wall components mannose and chitin substances involved in provoking phagocytosis. These findings suggest how Cryptococcus might tune its cell surface to induce but survive repeated phagocytosis during early pathogenesis in the lung.
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Affiliation(s)
- Jacquelyn A. Nielson
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Andrew J. Jezewski
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Melanie Wellington
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - J. Muse Davis
- Stead Family Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
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18
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Burnham-Marusich AR, Zayac KR, Galgiani JN, Lewis L, Kozel TR. Antigenic Relatedness between Mannans from Coccidioides immitis and Coccidioides posadasii Spherules and Mycelia. J Fungi (Basel) 2024; 10:89. [PMID: 38392761 PMCID: PMC10890221 DOI: 10.3390/jof10020089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/24/2024] Open
Abstract
Immunoassays for cell wall mannans that are excreted into serum and urine have been used as an aid in the diagnosis of many disseminated fungal infections, including coccidioidomycosis. Antigen-detection immunoassays are critically dependent on the detection of an analyte, such as mannan, by antibodies that are specific to the analyte. The goal of this study was to evaluate the extent of cross-reactivity of polyclonal antibodies raised against Coccidioides spp. Analysis of antigenic relatedness between mannans from C. posadasii and C. immitis spherules and mycelia showed complete relatedness when evaluated by the method of Archetti and Horsfall, which was originally used to study the antigenic relationships between Influenzae virus isolates. In a further effort to validate the suitability of the antigenic relatedness calculation methodology for polysaccharide antigens, we also applied the method of Archetti and Horsfall to published results that had previously identified the major capsular serotypes of Cryptococcus species. The results of this analysis showed that Archetti and Horsfall's antigenic relatedness calculation correctly identified the major cryptococcal serotypes. Together, these results suggest that the method is applicable to polysaccharide antigens, and that immunoassays that detect Coccidioides mannans are likely to have good reactivity across Coccidioides species (inclusivity) due to the species' high level of antigenic relatedness.
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Affiliation(s)
| | - Kathleen R Zayac
- Department of Microbiology and Immunology, University of Nevada, Reno School of Medicine, Reno, NV 89557, USA
| | - John N Galgiani
- Valley Fever Center for Excellence, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85721, USA
- Department of Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85721, USA
- Department of Immunobiology, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85721, USA
- BIO5 Institute, University of Arizona, Tucson, AZ 85721, USA
| | - Lourdes Lewis
- Valley Fever Center for Excellence, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85721, USA
| | - Thomas R Kozel
- Department of Microbiology and Immunology, University of Nevada, Reno School of Medicine, Reno, NV 89557, USA
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Wang P, Li Y, Gao L, Tang X, Zheng D, Wu K, Wang L, Guo P, Ye F. In vitro characterization and molecular epidemiology of Cryptococcus spp. isolates from non-HIV patients in Guangdong, China. Front Microbiol 2024; 14:1295363. [PMID: 38287960 PMCID: PMC10823435 DOI: 10.3389/fmicb.2023.1295363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/27/2023] [Indexed: 01/31/2024] Open
Abstract
Background The burden of cryptococcosis in mainland China is enormous. However, the in vitro characterization and molecular epidemiology in Guangdong, a key region with a high incidence of fungal infection in China, are not clear. Methods From January 1, 2010, to March 31, 2019, clinical strains of Cryptococcus were collected from six medical centres in Guangdong. The clinical information and characteristics of the strains were analysed. Furthermore, molecular types were determined. Results A total of 84 strains were collected, mostly from male and young or middle-aged adult patients. Pulmonary and cerebral infections (82.1%) were most common. All strains were Cryptococcus neoformans, grew well at 37°C and had capsules around their cells. One melanin- and urea- and one melanin+ and urea- variants were found. Although most strains exhibited a low minimum inhibitory concentration (MIC) value for voriconazole (mean: 0.04 μg/mL) and posaconazole (mean: 0.12 μg/mL), the results for these isolates showed a high degree of variation in the MIC values of fluconazole and 5-fluorocytosine, and resistance was observed for 4 out of 6 drugs. A significant proportion of these strains had MIC values near the ECV values, particularly in the case of amphotericin B. The proportion of strains near the clinical breakpoints was as follows: fluconazole: 3.66%; voriconazole: 3.66%; itraconazole: 6.10%; posaconazole: 13.41%; amphotericin B: 84.15%; 5-fluorocytosine: 2.44%. These strains were highly homogeneous and were dominated by the Grubii variant (95.2%), VNI (94.0%), α mating (100%), and ST5 (89.3%) genotypes. Other rare types, including ST4, 31, 278, 7, 57 and 106, were also found. Conclusion Phenotypically variant and non-wild-type strains were found in Guangdong, and a significant proportion of these strains had MIC values near the ECV values towards the 6 antifungal drugs, and resistance was observed for 4 out of 6 drugs. The molecular type was highly homogeneous but compositionally diverse, with rare types found. Enhanced surveillance of the aetiology and evolution and continuous monitoring of antifungal susceptibility are needed to provide references for decision-making in the health sector and optimization of disease prevention and control.
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Affiliation(s)
- Penglei Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, Guangzhou, China
- Department of Respiratory Medicine, Longgang Central Hospital, Shenzhen, China
| | - Yongming Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, Guangzhou, China
| | - Lei Gao
- Microscopy Core Facility, Biomedical Research Core Facilities, Westlake University, Hangzhou, China
| | - Xiang Tang
- Intensive Care Unit, Guangzhou First People's Hospital, Guangzhou, China
| | - Dandian Zheng
- Department of Hematology Oncology, Jieyang City People's Hospital, Jieyang, China
| | - Kuihai Wu
- Clinical Medicine Laboratory, Foshan City First People's Hospital, Foshan, China
| | - Luxia Wang
- Clinical Medicine Laboratory, Southern Military Region General Hospital, Guangzhou, China
| | - Penghao Guo
- Clinical Medicine Laboratory, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Feng Ye
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, Guangzhou, China
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20
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Horton Embrey P, Long A, Alfattal R, Qiu S, Hornak JP. Isolated cryptococcal osteomyelitis in the setting of immune reconstitution inflammatory syndrome. Ther Adv Infect Dis 2024; 11:20499361241230149. [PMID: 38333228 PMCID: PMC10851753 DOI: 10.1177/20499361241230149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/17/2024] [Indexed: 02/10/2024] Open
Abstract
Cryptococcal infections, though rare, must be considered in all immunocompromised patients. Patients with HIV/AIDS on antiretrovirals may have a treatment course complicated by immune reconstitution inflammatory syndrome. Here we present a case of a 38-year-old woman with HIV/AIDS with knee pain who only began to experience severe pain after induction of antiretroviral therapy. She was found to have cryptococcal osteomyelitis without dissemination to the central nervous system, an unusual presentation for immunocompromised patients. She was treated with oral fluconazole with a resolution of symptoms. This case report suggests conservative management of isolated cryptococcal infection with fluconazole, regardless of immune status.
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Affiliation(s)
- Pamela Horton Embrey
- University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX 77555, USA
| | - Alexandra Long
- University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Rasha Alfattal
- University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Suimin Qiu
- University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Joseph Patrik Hornak
- University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX 77555, USA
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21
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Quincho-Lopez A, Poma N, José Montenegro-Idrogo J. COVID-19 associated with cryptococcosis: a scoping review. Ther Adv Infect Dis 2024; 11:20499361241232851. [PMID: 38361915 PMCID: PMC10868154 DOI: 10.1177/20499361241232851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/30/2024] [Indexed: 02/17/2024] Open
Abstract
Background There is growing evidence of fungal infections associated with COVID-19. The development of cryptococcosis in these patients has been infrequently reported. However, it can be life-threatening. Objective To identify cases of COVID-19 patients who developed cryptococcosis and to compare baseline characteristics and management between those who survived and those who died. Methods We conducted a scoping review using PubMed, Scopus, Web of Science, and Embase to identify studies that reported patients with COVID-19 and cryptococcosis. No language restriction was applied. Single case reports, case series, and original articles were included. It is important to note that 'n' refers to the total number of individuals with the specified variable. Results A total of 58 studies were included. Among these studies, 51 included individual patient data, detailing information on a total of 65 patients, whereas eight studies reported the proportion of cryptococcosis in COVID-19 patients. One study provided both individual and aggregate case information. From individual patient data, the majority were male (73.9%; n = 48) with a median age of 60 years (range: 53-70). Severe COVID-19 and multiple comorbidities, led by arterial hypertension and diabetes mellitus, were frequently reported, but few had classic immunosuppression factors. On the other hand, HIV status, either negative or positive, was reported in just over half of the patients (61.5%; n = 40). Most were admitted to the intensive care unit (ICU) (58.5%; n = 31), received mechanical ventilation (MV) (50.0%; n = 26), and developed disseminated cryptococcosis (55.4%; n = 36). Secondary infection, mainly bacterial, was reported in 19 patients (29.2%). Mortality was 47.7% (n = 31). Of the studies that reported the proportion of cryptococcosis in COVID-19 cases, the majority were descriptive studies published as conference abstracts. Conclusion Cryptococcosis in COVID-19 patients has been reported more frequently. However, it is still not as common as other fungal infections associated with COVID-19. Few patients have some classic immunosuppression factors. The factors associated with mortality were male sex, age, ICU admission, MV, secondary infections, and lymphopenia.
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Affiliation(s)
- Alvaro Quincho-Lopez
- Unidad de Investigación en Bibliometría, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Nuvith Poma
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Juan José Montenegro-Idrogo
- Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru
- Infectious Diseases and Tropical Medicine Service, Hospital Nacional Dos de Mayo, Lima, Peru
- Centro de Investigaciones Tecnológicas, Biomédicas y Medioambientales, Universidad Nacional Mayor de San Marcos, Lima, Peru
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22
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Li X, Xu J, Lin X, Lin Q, Yu T, Chen L, Chen L, Huang X, Zhang X, Chen G, Xu L. Macrophages-derived exo-miR-4449 induced by Cryptococcus affects HUVEC permeability and promotes pyroptosis in BEAS-2B via the HIC1 pathway. Cytokine 2024; 173:156441. [PMID: 37995394 DOI: 10.1016/j.cyto.2023.156441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/27/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023]
Abstract
Macrophages have recently been discovered to assume a significant role in the progression of cryptococcosis. However, the potential involvement of macrophage-derived exosomes in the pathogenesis of cryptococcosis remains uncertain. In this study, we investigated the changes of microRNAs in macrophage exosomes (exo-miRNAs) in cryptococcal infections and the role of markedly altered exo-miRNAs in the modulation of Human Umbilical Vein Endothelial Cells (HUVEC) permeability and ROS accumulation and pyroptosis in Human Bronchial Epithelioid Cells (BEAS-2B). Techniques such as microarray analysis and real-time quantitative PCR were used to detect different exo-miRNAs and to screen for the most highly expressed exo-miRNAs. Then its mimics were transfected into HUVEC to study its effect on the monolayer permeability of HUVEC. Finally, the relationship between this exo-miRNAs and the ROS accumulation and pyroptosis was verified by bioinformatics analysis. The results showed that five exo-miRNAs were overexpressed and two exo-miRNAs were reduced, among which, exo-miR-4449 was expressed at the highest level. Exo-miR-4449 could be internalized by HUVEC and enhanced its monolayer permeability. Moreover, exo-miR-4449 was found to promote ROS accumulation and pyroptosis in BEAS-2B through HIC1 pathway. Thus, exo-miR-4449 plays an important role in the pathogenesis of cryptococcosis and holds promise as a significant biomarker for treatment.
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Affiliation(s)
- Xiaohua Li
- Department of Pulmonary and Critical Care Medicine, Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou 350009, China.
| | - Junping Xu
- Department of Pulmonary and Critical Care Medicine, Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou 350009, China.
| | - Xin Lin
- Department of Pulmonary and Critical Care Medicine, Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou 350009, China.
| | - Qiong Lin
- Department of Pulmonary and Critical Care Medicine, Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou 350009, China.
| | - Tianxing Yu
- Department of Pulmonary and Critical Care Medicine, Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou 350009, China.
| | - Lin Chen
- Department of Pulmonary and Critical Care Medicine, Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou 350009, China.
| | - Lifang Chen
- Department of Pulmonary and Critical Care Medicine, Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou 350009, China.
| | - Xiaoqing Huang
- Department of Pulmonary and Critical Care Medicine, Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou 350009, China.
| | - Xueping Zhang
- Department of Pulmonary and Critical Care Medicine, Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou 350009, China.
| | - Geng Chen
- Nursing Department, Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou 350009, China.
| | - Liyu Xu
- Department of Pulmonary and Critical Care Medicine, Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou 350009, China.
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23
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Rogerson T, Tam PC, Wong W, Nelson R, Gilhotra J. Cryptococcal endophthalmitis complicated by immune reconstitution inflammatory syndrome in a renal transplant recipient: A case report and review of the literature. Med Mycol Case Rep 2023; 42:100608. [PMID: 37790731 PMCID: PMC10542418 DOI: 10.1016/j.mmcr.2023.100608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 10/05/2023] Open
Abstract
A 59 year old male renal transplant recipient developed endogenous cryptococcal endophthalmitis which was complicated by immune reconstitution inflammatory syndrome (IRIS). Herein we report a novel diagnostic test using lateral flow assay, the management of cryptococcal endophthalmitis and the novel complication of intraocular IRIS in a solid organ transplant recipient.
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Affiliation(s)
- Thomas Rogerson
- Department of Ophthalmology, Royal Adelaide Hospital, Port Road, Adelaide, 5000, Australia
| | - Patrick C.K. Tam
- Department of Infectious Diseases, Royal Adelaide Hospital, Port Road, Adelaide, 5000, Australia
- College of Medicine and Public Health, Flinders Medical Centre, Bedford Park, 5042, Australia
| | - Wilson Wong
- Department of Ophthalmology, Royal Adelaide Hospital, Port Road, Adelaide, 5000, Australia
| | - Renjy Nelson
- Department of Infectious Diseases, Royal Adelaide Hospital, Port Road, Adelaide, 5000, Australia
- The University of Adelaide, Adelaide, 5005, Australia
| | - Jagjit Gilhotra
- Department of Ophthalmology, Royal Adelaide Hospital, Port Road, Adelaide, 5000, Australia
- The University of Adelaide, Adelaide, 5005, Australia
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24
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Gonzalez GA, Porto G, Tecce E, Oghli YS, Miao J, O'Leary M, Chadid DP, Vo M, Harrop J. Advances in diagnosis and management of atypical spinal infections: A comprehensive review. N Am Spine Soc J 2023; 16:100282. [PMID: 37915965 PMCID: PMC10616400 DOI: 10.1016/j.xnsj.2023.100282] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/28/2023] [Accepted: 09/24/2023] [Indexed: 11/03/2023]
Abstract
Atypical spinal infections (ASIs) of the spine are a challenging pathology to management with potentially devastating morbidity and mortality. To identify patients with atypical spinal infections, it is important to recognize the often insidious clinical and radiographic presentations, in the setting of indolent and smoldering organism growth. Trending of inflammatory markers, and culturing of organisms, is essential. Once identified, the spinal infection should be treated with antibiotics and possibly various surgical interventions including decompression and possible fusion depending on spine structural integrity and stability. Early diagnosis of ASIs and immediate treatment of debilitating conditions, such as epidural abscess, correlate with fewer neurological deficits and a shorter duration of medical treatment. There have been great advances in surgical interventions and spinal fusion techniques for patients with spinal infection. Overall, ASIs remain a perplexing pathology that could be successfully treated with early diagnosis and immediate, appropriate medical, and surgical management.
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Affiliation(s)
- Glenn A. Gonzalez
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, 909 Walnut St, Philadelphia, PA 19107, United States
| | - Guilherme Porto
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, 909 Walnut St, Philadelphia, PA 19107, United States
| | - Eric Tecce
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, 909 Walnut St, Philadelphia, PA 19107, United States
| | - Yazan Shamli Oghli
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, 909 Walnut St, Philadelphia, PA 19107, United States
| | - Jingya Miao
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, 909 Walnut St, Philadelphia, PA 19107, United States
| | - Matthew O'Leary
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, 909 Walnut St, Philadelphia, PA 19107, United States
| | | | - Michael Vo
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, 909 Walnut St, Philadelphia, PA 19107, United States
| | - James Harrop
- Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, 909 Walnut St, Philadelphia, PA 19107, United States
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25
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Sephton-Clark P, Temfack E, Tenor JL, Toffaletti DL, Loyse A, Molloy SF, Perfect JR, Bicanic T, Harrison TS, Lortholary O, Kouanfack C, Cuomo CA. Genetic diversity and microevolution in clinical Cryptococcus isolates from Cameroon. Med Mycol 2023; 61:myad116. [PMID: 37952096 PMCID: PMC10709296 DOI: 10.1093/mmy/myad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/03/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023] Open
Abstract
Cryptococcal meningitis is the second most common cause of death in people living with HIV/AIDS, yet we have a limited understanding of how cryptococcal isolates change over the course of infection. Cryptococcal infections are environmentally acquired, and the genetic diversity of these infecting isolates can also be geographically linked. Here, we employ whole genome sequences for 372 clinical Cryptococcus isolates from 341 patients with HIV-associated cryptococcal meningitis obtained via a large clinical trial, across both Malawi and Cameroon, to enable population genetic comparisons of isolates between countries. We see that isolates from Cameroon are highly clonal, when compared to those from Malawi, with differential rates of disruptive variants in genes with roles in DNA binding and energy use. For a subset of patients (22) from Cameroon, we leverage longitudinal sampling, with samples taken at days 7 and 14 post-enrollment, to interrogate the genetic changes that arise over the course of infection, and the genetic diversity of isolates within patients. We see disruptive variants arising over the course of infection in several genes, including the phagocytosis-regulating transcription factor GAT204. In addition, in 13% of patients sampled longitudinally, we see evidence for mixed infections. This approach identifies geographically linked genetic variation, signatures of microevolution, and evidence for mixed infections across a clinical cohort of patients affected by cryptococcal meningitis in Central Africa.
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Affiliation(s)
- Poppy Sephton-Clark
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Elvis Temfack
- Internal Medicine Unit, Douala General Hospital, Douala, Cameroon
- Institut Pasteur, Molecular Mycology Unit, CNRS UMR 2000, Paris, France
| | - Jennifer L Tenor
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Dena L Toffaletti
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Angela Loyse
- Institute of Infection and Immunity, St George's University of London, London, UK
- Clinical Academic Group in Infection, St George's University Hospital, London, UK
| | - Síle F Molloy
- Institute of Infection and Immunity, St George's University of London, London, UK
| | - John R Perfect
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Tihana Bicanic
- Institute of Infection and Immunity, St George's University of London, London, UK
- Clinical Academic Group in Infection, St George's University Hospital, London, UK
| | - Thomas S Harrison
- Institute of Infection and Immunity, St George's University of London, London, UK
- MRC Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Olivier Lortholary
- Department of Infectious Diseases and Tropical Medicine, Paris Cité University, Necker-Enfants Malades Hospital, AP-HP, IHU Imagine, Paris, France
- Mycology Department and National Reference Center for Invasive Mycoses and Antifungals, Institut Pasteur, Paris, France
| | - Charles Kouanfack
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Day Hospital, Hospital Central Yaoundé, Yaoundé, Cameroon
- Research Center for Emerging and Re-emerging Diseases, Cameroon Baptist Convention Health Services (CBCHS), Yaoundé, Cameroon
| | - Christina A Cuomo
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
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26
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Fraser B, Munawar M, Halani S, Sabur N. Disseminated Cryptococcus neoformans presenting with an isolated pleural effusion in a patient receiving temozolomide and long-term steroids. BMJ Case Rep 2023; 16:e256255. [PMID: 37993145 PMCID: PMC10668160 DOI: 10.1136/bcr-2023-256255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023] Open
Abstract
Cryptococcus neoformans is a ubiquitous environmental organism found worldwide. Infection with this organism occurs predominantly in immunocompromised hosts, including persons living with HIV or those with impaired cellular immunity. Cryptococcal pleural effusions have been described in cases with extensive pulmonary involvement. Here we present the case of a woman receiving temozolomide and steroids for glioblastoma multiforme, who developed cough and dyspnoea and was found to have an uncomplicated pleural effusion. Pleural fluid culture grew Cryptococcus neoformans with negative culture on bronchoalveolar lavage. High serum cryptococcal antigen titre of 1:64 prompted lumbar puncture which demonstrated positive cerebrospinal fluid for Cryptococcus neoformans She was treated with liposomal amphotericin B and flucytosine, followed by consolidation and maintenance therapy with fluconazole. Pleural involvement in the absence of pulmonary involvement has rarely been reported. We review pulmonary and radiographic manifestations of cryptococcal infection, when to assess for disseminated infection, and management principles.
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Affiliation(s)
- Brooke Fraser
- Medicine, University of Toronto, Toronto, Ontario, Canada
- Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Maha Munawar
- Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sheliza Halani
- Medicine, University of Toronto, Toronto, Ontario, Canada
- Infectious Diseases, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Natasha Sabur
- Medicine, University of Toronto, Toronto, Ontario, Canada
- Respirology, St Michael's Hospital, Toronto, Ontario, Canada
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27
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Wang Z, Teixeira SCM, Strother C, Bowen A, Casadevall A, Cordero RJB. Neutron Scattering Analysis of Cryptococcus neoformans Polysaccharide Reveals Solution Rigidity and Repeating Fractal-like Structural Patterns. bioRxiv 2023:2023.09.22.559017. [PMID: 37790378 PMCID: PMC10542156 DOI: 10.1101/2023.09.22.559017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Cryptococcus neoformans is a fungal pathogen that can cause life-threatening brain infections in immunocompromised individuals. Unlike other fungal pathogens, it possesses a protective polysaccharide capsule that is crucial for its virulence. During infections, Cryptococcus cells release copious amounts of extracellular polysaccharides (exo-PS) that interfere with host immune responses. Both exo-PS and capsular-PS play pivotal roles in Cryptococcus infections and serve as essential targets for disease diagnosis and vaccine development strategies. However, understanding their structure is complicated by their polydispersity, complexity, sensitivity to sample isolation and processing, and scarcity of methods capable of isolating and analyzing them while preserving their native structure. In this study, we employ small-angle neutron scattering (SANS) and ultra-small angle neutron scattering (USANS) for the first time to investigate both fungal cell suspensions and extracellular polysaccharides in solution. Our data suggests that exo-PS in solution exhibits collapsed chain-like behavior and demonstrates mass fractal properties that indicate a relatively condensed pore structure in aqueous environments. This observation is also supported by scanning electron microscopy (SEM). The local structure of the polysaccharide is characterized as a rigid rod, with a length-scale corresponding to 3 to 4 repeating units. This research not only unveils insights into exo-PS and capsular-PS structures but also demonstrates the potential of USANS for studying changes in cell dimensions and the promise of contrast variation in future neutron scattering studies.
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Affiliation(s)
- Ziwei Wang
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 21205, USA
| | - Susana C. M. Teixeira
- NIST Center of Neutron Research, National Institute of Standards and Technology, Gaithersburg, Maryland, 20899, USA
- Department of Chemical and Biomolecular Engineering, University of Delaware, Newark, Delaware, 19716, USA
| | - Camilla Strother
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 21205, USA
| | - Anthony Bowen
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 21205, USA
| | - Arturo Casadevall
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 21205, USA
| | - Radamés JB Cordero
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 21205, USA
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28
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Jung KW, Kwon S, Jung JH, Lim S, Bahn YS. Functional Characterization of DNA N-Glycosylase Ogg1 and Ntg1 in DNA Damage Stress of Cryptococcus neoformans. J Microbiol 2023; 61:981-992. [PMID: 38055144 DOI: 10.1007/s12275-023-00092-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023]
Abstract
Reactive oxygen species induce DNA strand breaks and DNA oxidation. DNA oxidation leads to DNA mismatches, resulting in mutations in the genome if not properly repaired. Homologous recombination (HR) and non-homologous end-joining (NHEJ) are required for DNA strand breaks, whereas the base excision repair system mainly repairs oxidized DNAs, such as 8-oxoguanine and thymine glycol, by cleaving the glycosidic bond, inserting correct nucleotides, and sealing the gap. Our previous studies revealed that the Rad53-Bdr1 pathway mainly controls DNA strand breaks through the regulation of HR- and NHEJ-related genes. However, the functional roles of genes involved in the base excision repair system remain elusive in Cryptococcus neoformans. In the present study, we identified OGG1 and NTG1 genes in the base excision repair system of C. neoformans, which are involved in DNA oxidation repair. The expression of OGG1 was induced in a Hog1-dependent manner under oxidative stress. On the other hand, the expression of NTG1 was strongly induced by DNA damage stress in a Rad53-independent manner. We demonstrated that the deletion of NTG1, but not OGG1, resulted in elevated susceptibility to DNA damage agents and oxidative stress inducers. Notably, the ntg1Δ mutant showed growth defects upon antifungal drug treatment. Although deletion of OGG1 or NTG1 did not increase mutation rates, the mutation profile of each ogg1Δ and ntg1Δ mutant was different from that of the wild-type strain. Taken together, we found that DNA N-glycosylase Ntg1 is required for oxidative DNA damage stress and antifungal drug resistance in C. neoformans.
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Affiliation(s)
- Kwang-Woo Jung
- Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongeup, 56212, Republic of Korea.
| | - Sunhak Kwon
- Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongeup, 56212, Republic of Korea
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Jong-Hyun Jung
- Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongeup, 56212, Republic of Korea
| | - Sangyong Lim
- Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongeup, 56212, Republic of Korea
- Department of Radiation Science, University of Science and Technology, Daejeon, 34113, Republic of Korea
| | - Yong-Sun Bahn
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
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29
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Maoloni A, Cardinali F, Milanović V, Reale A, Boscaino F, Di Renzo T, Ferrocino I, Rampanti G, Garofalo C, Osimani A, Aquilanti L. Impact of Different Drying Methods on the Microbiota, Volatilome, Color, and Sensory Traits of Sea Fennel ( Crithmum maritimum L.) Leaves. Molecules 2023; 28:7207. [PMID: 37894688 PMCID: PMC10609079 DOI: 10.3390/molecules28207207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
Sea fennel (Crithmum maritimum L.) is a strongly aromatic herb of the Apiaceae family, whose full exploitation by the modern food industry is of growing interest. This study aimed at investigating the microbiological quality, volatile profile, and sensory traits of sea fennel spices produced using room-temperature drying, oven drying, microwave drying, and freeze drying. All the assayed methods were able to remove moisture up until water activity values below 0.6 were reached; however, except for microwave drying, none of the assayed methods were effective in reducing the loads of contaminating microorganisms. The metataxonomic analysis highlighted the presence of phytopathogens and even human pathogens, including members of the genera Bacillus, Pseudomonas, Alternaria, and Cryptococcus. When compared to fresh leaves, dried leaves showed increased L* (lightness) and c* (chroma, saturation) values and reduced hue angle. Dried leaves were also characterized by decreased levels of terpene hydrocarbons and increased levels of aldehydes, alcohols, and esters. For the sensory test, the microwave-dried samples obtained the highest appreciation by the trained panel. Overall, the collected data indicated microwave drying as the best option for producing sea fennel spices with low microbial loads, brilliant green color, and high-quality sensory traits.
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Affiliation(s)
- Antonietta Maoloni
- Dipartimento di Scienze Agrarie, Alimentari e Ambientali, Università Politecnica delle Marche, 60131 Ancona, Italy; (A.M.); (F.C.); (V.M.); (G.R.); (C.G.); (A.O.)
| | - Federica Cardinali
- Dipartimento di Scienze Agrarie, Alimentari e Ambientali, Università Politecnica delle Marche, 60131 Ancona, Italy; (A.M.); (F.C.); (V.M.); (G.R.); (C.G.); (A.O.)
| | - Vesna Milanović
- Dipartimento di Scienze Agrarie, Alimentari e Ambientali, Università Politecnica delle Marche, 60131 Ancona, Italy; (A.M.); (F.C.); (V.M.); (G.R.); (C.G.); (A.O.)
| | - Anna Reale
- Istituto di Scienze dell’Alimentazione (ISA), Consiglio Nazionale delle Ricerche (CNR), 83100 Avellino, Italy; (A.R.); (F.B.); (T.D.R.)
| | - Floriana Boscaino
- Istituto di Scienze dell’Alimentazione (ISA), Consiglio Nazionale delle Ricerche (CNR), 83100 Avellino, Italy; (A.R.); (F.B.); (T.D.R.)
| | - Tiziana Di Renzo
- Istituto di Scienze dell’Alimentazione (ISA), Consiglio Nazionale delle Ricerche (CNR), 83100 Avellino, Italy; (A.R.); (F.B.); (T.D.R.)
| | - Ilario Ferrocino
- Department of Agricultural, Forest, and Food Science, University of Turin, Largo Paolo Braccini 2, Grugliasco, 10095 Turin, Italy;
| | - Giorgia Rampanti
- Dipartimento di Scienze Agrarie, Alimentari e Ambientali, Università Politecnica delle Marche, 60131 Ancona, Italy; (A.M.); (F.C.); (V.M.); (G.R.); (C.G.); (A.O.)
| | - Cristiana Garofalo
- Dipartimento di Scienze Agrarie, Alimentari e Ambientali, Università Politecnica delle Marche, 60131 Ancona, Italy; (A.M.); (F.C.); (V.M.); (G.R.); (C.G.); (A.O.)
| | - Andrea Osimani
- Dipartimento di Scienze Agrarie, Alimentari e Ambientali, Università Politecnica delle Marche, 60131 Ancona, Italy; (A.M.); (F.C.); (V.M.); (G.R.); (C.G.); (A.O.)
| | - Lucia Aquilanti
- Dipartimento di Scienze Agrarie, Alimentari e Ambientali, Università Politecnica delle Marche, 60131 Ancona, Italy; (A.M.); (F.C.); (V.M.); (G.R.); (C.G.); (A.O.)
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30
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Julian JULIAN, Robiatul ADAWIYAH, Sri WAHDINI. BIOMOLECULAR ACTIVITY OF CRYPTOCOCCUS DURING CRYPTOCOCCOSIS: A REVIEW OF MOLECULAR INTERACTIONS OF CRYPTOCOCCUS WITH HUMAN IMMUNE SYSTEM AND BLOOD-BRAIN-BARRIER. Afr J Infect Dis 2023; 18:11-22. [PMID: 38058414 PMCID: PMC10696652 DOI: 10.21010/ajidv18i1.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 12/08/2023] Open
Abstract
Global mycosis is still a problem. One of these is the cryptococcal disease. A systemic mycosis brought on by Cryptococcus is called cryptococcosis. Host immunological conditions influence infection with Cryptococcosis. When environmental spores are inhaled by the host, the spores get to the lungs, an infection is created. Alveolar macrophages and other immune cells recognize Cryptococcus in the lung. The initial line of defense against pathogens in the phagolysosome is provided by alveolar macrophages found in the lungs. When the immune system is weak, Cryptococcus uses the evasion system as a molecular interaction with the immune system and persists in the lungs without causing any symptoms such as Factor Transcription, Cell masking, N-glycan structure, Extracellular molecule, and Antioxidant system. The evasion mechanism protects and makes Cryptococcus disseminate throughout the other organs, especially CNS. If Cryptococcus escapes against the host immune system, it will disseminate to other organs, especially Cerebrospinal System by Three mechanisms. There are Trojan Horse, Paracellular, and Transcellular interactions with Blood-Brain Barrier. Disease severity is determined by the Interaction between the host's immune system and the fungus.
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Affiliation(s)
- JULIAN Julian
- Master’s Programme in biomedical science, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - ADAWIYAH Robiatul
- Master’s Programme in biomedical science, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - WAHDINI Sri
- Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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Giamberardino CD, Tenor JL, Toffaletti DL, Palmucci JR, Schell W, Boua JVK, Marius C, Stott KE, Steele SL, Hope W, Cilla D, Perfect JR. Pharmacodynamics of ATI-2307 in a rabbit model of cryptococcal meningoencephalitis. Antimicrob Agents Chemother 2023; 67:e0081823. [PMID: 37728934 PMCID: PMC10583688 DOI: 10.1128/aac.00818-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/22/2023] [Indexed: 09/22/2023] Open
Abstract
Cryptococcal meningoencephalitis (CM) is a devastating fungal disease with high morbidity and mortality. The current regimen that is standard-of-care involves a combination of three different drugs administered for up to one year. There is a critical need for new therapies due to both toxicity and inadequate fungicidal activity of the currently available antifungal drugs. ATI-2307 is a novel aryl amidine that disrupts the mitochondrial membrane potential and inhibits the respiratory chain complexes of fungi-it thus represents a new mechanism for direct antifungal action. Furthermore, ATI-2307 selectively targets fungal mitochondria via a fungal-specific transporter that is not present in mammalian cells. It has very potent in vitro anticryptococcal activity. In this study, the efficacy of ATI-2307 was tested in a rabbit model of CM. ATI-2307 demonstrated significant fungicidal activity at dosages between 1 and 2 mg/kg/d, and these results were superior to fluconazole and similar to amphotericin B treatment. When ATI-2307 was combined with fluconazole, the antifungal effect was greater than either therapy alone. While ATI-2307 has potent anticryptococcal activity in the subarachnoid space, its ability to reduce yeasts in the brain parenchyma was relatively less over the same study period. This new drug, with its unique mechanism of fungicidal action and ability to positively interact with an azole, has demonstrated sufficient anticryptococcal potential in this experimental setting to be further evaluated in clinical studies.
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Affiliation(s)
- Charles D. Giamberardino
- Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA
| | - Jennifer L. Tenor
- Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA
| | - Dena L. Toffaletti
- Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA
| | - Julia R. Palmucci
- Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA
| | - Wiley Schell
- Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA
| | | | - Choiselle Marius
- Department of Neurosurgery, Duke University, Durham, North Carolina, USA
| | - Katharine E. Stott
- Antimicrobial Pharmacodynamics and Therapeutics, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom
| | | | - William Hope
- Antimicrobial Pharmacodynamics and Therapeutics, Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom
| | - Don Cilla
- Appili Therapeutics Inc., Halifax, Nova Scotia, Canada
| | - John R. Perfect
- Department of Medicine, Division of Infectious Diseases, Duke University, Durham, North Carolina, USA
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Lamprell L, Broadhurst M. Cryptococcal Laryngitis: Three Cases Managed With Potassium-Titanyl-Phosphate Laser and Literature Review. J Voice 2023:S0892-1997(23)00267-9. [PMID: 37833110 DOI: 10.1016/j.jvoice.2023.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVES To present three case reports of cryptococcal laryngitis managed with potassium-titanyl-phosphate (KTP) laser, where only one case managed with KTP laser has previously been published to date to our knowledge. Further, to systematically review the medical literature and describe the epidemiology, clinical assessment, treatment, and prognosis of laryngeal cryptococcosis. METHODS The PubMed, Embase, and OVID MEDLINE databases were searched using the terms "cryptococcal laryngitis" or "cryptococcus" and "larynx or laryngeal." RESULTS Thirty-eight cases were identified. The median age was 65 years with a 1 male:1.2 female ratio. Thirty-six cases (95%) presented with hoarseness. Twenty-one cases (55%) were systemically immunosuppressed and 19 (50%) were taking an inhaled corticosteroid. This paper lists the five clinical features (i. white exudate or lesion; ii. exophytic, verrucous or tumor-like mass; iii. diffuse erythema; iv. mucosal irregularity; v. thickened vocal fold) and four pathologic features or tests (i. Grocott Gomori Methenamine stain; ii. Mucicarmine stain; iii. fungal or yeast organisms; iv. fungal culture) that encompass 97% of cases of cryptococcal laryngitis reported in the medical literature. In 34 cases (89%), antifungal therapy was given. Four cases (11%) had excisional biopsy and 11 (29%) received combined surgery and medical therapy. There was uncomplicated resolution in 24 cases (63%). CONCLUSION Cryptococcal laryngitis is a rare cause of hoarseness that may be mistaken for malignancy or may be a manifestation of disseminated cryptococcal infection or underlying immunosuppression. Clinicians should be aware of the diagnostic features of cryptococcal laryngitis to facilitate diagnosis and treatment to prevent complicated disease and overly aggressive treatment.
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Affiliation(s)
- Laura Lamprell
- Queensland Centre for Otolaryngology and Voice, Level 7, 457 Wickham Terrace, Spring Hill, QLD 4000, Australia.
| | - Matthew Broadhurst
- Queensland Centre for Otolaryngology and Voice, Level 7, 457 Wickham Terrace, Spring Hill, QLD 4000, Australia
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Zhu D, Rai R, Mechel E, Shah PP, Hymowitz M, Rohring V, Cheela I, Samson CM. Exogenous cryptococcal endophthalmitis in an immunocompetent patient. Taiwan J Ophthalmol 2023; 13:552-555. [PMID: 38249497 PMCID: PMC10798385 DOI: 10.4103/tjo.tjo-d-22-00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/25/2022] [Indexed: 01/12/2023] Open
Abstract
We describe a case of exogenous cryptococcal endophthalmitis without central nervous system (CNS) involvement or systemic infection in an immunocompetent patient. An 82-year-old male with hypertension, hyperlipidemia, type 2 diabetes mellitus, and primary open-angle glaucoma with a history of left eye trabeculectomy presented with 3 months of worsening left eye pain and redness. Vitreous cultures resulted as Cryptococcus, prompting treatment with intravitreal amphotericin and further investigation. Systemic workup was unrevealing for an endogenous source, CNS involvement, or immunocompromising conditions. He was treated with an aggressive regimen of systemic antifungals, leading to subjective improvements in clinical exam and in vision.
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Affiliation(s)
- Daniel Zhu
- Department of Ophthalmology, Northwell Health Eye Institute, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
| | - Ravneet Rai
- Department of Ophthalmology, Northwell Health Eye Institute, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
| | - Elzbieta Mechel
- Department of Ophthalmology, Northwell Health Eye Institute, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
| | - Paras P. Shah
- Department of Ophthalmology, Northwell Health Eye Institute, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
| | - Maggie Hymowitz
- Department of Ophthalmology, Northwell Health Eye Institute, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
| | - Victoria Rohring
- Department of Ophthalmology, Northwell Health Eye Institute, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
| | - Isha Cheela
- Department of Ophthalmology, Northwell Health Eye Institute, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
| | - C. Michael Samson
- Department of Ophthalmology, Northwell Health Eye Institute, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, USA
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Hatem NA, Denicol TL, Dagostini CM, Pasqualotto AC. Cyanotic Raynaud's phenomenon induced by amphotericin B deoxycholate: A case report. Med Mycol Case Rep 2023; 41:20-21. [PMID: 37706049 PMCID: PMC10495380 DOI: 10.1016/j.mmcr.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/13/2023] [Accepted: 06/18/2023] [Indexed: 09/15/2023] Open
Abstract
A 59-year-old male patient with chronic headache was admitted to the emergency department due to cryptococcal meningitis. His past medical history was marked by liver transplant 18 months prior to admission. Induction therapy with amphotericin B deoxycholate was initiated and the patient developed cyanotic Raynaud's phenomenon related to the infusion. The antifungal treatment was switched to liposomal amphotericin B, with complete resolution of the phenomenon.
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Affiliation(s)
- Nayla A. Hatem
- Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | - Taís L. Denicol
- Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | | | - Alessandro C. Pasqualotto
- Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, Brazil
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Carvalho JHDS, Nascimento JKC, Silva KGV, Silveira Neto S, Macedo ATD, Lima França H, Ferreira LDR, Silva RDS, Sa JC, Ramos DG, Marques DDAV, Furst C, Santos DA, Santos JRA, Holanda RA. Yeast-amoeba interaction influences murine cryptococcosis. Microbes Infect 2023; 25:105153. [PMID: 37244475 DOI: 10.1016/j.micinf.2023.105153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
The virulence of Cryptococcus spp. is modulated in the natural environment through interaction with abiotic and biotic factors, and this can occasionally have implications for the progression of cryptococcosis in mammals. Hence, we evaluated whether the prior interaction of highly virulent Cryptococcus gattii strain R265 with Acanthamoeba castellanii influenced the progression of cryptococcosis. The influence of the capsule on endocytosis was evaluated using amoeba and yeast morphometrics. Mice were intratracheally infected with yeast re-isolated from the amoeba (Interaction), yeast without prior contact with the amoeba (Non-Interaction), or sterile phosphate-buffered saline (SHAM). Morbidity signs and symptoms were monitored during the survival curve, while cytokine and fungal burden measurements and histopathological analysis were performed on the 10th day post infection. Morbidity and mortality parameters in experimental cryptococcosis were influenced by the prior interaction of yeast with amoeba, which led to phenotypic changes in the cryptococcal cells, polysaccharide secretion, and their tolerance to oxidative stress. Our results suggest that a prior yeast-amoeba interaction modulates yeast virulence, which is associated with a greater tolerance to oxidative stress related to the exo-polysaccharide content and influences the progression of cryptococcal infection.
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Affiliation(s)
| | | | | | - Sebastiao Silveira Neto
- Laboratório de Biologia Molecular de Microrganismos Patogênicos, Universidade CEUMA, São Luís, Maranhão, Brazil
| | | | - Hermeson Lima França
- Laboratório de Biologia Molecular de Microrganismos Patogênicos, Universidade CEUMA, São Luís, Maranhão, Brazil
| | - Larissa Dos Reis Ferreira
- Laboratório de Biologia Molecular de Microrganismos Patogênicos, Universidade CEUMA, São Luís, Maranhão, Brazil
| | - Rayssa de Sousa Silva
- Laboratório de Biologia Molecular de Microrganismos Patogênicos, Universidade CEUMA, São Luís, Maranhão, Brazil
| | - Joicy Cortez Sa
- Laboratório de Imunologia, Universidade CEUMA, São Luís, Maranhão, Brazil
| | - Diego Gomes Ramos
- Laboratório Integrado de Biotecnologia Aplicada, Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | | | - Cinthia Furst
- Departamento de Patologia, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Daniel Assis Santos
- Departamento de Microbiologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Rodrigo Assuncao Holanda
- Laboratório de Biologia Molecular de Microrganismos Patogênicos, Universidade CEUMA, São Luís, Maranhão, Brazil.
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Ellis J, Bangdiwala AS, Skipper CP, Tugume L, Nsangi L, Matovu J, Pastick KA, Ssebambulidde K, Morawski BM, Musubire AK, Schleiss MR, Moore DAJ, Jarvis JN, Boulware DR, Meya DB, Castelnuovo B. Baseline Cytomegalovirus Viremia at Cryptococcal Meningitis Diagnosis Is Associated With Long-term Increased Incident TB Disease and Mortality in a Prospective Cohort of Ugandan Adults With HIV. Open Forum Infect Dis 2023; 10:ofad449. [PMID: 37732168 PMCID: PMC10508356 DOI: 10.1093/ofid/ofad449] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/25/2023] [Indexed: 09/22/2023] Open
Abstract
Background Adults with HIV-associated cryptococcal meningitis have overlapping burdens of cytomegalovirus (CMV) and tuberculosis (TB) coinfections. CMV infection/reactivation is strongly associated with CMV-specific memory T-cell activation and upregulation of type 1 interferons, which may lead to increased risk of TB disease and poor outcomes. Methods We conducted a cohort study of 2-week survivors of cryptococcal meningitis during 2010-2021 to determine TB incidence and all-cause mortality over time stratified by baseline CMV status. Results We followed 497 Ugandans with HIV-associated cryptococcal meningitis for a median (interquartile range) of 4.6 (2.6-53.9) months. Overall, 42% (210/497) developed incident TB disease or died. One-fifth (98/497, 19.7%) developed incident TB disease, and 29% (142/497) of participants died during follow-up. Of 259 participants with CMV viral load measured at baseline, 37% (96/259) had concurrent CMV viremia (defined as anyone with detectable CMV DNA in plasma/serum by qualitative polymerase chain reaction [PCR] detection). Of 59 with measured CMV immunoglobulin G (IgG), 100% had positive CMV IgG antibody serology (≥10 enzyme-linked immunosorbent assay units/mL). CMV viremia was positively associated with higher HIV viral load (196 667 vs 73 295 copies/mL; P = .002) and higher cerebrospinal fluid fungal burden (68 500 vs 14 000 cfu/mL; P = .002) compared with those without. Participants with high-level CMV viremia (defined as CMV viral load ≥1000 IU/mL) had twice the risk of incident TB (subdistribution adjusted hazard ratio [aHR], 2.18; 95% CI, 1.11-4.27) and death (aHR, 1.99; 95% CI, 1.14-3.49) compared with participants with no or low-level CMV viremia. There was no association between the CMV IgG index and the incidence of TB/death (P = .75). Conclusions CMV viremia >1000 IU/mL at meningitis diagnosis was associated with increased incident TB disease and mortality during long-term follow-up. Future studies to determine the causal relationship and potential for therapeutic intervention are warranted.
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Affiliation(s)
- Jayne Ellis
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Lillian Tugume
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Laura Nsangi
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - John Matovu
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Kenneth Ssebambulidde
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Abdu K Musubire
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - David A J Moore
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Joseph N Jarvis
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | | | - David B Meya
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Barbara Castelnuovo
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
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Messina FA, Benchetrit A, Bocassi A, Romero MDLM, Bauer S, Marín E, Bertera F, Onis G, Enzenhofer M, Sánchez M, Mammana L, Mijalovsky D, Santiso G. Meningeal cryptococcosis and SARS-CoV-2 infection in people living with HIV/AIDS. Biomedica 2023; 43:206-216. [PMID: 37721913 PMCID: PMC10586798 DOI: 10.7705/biomedica.6872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/17/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION Fungal infections in patients with COVID-19 was one of the most debated topics during the pandemic. OBJECTIVES To analyze the clinical characteristics and evolution of people living with HIV/AIDS and coinfection with cryptococcus and COVID-19 (group A) or without it (group B). MATERIALS AND METHODS This is an analytical and retrospective study. We reviewed medical records of patients with meningeal cryptococcosis between April 2020 and May 2021. RESULTS We studied 65 people living with HIV/AIDS and with cryptococcosis infection diagnosed from April 2020 to May 2021. Fifteen patients with HIV/AIDS suffered from cryptococcosis and COVID-19, and out of these, 14 presented meningitis (group A), while 28 suffered from meningeal cryptococcosis, but did not have COVID-19 (group B). CONCLUSIONS No statistically significant differences were observed between the two groups (A and B) considering: intracranial hypertension, presence of Cryptococcus antigens in cerebrospinal fluid, sensorium deterioration or mortality. The detection of Cryptococcus antigens in serum by lateral flow assay was highly effective to rapidly diagnose cryptococcosis in patients with HIV/AIDS who also developed COVID-19. Patients of both groups consulted for cryptoccocosis sometime after, in comparison with the pre-pandemic cases related to this infection.
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Affiliation(s)
- Fernando Antonio Messina
- Unidad Micología, Hospital de Enfermedades Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
| | - Andrés Benchetrit
- Sala 21, Hospital de Enfermedades Infecciosas F. J. Muñiz Hospital, Buenos Aires, Argentina.
| | - Andrea Bocassi
- Laboratorio Central Hospital de Infecciosas, Francisco Javier Muñiz Hospital, Buenos Aires, Argentina.
| | | | - Sofía Bauer
- División SIDA, Hospital de infecciosas Francisco Javier Muñiz Hospital, Buenos Aires, Argentina.
| | - Emmanuel Marín
- Unidad Micología, Hospital de Enfermedades Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
| | - Facundo Bertera
- División Farmacia, Hospital de infecciosas Francisco Javier Muñiz Hospital, Buenos Aires, Argentina.
| | - Guillermo Onis
- Sala 20, Hospital de Infecciosas Francisco Javier Muñiz Hospital, Buenos Aires, Argentina.
| | - Matías Enzenhofer
- División SIDA, Hospital de infecciosas Francisco Javier Muñiz Hospital, Buenos Aires, Argentina.
| | - Milagro Sánchez
- División SIDA, Hospital de infecciosas Francisco Javier Muñiz Hospital, Buenos Aires, Argentina.
| | - Lilia Mammana
- Unidad Virología, Hospital de Infecciosas F. J. Muñiz Hospital, Buenos Aires, Argentina.
| | - Dana Mijalovsky
- División SIDA, Hospital de infecciosas Francisco Javier Muñiz Hospital, Buenos Aires, Argentina.
| | - Gabriela Santiso
- Unidad Micología, Hospital de Enfermedades Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
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Kajeekul R, Mekawichai P, Chayakulkeeree M. Clinical Features of Cryptococcal Meningoencephalitis in HIV-Positive and -Negative Patients in a Resource-Limited Setting. J Fungi (Basel) 2023; 9:869. [PMID: 37754977 PMCID: PMC10532421 DOI: 10.3390/jof9090869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
Cryptococcal meningoencephalitis is a systemic fungal infection in immunocompromised and immunocompetent individuals. This study investigated the clinical characteristics and factors associated with mortality in HIV-associated and non-HIV-associated cryptococcal meningoencephalitis in a resource-limited setting. This was a retrospective cohort study of patients with cryptococcal meningoencephalitis between January 2009 and December 2019 at a tertiary teaching hospital in Thailand. Overall, 1019 patients with cryptococcal meningoencephalitis were enrolled, and 923 (90.6%) were HIV-positive. The patients with HIV-associated cryptococcal meningoencephalitis were younger than the HIV-negative patients (37 versus 56 years, p < 0.01). The HIV-negative patients were more likely to have underlying conditions (52.1% versus 7.5%; p < 0.01), had a longer median duration of headaches prior to admission (14 days versus 6 days, p < 0.01), and were more likely to have an altered mental status at presentation (36.5% versus 18.6%, p < 0.01) and pulmonary involvement (15.6% versus 0.8%, p < 0.01). The HIV-positive patients had lower cerebrospinal fluid (CSF) white blood cell counts (4 versus 94 cells/mm3; p < 0.01), lower CSF protein (69 versus 157 mg/dL; p < 0.01), higher CSF glucose (38.8 versus 21 mg/dL; p < 0.01), and more frequent cryptococcemia (44.1% versus 20.5%; p < 0.01). The mortality rate was high but not significantly different between the two groups (30.2% versus 33.2%; p = 0.53). The HIV-positive patients with comorbidities, fever, an altered mental status at presentation, a CSF white blood cell count below 20 cell/mm3, fungemia, and positive CSF India ink were independently associated with 30-day mortality. In comparison, an altered mental status at presentation and fungemia were associated with 30-day mortality in HIV-negative patients. In conclusion, HIV-negative patients with cryptococcal meningoencephalitis had more extensive central nervous system inflammation, although the two groups' mortality rates were similar. Unfavorable prognostic factors included comorbidities, fever, an altered mental status at presentation, a low CSF white blood cell count, fungemia, and positive CSF India ink.
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Affiliation(s)
- Rattagan Kajeekul
- Department of Internal Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima 30000, Thailand;
| | - Pawut Mekawichai
- Department of Internal Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima 30000, Thailand;
| | - Methee Chayakulkeeree
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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Spiliopoulou A, Lekkou A, Vrioni G, Leonidou L, Cogliati M, Christofidou M, Marangos M, Kolonitsiou F, Paliogianni F. Fungemia due to rare non-Candida yeasts between 2018 and 2021 in a Greek tertiary care university hospital. J Mycol Med 2023; 33:101386. [PMID: 37031651 DOI: 10.1016/j.mycmed.2023.101386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 04/01/2023] [Accepted: 04/02/2023] [Indexed: 04/05/2023]
Abstract
INTRODUCTION Non-Candida yeasts, although rare, are increasingly encountered and recognized as a growing threat. METHODS Cases of bloodstream infections (BSIs) due to non-Candida yeasts (NCYs) during the last four years (2018-2021) are presented. RESULTS During the study period, 16 cases caused by non-Candida yeasts out of 400 cases of yeast BSIs were recorded, corresponding to an incidence of 4%. Yeasts that were isolated included Cryptococcus spp (4 isolates-25%), Rhodotorula mucilaginosa (2 isolates-12.5%), Trichosporon asahii (7 isolates-43.75%) and Saccharomyces cerevisiae (3 isolates-18.75%). Predisposing factors involved mostly hematological malignancies, long term hospitalization or major surgical interventions. Most isolates, 15 out of 16 were susceptible to amphotericin B. Voriconazole was the most active azole in vitro. All isolates, except Saccharomyces spp., were resistant to echinocandins. DISCUSSION Early recognition of rare yeasts as causative agents of BSIs and prompt initiation of appropriate treatment based on current guidelines and expertise remain crucial in efficient patient management.
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Affiliation(s)
| | - Alexandra Lekkou
- Dept of Infectious Diseases, University Hospital of Patras, Patras, Greece
| | - Georgia Vrioni
- Dept of Microbiology, National and Kapodistrian University of Athens, Athens, Greece
| | - Lydia Leonidou
- Dept of Infectious Diseases, University Hospital of Patras, Patras, Greece
| | - Massimo Cogliati
- Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | | | - Markos Marangos
- Dept of Infectious Diseases, University Hospital of Patras, Patras, Greece
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Farhadi Cheshmeh Morvari S, McCann BL, Bignell EM. Conserved and Divergent Features of pH Sensing in Major Fungal Pathogens. Curr Clin Microbiol Rep 2023; 10:120-130. [PMID: 37577059 PMCID: PMC10421798 DOI: 10.1007/s40588-023-00195-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 08/15/2023]
Abstract
Purpose of Review For human fungal pathogens, sensory perception of extracellular pH is essential for colonisation of mammalian tissues and immune evasion. The molecular complexes that perceive and transmit the fungal pH signal are membrane-proximal and essential for virulence and are therefore of interest as novel antifungal drug targets. Intriguingly, the sensory machinery has evolved divergently in different fungal pathogens, yet spatial co-ordination of cellular components is conserved. Recent Findings The recent discovery of a novel pH sensor in the basidiomycete pathogen Cryptococcus neformans highlights that, although the molecular conservation of fungal pH sensors is evolutionarily restricted, their subcellular localisation and coupling to essential components of the cellular ESCRT machinery are consistent features of the cellular pH sensing and adaptation mechanism. In both basidiomycetes and ascomycetes, the lipid composition of the plasma membrane to which pH sensing complexes are localised appears to have pivotal functional importance. Endocytosis of pH-sensing complexes occurs in multiple fungal species, but its relevance for signal transduction appears not to be universal. Summary Our overview of current understanding highlights conserved and divergent mechanisms of the pH sensing machinery in model and pathogenic fungal species, as well as important unanswered questions that must be addressed to inform the future study of such sensing mechanisms and to devise therapeutic strategies for manipulating them.
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Affiliation(s)
| | - Bethany L. McCann
- Medical Research Council Centre for Medical Mycology at The University of Exeter, Stocker Road, Exeter, EX4 4QD UK
| | - Elaine M. Bignell
- Medical Research Council Centre for Medical Mycology at The University of Exeter, Stocker Road, Exeter, EX4 4QD UK
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Malhotra R, Lodato Z, Brunk P, Manoharan A, Hajifathalian K, Finkel D, Mahendrakar S. A case of cryptococcoma in an immunocompetent man with polysubstance use. IDCases 2023; 33:e01851. [PMID: 37546172 PMCID: PMC10403704 DOI: 10.1016/j.idcr.2023.e01851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/08/2023] Open
Abstract
Cryptococcus most commonly affects the pulmonary and central nervous systems in patients who are immunocompromised. It is most likely to present as meningitis. However, it can affect immunocompetent patients in the cerebral parenchyma. Here we describe a rare case of cryptococcoma in an immunocompetent male patient who originally presented with headache and possible seizure-like activity and had IV drug use as a risk factor. Cryptococcomas are a rare manifestation of the disease, and can present due to Cryptococcus gatti. Definite diagnosis is dependent on culture of the organism and treatment includes a long course of anti-fungals.
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Iyer KR, Li SC, Revie NM, Lou JW, Duncan D, Fallah S, Sanchez H, Skulska I, Ušaj MM, Safizadeh H, Larsen B, Wong C, Aman A, Kiyota T, Yoshimura M, Kimura H, Hirano H, Yoshida M, Osada H, Gingras AC, Andes DR, Shapiro RS, Robbins N, Mazhab-Jafari MT, Whitesell L, Yashiroda Y, Boone C, Cowen LE. Identification of triazenyl indoles as inhibitors of fungal fatty acid biosynthesis with broad-spectrum activity. Cell Chem Biol 2023; 30:795-810.e8. [PMID: 37369212 PMCID: PMC11016341 DOI: 10.1016/j.chembiol.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 04/17/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023]
Abstract
Rising drug resistance among pathogenic fungi, paired with a limited antifungal arsenal, poses an increasing threat to human health. To identify antifungal compounds, we screened the RIKEN natural product depository against representative isolates of four major human fungal pathogens. This screen identified NPD6433, a triazenyl indole with broad-spectrum activity against all screening strains, as well as the filamentous mold Aspergillus fumigatus. Mechanistic studies indicated that NPD6433 targets the enoyl reductase domain of fatty acid synthase 1 (Fas1), covalently inhibiting its flavin mononucleotide-dependent NADPH-oxidation activity and arresting essential fatty acid biosynthesis. Robust Fas1 inhibition kills Candida albicans, while sublethal inhibition impairs diverse virulence traits. At well-tolerated exposures, NPD6433 extended the lifespan of nematodes infected with azole-resistant C. albicans. Overall, identification of NPD6433 provides a tool with which to explore lipid homeostasis as a therapeutic target in pathogenic fungi and reveals a mechanism by which Fas1 function can be inhibited.
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Affiliation(s)
- Kali R Iyer
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Sheena C Li
- Donnelly Centre for Cellular & Biomolecular Research, University of Toronto, Toronto, ON, Canada; RIKEN Center for Sustainable Resource Science, Wako, Japan
| | - Nicole M Revie
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Jennifer W Lou
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Dustin Duncan
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Sara Fallah
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Hiram Sanchez
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Medical Microbiology and Immunology, University of Wisconsin, Madison, WI, USA
| | - Iwona Skulska
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Mojca Mattiazzi Ušaj
- Department of Chemistry and Biology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Hamid Safizadeh
- Department of Computer Science and Engineering and Department of Electrical and Computer Engineering, University of Minnesota-Twin Cities, Minneapolis, MN, USA
| | - Brett Larsen
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada; Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Cassandra Wong
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada; Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - Ahmed Aman
- Drug Discovery Program, Ontario Institute for Cancer Research, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Taira Kiyota
- Drug Discovery Program, Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Mami Yoshimura
- RIKEN Center for Sustainable Resource Science, Wako, Japan
| | - Hiromi Kimura
- RIKEN Center for Sustainable Resource Science, Wako, Japan
| | | | - Minoru Yoshida
- RIKEN Center for Sustainable Resource Science, Wako, Japan
| | - Hiroyuki Osada
- RIKEN Center for Sustainable Resource Science, Wako, Japan
| | - Anne-Claude Gingras
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada; Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
| | - David R Andes
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Medical Microbiology and Immunology, University of Wisconsin, Madison, WI, USA
| | - Rebecca S Shapiro
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Nicole Robbins
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Mohammad T Mazhab-Jafari
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Luke Whitesell
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Yoko Yashiroda
- RIKEN Center for Sustainable Resource Science, Wako, Japan.
| | - Charles Boone
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada; Donnelly Centre for Cellular & Biomolecular Research, University of Toronto, Toronto, ON, Canada; RIKEN Center for Sustainable Resource Science, Wako, Japan.
| | - Leah E Cowen
- Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada.
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Tadjali A, Pan S, Perli E, Keaton T. Clinical presentation of idiopathic CD4 lymphocytopenia. BMJ Case Rep 2023; 16:e254746. [PMID: 37419499 DOI: 10.1136/bcr-2023-254746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023] Open
Abstract
An otherwise healthy man (60s) presented to our emergency department 5 years ago with stroke-like symptoms. Underlying cryptococcal meningitis infection was ultimately discovered leading to extensive workup to rule out underlying malignancy and HIV infection. Results returned negative with the exception of a CD4 count less than 25 /mm3 Several years later, he again presented to the emergency department with fatigue. He was then found to have severe anaemia with underlying Mycobacterium avium complex (MAC) infection involving the bone marrow and a left psoas abscess. After multiple courses of antibiotic therapy targeted towards MAC, the infection persisted due to bone marrow involvement. By diagnosis of exclusion, he was eventually found to have idiopathic CD4 lymphocytopenia. Here we describe this condition, which has the potential to cause significant morbidity, and obligates the need for high clinical suspicion for timely diagnosis to enhance life quality and outcomes for patients.
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Affiliation(s)
- Armand Tadjali
- Department of Medicine, Texas A&M University Health Sciences Center, Bryan, Texas, USA
| | - Sharon Pan
- Department of Medicine, Texas A&M University Health Sciences Center, Bryan, Texas, USA
| | - Elias Perli
- Department of Medicine, Texas A&M University Health Sciences Center, Bryan, Texas, USA
| | - Toni Keaton
- Department of Medicine, Texas A&M University Health Sciences Center, Bryan, Texas, USA
- Department of Medicine, Catholic Health Initiatives Saint Joseph Health, Bryan, Texas, USA
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Liu S, Zamith-Miranda D, Almeida-Paes R, da Silva LBR, Nacharaju P, Nosanchuk JD. Nitric oxide-loaded nano- and microparticle platforms serving as potential new antifungal therapeutics. Fungal Biol 2023; 127:1224-1230. [PMID: 37495312 PMCID: PMC10372338 DOI: 10.1016/j.funbio.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/17/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
Fungal diseases are a leading threat to human health, especially in individuals with compromised immunity. Although there have been recent important advances in antifungal drug development, antifungal resistance, drug-drug interactions and difficulties in delivery remain major challenges. Among its pleiotropic actions, nitric oxide (NO) is a key molecule in host defense. We have developed a flexible nanoparticle platform that delivers sustained release of NO and have demonstrated the platform's efficacy against diverse bacteria as well as some fungal species. In this work, we investigate the effects of two NO-releasing particles against a panel of important human yeast. Our results demonstrate that the compounds are both effective against diverse yeast, including ascomycota and basidiomycota species, and that NO-releasing particles may be a potent addition to our armamentarium for the treatment of focal and disseminated mycoses.
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Affiliation(s)
- Sichen Liu
- Departments of Medicine (Division of Infectious Diseases) and Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Daniel Zamith-Miranda
- Departments of Medicine (Division of Infectious Diseases) and Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Leandro Buffoni Roque da Silva
- Departments of Medicine (Division of Infectious Diseases) and Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Parimala Nacharaju
- Department of Biophysics and Physiology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Joshua D Nosanchuk
- Departments of Medicine (Division of Infectious Diseases) and Microbiology & Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
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El-Atoum M, Hargarten JC, Park YD, Ssebambulidde K, Ding L, Chittiboina P, Hammoud DA, Anjum SH, Glassman SR, Merchant S, Williamson PR, Hu JC. Persistent neurological symptoms and elevated intracranial pressures in a previously healthy host with cryptococcal meningitis. BMC Infect Dis 2023; 23:407. [PMID: 37316806 DOI: 10.1186/s12879-023-08349-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/25/2023] [Indexed: 06/16/2023] Open
Abstract
Cryptococcal meningoencephalitis can occur in both previously healthy and immunocompromised hosts. Here, we describe a 55 year-old HIV-negative male with no known prior medical problems, who presented with three months of worsening headaches, confusion, and memory changes without fever. Magnetic resonance imaging of the brain demonstrated bilateral enlargement/enhancement of the choroid plexi, with hydrocephalus, temporal and occipital horn entrapments, as well as marked periventricular transependymal cerebrospinal fluid (CSF) seepage. CSF analysis yielded a lymphocytic pleocytosis and cryptococcal antigen titer of 1:160 but sterile fungal cultures. Despite standard antifungal therapy and CSF drainage, the patient had worsening confusion and persistently elevated intracranial pressures. External ventricular drainage led to improved mental status but only with valve settings at negative values. Ventriculoperitoneal shunt placement could thus not be considered due to a requirement for drainage into the positive pressure venous system. Due to this persistent CSF inflammation and cerebral circulation obstruction, the patient required transfer to the National Institute of Health. He was treated for cryptococcal post-infectious inflammatory response syndrome with pulse-taper corticosteroid therapy, with resultant reductions in CSF pressures along with decreased protein and obstructive material, allowing successful shunt placement. After tapering of corticosteroids, the patient recovered without sequelae. This case highlights (1) the necessity to consider cryptococcal meningitis as a rare cause of neurological deterioration in the absence of fever even in apparently immunocompetent individuals and (2) the potential for obstructive phenomena from inflammatory sequelae and the prompt response to corticosteroid therapy.
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Affiliation(s)
- Mohammad El-Atoum
- Department of Medicine, Good Samaritan Hospital, SSM Health Medical Group, Mount Vernon, IL, USA.
| | - Jessica C Hargarten
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Yoon-Dong Park
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Kenneth Ssebambulidde
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Li Ding
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Prashant Chittiboina
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Dima A Hammoud
- Center for Infectious Disease Imaging (CIDI), Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Seher H Anjum
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - Seth R Glassman
- Department of Medicine, Division of Infectious Diseases, University at Buffalo, 955 Main Street, Buffalo, NY, 14203, USA
| | - Shehzad Merchant
- Department of Medicine, Division of Infectious Diseases, University at Buffalo, 955 Main Street, Buffalo, NY, 14203, USA
| | - Peter R Williamson
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA
| | - John C Hu
- Department of Medicine, Division of Infectious Diseases, University at Buffalo, 955 Main Street, Buffalo, NY, 14203, USA.
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Messina F, Santiso G, Arechavala A, Romero M, Depardo R, Marin E. Preemptive Therapy in Cryptococcosis Adjusted for Outcomes. J Fungi (Basel) 2023; 9:631. [PMID: 37367567 DOI: 10.3390/jof9060631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/27/2023] [Accepted: 05/29/2023] [Indexed: 06/28/2023] Open
Abstract
Cryptococcosis is one of the most serious opportunistic diseases in patients living with HIV. For this reason, early diagnosis and appropriate treatment are important. OBJECTIVES The aim of the study was to understand the development of patients diagnosed with cryptococcosis by detection of Cryptococcus antigen in serum by lateral flow assay (CrAg LFA) without nervous system involvement and with treatment in accordance with the results. MATERIALS AND METHODS A retrospective, longitudinal, analytical study was performed. Seventy patients with cryptococcosis initially diagnosed by serum CrAg LFA without meningeal involvement between January 2019 and April 2022 were analyzed for medical records. The treatment regimen was adapted to the results of blood culture, respiratory material, and pulmonary tomography imaging. RESULTS Seventy patients were included, 13 had probable pulmonary cryptococcosis, 4 had proven pulmonary cryptococcosis, 3 had fungemia, and 50 had preemptive therapy without microbiological or imaging findings compatible with cryptococcosis. Among the 50 patients with preemptive therapy, none had meningeal involvement or cryptococcosis recurrences to date. CONCLUSION Preemptive therapy avoided progression to meningitis in CrAg LFA-positive patients. Preemptive therapy with dose adjustment of fluconazole in patients with the mentioned characteristics was useful despite the use of lower doses than recommended.
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Affiliation(s)
- Fernando Messina
- Mycology Unit, Infectious Diseases Hospital F.J. Muñiz, Buenos Aires C1282AEN, Argentina
| | - Gabriela Santiso
- Mycology Unit, Infectious Diseases Hospital F.J. Muñiz, Buenos Aires C1282AEN, Argentina
| | - Alicia Arechavala
- Mycology Unit, Infectious Diseases Hospital F.J. Muñiz, Buenos Aires C1282AEN, Argentina
| | - Mercedes Romero
- Mycology Unit, Infectious Diseases Hospital F.J. Muñiz, Buenos Aires C1282AEN, Argentina
| | - Roxana Depardo
- Mycology Unit, Infectious Diseases Hospital F.J. Muñiz, Buenos Aires C1282AEN, Argentina
| | - Emmanuel Marin
- Mycology Unit, Infectious Diseases Hospital F.J. Muñiz, Buenos Aires C1282AEN, Argentina
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De Giovanni M, Dang EV, Chen KY, An J, Madhani HD, Cyster JG. Platelets and mast cells promote pathogenic eosinophil recruitment during invasive fungal infection via the 5-HIAA-GPR35 ligand-receptor system. Immunity 2023:S1074-7613(23)00223-6. [PMID: 37279752 PMCID: PMC10360074 DOI: 10.1016/j.immuni.2023.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 02/03/2023] [Accepted: 05/10/2023] [Indexed: 06/08/2023]
Abstract
Cryptococcus neoformans is the leading cause of fungal meningitis and is characterized by pathogenic eosinophil accumulation in the context of type-2 inflammation. The chemoattractant receptor GPR35 is expressed by granulocytes and promotes their migration to the inflammatory mediator 5-hydroxyindoleacetic acid (5-HIAA), a serotonin metabolite. Given the inflammatory nature of cryptococcal infection, we examined the role of GPR35 in the circuitry underlying cell recruitment to the lung. GPR35 deficiency dampened eosinophil recruitment and fungal growth, whereas overexpression promoted eosinophil homing to airways and fungal replication. Activated platelets and mast cells were the sources of GPR35 ligand activity and pharmacological inhibition of serotonin conversion to 5-HIAA, or genetic deficiency in 5-HIAA production by platelets and mast cells resulted in more efficient clearance of Cryptococcus. Thus, the 5-HIAA-GPR35 axis is an eosinophil chemoattractant receptor system that modulates the clearance of a lethal fungal pathogen, with implications for the use of serotonin metabolism inhibitors in the treatment of fungal infections.
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Affiliation(s)
- Marco De Giovanni
- Howard Hughes Medical Institute and Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA.
| | - Eric V Dang
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Kevin Y Chen
- Howard Hughes Medical Institute and Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Jinping An
- Howard Hughes Medical Institute and Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Hiten D Madhani
- Department of Biochemistry and Biophysics, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Jason G Cyster
- Howard Hughes Medical Institute and Department of Microbiology and Immunology, University of California, San Francisco, San Francisco, CA 94143, USA.
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Hogan D, Bishburg E, Suryadevara M. Cerebellitis associated with cryptococcal-immune reconstitution inflammatory syndrome. IDCases 2023; 33:e01790. [PMID: 37273775 PMCID: PMC10236292 DOI: 10.1016/j.idcr.2023.e01790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/03/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
Cerebellitis associated with cryptococcal immune reconstitution inflammatory syndrome (IRIS) has not been previously reported. We describe a unique case of IRIS associated cerebellitis in an AIDS patient with cryptococcosis.
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Upadhya R, Lam WC, Hole CR, Vasselli JG, Lodge JK. Cell wall composition in Cryptococcus neoformans is media dependent and alters host response, inducing protective immunity. Front Fungal Biol 2023; 4:1183291. [PMID: 37538303 PMCID: PMC10399910 DOI: 10.3389/ffunb.2023.1183291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Introduction Cryptococcus neoformans is a basidiomycete fungus that can cause meningoencephalitis, especially in immunocompromised patients. Cryptococcus grows in many different media, although little attention has been paid to the role of growth conditions on the cryptococcal cell wall or on virulence. Objective The purpose of this study was to determine how different media influenced the amount of chitin and chitosan in the cell wall, which in turn impacted the cell wall architecture and host response. Methods Yeast extract, peptone, and dextrose (YPD) and yeast nitrogen base (YNB) are two commonly used media for growing Cryptococcus before use in in vitro or in vivo experiments. As a result, C. neoformans was grown in either YPD or YNB, which were either left unbuffered or buffered to pH 7 with MOPS. These cells were then labeled with cell wall-specific fluorescent probes to determine the amounts of various cell wall components. In addition, these cells were employed in animal virulence studies using the murine inhalation model of infection. Results We observed that the growth of wild-type C. neoformans KN99 significantly changes the pH of unbuffered media during growth. It raises the pH to 8.0 when grown in unbuffered YPD but lowers the pH to 2.0 when grown in unbuffered YNB (YNB-U). Importantly, the composition of the cell wall was substantially impacted by growth in different media. Cells grown in YNB-U exhibited a 90% reduction in chitosan, the deacetylated form of chitin, compared with cells grown in YPD. The decrease in pH and chitosan in the YNB-U-grown cells was associated with a significant increase in some pathogen-associated molecular patterns on the surface of cells compared with cells grown in YPD or YNB, pH 7. This altered cell wall architecture resulted in a significant reduction in virulence when tested using a murine model of infection. Furthermore, when heat-killed cells were used as the inoculum, KN99 cells grown in YNB-U caused an aberrant hyper-inflammatory response in the lungs, resulting in rapid animal death. In contrast, heat-killed KN99 cells grown in YNB, pH 7, caused little to no inflammatory response in the host lung, but, when used as a vaccine, they conferred a robust protective response against a subsequent challenge infection with the virulent KN99 cells. Conclusion These findings emphasize the importance of culture media and pH during growth in shaping the content and organization of the C. neoformans cell wall, as well as their impact on fungal virulence and the host response.
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Affiliation(s)
- Rajendra Upadhya
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, United States
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC, United States
| | - Woei C. Lam
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Camaron R. Hole
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, United States
| | - Joseph G. Vasselli
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC, United States
| | - Jennifer K. Lodge
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, MO, United States
- Department of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC, United States
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50
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Tomazin R, Pliberšek T, Oštrbenk Valenčak A, Matos T. Different BD BACTEC ™ Blood Culture Bottle Types for the Detection of Fungi in Simulated Sterile Body Fluid Samples. Diagnostics (Basel) 2023; 13:diagnostics13101699. [PMID: 37238183 DOI: 10.3390/diagnostics13101699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Blood culture systems are a potential alternative to classical cultivation of fungi on mycological media, but there are limited data on the suitability of these systems for culturing other sample types (e.g., sterile body fluids). We conducted a prospective study to evaluate different types of blood culture (BC) bottles for the detection of different fungal species in non-blood samples. A total of 43 fungal isolates were tested for their ability to grow in BD BACTEC Mycosis-IC/F (Mycosis bottles), BD BACTEC Plus Aerobic/F (Aerobic bottles) and BD BACTEC Plus Anaerobic/F (Anaerobic bottles) (Becton Dickinson, East Rutherford, NJ, USA) BC bottles inoculated with spiked samples without the addition of blood or fastidious organism supplement. Time to detection (TTD) was determined for all BC types tested and compared between groups. In general, Mycosis and Aerobic bottles were similar (p > 0.05). The Anaerobic bottles failed to support growth in >86% of cases. The Mycosis bottles were superior in detecting Candida glabrata, Cryptococcus spp. and Aspergillus spp. (p < 0.05). The performance of Mycosis and Aerobic bottles was similar, but if cryptococcosis or aspergillosis is suspected, the use of Mycosis bottles is recommended. Anaerobic bottles are not recommended for fungal detection.
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Affiliation(s)
- Rok Tomazin
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, SI-1000 Ljubljana, Slovenia
| | | | - Anja Oštrbenk Valenčak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, SI-1000 Ljubljana, Slovenia
| | - Tadeja Matos
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška Cesta 4, SI-1000 Ljubljana, Slovenia
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