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Consuegra-Asprilla JM, Rodríguez-Echeverri C, Posada DH, Gómez BL, González Á. Patients with recurrent vulvovaginal candidiasis exhibit a decrease in both the fungicidal activity of neutrophils and the proliferation of peripheral blood mononuclear cells. Mycoses 2024; 67:e13720. [PMID: 38551114 DOI: 10.1111/myc.13720] [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: 12/12/2023] [Revised: 02/21/2024] [Accepted: 03/19/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Recurrent vulvovaginal candidiasis (RVVC) is an important and underestimated fungal infection. OBJECTIVE We aimed to determine the fungicidal and proliferative capacities of neutrophils and peripheral blood mononuclear cells (PBMCs), respectively and the clinical and microbiological characteristics of a cohort of Colombian patients diagnosed with RVVC. METHODS A cross-sectional study was conducted. A total of 66 women were included (40 diagnosed with RVVC and 26 healthy women [HW]). Demographic and clinical data were recorded. Vaginal fluid samples were obtained for isolation, identification and antifungal susceptibility testing of Candida species using selective culture media and the Vitek 2.0® system. Blood samples were also obtained to evaluate cell subpopulations; furthermore, neutrophils and PBMCs were isolated to determine their fungicidal and proliferative capacities, respectively. RESULTS The median age was 29 (IQR: 34-23) for RVVC and 24 (IQR: 30-23) for HW. Only two species of the genus Candida were identified: Candida albicans (92.5%) and Candida lusitaniae (7.5%). Resistance to fluconazole, voriconazole, flucytosine and amphotericin B was observed on six C. albicans isolates and one C. lusitaniae isolate. Only the family history of vulvovaginal candidiasis was associated with RVVC occurrence. The RVVC group exhibited a significantly higher number of neutrophils but with lower fungicidal activity in comparison to HW; likewise, PBMCs from RVVC patients presented a lower proliferation index when stimulated with C. albicans. CONCLUSION Contrary to what has been reported worldwide, in Colombian patients with RVVC, C. albicans was the main isolated species without increased antifungal resistance. The diminished fungicidal and proliferative capacities of neutrophils and PBMCs, respectively, could suggest a possible alteration in the innate and adaptive immune responses.
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Affiliation(s)
| | - Carolina Rodríguez-Echeverri
- Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellin, Colombia
| | - Daniela Herrera Posada
- Sexual Health and Cancer Group, School of Microbiology, Universidad de Antioquia, Medellin, Colombia
| | - Beatriz L Gómez
- Translational Microbiology and Emerging Diseases Research Group (MICROS), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Ángel González
- Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellin, Colombia
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Micelly-Moreno J, Barreto-Santamaría A, Arévalo-Pinzón G, Firacative C, Gómez BL, Escandón P, Patarroyo MA, Muñoz JE. Therapeutic Use of the Antimicrobial Peptide PNR20 to Resolve Disseminated Candidiasis in a Murine Model. J Fungi (Basel) 2023; 9:1149. [PMID: 38132750 PMCID: PMC10744665 DOI: 10.3390/jof9121149] [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: 10/27/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 12/23/2023] Open
Abstract
Invasive fungal infections (IFIs) caused by Candida species are an emerging threat globally, given that patients at-risk and antifungal resistance are increasing. Antimicrobial peptides (AMPs) have shown good therapeutic capacity against different multidrug-resistant (MDR) microorganisms. This study evaluated the activity of the synthetic peptide, PNR20, against Candida albicans ATCC 10231 and a MDR Colombian clinical isolate of Candida auris. Perturbation of yeast cell surface was evaluated using scanning electron microscopy. Cell viability of Vero cells was determined to assess peptide toxicity. Additionally, survival, fungal burden, and histopathology of BALB/c mice infected intravenously with each Candida species and treated with PNR20 were analyzed. Morphological alterations were identified in both species, demonstrating the antifungal effect of PNR20. In vitro, Vero cells' viability was not affected by PNR20. All mice infected with either C. albicans or C. auris and treated with PNR20 survived and had a significant reduction in the fungal burden in the kidney compared to the control group. The histopathological analysis in mice infected and treated with PNR20 showed more preserved tissues, without the presence of yeast, compared to the control groups. This work shows that the utilization of PNR20 is a promising therapeutic alternative against disseminated candidiasis.
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Affiliation(s)
- Jeisson Micelly-Moreno
- Faculty of Health Sciences, Universidad Colegio Mayor de Cundinamarca, Bogota 110311, Colombia;
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogota 111221, Colombia; (C.F.); (B.L.G.)
| | - Adriana Barreto-Santamaría
- Receptor-Ligand Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogota 111321, Colombia;
| | - Gabriela Arévalo-Pinzón
- Microbiology Department, Faculty of Sciences, Pontificia Universidad Javeriana, Carrera 7 #40–62, Bogota 110231, Colombia;
| | - Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogota 111221, Colombia; (C.F.); (B.L.G.)
| | - Beatriz L. Gómez
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogota 111221, Colombia; (C.F.); (B.L.G.)
| | - Patricia Escandón
- Microbiology Group, Instituto Nacional de Salud, Bogota 111321, Colombia;
| | - Manuel A. Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogota 111321, Colombia;
- Microbiology Department, Faculty of Medicine, Universidad Nacional de Colombia, Bogota 111321, Colombia
| | - Julián E. Muñoz
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogota 111221, Colombia; (C.F.); (B.L.G.)
- Public Health Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia
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Gómez BL. Ángela Restrepo Moreno (1931-2022). Biomedica 2023; 43:7-10. [PMID: 37721897 DOI: 10.7705/biomedica.7213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Indexed: 09/20/2023]
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Gómez BL, Escandón P. Fungal infections: A growing threat. Biomedica 2023; 43:11-16. [PMID: 37721896 PMCID: PMC10581601 DOI: 10.7705/biomedica.7214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Indexed: 09/20/2023]
Affiliation(s)
- Beatriz L Gómez
- Grupo de Estudios en Microbiología Translacional y Enfermedades Emergentes (MICROS), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, D.C., Colombia.
| | - Patricia Escandón
- Grupo de Microbiología, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
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Torres R, Barreto-Santamaría A, Arévalo-Pinzón G, Firacative C, Gómez BL, Escandón P, Patarroyo MA, Muñoz JE. In Vitro Antifungal Activity of Three Synthetic Peptides against Candida auris and Other Candida Species of Medical Importance. Antibiotics (Basel) 2023; 12:1234. [PMID: 37627654 PMCID: PMC10451292 DOI: 10.3390/antibiotics12081234] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/12/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023] Open
Abstract
Candidiasis is an opportunistic infection affecting immunosuppressed and hospitalized patients, with mortality rates approaching 40% in Colombia. The growing pharmacological resistance of Candida species and the emergence of multidrug-resistant Candida auris are major public health problems. Therefore, different antimicrobial peptides (AMPs) are being investigated as therapeutic alternatives to control candidiasis effectively and safely. This work aimed to evaluate the in vitro antifungal activity of three synthetic AMPs, PNR20, PNR20-1, and 35409, against ATCC reference strains of Candida albicans, Candida glabrata, Candida parapsilosis, Candida krusei, and Candida tropicalis, and clinical isolates of C. auris. Antifungal susceptibility testing, determined by broth microdilution, showed that the AMPs have antifungal activity against planktonic cells of all Candida species evaluated. In C. auris and C. albicans, the peptides had an effect on biofilm formation and cell viability, as determined by the XTT assay and flow cytometry, respectively. Also, morphological alterations in the membrane and at the intracellular level of these species were induced by the peptides, as observed by transmission electron microscopy. In vitro, the AMPs had no cytotoxicity against L929 murine fibroblasts. Our results showed that the evaluated AMPs are potential therapeutic alternatives against the most important Candida species in Colombia and the world.
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Affiliation(s)
- Richar Torres
- Faculty of Health Sciences, Universidad Colegio Mayor de Cundinamarca, Bogotá 110311, Colombia;
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogotá 111221, Colombia; (C.F.); (B.L.G.)
| | - Adriana Barreto-Santamaría
- Receptor-Ligand Department Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá 111321, Colombia; (A.B.-S.); (G.A.-P.)
| | - Gabriela Arévalo-Pinzón
- Receptor-Ligand Department Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá 111321, Colombia; (A.B.-S.); (G.A.-P.)
| | - Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogotá 111221, Colombia; (C.F.); (B.L.G.)
| | - Beatriz L. Gómez
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogotá 111221, Colombia; (C.F.); (B.L.G.)
| | - Patricia Escandón
- Microbiology Group, Instituto Nacional de Salud, Bogotá 111321, Colombia;
| | - Manuel Alfonso Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá 111321, Colombia;
- Microbiology Department, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, Colombia
| | - Julián E. Muñoz
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad de Rosario, Bogotá 111221, Colombia; (C.F.); (B.L.G.)
- Public Health Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá 111221, Colombia
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López LF, Tobón ÁM, Cáceres DH, Chiller T, Litvintseva AP, Gade L, González Á, Gómez BL. Application of Real-Time PCR Assays for the Diagnosis of Histoplasmosis in Human FFPE Tissues Using Three Molecular Targets. J Fungi (Basel) 2023; 9:700. [PMID: 37504689 PMCID: PMC10381543 DOI: 10.3390/jof9070700] [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: 05/31/2023] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 07/29/2023] Open
Abstract
Histoplasmosis is a fungal infection caused by the thermally dimorphic fungus Histoplasma capsulatum. This infection causes significant morbidity and mortality in people living with HIV/AIDS, especially in countries with limited resources. Currently used diagnostic tests rely on culture and serology but with some limitations. No molecular assays are commercially available and the results from different reports have been variable. We aimed to evaluate quantitative real-time PCR (qPCR) targeting three protein-coding genes of Histoplasma capsulatum (100-kDa, H and M antigens) for detection of this fungus in formalin-fixed paraffin-embedded (FFPE) samples from patients with proven histoplasmosis. The sensitivity of 100-kDa, H and M qPCR assays were 93.9%, 91% and 57%, respectively. The specificity of 100-kDa qPCR was 93% when compared against samples from patients with other mycoses and other infections, and 100% when samples from patients with non-infectious diseases were used as controls. Our findings demonstrate that real-time PCR assays targeting 100-kDa and H antigen showed the most reliable results and can be successfully used for diagnosing this mycosis when testing FFPE samples.
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Affiliation(s)
- Luisa F López
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín 050034, Colombia
| | - Ángela M Tobón
- Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín 055450, Colombia
| | - Diego H Cáceres
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín 050034, Colombia
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | | | - Lalitha Gade
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Ángel González
- Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín 050010, Colombia
| | - Beatriz L Gómez
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia
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Cáceres DH, Gómez BL, Tobón ÁM, Restrepo Á, Chiller T, Lindsley MD, Meis JF, Verweij PE. Tackling Histoplasmosis Infection in People Living with HIV from Latin America: From Diagnostic Strategy to Public Health Solutions. J Fungi (Basel) 2023; 9:jof9050558. [PMID: 37233269 DOI: 10.3390/jof9050558] [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: 04/09/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/27/2023] Open
Abstract
Histoplasmosis, caused by the thermally dimorphic fungus Histoplasma spp., is a disease with a broad clinical spectrum, presenting from asymptomatic/flu-like symptoms to progressive disseminated disease in people with immunosuppression. In recent years, the concept of histoplasmosis as a disease restricted to the American continent has changed, as now histoplasmosis is reported in many regions around the world. In Latin America, histoplasmosis represents a threat, especially in people with advanced HIV disease (AHD). Diagnosis of histoplasmosis in people living with HIV (PLHIV) is challenging due to the low index of suspicion of the disease, non-specificity of signs and symptoms, and limited access to specific laboratory testing, while the diagnostic delay is significantly associated with mortality. In the last decade, novel diagnostic tests have been developed for the rapid detection of histoplasmosis, such as commercial kits for antigen detection. Furthermore, advocacy groups were created that presented histoplasmosis as a public health problem, with emphasis on patients at risk of progressive disseminated disease. This review aims to discuss the impact of histoplasmosis associated with AHD in Latin America and the strategies employed to tackle histoplasmosis, from the implementation of laboratory testing to disease advocacy and public health interventions.
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Affiliation(s)
- Diego H Cáceres
- Center of Expertise in Mycology Radboudumc/Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia
- IMMY, Norman, OK 73069, USA
| | - Beatriz L Gómez
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia
| | - Ángela M Tobón
- Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín 055450, Colombia
| | - Ángela Restrepo
- COLCIENCIAS Emeritus Researcher, Ministerio de Ciencias, Tecnología e Innovación, Bogota 111321, Colombia
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Mark D Lindsley
- Mycotic Diseases Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Jacques F Meis
- Center of Expertise in Mycology Radboudumc/Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
- Department I of Internal Medicine, Excellence Center for Medical Mycology, University Hospital Cologne, 50931 Cologne, Germany
| | - Paul E Verweij
- Center of Expertise in Mycology Radboudumc/Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
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Rodríguez-Echeverri C, Gómez BL, González Á. Histoplasma capsulatum modulates the immune response, affects proliferation and differentiation, and induces apoptosis of mesenchymal stromal cells. Mycoses 2023; 66:157-167. [PMID: 36219488 DOI: 10.1111/myc.13537] [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: 07/24/2022] [Revised: 10/06/2022] [Accepted: 10/09/2022] [Indexed: 01/12/2023]
Abstract
Mesenchymal stromal cells (MSC) have been widely used not only for tissue regeneration but also for the treatment of various diseases; however, it has been shown that infection of MSCs by different pathogens can attenuate their intrinsic immunomodulatory properties, affecting the proliferation and differentiation of these cells. Currently, the mechanisms by which MSCs respond to pathogen invasion are poorly understood. Therefore, the objective of the present study was to determine if the infection of bone marrow-derived MSCs, with yeasts of the pathogenic fungus Histoplasma capsulatum affects the activation, differentiation and/or proliferation of the MSCs. The results indicate that MSCs have the ability to phagocytose H. capsulatum yeasts but do not exert a notable antifungal effect. On the contrary, the infection of the MSCs with this fungal pathogen not only modulates the expression of inflammatory mediators by a mechanism dependent on TLR2, TLR4 and Dectin-1 but also affects the viability and differentiation capacity of the MSCs. These findings suggest that infection of MSCs by H. capsulatum could not only affect haematopoiesis but also modulate the immune response in the infected host and, furthermore, these MSCs could provide a niche for the fungus, allowing it to persist and evade the immune response of the host.
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Affiliation(s)
- Carolina Rodríguez-Echeverri
- Basic and Applied Microbiology Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Beatriz L Gómez
- Translational Microbiology and Emerging Diseases Research Group (MICROS), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Ángel González
- Basic and Applied Microbiology Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
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Toro LJ, Rodriguez M, Gómez BL, Firacative C, Andreu D, Valle J, Santiago BR, Tellez GA, Henao DC, Castaño JC, Muñoz JE. P070 Antimicrobial peptides from the Coleoptera family Scarabaeidae against Candida and Cryptococcus pathogenic yeasts. Med Mycol 2022. [PMCID: PMC9510010 DOI: 10.1093/mmy/myac072.p070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM
Objectives
Host defense peptides (HDP) are produced by a diversity of beetles. The aims of this work were (1) to find new promising peptides from the Coleoptera family Scarabaeidae with potential biomedical applications, (2) to modify physicochemical and structural characteristics of one of the most promissory peptides in order to improve its antimicrobial properties, and (3) to evaluate the in vitro activity of the HDPs against reference strains of pathogenic Candida and Cryptococcus yeasts.
Materials and Methods
From the Scarabaeidae family transcriptome, 14 promising HDPs were identified. Subsequently, we designed 19 new sequences from Act8 peptide modifying the net charge, hydrophobic angle, and the general composition of amino acids, among other properties, in order to improve the HDPs antifungal activity. The in vitro antifungal susceptibility of the 33 HDPs against C. albicans SC5314, C. krusei, ATCC 6558, C. parapsilosis ATCC 22019, C. glabrata ATCC 2001, C. tropicalis ATCC 750, C. neoformans H99, and C. gattii H0058-I-2029 isolates were evaluated by broth microdilution, with a concentration ranging from 0.19 to 50 μg/ml.
Results
All 14 peptides identified showed in vitro activity against C. krusei, C. parapsilosis, and C. glabrata. One peptide showed in vitro activity against C. albicans, 6 against C. tropicalis, 11 against C. neoformans and 13 against C. gattii. As well the 19 modified peptides showed in vitro activity against C. krusei, C. parapsilosis, C. tropicalis, C. neoformans, and C. gattii. A total of 15 modified peptides showed in vitro activity against C. albicans, and 3 against C. glabrata. MIC ranges per species and per peptide are shown in Table 1.
Conclusions
The HDPs herein analyzed showed a significant in vitro antifungal activity against six Candida and two Cryptococcus pathogenic species. Our findings encourage further work with in vivo experimental models in order to better understand the action mechanisms of these antimicrobial peptides. HDPs from different species are becoming a promising therapeutic alternative in the control of fungal infections.
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Affiliation(s)
| | - Melissa Rodriguez
- Studies in Translational Microbiology and Emerging Diseases Research Group (MICROS) , School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C. , Colombia
| | - Beatriz L. Gómez
- Studies in Translational Microbiology and Emerging Diseases Research Group (MICROS) , School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C. , Colombia
| | - Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases Research Group (MICROS) , School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C. , Colombia
| | | | | | | | | | | | | | - Julian E. Muñoz
- Studies in Translational Microbiology and Emerging Diseases Research Group (MICROS) , School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C. , Colombia
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Torres R, Barreto-Santamaría A, Arévalo-Pinzón PG, Escandón P, Firacative C, Gómez BL, Patarroyo MA, Muñoz PJE. P002 Antifungal activity of antimicrobial synthetic peptides against Candida species of public health importance. Med Mycol 2022. [PMCID: PMC9509705 DOI: 10.1093/mmy/myac072.p002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Background Candidiasis is one of the most frequent opportunistic infections in immunosuppressed and/or hospitalized patients. In countries like Colombia, candidiasis is associated with a mortality rate of ∼ 46%. Growing pharmacological resistance of Candida spp., and the appearance of the emerging pathogen Candida auris, have turned candidiasis into a major public health problem. Different types of antimicrobial peptides have been investigated as a therapeutic alternative to control candidiasis effectively and safely. Objective This work aimed at evaluating the in vitro antifungal activity of three synthetic antimicrobial peptides (35 409, 1609, and 29 009) obtained from Plasmodium falciparum Rif1 protein against C. auris, C. albicans, C. glabrata, C. parapsilosis, C. krusei, and C. tropicalis, species with worldwide clinical importance. Methods The minimum inhibitory concentrations (MIC) of the three peptides against Candida species were determined by the plate microdilution method; the peptides’ effect on biofilm formation in C. auris and C. albicans species was also evaluated through the XTT metabolic activity assay. Additionally, the structural damages in C. auris and C. albicans caused by the action of the peptides were observed by transmission electron microscopy (TEM) and finally, the in vitro peptides’ cytotoxicity against L929 murine fibroblasts was verified. Results Our findings showed that the three peptides herein evaluated, displayed antifungal activity in both planktonic and sessile Candida cells. Likewise, the TEM evidenced morphological alterations induced by the peptides, both in the membrane and at the intracellular level of the yeasts. As well, total safety against the murine cell line L929 with 24 h of treatment was observed. Conclusions From these results, we conclude that the antimicrobial peptides 35 409, 1609, and 29 009 are potential therapeutic alternatives against the most important Candida species in Colombia and the world.
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Affiliation(s)
- Richar Torres
- Studies in Translational Microbiology and Emerging Diseases Research Group (MICROS) , School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C. , Colombia
| | - Adriana Barreto-Santamaría
- Receptor-Ligand Department , Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá D.C. , Colombia
| | | | - Patricia Escandón
- Group of Microbiology , National Institute of Health, Bogotá D.C. , Colombia
| | - Carolina Firacative
- Studies in Translational Microbiology and Emerging Diseases Research Group (MICROS) , School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C. , Colombia
| | - Beatriz L Gómez
- Studies in Translational Microbiology and Emerging Diseases Research Group (MICROS) , School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C. , Colombia
| | - Manuel A Patarroyo
- Receptor-Ligand Department , Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá D.C. , Colombia
- School of Medicine , Universidad Nacional de Colombia, Bogotá D.C. , Colombia
- Health Sciences Division , Main Campus, Universidad Santo Tomás, , Colombia
| | - Phd Julian E Muñoz
- Studies in Translational Microbiology and Emerging Diseases Research Group (MICROS) , School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C. , Colombia
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Abstract
Histoplasmosis is one of the most frequent causes of fungal respiratory infection in endemic regions, has a broad spectrum of clinical manifestations and can present in several forms. The extent of disease is determined by the number of conidia inhaled, the immune response of the host and the integrity of the respiratory tract. From an initial and most benign form, acute pulmonary histoplasmosis (an influenza-like illness that is typically asymptomatic or mild in persons without prior immune compromise), histoplasmosis can become a lifethreatening progressive disseminated infection (PDH) that affects mainly immunocompromised patients, with high morbidity and mortality. Chronic pulmonary histoplasmosis is an uncommon manifestation of Histoplasma infection, with features similar to pulmonary tuberculosis, and if it remains undiagnosed or untreated it also can cause significant morbidity. Some rare but serious complications may also occur that are produced by an excessive immune response, such as mediastinal fibrosis, histoplasmoma and broncholithiasis. Histoplasmosis is highly endemic in regions of North, Central and South America as well as being reported in parts of Asia and Africa. The risk of histoplasmosis is greatest in patients with HIV infection, especially those with CD4+ counts of <200 cells/μL. We review clinical manifestations, radiological findings and treatment options according to the clinical form (induction therapy and maintenance therapy), as well as different diagnosis tools and new laboratory tests that have been recently developed and validated and are becoming widely available. These should have an impact in reducing time for diagnosis and starting therapy and in reducing morbidity and mortality, especially in patients with HIV infection, where histoplasmosis is currently estimated to be responsible for 5-15% of AIDS-related deaths.
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Affiliation(s)
- Angela María Tobón
- Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín, Colombia
| | - Beatriz L Gómez
- Translational Microbiology and Emerging Diseases (MICROS), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia.
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Carvajal SK, Alvarado M, Rodríguez YM, Parra-Giraldo CM, Varón C, Morales-López SE, Rodríguez JY, Gómez BL, Escandón P. Pathogenicity Assessment of Colombian Strains of Candida auris in the Galleria mellonella Invertebrate Model. J Fungi (Basel) 2021; 7:jof7060401. [PMID: 34063862 PMCID: PMC8223996 DOI: 10.3390/jof7060401] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 04/12/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 02/07/2023] Open
Abstract
Candida auris, first described in 2009, is an opportunistic pathogenic yeast that causes nosocomial outbreaks around the world, with high mortality rates associated with therapeutic failure. In this study, we evaluated the pathogenicity of 107 isolates from two cities in Colombia, associated with fungemia or colonization processes; to achieve this, we used the Galleria mellonella invertebrate model to compare pathogenicity. Our results showed that less than half of the total isolates of C. auris presented a high pathogenicity compared to the reference strain SC5314, and most of those highly pathogenic strains were from colonization processes. We observed that there was formation of large aggregates of cells that cannot be disrupted easily, without statistically significant differences between the pathogenicity of the aggregated and non-aggregated strains. In addition, protease activity was observed in 100% of the C. auris strains; phospholipase and hemolysin activity were observed in 67.3 and 68.2% of the studied strains, respectively. In conclusion, these results highlight the utility of determining survival using G. mellonella, which allowed us to provide new information on the pathogenicity, enzymatic activity, and the relationship of the aggregated and non-aggregated phenotypes of C. auris in this model.
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Affiliation(s)
- Silvia Katherine Carvajal
- Grupo de Microbiología, Instituto Nacional de Salud, Bogota 111321, Colombia; (S.K.C.); (M.A.)
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Unidad de Proteómica y Micosis Humanas, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogota 110231, Colombia;
| | - Maira Alvarado
- Grupo de Microbiología, Instituto Nacional de Salud, Bogota 111321, Colombia; (S.K.C.); (M.A.)
| | - Yuli M. Rodríguez
- Bacteriología y Laboratorio Clínico, Universidad Colegio Mayor de Cundinamarca, Bogotá 111311, Colombia;
| | - Claudia M. Parra-Giraldo
- Grupo de Enfermedades Infecciosas, Departamento de Microbiología, Unidad de Proteómica y Micosis Humanas, Facultad de Ciencias, Pontificia Universidad Javeriana, Bogota 110231, Colombia;
| | - Carmen Varón
- Hospital Infantil Napoleón Franco Pareja, Cartagena 130010, Colombia;
| | - Soraya E. Morales-López
- Grupo CINBIOS, Departamento de Microbiología, Universidad Popular del Cesar, Valledupar 200004, Colombia;
| | - José Y. Rodríguez
- Centro de Investigaciones Microbiológicas del Cesar, Valledupar 200002, Colombia;
- Clínica Alta Complejidad, Valledupar 200002, Colombia
- Clínica Laura Daniela, Valledupar 200002, Colombia
- Instituto Cardiovascular del Cesar, Valledupar 200002, Colombia
| | - Beatriz L. Gómez
- Translational Microbiology and Emerging Diseases (MICROS), School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia;
| | - Patricia Escandón
- Grupo de Microbiología, Instituto Nacional de Salud, Bogota 111321, Colombia; (S.K.C.); (M.A.)
- Correspondence: ; Tel.: +57-1-2207700 (ext. 1558)
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13
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Maphanga TG, Naicker SD, Gómez BL, Mhlanga M, Mpembe RS, Schwartz IS, Bamford C, Nel J, Govender NP. Cross-reactivity of a Histoplasma capsulatum antigen enzyme immunoassay in urine specimens from persons with emergomycosis in South Africa. Med Mycol 2020; 59:672-682. [PMID: 33330930 DOI: 10.1093/mmy/myaa100] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 08/28/2020] [Revised: 10/26/2020] [Indexed: 01/20/2023] Open
Abstract
Histoplasma antigen detection in urine is a rapid diagnostic method for disseminated histoplasmosis, although cross-reactivity has been reported in specimens from patients with other thermally dimorphic fungal infections. We tested urine specimens, from persons with suspected invasive fungal infections, using a commercial monoclonal antibody Histoplasma enzyme immunoassay (EIA) at a South African national mycology reference laboratory from August 2014 through December 2018. Corresponding fungal culture and histopathology results were obtained from an electronic laboratory information system. In some cases, cultured fungal isolates were sent with the urine specimen for species-level identification by phenotypic and molecular methods. Cross-reactivity was confirmed using culture filtrates of several fungal pathogens. Of 212 referred cases, 41 (19%) were excluded since they had no recorded clinical history (n = 1), alternative diagnoses were confirmed (n = 2), or no fungal culture or histopathology results (n = 38). Eighty-seven of 212 (41%) had laboratory evidence of an invasive fungal disease, while 84 (40%) did not. Of the 87 cases, 37 (43%) were culture-confirmed mycoses: emergomycosis (n = 18), histoplasmosis (n = 8), sporotrichosis (n = 6), cryptococcosis (n = 2), talaromycosis (n = 1), and other fungi isolated (n = 2). The sensitivity and specificity of the EIA were calculated for two groups: culture-confirmed (n = 37) and histology-confirmed invasive fungal disease (n = 50). The sensitivity and specificity of the EIA for diagnosis of histoplasmosis compared to culture were 88% (7/8, 95%CI 47-100%) and 72% (21/29, 95%CI 53-87%), respectively, and for diagnosis of emergomycosis/histoplasmosis compared to histology was 83% (29/35, 95%CI 66-93%) and 93% (14/15, 95%CI 68-100%), respectively. Cross-reactions occurred in urine specimens of patients with Emergomyces africanus infection and in culture filtrates of E. africanus, T. marneffei and Blastomyces species. A commercial Histoplasma EIA had satisfactory accuracy for diagnosis of culture-confirmed histoplasmosis, but cross-reacted in urine specimens from patients with invasive disease caused by the closely-related pathogen, E. africanus and in culture filtrates of E. africanus and other related fungi. LAY SUMMARY Emergomyces africanus and Histoplasma capsulatum are fungi that cause a multi-system disease among HIV-seropositive persons with a low CD4 cell count. Handling live cultures of these fungi to confirm a diagnosis requires specialized laboratory equipment and infrastructure which is infrequently accessible in low-resource settings. The features of the two diseases (i.e., disseminated histoplasmosis and emergomycosis) may be indistinguishable when infected tissue is prepared, stained, and examined under a microscope. Enzyme immunoassays (EIA) have been developed as rapid diagnostic tools for the detection of a cell wall component of H. capsulatum in urine specimens, although cross-reactions have been reported in specimens from patients with other fungal infections. We evaluated the accuracy of a commercial Histoplasma EIA to diagnose histoplasmosis and to assess cross-reactions in urine specimens from persons with emergomycosis and in cultures of E. africanus and related fungi. We report a sensitivity and specificity of 88% (95%CI 47-100%) and 72% (95%CI 53-87%) for diagnosis of histoplasmosis compared to culture and 83% (95%CI 66-93%) and 93% (95%CI 68-100%) for diagnosis of either histoplasmosis/emergomycosis compared to a diagnosis made by microscopic examination of infected tissue. The assay cross-reacted in urine specimens from patients with emergomycosis and in culture filtrates of related fungi. Although the EIA cross-reacted with other related fungi, this test can decrease the time to diagnosis and facilitate early treatment of emergomycosis and histoplasmosis in South Africa.
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Affiliation(s)
- Tsidiso G Maphanga
- National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa.,Department of Medical Microbiology, University of the Free State, Bloemfontein, South Africa
| | - Serisha D Naicker
- National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Beatriz L Gómez
- School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Mabatho Mhlanga
- National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Ruth S Mpembe
- National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Ilan S Schwartz
- Department of Medicine, University of Alberta, Alberta, Canada
| | - Colleen Bamford
- National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa.,Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
| | - Jeremy Nel
- School of Pathology, University of the Witwatersrand, Johannesburg, South Africa
| | - Nelesh P Govender
- National Institute for Communicable Diseases (Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses), a Division of the National Health Laboratory Service, Johannesburg, South Africa.,School of Pathology, University of the Witwatersrand, Johannesburg, South Africa.,Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
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14
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Hoving JC, Brown GD, Gómez BL, Govender NP, Limper AH, May RC, Meya DB. AIDS-Related Mycoses: Updated Progress and Future Priorities. Trends Microbiol 2020; 28:425-428. [PMID: 32396822 DOI: 10.1016/j.tim.2020.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/01/2019] [Revised: 12/10/2019] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
Abstract
Serious fungal infections continue to devastate people living with HIV and remain a leading cause of infection-related deaths in this population, second only to tuberculosis. The third AIDS-related mycoses workshop updated progress in the field over the last 3 years and highlighted six key action points for the future.
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Affiliation(s)
- J Claire Hoving
- AFGrica Medical Mycology Research Unit, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, South Africa; Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, South Africa; MRC Centre for Medical Mycology at the University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, UK.
| | - Gordon D Brown
- AFGrica Medical Mycology Research Unit, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, South Africa; MRC Centre for Medical Mycology at the University of Exeter, Geoffrey Pope Building, Stocker Road, Exeter, UK
| | - Beatriz L Gómez
- School of Medicine and Health Sciences, Translational Microbiology and Emerging Diseases Research Group, Universidad del Rosario, Bogota, Colombia
| | - Nelesh P Govender
- National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, and Department of Clinical Microbiology and Infectious Diseases, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Andrew H Limper
- Thoracic Diseases Research Unit, Departments of Medicine and Biochemistry, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Robin C May
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, UK
| | - David B Meya
- Infectious Diseases Institute and Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, USA
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15
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Cáceres DH, Gómez BL, Tobón AM, Chiller TM, Lindsley MD. Evaluation of a Histoplasma antigen lateral flow assay for the rapid diagnosis of progressive disseminated histoplasmosis in Colombian patients with AIDS. Mycoses 2019; 63:139-144. [PMID: 31625627 DOI: 10.1111/myc.13023] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Progressive disseminated histoplasmosis (PDH) is an important cause of mortality in persons living with HIV (PLHIV), especially in countries where patients have limited access to antiretroviral therapies and diagnostic testing. OBJECTIVE A lateral flow assay (LFA) to detect Histoplasma capsulatum antigen in serum developed by MiraVista® was evaluated. METHODS We tested 75 serum samples: 24 from PLHIV and culture-proven PDH and 51 from PLHIV with other fungal and bacterial infections as well as people without HIV. LFA devices were read manually (read by eye) and by an automated reader. RESULTS When the LFA was read manually, sensitivity was 96% and specificity was 90%. When an automated reader was used, sensitivity was 92% and specificity was 94%. The Kappa index comparing manual and automated reader was 0.90. Cross-reactions were observed principally in samples from patients with proven diagnosis of paracoccidioidomycosis. CONCLUSIONS The MiraVista® Diagnostics Histoplasma antigen LFA had high analytical performance and good agreement between manual and automated reader. This LFA allows Histoplasma antigen testing with minimal laboratory equipment and infrastructure requirements.
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Affiliation(s)
- Diego H Cáceres
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Beatriz L Gómez
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Angela M Tobón
- Hospital La Maria, Medellin, Colombia.,Universidad CES, Medellin, Colombia
| | - Tom M Chiller
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Mark D Lindsley
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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16
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Nacher M, Leitao TS, Gómez BL, Couppié P, Adenis A, Damasceno L, Demar M, Samayoa B, Cáceres DH, Pradinaud R, Sousa ADQ, Arathoon E, Restrepo A. The Fight against HIV-Associated Disseminated Histoplasmosis in the Americas: Unfolding the Different Stories of Four Centers. J Fungi (Basel) 2019; 5:jof5020051. [PMID: 31212897 PMCID: PMC6617033 DOI: 10.3390/jof5020051] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 05/14/2019] [Revised: 06/13/2019] [Accepted: 06/14/2019] [Indexed: 11/17/2022] Open
Abstract
Disseminated histoplasmosis is a major opportunistic infection of HIV-infected patients, killing thousands in Latin America each year. Yet, it remains a neglected disease that is often confused with tuberculosis, for lack of simple, affordable, and rapid diagnostic tools. There is great heterogeneity in the level of histoplasmosis awareness. The purpose of this report was to describe how the historical “awakening” to the threat of histoplasmosis came to be in four different centers that have actively described this disease: In Brazil, the Sao José hospital in Fortaleza; in Colombia, the Corporación para Investigaciones Biológicas in Medellin; in French Guiana, Cayenne Hospital; and in Guatemala, the Association de Salud Integral in Guatemala city. In Brazil and French Guiana, the search for leishmaniasis on the buffy coat or skin smears, respectively, led to the rapid realization that HIV patients were suffering from disseminated histoplasmosis. With time and progress in fungal culture, the magnitude of this problem turned it into a local priority. In Colombia and Guatemala, the story is different because for these mycology centers, it was no surprise to find histoplasmosis in HIV patients. In addition, collaborations with the CDC to evaluate antigen-detection tests resulted in researchers and clinicians developing the capacity to rapidly screen most patients and to demonstrate the very high burden of disease in these countries. While the lack of awareness is still a major problem, it is instructive to review the ways through which different centers became histoplasmosis-aware. Nevertheless, as new rapid diagnostic tools are becoming available, their implementation throughout Latin America should rapidly raise the level of awareness in order to reduce the burden of histoplasmosis deaths.
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Affiliation(s)
- Mathieu Nacher
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana.
- EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT), Université de Guyane, DFR Santé, 97300 Cayenne, French Guiana.
| | - Terezinha Silva Leitao
- Departamento de Doenças Infecciosas, Universidade Federal do Ceará, Fortaleza, 60020-181 Ceará, Brasil.
| | - Beatriz L Gómez
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, 110111 Bogota, Colombia.
| | - Pierre Couppié
- EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT), Université de Guyane, DFR Santé, 97300 Cayenne, French Guiana.
- Service de Dermatologie Vénéréologie, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana.
| | - Antoine Adenis
- Centre d'Investigation Clinique Epidémiologie Clinique Antilles Guyane CIC INSERM 1424, Cayenne General Hospital, Cayenne, French Guiana.
| | - Lisandra Damasceno
- Departamento de Doenças Infecciosas, Universidade Federal do Ceará, Fortaleza, 60020-181 Ceará, Brasil.
| | - Magalie Demar
- EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT), Université de Guyane, DFR Santé, 97300 Cayenne, French Guiana.
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana.
| | - Blanca Samayoa
- Asociación de Salud Integral & Hospital General San Juan de Dios, 01001 Guatemala City, Guatemala, .
| | - Diego H Cáceres
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, 110111 Bogota, Colombia.
| | - Roger Pradinaud
- Service de Dermatologie Vénéréologie, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana.
| | | | - Eduardo Arathoon
- La Clinica Familiar de Luis Angel Garcia, 01001 Guatemala City, Guatemala.
| | - Angela Restrepo
- Corporacion para Investigaciones Biologicas, Hospital Pablo Tobon Uribe, 11001 Medellin, Colombia.
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17
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Zuluaga A, Arango Bustamante K, Caceres DH, Sánchez Quitian ZA, Velásquez V, Gómez BL, Parra Giraldo CM, Maldonado N, Cano LE, de Bedout C, Rivera RE. Concordance analysis between different methodologies used for identification of oral isolates of Candida species. cm 2018; 49:193-200. [PMID: 30410193 PMCID: PMC6220485 DOI: 10.25100/cm.v49i3.3774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: The yeasts species determination is fundamental not only for an accurate diagnosis but also for establishing a suitable patient treatment. We performed a concordance study of five methodologies for the species identification of oral isolates of Candida in Colombia. Methods: Sixty-seven Candida isolates were tested by; API® 20C-AUX, Vitek®2 Compact, Vitek®MS, Microflex® and a molecular test (panfungal PCR and sequencing). The commercial cost and processing time of the samples was done by graphical analysis. Results: Panfungal PCR differentiated 12 species of Candida, Vitek®MS and Microflex® methods identified 9 species, and API® 20C-AUX and Vitek®2 Compact methods identified 8 species each. Weighted Kappa (wK) showed a high agreement between Panfungal PCR, Vitek®MS, Microflex® and API® 20C-AUX (wK 0.62-0.93). The wK that involved the Vitek®2 Compact method presented moderate or good concordances compared with the other methods (wK 0.56-0.73). Methodologies based on MALDI TOF MS required 4 minutes to generate results and the Microflex® method had the lowest selling price. Conclusion: The methods evaluated showed high concordance in their results, being higher for the molecular methods and the methodologies based on MALDI TOF. The latter are faster and cheaper, presenting as promising alternatives for the routine identification of yeast species of the genus Candida.
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18
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Nosanchuk JD, Jeyakumar A, Ray A, Revskaya E, Jiang Z, Bryan RA, Allen KJH, Jiao R, Malo ME, Gómez BL, Morgenstern A, Bruchertseifer F, Rickles D, Thornton GB, Bowen A, Casadevall A, Dadachova E. Structure-function analysis and therapeutic efficacy of antibodies to fungal melanin for melanoma radioimmunotherapy. Sci Rep 2018; 8:5466. [PMID: 29615812 PMCID: PMC5882926 DOI: 10.1038/s41598-018-23889-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/22/2018] [Indexed: 02/06/2023] Open
Abstract
Metastatic melanoma remains difficult to treat despite recent approvals of several new drugs. Recently we reported encouraging results of Phase I clinical trial of radiolabeled with 188Re murine monoclonal IgM 6D2 to melanin in patients with Stage III/IV melanoma. Subsequently we generated a novel murine IgG 8C3 to melanin. IgGs are more amenable to humanization and cGMP (current Good Manufacturing Practice) manufacturing than IgMs. We performed comparative structural analysis of melanin-binding IgM 6D2 and IgG 8C3. The therapeutic efficacy of 213Bi- and 188Re-labeled 8C3 and its comparison with anti-CTLA4 immunotherapy was performed in B16-F10 murine melanoma model. The primary structures of these antibodies revealed significant homology, with the CDRs containing a high percentage of positively charged amino acids. The 8C3 model has a negatively charged binding surface and significant number of aromatic residues in its H3 domain, suggesting that hydrophobic interactions contribute to the antibody-melanin interaction. Radiolabeled IgG 8C3 showed significant therapeutic efficacy in murine melanoma, safety towards healthy melanin-containing tissues and favorable comparison with the anti-CTLA4 antibody. We have demonstrated that antibody binding to melanin relies on both charge and hydrophobic interactions while the in vivo data supports further development of 8C3 IgG as radioimmunotherapy reagent for metastatic melanoma.
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Affiliation(s)
- J D Nosanchuk
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - A Jeyakumar
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - A Ray
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - E Revskaya
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Z Jiang
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - R A Bryan
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - K J H Allen
- University of Saskatchewan, Saskatoon, SK, Canada
| | - R Jiao
- University of Saskatchewan, Saskatoon, SK, Canada
| | - M E Malo
- University of Saskatchewan, Saskatoon, SK, Canada
| | - B L Gómez
- School of Medicine and Health Sciences, Universidad Rosario, Bogota, Colombia
| | - A Morgenstern
- European Commission, Joint Research Centre, Directorate for Nuclear Safety and Security, Karlsruhe, Germany
| | - F Bruchertseifer
- European Commission, Joint Research Centre, Directorate for Nuclear Safety and Security, Karlsruhe, Germany
| | - D Rickles
- RadImmune Therapeutics, Tarrytown, NY, USA
| | | | - A Bowen
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A Casadevall
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - E Dadachova
- University of Saskatchewan, Saskatoon, SK, Canada.
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19
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Caceres DH, Tobón ÁM, Restrepo Á, Chiller T, Gómez BL. The important role of co-infections in patients with AIDS and progressive disseminated histoplasmosis (PDH): A cohort from Colombia. Med Mycol Case Rep 2018; 19:41-44. [PMID: 29379705 PMCID: PMC5775073 DOI: 10.1016/j.mmcr.2017.07.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 11/23/2016] [Revised: 01/25/2017] [Accepted: 07/18/2017] [Indexed: 01/28/2023] Open
Abstract
A total of 23/45 (51%) patients with AIDS and histoplasmosis from Medellín, Colombia had other infections. Tuberculosis was the most common (n = 16/23, 70%). Pneumocystosis and cryptococcosis were found in three patients each (13%), bacterial infection and cytomegalovirus occurred each in two patients (9%) while toxoplasmosis, herpes virus and esophageal candidiasis were recorded in one patient each (4%). Of all co-infected patients, 18/23 (78%) had one, four (17%) had two and one (4%) had three additional opportunistic infections.
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Affiliation(s)
- Diego H. Caceres
- Medical and Experimental Mycology Unit, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - Ángela M. Tobón
- Medical and Experimental Mycology Unit, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
- Hospital La Maria, Medellin, Colombia
| | - Ángela Restrepo
- Medical and Experimental Mycology Unit, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, (CDC), Atlanta, United States
| | - Beatriz L. Gómez
- Medical and Experimental Mycology Unit, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
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20
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López LF, Muñoz CO, Cáceres DH, Tobón ÁM, Loparev V, Clay O, Chiller T, Litvintseva A, Gade L, González Á, Gómez BL. Standardization and validation of real time PCR assays for the diagnosis of histoplasmosis using three molecular targets in an animal model. PLoS One 2017; 12:e0190311. [PMID: 29287097 PMCID: PMC5747470 DOI: 10.1371/journal.pone.0190311] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/12/2017] [Indexed: 12/04/2022] Open
Abstract
Histoplasmosis is considered one of the most important endemic and systemic mycoses worldwide. Until now few molecular techniques have been developed for its diagnosis. The aim of this study was to develop and evaluate three real time PCR (qPCR) protocols for different protein-coding genes (100-kDa, H and M antigens) using an animal model. Fresh and formalin-fixed and paraffin-embedded (FFPE) lung tissues from BALB/c mice inoculated i.n. with 2.5x106Histoplasma capsulatum yeast or PBS were obtained at 1, 2, 3, 4, 8, 12 and 16 weeks post-infection. A collection of DNA from cultures representing different clades of H. capsulatum (30 strains) and other medically relevant pathogens (36 strains of related fungi and Mycobacterium tuberculosis) were used to analyze sensitivity and specificity. Analytical sensitivity and specificity were 100% when DNAs from the different strains were tested. The highest fungal burden occurred at first week post-infection and complete fungal clearance was observed after the third week; similar results were obtained when the presence of H. capsulatum yeast cells was demonstrated in histopathological analysis. In the first week post-infection, all fresh and FFPE lung tissues from H. capsulatum-infected animals were positive for the qPCR protocols tested except for the M antigen protocol, which gave variable results when fresh lung tissue samples were analyzed. In the second week, all qPCR protocols showed variable results for both fresh and FFPE tissues. Samples from the infected mice at the remaining times post-infection and uninfected mice (controls) were negative for all protocols. Good agreement was observed between CFUs, histopathological analysis and qPCR results for the 100-kDa and H antigen protocols. We successfully standardized and validated three qPCR assays for detecting H. capsulatum DNA in fresh and FFPE tissues, and conclude that the 100-kDa and H antigen molecular assays are promising tests for diagnosing this mycosis.
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Affiliation(s)
- Luisa F. López
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - César O. Muñoz
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - Diego H. Cáceres
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Ángela M. Tobón
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - Vladimir Loparev
- Biotechnology Core Facility Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Oliver Clay
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
- Cell and Molecular Biology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Anastasia Litvintseva
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Lalitha Gade
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Ángel González
- Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Beatriz L. Gómez
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
- * E-mail:
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21
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Cáceres DH, Zuluaga A, Tabares ÁM, Chiller T, González Á, Gómez BL. Evaluation of a Cryptococcal antigen Lateral Flow Assay in serum and cerebrospinal fluid for rapid diagnosis of cryptococcosis in Colombia. Rev Inst Med Trop Sao Paulo 2017; 59:e76. [PMID: 29267584 PMCID: PMC5738761 DOI: 10.1590/s1678-9946201759076] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 08/10/2017] [Indexed: 11/26/2022] Open
Abstract
A Lateral Flow Assay to detect cryptococcal antigen (CrAg® LFA) in serum and cerebrospinal fluid for the rapid diagnosis of cryptococcosis was evaluated. A retrospective validation was performed. Sensitivity and specificity of the CrAg® LFA was 100%. High concordance (kappa index=1.0) between Cryptococcal Antigen Latex Agglutination System (CALAS®) and CrAg® LFA was observed. CrAg® LFA showed higher analytical sensitivity for detecting low concentrations of cryptococcal antigen.
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Affiliation(s)
- Diego H Cáceres
- Corporación para Investigaciones Biológicas (CIB), Medical and Experimental Mycology Group, Medellín, Colombia
| | - Alejandra Zuluaga
- Corporación para Investigaciones Biológicas (CIB), Medical and Experimental Mycology Group, Medellín, Colombia
| | - Ángela M Tabares
- Corporación para Investigaciones Biológicas (CIB), Medical and Experimental Mycology Group, Medellín, Colombia
| | - Tom Chiller
- Centers for Disease Control and Prevention, Mycotic Diseases Branch, Atlanta, United States
| | - Ángel González
- Universidad de Antioquia, Escuela de Microbiología, Grupo de Investigación en Microbiología Básica y Aplicada, Medellín, Colombia
| | - Beatriz L Gómez
- Corporación para Investigaciones Biológicas (CIB), Medical and Experimental Mycology Group, Medellín, Colombia.,Universidad del Rosario, Escuela de Medicina y Ciencias de la Salud, Bogotá, Colombia
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22
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Berrio I, Maldonado N, De Bedout C, Arango K, Cano LE, Valencia Y, Jiménez-Ortigosa C, Perlin DS, Gómez BL, Robledo C, Robledo J. Comparative study of Candida spp. isolates: Identification and echinocandin susceptibility in isolates obtained from blood cultures in 15 hospitals in Medellín, Colombia. J Glob Antimicrob Resist 2017; 13:254-260. [PMID: 29183771 DOI: 10.1016/j.jgar.2017.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 12/28/2016] [Revised: 10/04/2017] [Accepted: 11/20/2017] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES Invasive candidiasis has a high impact on morbidity and mortality in hospitalised patients. Accurate and timely methods for identification of Candida spp. and determination of echinocandin susceptibility have become a priority for clinical microbiology laboratories. METHODS This study was performed to compare matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS) identification with sequencing of the D1/D2 region of the rRNA gene complex 28 subunit in 147 Candida spp. isolates obtained from patients with candidaemia. Antimicrobial susceptibility testing was performed by broth microdilution (BMD) and Etest. Sequencing of the FKS1 and FKS2 genes was performed. RESULTS The most common species isolated were Candida albicans (40.8%), followed by Candida parapsilosis (23.1%) and Candida tropicalis (17.0%). Overall agreement between the results of identification by MALDI-TOF/MS and molecular identification was 99.3%. Anidulafungin and caspofungin susceptibility by the BMD method was 98.0% and 88.4%, respectively. Susceptibility to anidulafungin and caspofungin by Etest was 93.9% and 98.6%, respectively. Categorical agreement between Etest and BMD was 91.8% for anidulafungin and 89.8% for caspofungin, with lower agreements in C. parapsilosis for anidulafungin (76.5%) and C. glabrata for caspofungin (40.0%). No mutations related to resistance were found in the FKS genes, although 54 isolates presented synonymous polymorphisms in the hotspots sequenced. CONCLUSIONS MALDI-TOF/MS is a good alternative for routine identification of Candida spp. isolates. DNA sequencing of the FKS genes suggested that the isolates analysed were susceptible to echinocandins; alternatively, unknown resistance mechanisms or limitations related to antifungal susceptibility tests may explain the resistance found in a few isolates.
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Affiliation(s)
- Indira Berrio
- Clínica El Rosario, Carrera 41 #62-5, Medellín, Colombia; Corporación para Investigaciones Biológicas (CIB), Cra. 72 A No. 78 B 141, Medellín, Colombia; Hospital general de Medellín "Luz Castro de Gutierrez" ESE, Carrera 48 # 32-102, Medellín, Colombia
| | - Natalia Maldonado
- Laboratorio Médico de Referencia, Calle 63 No. 41-27, Medellín, Colombia.
| | - Catalina De Bedout
- Corporación para Investigaciones Biológicas (CIB), Cra. 72 A No. 78 B 141, Medellín, Colombia
| | - Karen Arango
- Corporación para Investigaciones Biológicas (CIB), Cra. 72 A No. 78 B 141, Medellín, Colombia
| | - Luz Elena Cano
- Corporación para Investigaciones Biológicas (CIB), Cra. 72 A No. 78 B 141, Medellín, Colombia; Microbiology School, Universidad de Antioquia (UdeA), Cl. 67 #53-108, Medellín, Colombia
| | - Yorlady Valencia
- Corporación para Investigaciones Biológicas (CIB), Cra. 72 A No. 78 B 141, Medellín, Colombia
| | - Cristina Jiménez-Ortigosa
- Public Health Research Institute, New Jersey Medical School, Rutgers University, 225 Warren Street, Newark, NJ, USA
| | - David S Perlin
- Public Health Research Institute, New Jersey Medical School, Rutgers University, 225 Warren Street, Newark, NJ, USA
| | - Beatriz L Gómez
- Corporación para Investigaciones Biológicas (CIB), Cra. 72 A No. 78 B 141, Medellín, Colombia; School of Medicine and Health Sciences, Universidad Rosario, Calle 12C No. 6-25, Bogotá, Colombia
| | - Carlos Robledo
- Laboratorio Médico de Referencia, Calle 63 No. 41-27, Medellín, Colombia
| | - Jaime Robledo
- Corporación para Investigaciones Biológicas (CIB), Cra. 72 A No. 78 B 141, Medellín, Colombia; Laboratorio Médico de Referencia, Calle 63 No. 41-27, Medellín, Colombia; School of Health Sciences, Universidad Pontificia Bolivariana (UPB), Calle 78b No. 72a-109, Medellín, Colombia
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23
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Caceres DH, Tobón AM, Cleveland AA, Scheel CM, Berbesi DY, Ochoa J, Restrepo A, Brandt ME, Chiller T, Gómez BL. Clinical and Laboratory Profile of Persons Living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome and Histoplasmosis from a Colombian Hospital. Am J Trop Med Hyg 2016; 95:918-924. [PMID: 27481056 PMCID: PMC5062801 DOI: 10.4269/ajtmh.15-0837] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 05/12/2016] [Indexed: 11/07/2022] Open
Abstract
Histoplasmosis is common among persons living with human immunodeficiency virus/acquired immune deficiency syndrome (PLWHA) in Latin America, but its diagnosis is difficult and often nonspecific. We conducted prospective screening for histoplasmosis among PLWHA with signs or symptoms suggesting progressive disseminated histoplasmosis (PDH) and hospitalized in Hospital La María in Medellín, Colombia. The study's aim was to obtain a clinical and laboratory profile of PLWHA with PDH. During 3 years (May 2008 to August 2011), we identified 89 PLWHA hospitalized with symptoms suggestive of PDH, of whom 45 (51%) had histoplasmosis. We observed tuberculosis (TB) coinfection in a large proportion of patients with PDH (35%), so all analyses were performed adjusting for this coinfection and, alternatively, excluding histoplasmosis patients with TB. Results showed that the patients with PDH were more likely to have Karnofsky score ≤ 30 (prevalence ratio [PR] = 1.98, 95% confidence interval [CI] = 0.97-4.06), liver compromised with hepatomegaly and/or splenomegaly (PR = 1.77, CI = 1.03-3.06) and elevation in serum of alanine aminotransferase and aspartate aminotransferase to values > 40 mU/mL (PR = 2.06, CI = 1.09-3.88 and PR = 1.53, CI = 0.99-2.35, respectively). Using multiple correspondence analyses, we identified in patients with PDH a profile characterized by the presence of constitutional symptoms, namely weight loss and Karnofsky classification ≤ 30, gastrointestinal manifestations with alteration of liver enzymes and hepatosplenomegaly and/or splenomegaly, skin lesions, and hematological alterations. Study of the profiles is no substitute for laboratory diagnostics, but identifying clinical and laboratory indicators of PLWHA with PDH should allow development of strategies for reducing the time to diagnosis and thus mortality caused by Histoplasma capsulatum.
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Affiliation(s)
- Diego H Caceres
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia. School of Medicine, Universidad CES, Medellín, Colombia
| | - Angela M Tobón
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia. Hospital La María, Medellín, Colombia
| | | | - Christina M Scheel
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Jesús Ochoa
- Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
| | - Angela Restrepo
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - Mary E Brandt
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Beatriz L Gómez
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia. School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia.
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Teixeira MDM, Patané JSL, Taylor ML, Gómez BL, Theodoro RC, de Hoog S, Engelthaler DM, Zancopé-Oliveira RM, Felipe MSS, Barker BM. Worldwide Phylogenetic Distributions and Population Dynamics of the Genus Histoplasma. PLoS Negl Trop Dis 2016; 10:e0004732. [PMID: 27248851 PMCID: PMC4889077 DOI: 10.1371/journal.pntd.0004732] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/03/2016] [Indexed: 12/11/2022] Open
Abstract
Background Histoplasma capsulatum comprises a worldwide complex of saprobiotic fungi mainly found in nitrogen/phosphate (often bird guano) enriched soils. The microconidia of Histoplasma species may be inhaled by mammalian hosts, and is followed by a rapid conversion to yeast that can persist in host tissues causing histoplasmosis, a deep pulmonary/systemic mycosis. Histoplasma capsulatum sensu lato is a complex of at least eight clades geographically distributed as follows: Australia, Netherlands, Eurasia, North American classes 1 and 2 (NAm 1 and NAm 2), Latin American groups A and B (LAm A and LAm B) and Africa. With the exception of the Eurasian cluster, those clades are considered phylogenetic species. Methodology/Principal Findings Increased Histoplasma sampling (n = 234) resulted in the revision of the phylogenetic distribution and population structure using 1,563 aligned nucleotides from four protein-coding regions. The LAm B clade appears to be divided into at least two highly supported clades, which are geographically restricted to either Colombia/Argentina or Brazil respectively. Moreover, a complex population genetic structure was identified within LAm A clade supporting multiple monophylogenetic species, which could be driven by rapid host or environmental adaptation (~0.5 MYA). We found two divergent clades, which include Latin American isolates (newly named as LAm A1 and LAm A2), harboring a cryptic cluster in association with bats. Conclusions/Significance At least six new phylogenetic species are proposed in the Histoplasma species complex supported by different phylogenetic and population genetics methods, comprising LAm A1, LAm A2, LAm B1, LAm B2, RJ and BAC-1 phylogenetic species. The genetic isolation of Histoplasma could be a result of differential dispersion potential of naturally infected bats and other mammals. In addition, the present study guides isolate selection for future population genomics and genome wide association studies in this important pathogen complex. Histoplasmosis is a potentially severe fungal disease of mammals caused by Histoplasma capsulatum. The highest incidence of the disease is reported on the American continent, and approximately 30% of HIV and histoplasmosis co-infections are fatal. Previous studies have suggested at least 7 phylogenetic species within H. capsulatum, however by increasing taxon sampling and using different phylogenetic and population genetic methods, we detect at least 5 additional phylogenetic species within Latin America (LAm A1, LAm A2, LAm B1, LAm B2, RJ and BAC-1). These phylogenetic species are nested in the former LAm A clade. We found evidence that bats may be a cause of speciation in Histoplasma, as well-supported monophyletic clades were found in association with different species of bats. The radiation of the Latin American H. capsulatum species took a place around 5 million years ago, which is consistent with the radiation and diversification of bat species. Previous phylogenetic distribution of Histoplasma is upheld and strong support is indicated for the species delineation and evolution of this important pathogen.
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Affiliation(s)
- Marcus de M. Teixeira
- Division of Pathogen Genomics, Translational Genomics Research Institute-North, Flagstaff, Arizona, United States of America
- Department of Cell Biology, University of Brasília, Brasilia, Brazil
| | - José S. L. Patané
- Department of Biochemistry, University of São Paulo, São Paulo, Brazil
| | - Maria L. Taylor
- Department of Microbiology and Parasitology, National Autonomous University of Mexico, Mexico City, Mexico
| | - Beatriz L. Gómez
- Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - Raquel C. Theodoro
- Department of Cell Biology and Genetics/ Institute of Tropical Medicine, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Sybren de Hoog
- CBS-KNAW Fungal Biodiversity Centre, Utrecht, Netherlands
| | - David M. Engelthaler
- Division of Pathogen Genomics, Translational Genomics Research Institute-North, Flagstaff, Arizona, United States of America
| | - Rosely M. Zancopé-Oliveira
- Mycology Laboratory, National Institute of Infectology Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Bridget M. Barker
- Division of Pathogen Genomics, Translational Genomics Research Institute-North, Flagstaff, Arizona, United States of America
- * E-mail:
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25
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Rodríguez-Leguizamón G, Fiori A, López LF, Gómez BL, Parra-Giraldo CM, Gómez-López A, Suárez CF, Ceballos A, Van Dijck P, Patarroyo MA. Characterising atypical Candida albicans clinical isolates from six third-level hospitals in Bogotá, Colombia. BMC Microbiol 2015; 15:199. [PMID: 26438104 PMCID: PMC4594647 DOI: 10.1186/s12866-015-0535-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 09/25/2015] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Candida species are the most frequently found fungal pathogens causing nosocomial disease in a hospital setting. Such species must be correctly identified to ensure that appropriate control measures are taken and that suitable treatment is given for each species. Candida albicans is causing most fungal disease burden worldwide; the challenge lies in differentiating it from emerging atypical, minor and related species such as Candida dubliniensis and Candida africana. The purpose of this study was to compare identification based on MALDI-TOF MS to standard identification systems using a set of nosocomial isolates. METHODS Eleven nosocomial samples were collected from 6 third-level hospitals in Bogotá, Colombia. All the samples were identified by combining MALDI-TOF MS with morphological characters, carbohydrate assimilation and molecular markers (D1/D2 and HWP1). RESULTS The present work describes the first collection of atypical Colombian Candida clinical isolates; these were identified as Candida albicans/Candida africana by their MALDI-TOF MS profile. Phenotypical characteristics showed that they were unable to produce chlamydospores, assimilate trehalose, glucosamine, N- acetyl-glucosamine and barely grew at 42 °C, as would be expected for Candida africana. The molecular identification of the D1/D2 region of large subunit ribosomal RNA and HWP1 hyphal cell wall protein 1 sequences from these isolates was consistent with those for Candida albicans. The mass spectra obtained by MALDI-TOF MS were analysed by multi-dimensional scaling (MDS) and cluster analysis, differences being revealed between Candida albicans, Candida africana, Candida dubliniensis reference spectra and two clinical isolate groups which clustered according to the clinical setting, one of them being clearly related to C. albicans. CONCLUSION This study highlights the importance of using MALDI-TOF MS in combination with morphology, substrate assimilation and molecular markers for characterising Candida albicans-related and atypical C. albicans species, thereby overcoming conventional identification methods. This is the first report of hospital-obtained isolates of this type in Colombia; the approach followed might be useful for gathering knowledge regarding local epidemiology which could, in turn, have an impact on clinical management. The findings highlight the complexity of distinguishing between typical and atypical Candida albicans isolates in hospitals.
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Affiliation(s)
- Giovanni Rodríguez-Leguizamón
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia. .,VIB Department of Molecular Microbiology, Leuven, Belgium. .,KU Leuven Laboratory of Molecular Cell Biology, Leuven, Belgium.
| | - Alessandro Fiori
- VIB Department of Molecular Microbiology, Leuven, Belgium. .,KU Leuven Laboratory of Molecular Cell Biology, Leuven, Belgium.
| | - Luisa F López
- Medical and Experimental Mycology Unit, Corporación para las Investigaciones Biológicas (CIB), Medellín, Colombia.
| | - Beatriz L Gómez
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia. .,Medical and Experimental Mycology Unit, Corporación para las Investigaciones Biológicas (CIB), Medellín, Colombia.
| | - Claudia M Parra-Giraldo
- Infectious Diseases Research Group, Microbiology Department, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | - Arley Gómez-López
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia.
| | - Carlos F Suárez
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia. .,Biomathematics Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia.
| | - Andrés Ceballos
- Infectious Diseases Research Group, Microbiology Department, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | - Patrick Van Dijck
- VIB Department of Molecular Microbiology, Leuven, Belgium. .,KU Leuven Laboratory of Molecular Cell Biology, Leuven, Belgium.
| | - Manuel A Patarroyo
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia. .,Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia.
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26
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Caceres DH, Zuluaga A, Arango-Bustamante K, de Bedout C, Tobón ÁM, Restrepo Á, Gómez BL, Cano LE, González Á. Implementation of a Training Course Increased the Diagnosis of Histoplasmosis in Colombia. Am J Trop Med Hyg 2015; 93:662-7. [PMID: 26123961 PMCID: PMC4559714 DOI: 10.4269/ajtmh.15-0108] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 05/02/2015] [Indexed: 11/07/2022] Open
Abstract
Histoplasmosis causes a significant mortality, especially persons living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) from developing countries where access to both appropriate diagnostic methods and antiretroviral therapy are limited. A total of 81 physicians assigned to 17 Colombian departments (states) received training in the clinical, epidemiological, and diagnostic aspects of histoplasmosis. Once this training was received and during the period of October 2009-November 2012, these physicians sent biological samples for immunodiagnostic, mycological, and molecular tests from their patients with suspicion of histoplasmosis. A total of 1,536 samples from 768 patients were evaluated. Of the 768 patients studied, 463 (60%) were HIV positive, 214 (28%) HIV negative, and in 91 (12%) this diagnosis was unknown, and 538 (70%) were males. The 1,536 specimens studied comprised 722 sera, 439 blood samples, and 241 urines, which were tested by immunodiffusion (ID), culture, and antigenuria, respectively; in addition, 134 specimens were tested by performing a molecular assay. Histoplasmosis was diagnosed in 133 patients (17%). After the training, we observed more diagnoses from 27 to 44 cases per year. In this study, a significantly increased number of histoplasmosis cases reported by year were observed after implementing an educational training program.
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Affiliation(s)
- Diego H Caceres
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Alejandra Zuluaga
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Karen Arango-Bustamante
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Catalina de Bedout
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Ángela Maria Tobón
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Ángela Restrepo
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Beatriz L Gómez
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Luz Elena Cano
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
| | - Ángel González
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia; School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; School of Microbiology, Universidad de Antioquia, Medellín, Colombia; Basic and Applied Microbiology Research Group (MICROBA), School of Microbiology, Universidad de Antioquia, Medellín, Colombia
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27
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Abstract
Diagnosis of histoplasmosis remains challenging in resource-limited regions where HIV/AIDS is epidemic and histoplasmosis is endemic. Early and rapid detection of histoplasmosis is essential to preventing morbidity and mortality, yet few diagnostic options are available in low-resource areas of the world. The aim of this review is to provide an overview of the current status of the diagnosis of histoplasmosis, including an update on recent developments and utilization of new technologies. We discuss the specific diagnostic challenges faced in endemic regions, emphasizing the need for greater availability and standardization of rapid diagnostics for this endemic and neglected disease. While significant progress has been made in the development of new methods, clinical utility must be established by means of formal and extensive clinical studies.
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Affiliation(s)
- Christina M Scheel
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS G11, Atlanta, GA, USA
| | - Beatriz L Gómez
- Corporación para Investigaciones Biólogicas, Cra. 72 No 78 B 141, Medellín, Colombia
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Abstract
The diagnosis of endemic and invasive fungal disease remains challenging. Molecular techniques for identification of fungi now play a significant and growing role in clinical mycology and offer distinct advantages as they are faster, more sensitive and more specific. The aim of this mini-review is to provide an overview of the state of the art of molecular diagnosis of endemic and invasive fungal diseases, and to emphasize the challenges and current need for standardization of the different methods. The European Aspergillus PCR Initiative (EAPCRI) has made significant progress in developing a standard for Aspergillus polymerase chain reaction (PCR), but recognizes that the process will not be finished until clinical utility has been established in formal and extensive clinical trials. Similar efforts should be implemented for the diagnosis of the other mycoses in order to fully validate the current methods or reinforce the need to design new ones. This manuscript is part of the series of works presented at the "V International Workshop: Molecular genetic approaches to the study of human pathogenic fungi" (Oaxaca, Mexico, 2012).
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Affiliation(s)
- Beatriz L Gómez
- School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia; Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellin, Colombia.
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29
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Torres I, Hernandez O, Tamayo D, Muñoz JF, García AM, Gómez BL, Restrepo A, McEwen JG. Paracoccidioides brasiliensis PbP27gene: knockdown procedures and functional characterization. FEMS Yeast Res 2013; 14:270-80. [DOI: 10.1111/1567-1364.12099] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 09/16/2013] [Accepted: 09/20/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- Isaura Torres
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB); Medellín Colombia
- Instituto de Biología; Universidad de Antioquia; Medellín Colombia
| | - Orville Hernandez
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB); Medellín Colombia
- Grupo de Investigación en Biociencias; Facultad de Ciencias de la Salud; Institución Universitaria Colegio Mayor de Antioquia; Medellín Colombia
| | - Diana Tamayo
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB); Medellín Colombia
- Instituto de Biología; Universidad de Antioquia; Medellín Colombia
| | - Jose F. Muñoz
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB); Medellín Colombia
- Instituto de Biología; Universidad de Antioquia; Medellín Colombia
| | - Ana M. García
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB); Medellín Colombia
| | - Beatriz L. Gómez
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB); Medellín Colombia
- School of Medicine and Health Sciences; Universidad del Rosario; Bogotá Colombia
| | - Angela Restrepo
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB); Medellín Colombia
| | - Juan G. McEwen
- Unidad de Biología Celular y Molecular; Corporación para Investigaciones Biológicas (CIB); Medellín Colombia
- Facultad de Medicina; Universidad de Antioquia; Medellín Colombia
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Urán ME, Nosanchuk JD, Restrepo A, Hamilton AJ, Gómez BL, Cano LE. Detection of antibodies against Paracoccidioides brasiliensis melanin in in vitro and in vivo studies during infection. Clin Vaccine Immunol 2011; 18:1680-8. [PMID: 21813659 PMCID: PMC3187017 DOI: 10.1128/cvi.05099-11] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 07/26/2011] [Indexed: 12/18/2022]
Abstract
Several cell wall constituents, including melanins or melanin-like compounds, have been implicated in the pathogenesis of a wide variety of microbial diseases caused by diverse species of pathogenic bacteria, fungi, and helminthes. Among these microorganisms, the dimorphic fungal pathogen Paracoccidioides brasiliensis produces melanin in its conidial and yeast forms. In the present study, melanin particles from P. brasiliensis were injected into BALB/c mice in order to produce monoclonal antibodies (MAbs). We identified five immunoglobulin G1 (IgG1) κ-chain and four IgM melanin-binding MAbs. The five IgG1 κ-chain isotypes are the first melanin-binding IgG MAbs ever reported. The nine MAbs labeled P. brasiliensis conidia and yeast cells both in vitro and in pulmonary tissues. The MAbs cross-reacted with melanin-like purified particles from other fungi and also with commercial melanins, such as synthetic and Sepia officinalis melanin. Melanization during paracoccidioidomycosis (PCM) was also further supported by the detection of IgG antibodies reactive to melanin from P. brasiliensis conidia and yeast in sera and bronchoalveolar lavage fluids from P. brasiliensis-infected mice, as well as in sera from human patients with PCM. Serum specimens from patients with other mycoses were also tested for melanin-binding antibodies by enzyme-linked immunosorbent assay, and cross-reactivities were detected for melanin particles from different fungal sources. These results suggest that melanin from P. brasiliensis is an immunologically active fungal structure that activates a strong IgG humoral response in humans and mice.
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Affiliation(s)
- Martha E Urán
- Medical and Experimental Mycology Unit, Corporación para Investigaciones Biológicas, Carrera 72A No. 78B-141, A.A. 73-78, Medellín, Colombia.
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García Blanco S, Muñoz JF, Torres I, Díez Posada S, Gómez BL, McEwen JG, Restrepo S, García AM. Differential PbP27 expression in the yeast and mycelial forms of the Paracoccidioides brasiliensis species complex. Fungal Genet Biol 2011; 48:1087-95. [PMID: 21945996 DOI: 10.1016/j.fgb.2011.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 08/17/2011] [Accepted: 09/10/2011] [Indexed: 11/15/2022]
Abstract
p27 is an antigenic protein produced by Paracoccidioides brasiliensis, the etiologic agent of paracoccidioidomycosis (PCM). Despite its unknown function, it has been suggested as a putative virulence factor, proposed as a suitable target for the design of diagnostic tools and vaccines, and considered as an enhancer in antifungal treatment of PCM. We evaluated sequence polymorphisms of PbP27 gene sequence among isolates, finding some polymorphisms associated with the isolates' phylogenetic origin. In order to determine if there was a differential expression pattern between morphological states and among isolates, we also evaluated PbP27 expression, at transcriptional and translational levels, in mycelia and yeast cultures in 14 isolates belonging to the P. brasiliensis species complex (S1, PS2, PS3, and "Pb01-like", proposed to be named Paracoccidioides lutzii) by two techniques, real time RT-PCR (RT-qPCR) and protein dot blot. For the latter, four protein extracts from different cell localizations (SDS or β-mercaptoethanol, cytoplasmic and extracellular proteins) were analyzed for each isolate. p27 was present in the four extracts evaluated, mainly in the SDS extract, corresponding to an extract containing proteins loosely attached to the cell wall. This information correlates with immunohistochemical analysis, where positive staining of the yeasts' cell wall was observed. We found that p27 was present in all isolates, mainly in the yeast form. This pattern was corroborated by RT-qPCR results, with higher expression levels found in the yeast form for most of the isolates. The results provide new insights into the expression patterns of this protein, and further characterize it in view of potential uses as a diagnostic and/or therapeutic tool.
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Affiliation(s)
- S García Blanco
- Laboratorio de Micología y Fitopatología, Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá DC, Colombia
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Walker CA, Gómez BL, Mora-Montes HM, Mackenzie KS, Munro CA, Brown AJP, Gow NAR, Kibbler CC, Odds FC. Melanin externalization in Candida albicans depends on cell wall chitin structures. Eukaryot Cell 2010; 9:1329-42. [PMID: 20543065 PMCID: PMC2937336 DOI: 10.1128/ec.00051-10] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 06/01/2010] [Indexed: 01/03/2023]
Abstract
The fungal pathogen Candida albicans produces dark-pigmented melanin after 3 to 4 days of incubation in medium containing l-3,4-dihydroxyphenylalanine (l-DOPA) as a substrate. Expression profiling of C. albicans revealed very few genes significantly up- or downregulated by growth in l-DOPA. We were unable to determine a possible role for melanin in the virulence of C. albicans. However, we showed that melanin was externalized from the fungal cells in the form of electron-dense melanosomes that were free or often loosely bound to the cell wall exterior. Melanin production was boosted by the addition of N-acetylglucosamine to the medium, indicating a possible association between melanin production and chitin synthesis. Melanin externalization was blocked in a mutant specifically disrupted in the chitin synthase-encoding gene CHS2. Melanosomes remained within the outermost cell wall layers in chs3Delta and chs2Delta chs3Delta mutants but were fully externalized in chs8Delta and chs2Delta chs8Delta mutants. All the CHS mutants synthesized dark pigment at equivalent rates from mixed membrane fractions in vitro, suggesting it was the form of chitin structure produced by the enzymes, not the enzymes themselves, that was involved in the melanin externalization process. Mutants with single and double disruptions of the chitinase genes CHT2 and CHT3 and the chitin pathway regulator ECM33 also showed impaired melanin externalization. We hypothesize that the chitin product of Chs3 forms a scaffold essential for normal externalization of melanosomes, while the Chs8 chitin product, probably produced in cell walls in greater quantity in the absence of CHS2, impedes externalization.
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Affiliation(s)
- Claire A. Walker
- Aberdeen Fungal Group, University of Aberdeen, Institute of Medical Sciences, Aberdeen AB25 2ZD, United Kingdom
| | - Beatriz L. Gómez
- Department of Medical Microbiology, Royal Free Hampstead NHS Trust, Pond Street, London NW3 2QG, United Kingdom
| | - Héctor M. Mora-Montes
- Aberdeen Fungal Group, University of Aberdeen, Institute of Medical Sciences, Aberdeen AB25 2ZD, United Kingdom
| | - Kevin S. Mackenzie
- Aberdeen Fungal Group, University of Aberdeen, Institute of Medical Sciences, Aberdeen AB25 2ZD, United Kingdom
| | - Carol A. Munro
- Aberdeen Fungal Group, University of Aberdeen, Institute of Medical Sciences, Aberdeen AB25 2ZD, United Kingdom
| | - Alistair J. P. Brown
- Aberdeen Fungal Group, University of Aberdeen, Institute of Medical Sciences, Aberdeen AB25 2ZD, United Kingdom
| | - Neil A. R. Gow
- Aberdeen Fungal Group, University of Aberdeen, Institute of Medical Sciences, Aberdeen AB25 2ZD, United Kingdom
| | - Christopher C. Kibbler
- Department of Medical Microbiology, Royal Free Hampstead NHS Trust, Pond Street, London NW3 2QG, United Kingdom
| | - Frank C. Odds
- Aberdeen Fungal Group, University of Aberdeen, Institute of Medical Sciences, Aberdeen AB25 2ZD, United Kingdom
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González A, Gómez BL, Muñoz C, Aristizabal BH, Restrepo A, Hamilton AJ, Cano LE. Involvement of extracellular matrix proteins in the course of experimental paracoccidioidomycosis. ACTA ACUST UNITED AC 2008; 53:114-25. [PMID: 18400008 DOI: 10.1111/j.1574-695x.2008.00411.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We aimed at determining involvement of extracellular matrix proteins (ECMp) and an ECM-binding adhesin (32-kDa protein) from Paracoccidioides brasiliensis, in the course of experimental paracoccidioidomycosis. BALB/c mice were infected with P. brasiliensis conidia previously incubated with soluble laminin, fibronectin and fibrinogen or a mAb against the fungal adhesin. Inflammatory response, chitin levels and cytokine production at different postinfection periods were determined. Chitin was significantly decreased in lungs of mice infected with ECMp-treated conidia when compared with controls at week 8, especially with laminin and fibrinogen. Contrariwise, when animals were infected with mAb-treated conidia no differences in chitin content were found. The observed inflammatory reaction in lungs was equivalent in all cases. IFN-gamma increased significantly in lungs from mice infected with soluble ECMp - (at day 4 and week 12) or mAb-treated conidia (at week 12) when compared with animals infected with untreated conidia. Significant increased levels of tumour necrosis factor-alpha were observed at 8 weeks in animals infected with ECMp-treated conidia while no differences were observed during the remaining periods. These findings point toward an inhibitory effect of ECMp on P. brasiliensis conidia infectivity and suggest that these proteins may interfere with conidia initial adhesion to host tissues probably modulating the immune response in paracoccidioidomycosis.
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Affiliation(s)
- Angel González
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas, Medellín, Colombia.
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González A, Gómez BL, Diez S, Hernández O, Restrepo A, Hamilton AJ, Cano LE. Purification and partial characterization of a Paracoccidioides brasiliensis protein with capacity to bind to extracellular matrix proteins. Infect Immun 2005; 73:2486-95. [PMID: 15784595 PMCID: PMC1087412 DOI: 10.1128/iai.73.4.2486-2495.2005] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Microorganisms adhere to extracellular matrix proteins by means of their own surface molecules. Paracoccidioides brasiliensis conidia have been shown to be capable of interacting with extracellular matrix proteins. We aimed at determining the presence of fungal proteins that could interact with extracellular matrix protein and, if found, attempt their purification and characterization. Various extracts were prepared from P. brasiliensis mycelial and yeast cultures (total homogenates, beta-mercaptoethanol, and sodium dodecyl sulfate [SDS] extracts) and analyzed by ligand affinity assays with fibronectin, fibrinogen and laminin. Two polypeptides were detected in both fungal forms. SDS extracts that interacted with all the extracellular matrix protein were tested; their molecular masses were 19 and 32 kDa. Analysis of the N-terminal amino acid sequence of the purified 32-kDa mycelial protein showed substantial homology with P. brasiliensis, Histoplasma capsulatum, and Neurospora crassa hypothetical proteins. Additionally, a monoclonal antibody (MAb) produced against this protein recognized the 32-kDa protein in the SDS extracts of both fungal forms for immunoblot. Immunofluorescence analysis revealed that this MAb reacted not only with mycelia and yeast cells, but also with conidia, indicating that this protein was shared by the three fungal propagules. By immunoelectron microscopy, this protein was detected in the cell walls and in the cytoplasm. Both the 32-kDa purified protein and MAb inhibited the adherence of conidia to the three extracellular matrix proteins in a dose-dependent manner. These findings demonstrate the presence of two polypeptides capable of interacting with extracellular matrix proteins on the surface of P. brasiliensis propagules, indicating that there may be common receptors for laminin, fibronectin, and fibrinogen. These proteins would be crucial for initial conidial adherence and perhaps also in dissemination of paracoccidioidomycosis.
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Affiliation(s)
- Angel González
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Carrera 72 A, No. 78B 141, A. A. 73 78 Medellín, Colombia.
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Abstract
PURPOSE OF REVIEW Production of melanin has been associated with virulence in diverse microorganisms. Melanization of fungi has been noted for many years in predominantly subcutaneous infections such as chromoblastomycosis and more recently most extensively studied in a yeast causing systemic infection, Cryptococcus neoformans. Pigmented fungi are increasingly important human pathogens and currently available antifungals are often sub-optimal for serious infections. This review focuses on recent publications on melanin in fungi with particular reference to the role of melanin in virulence, protection against antifungal drugs, and promoting survival in the environment. RECENT FINDINGS Inhibition of melanin production by C. neoformans can prolong survival of lethally infected mice. In contrast, melanin in C. neoformans and Histoplasma capsulatum yeast cells can bind amphotericin B and caspofungin, thereby reducing the fungicidal affects of these drugs. H. capsulatum and Paracoccidioides brasiliensis have only recently been shown to produce melanin in vitro and during infection. Additionally, melanin derived from melanized C. neoformans yeast and Aspergillus niger conidia can activate complement, which may modify immune responses to infection. Studies on C. neoformans laccase have revealed that the enzyme is located on the cell wall, which may allow for interactions with the host. Melanization reduces the susceptibility of C. neoformans to enzymatic degradation and toxicity from a heavy metal, which may afford protection to the fungus against similar insults in the environment. SUMMARY Melanin has been referred to as 'fungal armor' due to the ability of the polymer to protect microorganisms against a broad range of toxic insults. Recent publications continue to reveal important contributions of melanin to survival of fungi in the environment and during infection.
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Affiliation(s)
- Beatriz L Gómez
- Dermatology Department, St. Johns Institute of Dermatology, Guy's Hospital, Guy's, Kings, and St Thomas Medical School, London, UK.
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Díez S, Gómez BL, McEwen JG, Restrepo A, Hay RJ, Hamilton AJ. Combined use of Paracoccidioides brasiliensis recombinant 27-kilodalton and purified 87-kilodalton antigens in an enzyme-linked immunosorbent assay for serodiagnosis of paracoccidioidomycosis. J Clin Microbiol 2003; 41:1536-42. [PMID: 12682142 PMCID: PMC153928 DOI: 10.1128/jcm.41.4.1536-1542.2003] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The diagnosis of paracoccidioidomycosis (PCM) has relied on the identification of the host's humoral response by using a variety of immunological methods, such as complement fixation and immunodiffusion. Although these approaches are useful, historically their sensitivity and specificity have often been compromised by the use of complex mixtures of undefined antigens. The use of combinations of purified, well-characterized antigens appears preferable and may yield optimum results. Accordingly an indirect enzyme-linked immunosorbent assay (ELISA) using combinations of the previously described 27-kDa recombinant antigen and the 87-kDa heat shock protein were used for diagnosis and follow-up of patients with PCM. A total of 37 patients classified according to their clinical presentations (7 with the acute or subacute form of the disease, 22 with the chronic form of the disease, and 8 with the chronic unifocal form) were studied. Eighteen of these patients were also evaluated at every follow-up appointment. Forty serum samples from patients with other diseases and 50 serum samples from healthy individuals were also studied. Detection of anti-27-kDa and anti-87-kDa antibodies in sera of patients with PCM by ELISA using a combination of the two purified proteins showed a sensitivity of 92% with a specificity of 88% in comparison with normal human sera and 90% in comparison with the heterologous sera. These results demonstrated a significant increase in sensitivity and specificity compared to results when the antigens were used separately. Thus, the use of combinations of well-defined antigens appears to offer clear advantages over the use of single antigens when diagnosing PCM.
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Affiliation(s)
- Soraya Díez
- St. John's Institute of Dermatology, Guy's Hospital, London, England.
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Nosanchuk JD, Gómez BL, Youngchim S, Díez S, Aisen P, Zancopé-Oliveira RM, Restrepo A, Casadevall A, Hamilton AJ. Histoplasma capsulatum synthesizes melanin-like pigments in vitro and during mammalian infection. Infect Immun 2002; 70:5124-31. [PMID: 12183562 PMCID: PMC128224 DOI: 10.1128/iai.70.9.5124-5131.2002] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Melanin is made by several important pathogenic fungi and has been implicated in the pathogenesis of a number of fungal infections. This study investigated whether the thermally dimorphic fungal pathogen Histoplasma capsulatum var. capsulatum produced melanin or melanin-like compounds in vitro and during infection. Growth of H. capsulatum mycelia in chemically defined minimal medium produced pigmented conidia. Growth of H. capsulatum yeast in chemically defined minimal medium with L-3,4-dihydroxyphenylalanine (DOPA) or (-)-epinephrine produced pigmented cells. Treatment of the pigmented cells with proteolytic enzymes, denaturant, and hot concentrated acid yielded dark particles that were similar in size and shape to their respective propagules. Melanin-binding monoclonal antibodies (MAb) labeled pigmented conidia, yeast, and the isolated particles as determined by immunofluorescence microscopy. Electron spin resonance spectroscopy revealed that pigmented yeast cells and particles derived from pigmented cells were stable free radicals consistent with their identification as melanins. Tissues from mice infected with H. capsulatum and from biopsy specimens from a patient with histoplasmosis contained fungal cells that were labeled by melanin-binding MAb. Digestion of infected mouse tissues yielded dark particles that reacted with the melanin-binding MAb and were similar in appearance to H. capsulatum yeast cells. Additionally, sera from infected mice contained antibodies that bound melanin particles. Phenoloxidase activity capable of synthesizing melanin from L-DOPA was detected in cytoplasmic yeast cell extracts. These findings indicate that H. capsulatum conidia and yeast can produce melanin or melanin-like compounds in vitro and that yeast cells can synthesize pigment in vivo. Since melanin is an important virulence factor in other pathogenic fungi, this pigment may have a similar role to play in the pathogenesis of histoplasmosis.
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Affiliation(s)
- Joshua D Nosanchuk
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
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Roldán JC, Tabares AM, Gómez BL, Aristizábal BE, Cock AM, Restrepo A. The oral route in the pathogenesis of paracoccidioidomycosis: an experimental study in BALB/c mice infected with P. brasiliensis conidia. Mycopathologia 2002; 151:57-62. [PMID: 11554579 DOI: 10.1023/a:1010961514974] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Due to the high frequency of oral mucosal lesions observed in paracoccidioidomycosis patients, it was advocated that the infection was acquired by the traumatic implantation of the etiologic agent Paracoccidioides brasiliensis. Although at present this theory is considered invalid, it has not yet been excluded in experimental studies. In order to determine if intra-oral inoculation could explain the pathogenesis of paracoccidioidomycosis, 64 BALB/c mice were inoculated intra-orally with 850.000 viable P. brasiliensis conidia into the mandibular body. Animals were sacrificed at various time intervals up to 20 weeks and cultures were made from gingiva, lungs, spleen, and liver. Additionally, histopathological studies of the mandibular body were also performed. P. brasiliensis was isolated from all gingival tissues during the interval 24-72 h, indicating that the infection was active. During the 5-10 week period, the infection appeared to have been controlled at the inoculation site as cultures showed a significant reduction in colony forming units (CFU); however, at the 15-20 week period such control was lost and the fungus was recovered once more. Dissemination to other body sites was rare; thus, the lungs were involved in just one animal (2%), the liver in two (3%) and the spleen in seven (11%). The infection became established as proven by positive organ cultures, but the dissemination pattern did not correspond to the one observed in humans. Based on these findings, the intra-oral traumatic route does not appear to mimic the natural history of paracoccidioidomycosis.
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Affiliation(s)
- J C Roldán
- Corporación para Investigaciones Biológicas (CIB), Carrera, Medellín, Colombia.
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Díez S, Gómez BL, Restrepo A, Hay RJ, Hamilton AJ. Paracoccidioides brasiliensis 87-kilodalton antigen, a heat shock protein useful in diagnosis: characterization, purification, and detection in biopsy material via immunohistochemistry. J Clin Microbiol 2002; 40:359-65. [PMID: 11825942 PMCID: PMC153377 DOI: 10.1128/jcm.40.2.359-365.2002] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The 87-kDa antigen derived from the fungal pathogen Paracoccidioides brasiliensis can be detected in the sera of infected patients, and its levels have been shown to correlate well with response to treatment and with clinical cure. Despite its potential importance, the antigen has been poorly characterized. The 87-kDa antigen was purified to homogeneity via preparative gel electrophoresis; N-terminal amino acid sequencing revealed substantial homology with heat shock proteins (hsps) from a variety of organisms. A monoclonal antibody (MAb) raised against a Histoplasma capsulatum 80-kDa hsp showed cross-reactivity to the purified 87-kDa antigen via Western blotting, and the 87-kDa-specific MAb P1B demonstrated that the antigen was expressed at higher levels in yeast than in mycelia by the same technique. Enzyme-linked immunosorbent assay and immunofluorescence reactivity using P1B confirmed increased expression of the 87-kDa antigen during the temperature-induced transformation of mycelia to yeast. Yeast-to-mycelium transformation was accompanied by a fall in expression, although the 87-kDa antigen was clearly constitutively expressed in both phases. Immunochemical staining of tissues from patients with MAb P1B who were infected with P. brasiliensis confirmed in vivo expression of the 87-kDa antigen by yeasts, and identification of this antigen via this method appears to be a useful adjunct to other methods used to diagnose paracoccidioidomycosis.
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Affiliation(s)
- Soraya Díez
- St. John's Institute of Dermatology, Guy's Hospital, London, England.
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40
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Gómez BL, Nosanchuk JD, Díez S, Youngchim S, Aisen P, Cano LE, Restrepo A, Casadevall A, Hamilton AJ. Detection of melanin-like pigments in the dimorphic fungal pathogen Paracoccidioides brasiliensis in vitro and during infection. Infect Immun 2001; 69:5760-7. [PMID: 11500453 PMCID: PMC98693 DOI: 10.1128/iai.69.9.5760-5767.2001] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Melanins are implicated in the pathogenesis of several human diseases, including some microbial infections. In this study, we analyzed whether the conidia and the yeasts of the thermally dimorphic fungal pathogen Paracoccidioides brasiliensis produce melanin or melanin-like compounds in vitro and during infection. Growth of P. brasiliensis mycelia on water agar alone produced pigmented conidia, and growth of yeasts in minimal medium with L-3,4-dihydroxyphenylalanine (L-DOPA) produced pigmented cells. Digestion of the pigmented conidia and yeasts with proteolytic enzymes, denaturant, and hot concentrated acid yielded dark particles that were the same size and shape as their propagules. Immunofluorescence analysis demonstrated reactivity of a melanin-binding monoclonal antibody (MAb) with the pigmented conidia, yeasts, and particles. Electron spin resonance spectroscopy identified the yeast-derived particles produced in vitro when P. brasiliensis was grown in L-DOPA medium as a melanin-like compound. Nonreducing polyacrylamide gel electrophoresis of cytoplasmic yeast extract revealed a protein that catalyzed melanin synthesis from L-DOPA. The melanin binding MAb reacted with yeast cells in tissue from mice infected with P. brasiliensis. Finally digestion of infected tissue liberated particles reactive to the melanin binding MAb that had the typical morphology of P. brasiliensis yeasts. These data strongly suggest that P. brasiliensis propagules, both conidia and yeast cells, can produce melanin or melanin-like compounds in vitro and in vivo. Based on what is known about the function of melanin in the virulence of other fungi, this pigment may play a role in the pathogenesis of paracoccidioidomycosis.
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Affiliation(s)
- B L Gómez
- Dermatology Department, St. Johns Institute of Dermatology, Guy's Hospital, Guy's, Kings and St. Thomas Medical Schools, London, United Kingdom
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41
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Verweij PE, Figueroa J, Van Burik J, Holdom MD, Dei-Cas E, Gómez BL, Mendes-Giannini MJ. Clinical applications of non-culture based methods for the diagnosis and management of opportunistic and endemic mycoses. Med Mycol 2001; 38 Suppl 1:161-71. [PMID: 11204141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Nonculture based methods for the detection of infections caused by fungal pathogens are becoming more important tools in the management of infected patients. Detection of fungal antigens and DNA appear to be the most promising in this respect for both opportunistic and endemic mycoses. In this article we present an overview of the most recent developments in nonculture based methods and examine their value in clinical practice.
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Affiliation(s)
- P E Verweij
- Department of Medical Microbiology, University Medical Center Nijmegen, The Netherlands.
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Abstract
Melanins are notoriously difficult to work with because of their unique physical and chemical properties. The study of melanins is hampered by the scarcity of melanin-specific reagents and serological techniques. In this study we describe modifications to the standard method for the isolation of melanins from in vitro-melanized fungal cells and detail the optimization of serological techniques for the study of melanin compounds. The isolation procedure involves the digestion of melanized cells with a combination of proteolytic and glycolytic enzymes, denaturant, organic extractions, and boiling in 6.0 M HCl. Elemental quantitative analyses suggest that this procedure does not significantly affect the relative elemental composition of melanins. For the serological assays, our goal was to achieve a homogenous distribution of melanin particles on a solid support to maximize their recognition by melanin-binding antibodies. The results from enzyme-linked immunosorbent assays (ELISAs) demonstrate that melanins, in general, disperse more efficiently on, and adhere better to, medium-binding polystyrene surfaces, especially in the presence of trace amounts of salt. Blocking the melanin-coated ELISA plates with the commercially available SuperBlock((R)) Blocking Buffer for 4 h was more efficient at reducing non-specific binding of a negative control monoclonal antibody (mAb) compared to blocking with 2% bovine serum albumin (BSA) and 5% milk. Increasing the ionic strength of the antibody solutions reduced binding to the melanins, indicating that binding is in part mediated by electrostatic interactions. These conditions were also applied to immunofluorescence (IF) analyses of melanins, and the results were consistent with those obtained by ELISA.
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Affiliation(s)
- A L Rosas
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
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43
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Villa LA, Tobón A, Restrepo A, Calle D, Rosero DS, Gómez BL, Restrepo A. Central nervous system paracoccidioidomycosis. Report of a case successfully treated with itraconazol. Rev Inst Med Trop Sao Paulo 2000; 42:231-4. [PMID: 10968887 DOI: 10.1590/s0036-46652000000400009] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Paracoccidioidomycosis (PCM) is a primary pulmonary infection that often disseminates to other organs and systems. Involvement of the central nervous system (CNS) is rare and due to the fact that both clinical alertness and establishment of the diagnosis are delayed, the disease progresses causing serious problems. We report here a case of neuroparacoccidioidomycosis (NPCM), observed in a 55 year-old male, who consulted due to neurological symptoms (left hemiparesis, paresthesias, right palpebral ptosis, headache, vomiting and tonic clonic seizures) of a month duration. Upon physical examination, an ulcerated granulomatous lesion was observed in the abdomen. To confirm the diagnosis a stereotactic biopsy was taken; additionally, mycological tests from the ulcerated lesion and a bronchoalveolar lavage were performed. In the latter specimens, P. brasiliensis yeast cells were visualized and later on, the brain biopsy revealed the presence of the fungus. Treatment with itraconazole (ITZ) was initiated but clinical improvement was unremarkable; due to the fact that the patient was taking sodium valproate for seizure control, drug interactions were suspected and confirmed by absence of ITZ plasma levels. The latter medication was changed to clonazepam and after several weeks, clinical improvement began to be noticed and was accompanied by diminishing P. brasiliensis antigen and antibody titers. In the PCM endemic areas, CNS involvement should be considered more often and the efficacy of itraconazole therapy should also be taken into consideration.
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Affiliation(s)
- L A Villa
- Departamento de Neurología, Facultad de Medicina, Hospital Universitario San Vicente, Universidad de Antioquia, Colombia
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De Bedout C, Ordóñez N, Gómez BL, Rodríguez MC, Arango M, Restrepo A, Castañeda E. In vitro antifungal susceptibility of clinical isolates of Cryptococcus neoformans var. neoformans and C. neoformans var. gattii. Rev Iberoam Micol 1999; 16:36-39. [PMID: 18473590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
One of the differences observed between the two varieties of Cryptococcus neoformansis the greater difficulty to achieve an adequate therapeutical response in patients affected by C. neoformans var. gattii, an observation that has been validated in vitro only rarely. The aim of this work was to study the susceptibility patterns of 35 Colombian clinical isolates of C. neoformans, 20 of which belonged to the var. neoformans and 15 to the var. gattii. The minimal inhibitory concentration (MIC) was determined by broth microdilution, according to a modification of the methodology proposed by the National Committee for Clinical Laboratory Standards (NCCLS), using the breakpoints recently suggested by Nguyen et al. (Antimicrob Agents Chemother 1998; 42: 471-472). The antifungals tested were amphotericin B, fluconazole and itraconazole. Most of the isolates were susceptible to the three antimycotics tested regardless of the variety. Resistance to amphotericin B (MIC=2 microg/ml) was documented in two (10%) C. neoformans var. neoformans isolates; additionally, five (33%) C. neoformans var. gattii isolates felt in the category of fluconazole susceptible but dose dependent (MIC 16 microg/ml). In general, all C. neoformans var. gattii isolates proved susceptible only to the higher concentrations of the antifungals tested. For amphotericin B, seven (47%) isolates of this variety had MICs of 1 microg/ml, for fluconazole there were seven (47%) with MICs of 8 microg/ml and in the case of itraconazole, 10 isolates (66%) had MICs > 0.03 microg/ml. The data showed that although these isolates would be classified as susceptible, they actually require greater concentrations of the antifungals to be inhibited. This finding may well correlate both with the difficulty to attain therapeutic success in patients affected with C. neoformans var. gattii and with the need for more prolonged treatment courses in such cases.
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Affiliation(s)
- C De Bedout
- Corporación para Investigaciones Biológicas, CIB, Medellín, Colombia
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45
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Gómez BL, Figueroa JI, Hamilton AJ, Diez S, Rojas M, Tobón A, Restrepo A, Hay RJ. Detection of the 70-kilodalton histoplasma capsulatum antigen in serum of histoplasmosis patients: correlation between antigenemia and therapy during follow-up. J Clin Microbiol 1999; 37:675-80. [PMID: 9986830 PMCID: PMC84514 DOI: 10.1128/jcm.37.3.675-680.1999] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/1998] [Accepted: 12/02/1998] [Indexed: 11/20/2022] Open
Abstract
Histoplasmosis is an important systemic fungal infection, particularly among immunocompromised individuals, who may develop a progressive disseminated form which is often fatal if it is untreated. In such patients, the detection of antibody responses for both diagnosis and follow-up may be of limited use, whereas the detection of Histoplasma capsulatum var. capsulatum antigens may provide a more practical approach. We have recently described an inhibition enzyme-linked immunosorbent assay (ELISA) for the detection in patients' sera of a 69- to 70-kDa H. capsulatum var. capsulatum-specific antigen which appears to be useful in diagnosis. To investigate its potential for the follow-up of histoplasmosis patients during treatment, antigen titers in the sera of 16 patients presenting with different clinical forms of histoplasmosis were monitored at regular intervals for up to 80 weeks. Sera from four of five patients with the acute form of the disease showed rapid falls in antigenemia, becoming antigen negative by week 14 (range, weeks 10 to 16). Sera from four patients with disseminated histoplasmosis showed falls in antigen levels; three of them became antigen negative by week 32; the fourth patient became negative by week 48. In contrast, antigen titers in four of six AIDS patients with the disseminated form of the disease remained positive throughout follow-up. Sera from only one patient who presented with the chronic form of the disease were analyzed, and this individual's serum became antigen negative by week 9. The inhibition ELISA is shown to be of particular use in the monitoring of non-AIDS patients with the acute and disseminated forms of the disease and may complement existing means of follow-up.
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Affiliation(s)
- B L Gómez
- Corporación para Investigaciones Biológicas, A. A. 73-78, Medellín, Colombia.
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46
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Gómez BL, Figueroa JI, Hamilton AJ, Diez S, Rojas M, Tobón AM, Hay RJ, Restrepo A. Antigenemia in patients with paracoccidioidomycosis: detection of the 87-kilodalton determinant during and after antifungal therapy. J Clin Microbiol 1998; 36:3309-16. [PMID: 9774584 PMCID: PMC105320 DOI: 10.1128/jcm.36.11.3309-3316.1998] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/1998] [Accepted: 08/19/1998] [Indexed: 11/20/2022] Open
Abstract
Serological diagnosis and follow-up of paracoccidioidomycosis (PCM) patients have relied mainly on the detection of antibody responses by using techniques such as complement fixation (CF) and immunodiffusion. We recently described a novel inhibition enzyme-linked immunosorbent assay (inh-ELISA) which proved to be useful in the diagnosis of PCM via the detection of an 87-kDa determinant in patient sera (B. L. Gomez, J. I. Figueroa, A. J. Hamilton, B. Ortiz, M. A. Robledo, R. J. Hay, and A. Restrepo, J. Clin. Microbiol. 35:3278-3283, 1997). This test has now been assessed as a means of following up PCM patients. A total of 24 PCM patients, classified according to their clinical presentation (6 with the acute form of the disease, of whom two had AIDS, 12 with the multifocal form of the disease, and 6 with the unifocal form of the disease), were studied. The four human immunodeficiency virus-negative patients with acute PCM showed a statistically significant decrease in circulating antigen levels after the start of antifungal therapy. Antigen levels in this group became negative by our criteria (=2.3 microgram/ml) before week 20 and remained so in three of four of these patients. In contrast, the two AIDS patients who also presented with the acute form of PCM showed no statistically significant decrease in circulating antigen levels even after 68 weeks of therapy. Taken together as a group, the patients with the multifocal form showed a statistically significant decrease in antigenemia after 28 weeks of therapy. In addition, five of six patients with the unifocal form became antigen negative by week 40. Antigen level decrease mirrored clinical cure in the majority of patients in all clinical groups; in contrast, measurement of anti-PCM antibodies via the CF test showed wide fluctuations in titers during the follow-up period. The inh-ELISA for the detection of the 87-kDa Paracoccidioides brasiliensis determinant would appear to be a valuable additional tool in the follow-up of PCM patients.
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Affiliation(s)
- B L Gómez
- Corporación para Investigaciones Biológicas, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
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47
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Hamilton AJ, Gómez BL. The application of monoclonal antibodies to the diagnosis of disseminated mycoses. Rev Iberoam Micol 1998; 15:118-124. [PMID: 18473530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Monoclonal antibodies (MoAbs) have had a major impact on many areas of biomedical research and almost since their advent have been used in the characterisation and identification of diagnostically important antigens of fungal pathogens. Their main significance lies in three, often inter-related areas: a) the definition and characterisation of antigens for use in detection of antibody responses, b) their direct use in the detection of diagnostically useful antigen in body fluids c) their application in immunohistochemical diagnosis. The degree to which MoAbs have been applied varies between fungal pathogens, and they have now been used, for example, in the serodiagnosis of Aspergillus spp., Cryptococcus neoformans, Histoplasma capsulatum and Paracoccidioides brasiliensis. Their use in producing diagnostic tests for other fungi such as Sporothrix schenckii and Penicillium marneffei has been more restricted but considerable potential exists for further development.
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Affiliation(s)
- A J Hamilton
- Dunhill Dermatology Laboratory, St Johns Institute of Dermatology, Thomas Guy House, Guys Hospital, London, UK.
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48
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Gómez BL, Figueroa JI, Hamilton AJ, Ortiz B, Robledo MA, Hay RJ, Restrepo A. Use of monoclonal antibodies in diagnosis of paracoccidioidomycosis: new strategies for detection of circulating antigens. J Clin Microbiol 1997; 35:3278-83. [PMID: 9399534 PMCID: PMC230162 DOI: 10.1128/jcm.35.12.3278-3283.1997] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The precise diagnosis of paracoccidioidomycosis, in most cases, is established by direct methods and indirect immunological tests. The latter method is reliant on the identification of the host's humoral responses, which are usually impaired or absent in patients with severe juvenile forms of the disease and in immunocompromised patients. Determining disease activity or assessing treatment responses by measuring antibody levels is difficult, since antibody titer may remain elevated or persist at stationary levels, even in the presence of clinical improvement. Consequently, there is a need for alternative tests aimed at the identification of circulating antigens. A modification of the standard hybridoma production method was used to raise a panel of murine monoclonal antibodies (MAbs) against the yeast form of Paracoccidioides brasiliensis. Of these, MAb PIB, directed against an 87-kDa determinant, was used to develop an inhibition ELISA (inh-ELISA) capable of detecting as little as 5.8 ng of circulating antigen per ml of serum. Sera from 46 patients with paracoccidioidomycosis or other mycoses and sera from healthy individuals were evaluated by the inh-ELISA; overall sensitivity was 80.4% (37 of 46 paracoccidioidomycosis patients tested positive), and specificity compared with that of normal controls from areas of endemicity was 81.4%. The inh-ELISA detected circulating antigen in 100% of patients with the acute form of paracoccidioidomycosis and in 83.3 and 60% of patients with the chronic multifocal and unifocal forms of paracoccidioidomycosis according to the patients' clinical presentation. These results indicate that the inh-ELISA with MAb PIB is effective in the detection of circulating antigen and that this test may be useful for monitoring responses to treatment and establishing disease prognoses.
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Affiliation(s)
- B L Gómez
- Corporación para Investigaciones Biológicas, Medellín, Colombia
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49
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Abstract
Based on the difficulties experienced in the treatment of chromoblastomycosis, 12 primary human isolates of F. pedrosoi, were tested for their in vitro susceptibility to various antimycotics. We adapted the recommendations of the NCCLS for yeasts and followed the indications for mold testing from other authors in order to determine their MIC's and the MLC's. It was found that a significant proportion of the isolates were resistant to 3 of the 4 antimycotics tested, as revealed by high MIC values, as follows: 33% were resistant to amphotericin B (AMB), 58.3% to 5 fluocytosine (5 FC) and 66.7% to fluconazole (FLU). Contrarywise, none of the isolates proved resistant to itraconazole (ITZ). Determination of the MLC's revealed that a larger proportion of the isolates were not killed by AMB, 5 FC (91.7%), FLU (100%) or even, ITZ (41.7%). These data indicate that it would be desirable to determine the susceptibility of F. pedrosoi before initiating therapy, in order to choose the more effective antifungal and avoid clinical failure.
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Affiliation(s)
- C de Bedout
- Sección de Micología, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
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