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Reduced Multidrug Susceptibility Profile Is a Common Feature of Opportunistic Fusarium Species: Fusarium Multi-Drug Resistant Pattern. J Fungi (Basel) 2017; 3:jof3020018. [PMID: 29371536 PMCID: PMC5715927 DOI: 10.3390/jof3020018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 03/27/2017] [Accepted: 04/07/2017] [Indexed: 01/26/2023] Open
Abstract
The resistance among various opportunistic Fusarium species to different antifungal agents has emerged as a cause of public health problems worldwide. Considering the significance of multi-drug resistant (MDR), this paper emphasizes the problems associated with MDR and the need to understand its clinical significance to combat microbial infections. The search platform PubMed/MEDLINE and a review of 32 cases revealed a common multidrug-resistant profile exists, and clinically relevant members of Fusarium are intrinsically resistant to most currently used antifungals. Dissemination occurs in patients with prolonged neutropenia, immune deficiency, and especially hematological malignancies. Amphotericin B displayed the lowest minimum inhibitory concentrarions (MICs) followed by voriconazole, and posaconazole. Itraconazole and fluconazole showed high MIC values, displaying in vitro resistance. Echinocandins showed the highest MIC values. Seven out of ten (70%) patients with neutropenia died, including those with fungemia that progressed to skin lesions. Clinical Fusarium isolates displayed a common MDR profile and high MIC values for the most available antifungal agents with species- and strain-specific differences in antifungal susceptibility. Species identification of Fusarium infections is important. While the use of natamycin resulted in a favorable outcome in keratitis, AmB and VRC are the most used agents for the treatment of fusariosis in clinical settings.
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52
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Novel alkylated azoles as potent antifungals. Eur J Med Chem 2017; 133:309-318. [PMID: 28395217 DOI: 10.1016/j.ejmech.2017.03.075] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 03/27/2017] [Accepted: 03/30/2017] [Indexed: 11/23/2022]
Abstract
Fluconazole (FLC) is the drug of choice when it comes to treat fungal infections such as invasive candidiasis in humans. However, the widespread use of FLC has resulted in the development of resistance to this drug in various fungal strains and, simultaneously has occasioned the need for new antifungal agents. Herein, we report the synthesis of 27 new FLC derivatives along with their antifungal activity against a panel of 13 clinically relevant fungal strains. We also explore their toxicity against mammalian cells, their hemolytic activity, as well as their mechanism of action. Overall, many of our FLC derivatives exhibited broad-spectrum antifungal activity and all compounds displayed an MIC value of <0.03 μg/mL against at least one of the fungal strains tested. We also found them to be less hemolytic and less cytotoxic to mammalian cells than the FDA approved antifungal agent amphotericin B. Finally, we demonstrated with our best derivative that the mechanism of action of our compounds is the inhibition of the sterol 14α-demethylase enzyme involved in ergosterol biosynthesis.
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Alizadeh F, Khodavandi A, Zalakian S. Quantitation of ergosterol content and gene expression profile of ERG11 gene in fluconazole-resistant Candida albicans. Curr Med Mycol 2017; 3:13-19. [PMID: 29302625 PMCID: PMC5747584 DOI: 10.29252/cmm.3.1.13] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background and Purpose: The frequency of opportunistic fungal infections in immunocompromised patients, especially by Candida species, has sharply increased in the last few decades. The objective of this study was to analyse the ergosterol content and gene expression profiling of clinical isolates of fluconazole-resistant Candida albicans. Materials and Methods: Sixty clinical samples were identified and collected from immunocompromised patients, namely recurrent oral, vaginal, and cutaneous candidiasis, during 2015-16. Antifungal susceptibility testing of fluconazole against clinical Candida species was performed according to Clinical and Laboratory Standards Institute guidelines. Ergosterol content and gene expression profiling of sterol 14α-demethylase (ERG11) gene in fluconazole-susceptible and –resistant C. albicans were investigated. Results: The specimens consisted of C. albicans (46.67%), Candida krusei (41.67%), and Candida tropicalis (11.67%). All the isolates were resistant to fluconazole. No significant reduction was noted in total cellular ergosterol content in comparison with untreated controls in terms of fluconazole-resistant C. albicans. The expressionlevel of ERG11 gene was down-regulated in fluconazole-susceptible C. albicans. Eventually, the expression pattern of ERG11 gene revealed no significant changes in fluconazole-resistant isolates compared to untreated controls. The results revealed no significant differences between fluconazole-susceptible and –resistant C. albicans sequences by comparison with ERG11 reference sequence. Conclusion: Our findings provide an insight into the mechanism of fluconazole resistance in C. albicans. The mechanisms proposed for clinical isolates of fluconazole-resistant C. albicans are alteration in sterol biosynthesis, analysis of expression level of ERG11 gene, and analysis of gene sequences. Nonetheless, further studies are imperative to find molecular mechanisms that could be targeted to control fluconazole resistance.
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Affiliation(s)
- F Alizadeh
- Department of Microbiology, Yasooj Branch, Islamic Azad University, Yasooj, Iran
| | - A Khodavandi
- Department of Biology, Gachsaran Branch, Islamic Azad University, Gachsaran, Iran
| | - S Zalakian
- Department of Microbiology, Yasooj Branch, Islamic Azad University, Yasooj, Iran
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54
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Critical role for CaFEN1 and CaFEN12 of Candida albicans in cell wall integrity and biofilm formation. Sci Rep 2017; 7:40281. [PMID: 28079132 PMCID: PMC5227966 DOI: 10.1038/srep40281] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 12/02/2016] [Indexed: 02/08/2023] Open
Abstract
Sphingolipids are involved in several cellular functions, including maintenance of cell wall integrity. To gain insight into the role of individual genes of sphingolipid biosynthetic pathway, we have screened Saccharomyces cerevisiae strains deleted in these genes for sensitivity to cell wall perturbing agents calcofluor white and congo red. Only deletants of FEN1 and SUR4 genes were found to be sensitive to both these agents. Candida albicans strains deleted in their orthologs, CaFEN1 and CaFEN12, respectively, also showed comparable phenotypes, and a strain deleted for both these genes was extremely sensitive to cell wall perturbing agents. Deletion of these genes was reported earlier to sensitise cells to amphotericin B (AmB), which is a polyene drug that kills the cells mainly by binding and sequestering ergosterol from the plasma membrane. Here we show that their AmB sensitivity is likely due to their cell wall defect. Further, we show that double deletant of C. albicans is defective in hyphae formation as well as biofilm development. Together this study reveals that deletion of FEN1 and SUR4 orthologs of C. albicans leads to impaired cell wall integrity and biofilm formation, which in turn sensitise cells to AmB.
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55
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Abstract
Eugenol is a natural allylphenol responsible for a wide range of biological activities, especially antimicrobial. Benzoxazoles are heterocycles with recognized antimicrobial activities. This paper describes the design, synthesis, and the biological results for benzoxazole type derivatives of eugenol as antifungal agents. The products were obtained in good yields by a four-step synthetic sequence involving aromatic nitration, nitroreduction, amide formation, and cycle condensation. They were evaluated against species of Candida spp. in microdilution assays, and four products (5a, 5b′, 5c, and 5d′) were about five times more active than eugenol against C. albicans and C. glabrata. Two of them (5b′ and 5d′) showed good activity against C. krusei, a species which is naturally resistant to fluconazole. Furthermore, the active products were more selective than eugenol against human blood cells, showing that they are interesting substances for further optimization.
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56
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Hasim S, Allison DP, Retterer ST, Hopke A, Wheeler RT, Doktycz MJ, Reynolds TB. β-(1,3)-Glucan Unmasking in Some Candida albicans Mutants Correlates with Increases in Cell Wall Surface Roughness and Decreases in Cell Wall Elasticity. Infect Immun 2017; 85:e00601-16. [PMID: 27849179 PMCID: PMC5203643 DOI: 10.1128/iai.00601-16] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 11/08/2016] [Indexed: 11/20/2022] Open
Abstract
Candida albicans is among the most common human fungal pathogens, causing a broad range of infections, including life-threatening systemic infections. The cell wall of C. albicans is the interface between the fungus and the innate immune system. The cell wall is composed of an outer layer enriched in mannosylated glycoproteins (mannan) and an inner layer enriched in β-(1,3)-glucan and chitin. Detection of C. albicans by Dectin-1, a C-type signaling lectin specific for β-(1,3)-glucan, is important for the innate immune system to recognize systemic fungal infections. Increased exposure of β-(1,3)-glucan to the immune system occurs when the mannan layer is altered or removed in a process called unmasking. Nanoscale changes to the cell wall during unmasking were explored in live cells with atomic force microscopy (AFM). Two mutants, the cho1Δ/Δ and kre5Δ/Δ mutants, were selected as representatives that exhibit modest and strong unmasking, respectively. Comparisons of the cho1Δ/Δ and kre5Δ/Δ mutants to the wild type reveal morphological changes in their cell walls that correlate with decreases in cell wall elasticity. In addition, AFM tips functionalized with Dectin-1 revealed that the forces of binding of Dectin-1 to all of the strains were similar, but the frequency of binding was highest for the kre5Δ/Δ mutant, decreased for the cho1Δ/Δ mutant, and rare for the wild type. These data show that nanoscale changes in surface topology are correlated with increased Dectin-1 adhesion and decreased cell wall elasticity. AFM, using tips functionalized with immunologically relevant molecules, can map epitopes of the cell wall and increase our understanding of pathogen recognition by the immune system.
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Affiliation(s)
- Sahar Hasim
- Department of Microbiology, University of Tennessee, Knoxville, Tennessee, USA
| | - David P Allison
- Biosciences Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee, USA
- Department of Biochemistry and Cellular and Molecular Biology, University of Tennessee, Knoxville, Tennessee, USA
| | - Scott T Retterer
- Biosciences Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee, USA
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee, USA
| | - Alex Hopke
- Department of Molecular and Biomedical Sciences, University of Maine, Orono, Maine, USA
| | - Robert T Wheeler
- Department of Molecular and Biomedical Sciences, University of Maine, Orono, Maine, USA
| | - Mitchel J Doktycz
- Biosciences Division, Oak Ridge National Laboratory, Oak Ridge, Tennessee, USA
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee, USA
| | - Todd B Reynolds
- Department of Microbiology, University of Tennessee, Knoxville, Tennessee, USA
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57
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Polvi EJ, Averette AF, Lee SC, Kim T, Bahn YS, Veri AO, Robbins N, Heitman J, Cowen LE. Metal Chelation as a Powerful Strategy to Probe Cellular Circuitry Governing Fungal Drug Resistance and Morphogenesis. PLoS Genet 2016; 12:e1006350. [PMID: 27695031 PMCID: PMC5047589 DOI: 10.1371/journal.pgen.1006350] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 09/08/2016] [Indexed: 01/01/2023] Open
Abstract
Fungal pathogens have evolved diverse strategies to sense host-relevant cues and coordinate cellular responses, which enable virulence and drug resistance. Defining circuitry controlling these traits opens new opportunities for chemical diversity in therapeutics, as the cognate inhibitors are rarely explored by conventional screening approaches. This has great potential to address the pressing need for new therapeutic strategies for invasive fungal infections, which have a staggering impact on human health. To explore this approach, we focused on a leading human fungal pathogen, Candida albicans, and screened 1,280 pharmacologically active compounds to identify those that potentiate the activity of echinocandins, which are front-line therapeutics that target fungal cell wall synthesis. We identified 19 compounds that enhance activity of the echinocandin caspofungin against an echinocandin-resistant clinical isolate, with the broad-spectrum chelator DTPA demonstrating the greatest synergistic activity. We found that DTPA increases susceptibility to echinocandins via chelation of magnesium. Whole genome sequencing of mutants resistant to the combination of DTPA and caspofungin identified mutations in the histidine kinase gene NIK1 that confer resistance to the combination. Functional analyses demonstrated that DTPA activates the mitogen-activated protein kinase Hog1, and that NIK1 mutations block Hog1 activation in response to both caspofungin and DTPA. The combination has therapeutic relevance as DTPA enhanced the efficacy of caspofungin in a mouse model of echinocandin-resistant candidiasis. We found that DTPA not only reduces drug resistance but also modulates morphogenesis, a key virulence trait that is normally regulated by environmental cues. DTPA induced filamentation via depletion of zinc, in a manner that is contingent upon Ras1-PKA signaling, as well as the transcription factors Brg1 and Rob1. Thus, we establish a new mechanism by which metal chelation modulates morphogenetic circuitry and echinocandin resistance, and illuminate a novel facet to metal homeostasis at the host-pathogen interface, with broad therapeutic potential. Invasive fungal infections pose a serious threat to human health worldwide, with Candida albicans being a leading fungal pathogen. Mortality is in part due to the limited arsenal of effective antifungals, with drug resistance on the rise. The echinocandins, which target the fungal cell wall, are the newest class of antifungal, and echinocandin resistance has already emerged. Here, we screened a library of 1,280 pharmacologically active compounds to identify those that potentiate echinocandin activity against an echinocandin-resistant isolate. The lead compound was a chelator, DTPA, which affects resistance by depleting magnesium. Genome sequencing of mutants resistant to the combination of DTPA and echinocandin revealed mutations in the gene encoding Nik1, which signals upstream of the Hog1 stress response pathway. We established that DTPA acts through Nik1 to modulate Hog1 signaling and enhance echinocandin activity, and that this combination has therapeutic benefits in a murine model of candidiasis. We also discovered that DTPA modulates C. albicans morphogenesis, a key virulence trait. DTPA induced filamentation by chelating zinc, in a manner that is contingent upon core filamentation pathways and specialized circuitry. Thus, we establish novel roles for metal homeostasis in C. albicans pathogenesis, thereby illuminating new therapeutic strategies for life-threatening infectious disease.
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Affiliation(s)
- Elizabeth J. Polvi
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Anna F. Averette
- Department of Molecular Genetics and Microbiology, Medicine, and Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Soo Chan Lee
- Department of Molecular Genetics and Microbiology, Medicine, and Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina, United States of America
- Department of Biology, University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Taeyup Kim
- Department of Molecular Genetics and Microbiology, Medicine, and Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Yong-Sun Bahn
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - Amanda O. Veri
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Robbins
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Joseph Heitman
- Department of Molecular Genetics and Microbiology, Medicine, and Pharmacology and Cancer Biology, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Leah E. Cowen
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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58
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Comparing the Effect of Garlic, Zataria multiflora and Clotrimazole Vaginal Cream 2% on Improvement of Fungal Vaginitis: A Randomized Controlled Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.29262] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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59
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Zhao S, Zhao L, Zhang X, Liu C, Hao C, Xie H, Sun B, Zhao D, Cheng M. Design, synthesis, and structure-activity relationship studies of benzothiazole derivatives as antifungal agents. Eur J Med Chem 2016; 123:514-522. [PMID: 27494168 DOI: 10.1016/j.ejmech.2016.07.067] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/25/2016] [Accepted: 07/26/2016] [Indexed: 01/18/2023]
Abstract
A series of compounds with benzothiazole and amide-imidazole scaffolds were designed and synthesized to combat the increasing incidence of drug-resistant fungal infections. The antifungal activity of these compounds was evaluated in vitro, and their structure-activity relationships (SARs) were evaluated. The synthesized compounds showed excellent inhibitory activity against Candida albicans and Cryptococcus neoformans. The most potent compounds 14o, 14p, and 14r exhibited potent activity, with minimum inhibitory concentration (MIC) values in the range of 0.125-2 μg/mL. Preliminary mechanism studies revealed that the compound 14p might act by inhibiting the CYP51 of Candida albicans. The SARs and binding mode established in this study are useful for further lead optimization.
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Affiliation(s)
- Shizhen Zhao
- Key Laboratory of Structure-Based Drug Design and Discovery, Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang 110016, PR China
| | - Liyu Zhao
- Key Laboratory of Structure-Based Drug Design and Discovery, Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang 110016, PR China
| | - Xiangqian Zhang
- Key Laboratory of Structure-Based Drug Design and Discovery, Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang 110016, PR China
| | - Chunchi Liu
- Key Laboratory of Structure-Based Drug Design and Discovery, Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang 110016, PR China
| | - Chenzhou Hao
- Key Laboratory of Structure-Based Drug Design and Discovery, Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang 110016, PR China
| | - Honglei Xie
- Key Laboratory of Structure-Based Drug Design and Discovery, Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang 110016, PR China
| | - Bin Sun
- Institute of BioPharmaceutical Research, Liaocheng University, 1 Hunan Road, Liaocheng 252000, PR China
| | - Dongmei Zhao
- Key Laboratory of Structure-Based Drug Design and Discovery, Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang 110016, PR China.
| | - Maosheng Cheng
- Key Laboratory of Structure-Based Drug Design and Discovery, Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenhe District, Shenyang 110016, PR China
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60
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Tap RM, Ramli NY, Sabaratnam P, Hashim R, Bakri ARA, Bee LB, Ginsapu SJ, Ahmad R, Razak MFA, Ahmad N. First Two Cases of Fungal Infections Associated with Multi-drug Resistant Yeast, Fereydounia khargensis. Mycopathologia 2016; 181:531-7. [PMID: 27010640 PMCID: PMC4937094 DOI: 10.1007/s11046-016-0002-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 03/12/2016] [Indexed: 11/28/2022]
Abstract
The number of new fungal pathogens is increasing due to growing population of immunocompromised patients and advanced identification techniques. Fereydounia khargensis is a yeast and was first described in 2014 from environmental samples. As far as we know, this is the first report of human infections associated with F. khargensis.
The yeasts were isolated from blood of a HIV-positive patient and pleural fluid of chronic renal failure patient. Amplification and sequencing of the internal transcribed spacer and the large subunit regions confirmed the identity of the isolates. Both isolates showed multi-drug resistance to antifungal agents tested.
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Affiliation(s)
- Ratna Mohd Tap
- Bacteriology Unit, Infectious Diseases Research Centre, Institute for Medical Research, 50588, Jalan Pahang, Kuala Lumpur, Malaysia.
| | - Nur Yasmin Ramli
- Bacteriology Unit, Infectious Diseases Research Centre, Institute for Medical Research, 50588, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Parameswari Sabaratnam
- Bacteriology Unit, Infectious Diseases Research Centre, Institute for Medical Research, 50588, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Rohaidah Hashim
- Bacteriology Unit, Infectious Diseases Research Centre, Institute for Medical Research, 50588, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Ahmed Rafezzan Ahmed Bakri
- Microbiology Unit, Pathology Department, Queen Elizabeth Hospital, 88200, Kota Kinabalu, Sabah, Malaysia
| | - Lim Bee Bee
- Microbiology Unit, Pathology Department, Sultanah Fatimah Specialist Hospital, 84000, Muar, Johor, Malaysia
| | - Stephanie Jane Ginsapu
- Bacteriology Unit, Infectious Diseases Research Centre, Institute for Medical Research, 50588, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Rahimah Ahmad
- Haematology Unit, Cancer Research Centre, Institute for Medical Research, Jalan Pahang, Kuala Lumpur, 50588, Malaysia
| | - Mohd Fuat Abd Razak
- Bacteriology Unit, Infectious Diseases Research Centre, Institute for Medical Research, 50588, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Norazah Ahmad
- Bacteriology Unit, Infectious Diseases Research Centre, Institute for Medical Research, 50588, Jalan Pahang, Kuala Lumpur, Malaysia
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61
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Gyarmati P, Kjellander C, Aust C, Song Y, Öhrmalm L, Giske CG. Metagenomic analysis of bloodstream infections in patients with acute leukemia and therapy-induced neutropenia. Sci Rep 2016; 6:23532. [PMID: 26996149 PMCID: PMC4800731 DOI: 10.1038/srep23532] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/08/2016] [Indexed: 01/05/2023] Open
Abstract
Leukemic patients are often immunocompromised due to underlying conditions, comorbidities and the effects of chemotherapy, and thus at risk for developing systemic infections. Bloodstream infection (BSI) is a severe complication in neutropenic patients, and is associated with increased mortality. BSI is routinely diagnosed with blood culture, which only detects culturable pathogens. We analyzed 27 blood samples from 9 patients with acute leukemia and suspected BSI at different time points of their antimicrobial treatment using shotgun metagenomics sequencing in order to detect unculturable and non-bacterial pathogens. Our findings confirm the presence of bacterial, fungal and viral pathogens alongside antimicrobial resistance genes. Decreased white blood cell (WBC) counts were associated with the presence of microbial DNA, and was inversely proportional to the number of sequencing reads. This study could indicate the use of high-throughput sequencing for personalized antimicrobial treatments in BSIs.
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Affiliation(s)
- P Gyarmati
- Karolinska Institutet, Department of Laboratory Medicine, Alfred Nobels Allé 8, Stockholm, 17177 Sweden.,Karolinska University Hospital, Department of Clinical Microbiology L2:02, Stockholm, 17176 Sweden
| | - C Kjellander
- Karolinska Institutet, Department of Medicine, Division of Hematology, Stockholm, 17176 Sweden
| | - C Aust
- Karolinska Institutet, Department of Medicine, Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska University Hospital, Stockholm, 17176 Sweden
| | - Y Song
- Royal Institute of Technology, Science for Life Laboratory, Stockholm, 17176 Sweden
| | - L Öhrmalm
- Karolinska Institutet, Department of Medicine, Solna, Infectious Diseases Unit, Center for Molecular Medicine, Karolinska University Hospital, Stockholm, 17176 Sweden
| | - C G Giske
- Karolinska Institutet, Department of Laboratory Medicine, Alfred Nobels Allé 8, Stockholm, 17177 Sweden.,Karolinska University Hospital, Department of Clinical Microbiology L2:02, Stockholm, 17176 Sweden
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62
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Ramakrishnan J, Rathore SS, Raman T. Review on fungal enzyme inhibitors – potential drug targets to manage human fungal infections. RSC Adv 2016. [DOI: 10.1039/c6ra01577h] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The potential applications of enzyme inhibitors for the management of invasive fungal infections are explored.
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Affiliation(s)
- Jayapradha Ramakrishnan
- Centre for Research in Infectious Diseases (CRID)
- School of Chemical and Biotechnology
- SASTRA University
- Thanjavur
- India-613401
| | - Sudarshan Singh Rathore
- Centre for Research in Infectious Diseases (CRID)
- School of Chemical and Biotechnology
- SASTRA University
- Thanjavur
- India-613401
| | - Thiagarajan Raman
- Centre for Research in Infectious Diseases (CRID)
- School of Chemical and Biotechnology
- SASTRA University
- Thanjavur
- India-613401
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63
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Eckert JC, Ertas B, Falk TM, Metze D, Böer-Auer A. Species identification of dermatophytes in paraffin-embedded biopsies with a new polymerase chain reaction assay targeting the internal transcribed spacer 2 region and comparison with histopathological features. Br J Dermatol 2015; 174:869-77. [PMID: 26556042 DOI: 10.1111/bjd.14281] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dermatophytosis is a very common skin infection with a broad clinical spectrum. Biopsies are often used to confirm the diagnosis, especially when the clinical presentation is unusual. Not uncommonly, organisms are hard to find even with periodic acid-Schiff stains. Polymerase chain reaction (PCR) for dermatophytes can be used in such cases. OBJECTIVES To test a new PCR assay allowing species identification of dermatophytes on paraffin-embedded biopsies, and to reassess histopathological criteria for diagnosis of dermatophytosis. METHODS In total, 121 biopsies of 92 patients with clinical suspicion of tinea were included. In 42 samples the clinical diagnosis had been confirmed histopathologically, and in 79 no fungal elements had been identified. PCRs targeting the internal transcribed spacer (ITS)2 region of dermatophytes were performed on the biopsies with subsequent sequencing. Sections were reassessed for the presence/absence of hyphae/spores, pattern and composition of infiltrate, and epidermal/follicular changes. Patient charts were reviewed for clinical data. RESULTS The new ITS2 PCR assay detected 94% of the dermatophyte infections (compared with 79% identified by microscopy). Trichophyton rubrum was the dominant species (89%), and other species identified were Trichophyton verrucosum (2%), Microsporum canis (4%), Epidermophyton floccosum (2%) and Trichophyton interdigitale (4%). In particular, infections with T. interdigitale and manifestations with prominent spongiosis were not diagnosed histologically. Intracorneal neutrophils, which have been emphasized as a histopathological clue to dermatophytosis, were present in only 46% of PCR-positive samples. CONCLUSIONS Molecular species identification of dermatophytes via ITS2 PCR can easily be implemented in a routine dermatopathology setting. It is fast and highly specific and improves the sensitivity of histopathological diagnosis of dermatophytosis.
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Affiliation(s)
- J C Eckert
- Dermatologikum Hamburg, Stephansplatz 5, 20354, Hamburg, Germany.,Department of Dermatology, Münster University, Von Esmarch Straße 58, 48149, Münster, Germany
| | - B Ertas
- Dermatologikum Hamburg, Stephansplatz 5, 20354, Hamburg, Germany
| | - T M Falk
- Dermatologikum Hamburg, Stephansplatz 5, 20354, Hamburg, Germany
| | - D Metze
- Department of Dermatology, Münster University, Von Esmarch Straße 58, 48149, Münster, Germany
| | - A Böer-Auer
- Dermatologikum Hamburg, Stephansplatz 5, 20354, Hamburg, Germany
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64
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Muhammed M, Arvanitis M, Mylonakis E. Whole animal HTS of small molecules for antifungal compounds. Expert Opin Drug Discov 2015; 11:177-84. [PMID: 26593386 DOI: 10.1517/17460441.2016.1122591] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The high morbidity and mortality among patients with invasive fungal infections and the growing problem of fungal resistance have resulted in an urgent need for new antifungal agents. AREAS COVERED This review covers the importance of antifungal drug discovery with an emphasis on whole-animal high-throughput techniques. More specifically, the authors focus on Caenorhabditis elegans, as a substitute model host and discuss C. elegans as an alternative model host for the study of microbial pathogenesis and the identification of novel antifungal compounds. EXPERT OPINION There are significant advantages from using the substitute model host C. elegans in high-throughput drug discovery. The C. elegans-microbe model provides a whole animal system where host-pathogen interactions can be studied along with the evaluation of antimicrobial efficacy of compounds. This approach allows the study of compound characteristics, such as toxicity and solubility, during the initial screen and compounds discovered using C. elegans are affective in mammalian models.
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Affiliation(s)
- Maged Muhammed
- a Division of Infectious Diseases , Rhode Island Hospital , Providence , RI , USA.,b Warren Alpert Medical School of Brown University , Providence , RI , USA
| | - Marios Arvanitis
- c Department of Medicine , Boston Medical Center, Boston University , Boston , MA , USA
| | - Eleftherios Mylonakis
- a Division of Infectious Diseases , Rhode Island Hospital , Providence , RI , USA.,b Warren Alpert Medical School of Brown University , Providence , RI , USA
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Mane A, Vidhate P, Kusro C, Waman V, Saxena V, Kulkarni-Kale U, Risbud A. Molecular mechanisms associated with Fluconazole resistance in clinical Candida albicans isolates from India. Mycoses 2015; 59:93-100. [PMID: 26648048 DOI: 10.1111/myc.12439] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 10/12/2015] [Accepted: 10/30/2015] [Indexed: 11/27/2022]
Abstract
Resistance to azole antifungals is a significant problem in Candida albicans. An understanding of resistance at molecular level is essential for the development of strategies to tackle resistance and rationale design of newer antifungals and target-based molecular approaches. This study presents the first evaluation of molecular mechanisms associated with fluconazole resistance in clinical C.albicans isolates from India. Target site (ERG11) alterations were determined by DNA sequencing, whereas real-time PCRs were performed to quantify target and efflux pump genes (CDR1, CDR2, MDR1) in 87 [Fluconazole susceptible (n = 30), susceptible-dose dependent (n = 30) and resistant (n = 27)] C.albicans isolates. Cross-resistance to fluconazole, ketoconazole and itraconazole was observed in 74.1% isolates. Six amino acid substitutions were identified, including 4 (E116D, F145L, E226D, I437V) previously reported ones and 2 (P406L, Q474H) new ones. CDR1 over-expression was seen in 77.7% resistant isolates. CDR2 was exclusively expressed with CDR1 and their concomitant over-expression was associated with azole cross-resistance. MDR1 and ERG11 over-expression did not seem to be associated with resistance. Our results show that drug efflux mediated by Adenosine-5'-triphosphate (ATP)-binding cassette transporters, especially CDR1 is the predominant mechanism of fluconazole resistance and azole cross-resistance in C. albicans and indicate the need for research directed towards developing strategies to tackle efflux mediated resistance to salvage azoles.
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Affiliation(s)
- Arati Mane
- National AIDS Research Institute, Pune, Maharashtra, India
| | | | - Chanchal Kusro
- National AIDS Research Institute, Pune, Maharashtra, India
| | - Vaishali Waman
- Savitribai Phule Pune University (Formerly University of Pune), Bioinformatics Centre, Pune, Maharashtra, India
| | - Vandana Saxena
- National AIDS Research Institute, Pune, Maharashtra, India
| | - Urmila Kulkarni-Kale
- Savitribai Phule Pune University (Formerly University of Pune), Bioinformatics Centre, Pune, Maharashtra, India
| | - Arun Risbud
- National AIDS Research Institute, Pune, Maharashtra, India
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Dubrovskaya Y, Tejada R, Bosco J, Stachel A, Chen D, Feng M, Rosenberg A, Phillips M. Single high dose gentamicin for perioperative prophylaxis in orthopedic surgery: Evaluation of nephrotoxicity. SAGE Open Med 2015; 3:2050312115612803. [PMID: 26770808 PMCID: PMC4679329 DOI: 10.1177/2050312115612803] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 09/17/2015] [Indexed: 11/16/2022] Open
Abstract
Background: Recent studies described an increase in acute kidney injury when high dose gentamicin was included in perioperative prophylaxis for orthopedic surgeries. To this effect, we compared the rate of nephrotoxicity for selected orthopedic surgeries where gentamicin was included (Gentamicin Group) to those where it was not included (Control Group) for perioperative prophylaxis and evaluated risk factors for nephrotoxicity. Methods: Spine, hip and knee surgeries performed between April 2011 and December 2013 were reviewed retrospectively. Gentamicin was given to eligible patients based on age, weight and Creatinine Clearance. Nephrotoxicity was assessed using Risk, Injury, Failure, Loss, End-stage kidney disease (RIFLE) criteria. Results: Among selected surgeries (N = 1590 in Gentamicin Group: hip = 926, spine = 600, knee = 64; N = 2587 in Control Group: hip = 980, spine = 902, knee = 705), patients’ body weight, serum creatinine, comorbidities and surgery duration were similar in Gentamicin Group and Control Group. Gentamicin median dose was 4.5 mg/kg of dosing weight. Nephrotoxicity rate was 2.5% in Gentamicin Group and 1.8% in Control Group, p = 0.17. Most cases of nephrotoxicity were Risk category by RIFLE criteria (67% in Gentamicin Group and 72% in Control Group, p = 0.49). In logistic regression, risk factors for nephrotoxicity were hospital stay >1 day prior to surgery (odds ratio = 8.1; 95% confidence interval = 2.25–28.97, p = 0.001), knee or hip surgery (odds ratio = 4.7; 95% confidence interval = 2.9–9.48, p = 0.0005) and diabetes (odds ratio = 1.95; 95% confidence interval = 1.13–3.35, p = 0.016). Receipt of gentamicin was not an independent predictor of nephrotoxicity (odds ratio = 1.5; 95% confidence interval = 0.97–2.35, p = 0.07). Conclusion: In this cohort, rate of nephrotoxicity was similar between Gentamicin Group and Control Group. Single high dose gentamicin is a safe and acceptable option for perioperative prophylaxis in eligible patients undergoing orthopedic surgeries.
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Affiliation(s)
| | - Rainer Tejada
- Department of Infection Prevention and Control, NYU Langone Medical Center, New York, NY, USA
| | - Joseph Bosco
- Department of Orthopedic Surgery, Hospital for Joint Diseases and Orthopedic Surgery, New York, NY, USA
| | - Anna Stachel
- Department of Infection Prevention and Control, NYU Langone Medical Center, New York, NY, USA
| | - Donald Chen
- Department of Infection Prevention and Control, NYU Langone Medical Center, New York, NY, USA
| | - Melinda Feng
- Department of Infection Prevention and Control, NYU Langone Medical Center, New York, NY, USA
| | - Andrew Rosenberg
- Department of Anesthesiology, Hospital for Joint Diseases and Orthopedic Surgery, New York, NY, USA
| | - Michael Phillips
- Department of Infection Prevention and Control, NYU Langone Medical Center, New York, NY, USA; Department of Infectious Diseases & Immunology, NYU Langone Medical Center, New York, NY, USA
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67
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Al-Shayyab MH, Abu-Hammad OA, Al-Omiri MK, Dar-Odeh NS. Antifungal prescribing pattern and attitude towards the treatment of oral candidiasis among dentists in Jordan. Int Dent J 2015; 65:216-26. [PMID: 26148537 DOI: 10.1111/idj.12173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
AIM The aim of this study was to evaluate the attitude of Jordanian dentists towards the treatment of oral candidiasis and their current antifungal prescribing habits, shedding more light on the possible influence of their socio-professional factors on the pattern of prescribing and practice. METHODS A structured validated questionnaire was developed and tested; it was then emailed to a random sample of 600 Jordanian dental practitioners during the period of this cross-sectional survey. The questionnaire recorded practitioners' personal details and their attitude and prescribing of antifungal therapy for oral candidiasis. Statistical significance was based on probability values of <0.05 and was measured using the chi-square and Fisher's exact tests. Multiple logistic regression analysis was used to analyse the influence of respondents' socio-professional factors on their attitude towards oral candidiasis. RESULTS Of the 423 questionnaires returned, only 330 were included. The attitude of respondents was significantly influenced by their experience [odds ratio (OR) = 0.14; P < 0.001] and workplace (OR = 4.70; P < 0.001). Nystatin was the most commonly prescribed antifungal agent (78.2%), followed by miconazole (62.4%), which was prescribed for topical use. Systemic antifungals were prescribed by 21.2% of respondents, with a significant (P < 0.05) association with the country in which their qualification was obtained. CONCLUSION The attitude towards the treatment of oral candidiasis is much better among the least-experienced dentists working in private practice. Nystatin and miconazole are the most popular choices of antifungal agents among Jordanian dentists.
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Affiliation(s)
- Mohammad H Al-Shayyab
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, Faculty of Dentistry, The University of Jordan, Amman, Jordan
| | - Osama A Abu-Hammad
- Department of Prosthodontics, Faculty of Dentistry, Taibah University, Al Madina Al Monawara, Saudi Arabia
| | - Mahmoud K Al-Omiri
- Department of Prosthodontics, Faculty of Dentistry, The University of Jordan, Amman, Jordan
| | - Najla S Dar-Odeh
- Department of Oral Medicine, Faculty of Dentistry, Taibah University, Al Madina Al Monawara, Saudi Arabia
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Shishido TK, Humisto A, Jokela J, Liu L, Wahlsten M, Tamrakar A, Fewer DP, Permi P, Andreote APD, Fiore MF, Sivonen K. Antifungal compounds from cyanobacteria. Mar Drugs 2015; 13:2124-40. [PMID: 25871291 PMCID: PMC4413203 DOI: 10.3390/md13042124] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 03/24/2015] [Accepted: 03/26/2015] [Indexed: 12/05/2022] Open
Abstract
Cyanobacteria are photosynthetic prokaryotes found in a range of environments. They are infamous for the production of toxins, as well as bioactive compounds, which exhibit anticancer, antimicrobial and protease inhibition activities. Cyanobacteria produce a broad range of antifungals belonging to structural classes, such as peptides, polyketides and alkaloids. Here, we tested cyanobacteria from a wide variety of environments for antifungal activity. The potent antifungal macrolide scytophycin was detected in Anabaena sp. HAN21/1, Anabaena cf. cylindrica PH133, Nostoc sp. HAN11/1 and Scytonema sp. HAN3/2. To our knowledge, this is the first description of Anabaena strains that produce scytophycins. We detected antifungal glycolipopeptide hassallidin production in Anabaena spp. BIR JV1 and HAN7/1 and in Nostoc spp. 6sf Calc and CENA 219. These strains were isolated from brackish and freshwater samples collected in Brazil, the Czech Republic and Finland. In addition, three cyanobacterial strains, Fischerella sp. CENA 298, Scytonema hofmanni PCC 7110 and Nostoc sp. N107.3, produced unidentified antifungal compounds that warrant further characterization. Interestingly, all of the strains shown to produce antifungal compounds in this study belong to Nostocales or Stigonematales cyanobacterial orders.
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Affiliation(s)
- Tânia K Shishido
- Department of Food and Environmental Sciences, Viikki Biocenter 1, University of Helsinki, FI-00014, Helsinki, Finland.
| | - Anu Humisto
- Department of Food and Environmental Sciences, Viikki Biocenter 1, University of Helsinki, FI-00014, Helsinki, Finland.
| | - Jouni Jokela
- Department of Food and Environmental Sciences, Viikki Biocenter 1, University of Helsinki, FI-00014, Helsinki, Finland.
| | - Liwei Liu
- Department of Food and Environmental Sciences, Viikki Biocenter 1, University of Helsinki, FI-00014, Helsinki, Finland.
| | - Matti Wahlsten
- Department of Food and Environmental Sciences, Viikki Biocenter 1, University of Helsinki, FI-00014, Helsinki, Finland.
| | - Anisha Tamrakar
- Department of Food and Environmental Sciences, Viikki Biocenter 1, University of Helsinki, FI-00014, Helsinki, Finland.
| | - David P Fewer
- Department of Food and Environmental Sciences, Viikki Biocenter 1, University of Helsinki, FI-00014, Helsinki, Finland.
| | - Perttu Permi
- Program in Structural Biology and Biophysics, Institute of Biotechnology/Nuclear Magnetic Resonance Laboratory, University of Helsinki, FI-00014, Helsinki, Finland.
| | - Ana P D Andreote
- Center for Nuclear Energy in Agriculture, University of São Paulo, Avenida Centenário 303, Piracicaba, 13400-970, São Paulo, Brazil.
| | - Marli F Fiore
- Center for Nuclear Energy in Agriculture, University of São Paulo, Avenida Centenário 303, Piracicaba, 13400-970, São Paulo, Brazil.
| | - Kaarina Sivonen
- Department of Food and Environmental Sciences, Viikki Biocenter 1, University of Helsinki, FI-00014, Helsinki, Finland.
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Synthesis and biological evaluation of fluconazole analogs with triazole-modified scaffold as potent antifungal agents. Bioorg Med Chem 2015; 23:1481-91. [DOI: 10.1016/j.bmc.2015.02.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Revised: 01/30/2015] [Accepted: 02/07/2015] [Indexed: 11/23/2022]
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Azole drug import into the pathogenic fungus Aspergillus fumigatus. Antimicrob Agents Chemother 2015; 59:3390-8. [PMID: 25824209 DOI: 10.1128/aac.05003-14] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 03/20/2015] [Indexed: 01/19/2023] Open
Abstract
The fungal pathogen Aspergillus fumigatus causes serious illness and often death when it invades tissues, especially in immunocompromised individuals. The azole class of drugs is the most commonly prescribed treatment for many fungal infections and acts on the ergosterol biosynthesis pathway. One common mechanism of acquired azole drug resistance in fungi is the prevention of drug accumulation to toxic levels in the cell. While drug efflux is a well-known resistance strategy, reduced azole import would be another strategy to maintain low intracellular azole levels. Recently, azole uptake in Candida albicans and other yeasts was analyzed using [(3)H]fluconazole. Defective drug import was suggested to be a potential mechanism of drug resistance in several pathogenic fungi, including Cryptococcus neoformans, Candida krusei, and Saccharomyces cerevisiae. We have adapted and developed an assay to measure azole accumulation in A. fumigatus using radioactively labeled azole drugs, based on previous work done with C. albicans. We used this assay to study the differences in azole uptake in A. fumigatus isolates under a variety of drug treatment conditions, with different morphologies and with a select mutant strain with deficiencies in the sterol uptake and biosynthesis pathway. We conclude that azole drugs are specifically selected and imported into the fungal cell by a pH- and ATP-independent facilitated diffusion mechanism, not by passive diffusion. This method of drug transport is likely to be conserved across most fungal species.
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Lohan S, Monga J, Chauhan CS, Bisht GS. In Vitro and In Vivo Evaluation of Small Cationic Abiotic Lipopeptides as Novel Antifungal Agents. Chem Biol Drug Des 2015; 86:829-36. [PMID: 25777475 DOI: 10.1111/cbdd.12558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 02/24/2015] [Accepted: 03/10/2015] [Indexed: 12/01/2022]
Abstract
We investigated the antifungal potential of short lipopeptides against clinical fungal isolates with an objective to evaluate their clinical feasibility. All tested lipopeptides exhibit good antifungal activity with negligible difference between the MICs against susceptible and drug-resistant clinical fungal isolates. The MTT assay results revealed the lower cytotoxicity of lipopeptides toward mammalian cells (NRK-52E). In particular, LP24 displayed highest potency against most of the tested fungal isolates with MICs in the range of 1.5-4.5 μg/mL. Calcein dye leakage experiments with model membrane suggested the membrane-active mode of action for LP24. Extending our work from model membranes to intact Aspergillus fumigatus in scanning electron micrographs, we could visualize surface perturbation caused by LP24. LP24 (5 mg/kg) significantly reduces the A. fumigatus burden among the various organs of infected animals, and 70% of the infected mice survived when observed for 28 days. This study underscores the potential of small cationic abiotic lipopeptides to develop into the next-generation antimicrobial therapy.
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Affiliation(s)
- Sandeep Lohan
- Department of Pharmacy, Jaypee University of Information Technology, Solan, 173234, India
| | - Jitender Monga
- Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Chetan Singh Chauhan
- Department of Pharmacy, Bhupal Noble College of Pharmacy, Udaipur, Rajasthan, 313002, India
| | - Gopal Singh Bisht
- Department of Pharmacy, Jaypee University of Information Technology, Solan, 173234, India.,Department of Biotechnology and Bioinformatics, Jaypee University of Information Technology, Solan, 173234, India
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Li Y, Chang W, Zhang M, Li X, Jiao Y, Lou H. Synergistic and drug-resistant reversing effects of diorcinol D combined with fluconazole against Candida albicans. FEMS Yeast Res 2015; 15:fov001. [DOI: 10.1093/femsyr/fov001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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73
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Eidi S, Azadi HG, Rahbar N, Mehmannavaz HR. Evaluation of antifungal activity of hydroalcoholic extracts of Citrullus colocynthis fruit. J Herb Med 2015. [DOI: 10.1016/j.hermed.2015.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Apisarnthanarak A, Yatrasert A, Mundy LM. Impact of Education and an Antifungal Stewardship Program for Candidiasis at a Thai Tertiary Care Center. Infect Control Hosp Epidemiol 2015; 31:722-7. [DOI: 10.1086/653616] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background.We evaluated the impact of education and an antifungal stewardship program for candidiasis on prescribing practices, antifungal consumption, Candida species infections, and estimated costs at a Thai tertiary care hospital.Methods.A hospital-wide, quasi-experimental study was conducted for 1.5 years before the intervention and 1.5 years after the implementation of an antifungal stewardship program. Inpatient antifungal prescriptions were prospectively observed, and patients' demographic, clinical, and administrative-cost data were collected. Interventions included education, introduction of an antifungal hepatic and/or renal dose adjustment tool, antifungal prescription forms, and prescription-control strategies.Results.After the intervention, there was a 59% reduction in antifungal prescriptions (from 194 to 80 prescriptions per 1,000 hospitalizations; P < .001). Inappropriate antifungal use decreased (from 71% to 24%; P < .001), a sustained reduction in antifungal use was observed (r = 0.83; P < .001), and fluconazole use decreased (from 242 to 117 defined daily doses per 1,000 patient-days; P < .001). Reductions in the incidence of infection with Candida glabrata (r = 0.69; P < .001) and Candida krusei (r = 0.71; P < .001) were observed, whereas the incidence of infection with Candida albicans (r = —0.81; P < .001) increased. Total cost savings were US$31,615 during the 18-month postintervention period.Conclusions.Implementation of an antifungal stewardship program was associated with appropriate antifungal drug use, improved resource utilization, and cost savings.
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Sutepvarnon A, Apisarnthanarak A, Camins B, Mondy K, Fraser VJ. Inappropriate Use of Antifungal Medications in a Tertiary Care Center in Thailand: A Prospective Study. Infect Control Hosp Epidemiol 2015; 29:370-3. [DOI: 10.1086/587633] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The incidence and factors associated with inappropriate use of antifungal medications were studied in a Thai tertiary care center. The incidence of inappropriate antifungal use was 74% (in 42 of 57 patients). Isolation of Candida species from urine (P = .004) was a risk factor, whereas receipt of an infectious diseases consultation (P = .004) was protective.
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Gaurav C, Nikhil G, Deepti S, Kalra S, Goutam R, Amit GK. Albumin stabilized silver nanoparticles–clotrimazole β-cyclodextrin hybrid nanocomposite for enriched anti-fungal activity in normal and drug resistant Candida cells. RSC Adv 2015. [DOI: 10.1039/c5ra08274a] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Nanohybrid based strategy to counter the problem of drug resistance inCandidacells.
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Affiliation(s)
- Chauhan Gaurav
- DBT Lab
- Department of Pharmaceutics
- Indo-Soviet Friendship College of Pharmacy
- Moga
- India
| | - Gupta Nikhil
- DBT Lab
- Department of Pharmaceutics
- Indo-Soviet Friendship College of Pharmacy
- Moga
- India
| | - Sehrawat Deepti
- DBT Lab
- Department of Pharmaceutics
- Indo-Soviet Friendship College of Pharmacy
- Moga
- India
| | - Sourav Kalra
- Bioinformatics Centre
- CSIR-Institute of Microbial Technology
- Chandigarh
- India
| | - Rath Goutam
- DBT Lab
- Department of Pharmaceutics
- Indo-Soviet Friendship College of Pharmacy
- Moga
- India
| | - Goyal K. Amit
- DBT Lab
- Department of Pharmaceutics
- Indo-Soviet Friendship College of Pharmacy
- Moga
- India
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Medina Marrero R, Marrero-Ponce Y, Barigye SJ, Echeverría Díaz Y, Acevedo-Barrios R, Casañola-Martín GM, García Bernal M, Torrens F, Pérez-Giménez F. QuBiLs-MAS method in early drug discovery and rational drug identification of antifungal agents. SAR AND QSAR IN ENVIRONMENTAL RESEARCH 2015; 26:943-58. [PMID: 26567876 DOI: 10.1080/1062936x.2015.1104517] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The QuBiLs-MAS approach is used for the in silico modelling of the antifungal activity of organic molecules. To this effect, non-stochastic (NS) and simple-stochastic (SS) atom-based quadratic indices are used to codify chemical information for a comprehensive dataset of 2478 compounds having a great structural variability, with 1087 of them being antifungal agents, covering the broadest antifungal mechanisms of action known so far. The NS and SS index-based antifungal activity classification models obtained using linear discriminant analysis (LDA) yield correct classification percentages of 90.73% and 92.47%, respectively, for the training set. Additionally, these models are able to correctly classify 92.16% and 87.56% of 706 compounds in an external test set. A comparison of the statistical parameters of the QuBiLs-MAS LDA-based models with those for models reported in the literature reveals comparable to superior performance, although the latter were built over much smaller and less diverse datasets, representing fewer mechanisms of action. It may therefore be inferred that the QuBiLs-MAS method constitutes a valuable tool useful in the design and/or selection of new and broad spectrum agents against life-threatening fungal infections.
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Affiliation(s)
- R Medina Marrero
- a Computer-Aided Molecular 'Biosilico' Discovery and Bioinformatic Research International Network (CAMD-BIR-IN) , Cartagena de Indias , Bolivar , Colombia
- b Department of Microbiology , Chemical Bioactive Center, Central University of Las Villas , Villa Clara , Cuba
| | - Y Marrero-Ponce
- a Computer-Aided Molecular 'Biosilico' Discovery and Bioinformatic Research International Network (CAMD-BIR-IN) , Cartagena de Indias , Bolivar , Colombia
- c Grupo de Investigación en Estudios Químicos y Biológicos, Facultad de Ciencias Básicas , Universidad Tecnológica de Bolívar , Cartagena de Indias , Bolívar , Colombia
- d Unidad de Investigación de Diseño de Fármacos y Conectividad Molecular, Departamento de Química Física, Facultad de Farmacia , Universitat de València , Valencia , Spain
- h Grupo de Investigación Microbiología y Ambiente (GIMA) . Programa de Bacteriología, Facultad Ciencias de la Salud, Universidad de San Buenaventura , Calle Real de Ternera, 130010, Cartagena (Bolivar) , Colombia
| | - S J Barigye
- a Computer-Aided Molecular 'Biosilico' Discovery and Bioinformatic Research International Network (CAMD-BIR-IN) , Cartagena de Indias , Bolivar , Colombia
- e Departamento de Química , Universidade Federal de Lavras , Lavras , MG , Brazil
| | - Y Echeverría Díaz
- a Computer-Aided Molecular 'Biosilico' Discovery and Bioinformatic Research International Network (CAMD-BIR-IN) , Cartagena de Indias , Bolivar , Colombia
| | - R Acevedo-Barrios
- c Grupo de Investigación en Estudios Químicos y Biológicos, Facultad de Ciencias Básicas , Universidad Tecnológica de Bolívar , Cartagena de Indias , Bolívar , Colombia
| | - G M Casañola-Martín
- a Computer-Aided Molecular 'Biosilico' Discovery and Bioinformatic Research International Network (CAMD-BIR-IN) , Cartagena de Indias , Bolivar , Colombia
- d Unidad de Investigación de Diseño de Fármacos y Conectividad Molecular, Departamento de Química Física, Facultad de Farmacia , Universitat de València , Valencia , Spain
- f Facultad de Ingeniería Ambiental , Universidad Estatal Amazónica , Puyo , Ecuador
| | - M García Bernal
- b Department of Microbiology , Chemical Bioactive Center, Central University of Las Villas , Villa Clara , Cuba
| | - F Torrens
- g Institut Universitari de Ciència Molecular, Universitat de València , Valencia , Spain
| | - F Pérez-Giménez
- d Unidad de Investigación de Diseño de Fármacos y Conectividad Molecular, Departamento de Química Física, Facultad de Farmacia , Universitat de València , Valencia , Spain
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Lee W, Lee DG. An antifungal mechanism of curcumin lies in membrane-targeted action withinCandida albicans. IUBMB Life 2014; 66:780-5. [DOI: 10.1002/iub.1326] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 10/22/2014] [Indexed: 01/04/2023]
Affiliation(s)
- Wonyoung Lee
- School of Life Sciences, BK21 Plus KNU Creative BioResearch Group, College of Natural Sciences, Kyungpook National University; Buk-Gu Daegu Republic of Korea
| | - Dong Gun Lee
- School of Life Sciences, BK21 Plus KNU Creative BioResearch Group, College of Natural Sciences, Kyungpook National University; Buk-Gu Daegu Republic of Korea
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79
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Novel triazole alcohol antifungals derived from fluconazole: design, synthesis, and biological activity. Mol Divers 2014; 19:15-27. [DOI: 10.1007/s11030-014-9548-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 08/13/2014] [Indexed: 10/24/2022]
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80
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Moraca F, De Vita D, Pandolfi F, Di Santo R, Costi R, Cirilli R, D’Auria FD, Panella S, Palamara AT, Simonetti G, Botta M, Scipione L. Synthesis, biological evaluation and structure–activity correlation study of a series of imidazol-based compounds as Candida albicans inhibitors. Eur J Med Chem 2014; 83:665-73. [DOI: 10.1016/j.ejmech.2014.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 06/25/2014] [Accepted: 07/01/2014] [Indexed: 11/29/2022]
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81
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Kasanah N, Farr LL, Gholipour A, Wedge DE, Hamann MT. Metabolism and resistance of Fusarium spp. to the manzamine alkaloids via a putative retro pictet-spengler reaction and utility of the rational design of antimalarial and antifungal agents. MARINE BIOTECHNOLOGY (NEW YORK, N.Y.) 2014; 16:412-422. [PMID: 24553735 PMCID: PMC4139108 DOI: 10.1007/s10126-014-9557-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Accepted: 10/14/2013] [Indexed: 06/03/2023]
Abstract
As a part of our continuing investigation of the manzamine alkaloids we studied the in vitro activity of the β-carboline containing manzamine alkaloids against Fusarium solani, Fusarium oxysporium, and Fusarium proliferatum by employing several bioassay techniques including one-dimensional direct bioautography, dilution, and plate susceptibility, and microtiter broth assays. In addition, we also studied the metabolism of the manzamine alkaloids by Fusarium spp. in order to facilitate the redesign of the compounds to prevent resistance of Fusarium spp. through metabolism. The present research reveals that the manzamine alkaloids are inactive against Fusarium spp. and the fungi transform manzamines via hydrolysis, reduction, and a retro Pictet-Spengler reaction. This is the first report to demonstrate an enzymatically retro Pictet-Spengler reaction. The results of this study reveal the utility of the rational design of metabolically stable antifungal agents from this class and the development of manzamine alkaloids as antimalarial drugs through the utilization of Fusarium's metabolic products to reconstruct the molecule.
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Affiliation(s)
- Noer Kasanah
- Department of Pharmacognosy, School of Pharmacy, The University of Mississippi, Oxford, MS, USA,
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82
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Multidrug resistance: an emerging crisis. Interdiscip Perspect Infect Dis 2014; 2014:541340. [PMID: 25140175 PMCID: PMC4124702 DOI: 10.1155/2014/541340] [Citation(s) in RCA: 279] [Impact Index Per Article: 27.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 07/03/2014] [Indexed: 01/15/2023] Open
Abstract
The resistance among various microbial species (infectious agents) to different antimicrobial drugs has emerged as a cause of public health threat all over the world at a terrifying rate. Due to the pacing advent of new resistance mechanisms and decrease in efficiency of treating common infectious diseases, it results in failure of microbial response to standard treatment, leading to prolonged illness, higher expenditures for health care, and an immense risk of death. Almost all the capable infecting agents (e.g., bacteria, fungi, virus, and parasite) have employed high levels of multidrug resistance (MDR) with enhanced morbidity and mortality; thus, they are referred to as “super bugs.” Although the development of MDR is a natural phenomenon, the inappropriate use of antimicrobial drugs, inadequate sanitary conditions, inappropriate food-handling, and poor infection prevention and control practices contribute to emergence of and encourage the further spread of MDR. Considering the significance of MDR, this paper, emphasizes the problems associated with MDR and the need to understand its significance and mechanisms to combat microbial infections.
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83
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Mahindra A, Bagra N, Wangoo N, Khan SI, Jacob MR, Jain R. Discovery of Short Peptides Exhibiting High Potency against Cryptococcus neoformans. ACS Med Chem Lett 2014; 5:315-20. [PMID: 24900833 DOI: 10.1021/ml500011v] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 01/15/2014] [Indexed: 01/06/2023] Open
Abstract
Rapid increase in the emergence of resistance against existing antifungal drugs created a need to discover new structural classes of antifungal agents. In this study we describe the synthesis of a new structural class of short antifungal peptidomimetcis, their activity, and plausible mechanism of action. The results of the study show that peptides 11e and 11f are more potent than the control drug amphotericin B, with no cytotoxicity to human cancer cells and noncancerous mammalian kidney cells. The selectivity of peptides to fungus is depicted by transmission electron microscopy studies, and it revealed that 11e possibly disrupts the model membrane of the fungal pathogen.
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Affiliation(s)
- Amit Mahindra
- Department
of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research, Sector 67, S. A. S. Nagar, Punjab 160 062, India
| | - Nitin Bagra
- Department
of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research, Sector 67, S. A. S. Nagar, Punjab 160 062, India
| | - Nishima Wangoo
- Center
for Nanoscience and Nanotechnology, Panjab University, Sector 14, Chandigarh 160 014, India
| | - Shabana I. Khan
- National
Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, Mississippi 38677, United States
| | - Melissa R. Jacob
- National
Center for Natural Products Research, School of Pharmacy, The University of Mississippi, University, Mississippi 38677, United States
| | - Rahul Jain
- Department
of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research, Sector 67, S. A. S. Nagar, Punjab 160 062, India
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84
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Darvishi E, Omidi M, Bushehri AAS, Golshani A, Smith ML. The antifungal eugenol perturbs dual aromatic and branched-chain amino acid permeases in the cytoplasmic membrane of yeast. PLoS One 2013; 8:e76028. [PMID: 24204588 PMCID: PMC3799837 DOI: 10.1371/journal.pone.0076028] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 08/23/2013] [Indexed: 12/13/2022] Open
Abstract
Eugenol is an aromatic component of clove oil that has therapeutic potential as an antifungal drug, although its mode of action and precise cellular target(s) remain ambiguous. To address this knowledge gap, a chemical-genetic profile analysis of eugenol was done using ∼4700 haploid Saccharomyces cerevisiae gene deletion mutants to reveal 21 deletion mutants with the greatest degree of susceptibility. Cellular roles of deleted genes in the most susceptible mutants indicate that the main targets for eugenol include pathways involved in biosynthesis and transport of aromatic and branched-chain amino acids. Follow-up analyses showed inhibitory effects of eugenol on amino acid permeases in the yeast cytoplasmic membrane. Furthermore, phenotypic suppression analysis revealed that eugenol interferes with two permeases, Tat1p and Gap1p, which are both involved in dual transport of aromatic and branched-chain amino acids through the yeast cytoplasmic membrane. Perturbation of cytoplasmic permeases represents a novel antifungal target and may explain previous observations that exposure to eugenol results in leakage of cell contents. Eugenol exposure may also contribute to amino acid starvation and thus holds promise as an anticancer therapeutic drug. Finally, this study provides further evidence of the usefulness of the yeast Gene Deletion Array approach in uncovering the mode of action of natural health products.
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Affiliation(s)
- Emad Darvishi
- Department of Agronomy and Plant Breeding, University of Tehran, Karaj, Iran
- Biology Department, Carleton University, Ottawa, Ontario, Canada
| | - Mansoor Omidi
- Department of Agronomy and Plant Breeding, University of Tehran, Karaj, Iran
| | | | - Ashkan Golshani
- Biology Department, Carleton University, Ottawa, Ontario, Canada
- * E-mail: (AG); (MLS)
| | - Myron L. Smith
- Biology Department, Carleton University, Ottawa, Ontario, Canada
- * E-mail: (AG); (MLS)
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85
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Flevari A, Theodorakopoulou M, Velegraki A, Armaganidis A, Dimopoulos G. Treatment of invasive candidiasis in the elderly: a review. Clin Interv Aging 2013; 8:1199-208. [PMID: 24043935 PMCID: PMC3772869 DOI: 10.2147/cia.s39120] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Fungi are major causes of infections among immunocompromised or hospitalized patients with serious underlying diseases and comorbidities. Candida species remain the most important cause of opportunistic infections worldwide, affecting predominantly patients over 65 years old, while they are considered to be the fourth most common cause of nosocomial bloodstream infections. The rapidly growing elderly population has specific physiological characteristics, which makes it susceptible to colonization and subsequent infection due to Candida species. Comorbidities and multidrug use should be taken into account any time the therapeutic regimen is under consideration. Different classes of antifungal drugs are available for the treatment of invasive fungal infections but echinocandins, apart from their activity against resistant strains (Candida glabrata and Candida krusei), seem to be safe, with limited adverse events and minimal drug-drug interactions in comparison to the other regimens. Therefore, these agents are strongly recommended when dealing with elderly patients suffering from an invasive form of Candida infection.
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Affiliation(s)
- Aikaterini Flevari
- Department of Critical Care, University Hospital Attikon, Medical School, Athens, Greece
| | - Maria Theodorakopoulou
- Department of Critical Care, University Hospital Attikon, Medical School, Athens, Greece
| | - Aristea Velegraki
- Mycology Laboratory, Department of Microbiology, Medical School, University of Athens, Athens, Greece
| | - Apostolos Armaganidis
- Department of Critical Care, University Hospital Attikon, Medical School, Athens, Greece
| | - George Dimopoulos
- Department of Critical Care, University Hospital Attikon, Medical School, Athens, Greece
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86
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Furman C, Mehla J, Ananthaswamy N, Arya N, Kulesh B, Kovach I, Ambudkar SV, Golin J. The deviant ATP-binding site of the multidrug efflux pump Pdr5 plays an active role in the transport cycle. J Biol Chem 2013; 288:30420-30431. [PMID: 24019526 DOI: 10.1074/jbc.m113.494682] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Pdr5 is the founding member of a large subfamily of evolutionarily distinct, clinically important fungal ABC transporters containing a characteristic, deviant ATP-binding site with altered Walker A, Walker B, Signature (C-loop), and Q-loop residues. In contrast to these motifs, the D-loops of the two ATP-binding sites have similar sequences, including a completely conserved aspartate residue. Alanine substitution mutants in the deviant Walker A and Signature motifs retain significant, albeit reduced, ATPase activity and drug resistance. The D-loop residue mutants D340A and D1042A showed a striking reduction in plasma membrane transporter levels. The D1042N mutation localized properly had nearly WT ATPase activity but was defective in transport and was profoundly hypersensitive to Pdr5 substrates. Therefore, there was a strong uncoupling of ATPase activity and drug efflux. Taken together, the properties of the mutants suggest an additional, critical intradomain signaling role for deviant ATP-binding sites.
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Affiliation(s)
| | | | | | | | | | | | - Suresh V Ambudkar
- Laboratory of Cell Biology, Center for Cancer Research, NCI, National Institutes of Health, Bethesda, Maryland 20892; Chemistry, Catholic University of America, Washington, D. C. 20064
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87
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Balhara M, Ruhil S, kumar M, Dhankhar S, Chhillar AK. An anti-Aspergillusprotein fromEscherichia coliDH5α: Putative inhibitor of siderophore biosynthesis inAspergillus fumigatus. Mycoses 2013; 57:153-62. [DOI: 10.1111/myc.12119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 07/18/2013] [Accepted: 07/18/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Meenakshi Balhara
- Centre for Biotechnology; Maharshi Dayanand University; Rohtak Haryana India
| | - Sonam Ruhil
- Centre for Biotechnology; Maharshi Dayanand University; Rohtak Haryana India
| | - Manish kumar
- Centre for Biotechnology; Maharshi Dayanand University; Rohtak Haryana India
| | - Sandeep Dhankhar
- Centre for Biotechnology; Maharshi Dayanand University; Rohtak Haryana India
| | - A. K. Chhillar
- Centre for Biotechnology; Maharshi Dayanand University; Rohtak Haryana India
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88
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Chromosome 5 monosomy of Candida albicans controls susceptibility to various toxic agents, including major antifungals. Antimicrob Agents Chemother 2013; 57:5026-36. [PMID: 23896475 DOI: 10.1128/aac.00516-13] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Candida albicans is a prevailing fungal pathogen with a diploid genome that can adapt to environmental stresses by losing or gaining an entire chromosome or a large portion of a chromosome. We have previously found that the loss of one copy of chromosome 5 (Ch5) allows for adaptation to the toxic sugar l-sorbose. l-Sorbose is similar to caspofungin and other antifungals from the echinocandins class, in that it represses synthesis of cell wall glucan in fungi. Here, we extended the study of the phenotypes controlled by Ch5 copy number. We examined 57 strains, either disomic or monosomic for Ch5 and representing five different genetic backgrounds, and found that the monosomy of Ch5 causes elevated levels of chitin and repressed levels of 1,3-β-glucan components of the cell wall, as well as diminished cellular ergosterol. Increased deposition of chitin in the cell wall could be explained, at least partially, by a 2-fold downregulation of CHT2 on the monosomic Ch5 that encodes chitinase and a 1.5-fold upregulation of CHS7 on Ch1 that encodes the protein required for wild-type chitin synthase III activity. Other important outcomes of Ch5 monosomy consist of susceptibility changes to agents representing four major classes of antifungals. Susceptibility to caspofungin increased or decreased and susceptibility to 5-fluorocytosine decreased, whereas susceptibility to fluconazole and amphotericin B increased. Our results suggest that Ch5 monosomy represents an unrecognized C. albicans regulatory strategy that impinges on multiple stress response pathways.
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89
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Darvishi E, Omidi M, Bushehri AA, Golshani A, Smith ML. Thymol antifungal mode of action involves telomerase inhibition. Med Mycol 2013; 51:826-34. [PMID: 23718894 DOI: 10.3109/13693786.2013.795664] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The antifungal mode of action of thymol was investigated by a chemical-genetic profile analysis. Growth of each of ~4700 haploid Saccharomyces cerevisiae gene deletion mutants was monitored on medium with a subinhibitory concentration (50 μg/ml) of thymol and compared to growth on non-thymol control medium. This analysis revealed that, of the 76 deletion mutants with the greatest degree of susceptibility to thymol, 29% had deletions in genes involved in telomere length maintenance. A telomere restriction fragment (TRF) length assay showed that yeast exposed to a subinhibitory concentration of thymol for 15 days had telomere size reductions of 13-20% compared to non-thymol controls. By accelerating telomere shortening, thymol may increase the rate of cell senescence and apoptosis. Furthermore, real-time RT-PCR analysis revealed approximately two-fold reductions in EST2 mRNA but no change in TLC1 RNA in thymol-treated S. cerevisiae relative to untreated cells. EST2 encodes the essential reverse transcriptase subunit of telomerase that uses TLC1 RNA as a template during addition of TG(1-3) repeats to maintain telomere ends. This study provides compelling evidence that a primary mode of thymol antifungal activity is through inhibition of transcription of EST2 and thus telomerase activity.
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Affiliation(s)
- Emad Darvishi
- * Department of Agronomy and Plant Breeding, College of Agriculture, University of Tehran , Karaj , Iran
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90
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Abstract
The incidence of invasive fungal infections (IFIs) has seen a marked increase in the last two decades. This is especially evident among transplant recipients, patients suffering from AIDS, in addition to those in receipt of immunosuppressive therapy. Worryingly, this increased incidence includes infections caused by opportunistic fungi and emerging fungal infections which are resistant to or certainly less susceptible than others to standard antifungal agents. As a direct response to this phenomenon, there has been a resolute effort over the past several decades to improve early and accurate diagnosis and provide reliable screening protocols thereby promoting the administration of appropriate antifungal therapy for fungal infections. Early diagnosis and treatment with antifungal therapy are vital if a patient is to survive an IFI. Substantial advancements have been made with regard to both the diagnosis and subsequent treatment of an IFI. In parallel, stark changes in the epidemiological profile of these IFIs have similarly occurred, often in direct response the type of antifungal agent being administered. The effects of an IFI can be far reaching, ranging from increased morbidity and mortality to increased length hospital stays and economic burden.
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Affiliation(s)
- Nina L Tuite
- Molecular Diagnostics Research Group, National University of Ireland, Galway, Ireland.
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91
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Choi H, Cho J, Jin Q, Woo ER, Lee DG. Antifungal property of dihydrodehydrodiconiferyl alcohol 9′-O-β-d-glucoside and its pore-forming action in plasma membrane of Candida albicans. BIOCHIMICA ET BIOPHYSICA ACTA-BIOMEMBRANES 2012; 1818:1648-55. [DOI: 10.1016/j.bbamem.2012.02.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Revised: 02/10/2012] [Accepted: 02/22/2012] [Indexed: 11/29/2022]
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92
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Brilhante RSN, Fechine MAB, Mesquita JRL, Cordeiro RA, Rocha MFG, Monteiro AJ, Lima RAC, Caetano ÉP, Pereira JF, Castelo-Branco DSCM, Camargo ZP, Sidrim JJC. Histoplasmosis in HIV-positive patients in Ceará, Brazil: clinical-laboratory aspects and in vitro antifungal susceptibility of Histoplasma capsulatum isolates. Trans R Soc Trop Med Hyg 2012; 106:484-8. [PMID: 22703696 DOI: 10.1016/j.trstmh.2012.05.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 05/15/2012] [Accepted: 05/15/2012] [Indexed: 11/28/2022] Open
Abstract
This study contains a descriptive analysis of histoplasmosis in AIDS patients between 2006 and 2010 in the state of Ceará, Brazil. Additionally, the in vitro susceptibility of Histoplasma capsulatum isolates obtained during this period was assessed. We report 208 cases of patients with histoplasmosis and AIDS, describing the epidemiological, clinical, laboratory and therapeutic aspects. The in vitro antifungal susceptibility test was carried out by the microdilution method, according to Clinical and Laboratory Standards Institute, with H. capsulatum in the filamentous and yeast phases, against the antifungals amphotericin B, fluconazole, itraconazole, voriconazole and caspofungin. In 38.9% of the cases, histoplasmosis was the first indicator of AIDS and in 85.8% of the patients the CD4 cell count was lower than 100 cells/mm(3). The lactate dehydrogenase levels were high in all the patients evaluated, with impairment of hepatic and renal function and evolution to death in 42.3% of the cases. The in vitro susceptibility profile demonstrated there was no antifungal resistance among the isolates evaluated. There was a significant increase in the number of histoplasmosis cases in HIV-positive patients during the period surveyed in the state of Ceará, northeastern Brazil, but no antifungal resistance among the recovered isolates of H. capsulatum.
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Affiliation(s)
- Raimunda S N Brilhante
- Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.
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93
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O’Hanlon KA, Margison GP, Hatch A, Fitzpatrick DA, Owens RA, Doyle S, Jones GW. Molecular characterization of an adaptive response to alkylating agents in the opportunistic pathogen Aspergillus fumigatus. Nucleic Acids Res 2012; 40:7806-20. [PMID: 22669901 PMCID: PMC3439912 DOI: 10.1093/nar/gks522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
An adaptive response to alkylating agents based upon the conformational change of a methylphosphotriester (MPT) DNA repair protein to a transcriptional activator has been demonstrated in a number of bacterial species, but this mechanism appears largely absent from eukaryotes. Here, we demonstrate that the human pathogen Aspergillus fumigatus elicits an adaptive response to sub-lethal doses of the mono-functional alkylating agent N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). We have identified genes that encode MPT and O(6)-alkylguanine DNA alkyltransferase (AGT) DNA repair proteins; deletions of either of these genes abolish the adaptive response and sensitize the organism to MNNG. In vitro DNA repair assays confirm the ability of MPT and AGT to repair methylphosphotriester and O(6)-methylguanine lesions respectively. In eukaryotes, the MPT protein is confined to a select group of fungal species, some of which are major mammalian and plant pathogens. The evolutionary origin of the adaptive response is bacterial and rooted within the Firmicutes phylum. Inter-kingdom horizontal gene transfer between Firmicutes and Ascomycete ancestors introduced the adaptive response into the Fungal kingdom. Our data constitute the first detailed characterization of the molecular mechanism of the adaptive response in a lower eukaryote and has applications for development of novel fungal therapeutics targeting this DNA repair system.
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Affiliation(s)
- Karen A. O’Hanlon
- Biotechnology Laboratory, Department of Biology, National University of Ireland, Maynooth, County Kildare, Ireland, Cancer Research-UK Carcinogenesis Group, Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK, Genome Evolution Laboratory and Yeast Genetics Laboratory, Department of Biology, National University of Ireland Maynooth, Maynooth, County Kildare, Ireland
| | - Geoffrey P. Margison
- Biotechnology Laboratory, Department of Biology, National University of Ireland, Maynooth, County Kildare, Ireland, Cancer Research-UK Carcinogenesis Group, Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK, Genome Evolution Laboratory and Yeast Genetics Laboratory, Department of Biology, National University of Ireland Maynooth, Maynooth, County Kildare, Ireland
| | - Amy Hatch
- Biotechnology Laboratory, Department of Biology, National University of Ireland, Maynooth, County Kildare, Ireland, Cancer Research-UK Carcinogenesis Group, Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK, Genome Evolution Laboratory and Yeast Genetics Laboratory, Department of Biology, National University of Ireland Maynooth, Maynooth, County Kildare, Ireland
| | - David A. Fitzpatrick
- Biotechnology Laboratory, Department of Biology, National University of Ireland, Maynooth, County Kildare, Ireland, Cancer Research-UK Carcinogenesis Group, Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK, Genome Evolution Laboratory and Yeast Genetics Laboratory, Department of Biology, National University of Ireland Maynooth, Maynooth, County Kildare, Ireland
| | - Rebecca A. Owens
- Biotechnology Laboratory, Department of Biology, National University of Ireland, Maynooth, County Kildare, Ireland, Cancer Research-UK Carcinogenesis Group, Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK, Genome Evolution Laboratory and Yeast Genetics Laboratory, Department of Biology, National University of Ireland Maynooth, Maynooth, County Kildare, Ireland
| | - Sean Doyle
- Biotechnology Laboratory, Department of Biology, National University of Ireland, Maynooth, County Kildare, Ireland, Cancer Research-UK Carcinogenesis Group, Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK, Genome Evolution Laboratory and Yeast Genetics Laboratory, Department of Biology, National University of Ireland Maynooth, Maynooth, County Kildare, Ireland
| | - Gary W. Jones
- Biotechnology Laboratory, Department of Biology, National University of Ireland, Maynooth, County Kildare, Ireland, Cancer Research-UK Carcinogenesis Group, Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK, Genome Evolution Laboratory and Yeast Genetics Laboratory, Department of Biology, National University of Ireland Maynooth, Maynooth, County Kildare, Ireland
- *To whom correspondence should be addressed. Tel: +353 1 708 3839; Fax: +353 1 708 3845;
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94
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Campbell BC, Chan KL, Kim JH. Chemosensitization as a means to augment commercial antifungal agents. Front Microbiol 2012; 3:79. [PMID: 22393330 PMCID: PMC3289909 DOI: 10.3389/fmicb.2012.00079] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2011] [Accepted: 02/15/2012] [Indexed: 11/13/2022] Open
Abstract
Antimycotic chemosensitization and its mode of action are of growing interest. Currently, use of antifungal agents in agriculture and medicine has a number of obstacles. Foremost of these is development of resistance or cross-resistance to one or more antifungal agents. The generally high expense and negative impact, or side effects, associated with antifungal agents are two further issues of concern. Collectively, these problems are exacerbated by efforts to control resistant strains, which can evolve into a treadmill of higher dosages for longer periods. This cycle in turn, inflates cost of treatment, dramatically. A further problem is stagnation in development of new and effective antifungal agents, especially for treatment of human mycoses. Efforts to overcome some of these issues have involved using combinations of available antimycotics (e.g., combination therapy for invasive mycoses). However, this approach has had inconsistent success and is often associated with a marked increase in negative side effects. Chemosensitization by natural compounds to increase effectiveness of commercial antimycotics is a somewhat new approach to dealing with the aforementioned problems. The potential for safe natural products to improve antifungal activity has been observed for over three decades. Chemosensitizing agents possess antifungal activity, but at insufficient levels to serve as antimycotics, alone. Their main function is to disrupt fungal stress response, destabilize the structural integrity of cellular and vacuolar membranes or stimulate production of reactive oxygen species, augmenting oxidative stress and apoptosis. Use of safe chemosensitizing agents has potential benefit to both agriculture and medicine. When co-applied with a commercial antifungal agent, an additive or synergistic interaction may occur, augmenting antifungal efficacy. This augmentation, in turn, lowers effective dosages, costs, negative side effects and, in some cases, countermands resistance.
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Affiliation(s)
- Bruce C. Campbell
- Plant Mycotoxin Research Unit, Western Regional Research Center, Agricultural Research Service, United States Department of AgricultureAlbany, CA, USA
| | - Kathleen L. Chan
- Plant Mycotoxin Research Unit, Western Regional Research Center, Agricultural Research Service, United States Department of AgricultureAlbany, CA, USA
| | - Jong H. Kim
- Plant Mycotoxin Research Unit, Western Regional Research Center, Agricultural Research Service, United States Department of AgricultureAlbany, CA, USA
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95
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Culakova H, Dzugasova V, Gbelska Y, Subik J. CTBT (7-chlorotetrazolo[5,1-c]benzo[1,2,4]triazine) producing ROS affects growth and viability of filamentous fungi. FEMS Microbiol Lett 2012; 328:138-43. [DOI: 10.1111/j.1574-6968.2011.02491.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 11/12/2011] [Accepted: 12/17/2011] [Indexed: 12/20/2022] Open
Affiliation(s)
- Hana Culakova
- Department of Microbiology and Virology; Faculty of Natural Sciences; Comenius University in Bratislava; Bratislava; Slovak Republic
| | - Vladimira Dzugasova
- Department of Genetics; Faculty of Natural Sciences; Comenius University in Bratislava; Bratislava; Slovak Republic
| | - Yvetta Gbelska
- Department of Microbiology and Virology; Faculty of Natural Sciences; Comenius University in Bratislava; Bratislava; Slovak Republic
| | - Julius Subik
- Department of Genetics; Faculty of Natural Sciences; Comenius University in Bratislava; Bratislava; Slovak Republic
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96
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Cumbo-Nacheli G, de Sanctis J, Holden D. Pseudallescheria Boydii pneumonia in an immunocompetent host. AMERICAN JOURNAL OF CASE REPORTS 2012; 13:163-5. [PMID: 23569518 PMCID: PMC3616179 DOI: 10.12659/ajcr.883276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Accepted: 07/09/2012] [Indexed: 12/04/2022]
Abstract
Background: Pseudallescheria boydii pneumonia is rarely reported among immunocompetent patients. Case Report: We report a case of a 62 year old white female with pseudallescheria boydii pneumonia. The patient was non-immunocompromised, had a history of mycobacterium avium complex (MAC) infection prior to presentation. After successful response to initial antitubercular therapy, the patient developed recurrent symptoms and bibasilar nodular infiltrates. Second line therapy for MAC failed to improve symptomatology. Pseudallescheria boydii pneumonia was diagnosed from a bronchoscopic biopsy. Treatment with voriconazole resolved her symptomatology and radiological infiltrates. Conclusions: This case highlights the importance of a high index of suspicion for superimposed fungal infections in patients who are refractory to medical treatment of bacterial pneumonitis such as MAC. Further diagnostic interventions are encouraged when insufficient clinical improvement is observed. Prompt initiation of an antifungal regimen is warranted.
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97
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In Vitro Activities of New Triazole Antifungal Agents, Posaconazole and Voriconazole, Against Oral Candida Isolates from Patients Suffering from Denture Stomatitis. Mycopathologia 2011; 173:35-46. [DOI: 10.1007/s11046-011-9460-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Accepted: 08/03/2011] [Indexed: 11/27/2022]
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98
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Abstract
Candida auris is a newly described species whose clinical significance is not clear. Here, we describe the first three cases of nosocomial fungemia caused by C. auris, which confirms that it is a causative agent of bloodstream infections. All three patients presented persistent fungemia for 10 to 31 days. The isolates obtained from the three patients were misidentified as Candida haemulonii and Rhodotorula glutinis by the Vitek 2 and the API 20C systems, respectively. C. auris was confirmed by sequence analysis of the internal transcribed spacer region and D1/D2 regions of the 26S ribosomal DNA of the rRNA gene. The MIC ranges of amphotericin B (AMB), fluconazole (FLU), itraconazole, and voriconazole were 0.5 to 1, 2 to 128, 0.125 to 2, and 0.06 to 1 μg/ml, respectively. All isolates were susceptible to caspofungin (MIC = 0.06 μg/ml) and micafungin (MIC = 0.03 μg/ml). One patient developed breakthrough fungemia while receiving FLU therapy, and two patients who received FLU therapy followed by AMB showed therapeutic failure and fatal outcomes. Our cases show that C. auris fungemia can be persistent, despite FLU or AMB therapy, which emphasizes the importance of accurately identifying this species.
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99
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Manastır L, Ergon MC, Yücesoy M. Investigation of mutations in Erg11 gene of fluconazole resistant Candida albicans isolates from Turkish hospitals. Mycoses 2011; 54:99-104. [PMID: 19732347 DOI: 10.1111/j.1439-0507.2009.01766.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Widespread use of fluconazole has resulted in resistance in strains of Candida. The aim of our study was to investigate Y132H and other mutations in the ERG11 gene in conferring fluconazole resistance to C. albicans isolates. Seven fluconazole-resistant (R)/susceptible dose-dependent (SDD)/trailing and 10 fluconazole-susceptible (S) isolates were included. Restriction enzyme analysis was performed on all isolates for Y132H mutation and sequence analysis was performed for other mutations in the ERG11 gene. None of our strains had Y132H mutation. One single mutation (D153E, E266D, D116E, V437I) was detected in isolates 348, 533, 644, 1453, 2157, while the others had more than one nucleotide change. D116E and E266D, which were two mutations found in fluconazole R/SDD/trailing isolates with the highest frequency, were also detected in azole S strains. K143R, G464S, G465S and V488I mutations were determined in three of the R/SDD isolates. S412T and R469K mutations were detected only in this group of strains by sequence analysis. Mutations such as K143R, G464S, G465S, V488I, S412T and R469K in the ERG11 gene were determined to be effective mechanisms in our fluconazole R/SDD C. albicans isolates. Other mechanisms of resistance, such as overexpression of ERG11 and efflux pumps and mutations in the ERG3 gene should also be investigated.
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Affiliation(s)
- Lerzan Manastır
- Department of Microbiology and Clinical Microbiology, School of Medicine, Dokuz Eylul University, Inciralti, Izmir, Turkey
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Desalermos A, Muhammed M, Glavis-Bloom J, Mylonakis E. Using C. elegans for antimicrobial drug discovery. Expert Opin Drug Discov 2011; 6:645-652. [PMID: 21686092 DOI: 10.1517/17460441.2011.573781] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION: The number of microorganism strains with resistance to known antimicrobials is increasing. Therefore, there is a high demand for new, non-toxic and efficient antimicrobial agents. Research with the microscopic nematode Caenorhabditis elegans can address this high demand for the discovery of new antimicrobial compounds. In particular, C. elegans can be used as a model host for in vivo drug discovery through high-throughput screens of chemical libraries. AREAS COVERED: This review introduces the use of substitute model hosts and especially C. elegans in the study of microbial pathogenesis. The authors also highlight recently published literature on the role of C. elegans in drug discovery and outline its use as a promising host with unique advantages in the discovery of new antimicrobial drugs. EXPERT OPINION: C. elegans can be used, as a model host, to research many diseases, including fungal infections and Alzheimer's disease. In addition, high-throughput techniques, for screening chemical libraries, can also be facilitated. Nevertheless, C. elegans and mammals have significant differences that both limit the use of the nematode in research and the degree by which results can be interpreted. That being said, the use of C. elegans in drug discovery still holds promise and the field continues to grow, with attempts to improve the methodology already underway.
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Affiliation(s)
- Athanasios Desalermos
- Division of Infectious Diseases, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
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