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Kim JH, Chan KL, Hart-Cooper WM, Palumbo JD, Orts WJ. High-efficiency fungal pathogen intervention for seed protection: new utility of long-chain alkyl gallates as heat-sensitizing agents. FRONTIERS IN FUNGAL BIOLOGY 2023; 4:1172893. [PMID: 37746121 PMCID: PMC10512402 DOI: 10.3389/ffunb.2023.1172893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/13/2023] [Indexed: 09/26/2023]
Abstract
Control of food-contaminating fungi, especially pathogens that produce mycotoxins, is problematic since effective method for intervening fungal infection on food crops is often limited. Generally Regarded As Safe (GRAS) chemicals, such as natural compounds or their structural derivatives, can be developed as antimicrobial agents for sustainable food/crop production. This study identified that long-chain alkyl gallates, i.e., octyl-, nonyl-, and decyl gallates (OG (octyl 3,4,5-trihydroxybenzoic acid), NG, DG), can function as heat-sensitizing agents that effectively prevent fungal contamination. Out of twenty-eight candidate compounds and six conventional antifungal agents examined, the heat-sensitizing capacity was unique to the long-chain alkyl gallates, where OG exhibited the highest activity, followed by DG and NG. Since OG is a GRAS compound classified by the United States Food and Drug Administration (FDA), further in vitro antifungal studies were performed using OG. When OG and mild heat (57.5°C) were co-administered for 90 seconds, the treatment achieved > 99.999% fungal death (> 5 log reduction). Application of either treatment alone was significantly less effective at reducing fungal survival. Of note, co-application of OG (3 mM) and mild heat (50°C) for 20 minutes completely prevented the survival of aflatoxigenic Aspergillus flavus contaminating crop seeds (Brassica rapa Pekinensis), while seed germination rate was unaffected. Heat-sensitization was also determined in selected bacterial strains (Escherichia coli, Agrobacterium tumefaciens). Altogether, OG is an effective heat-sensitizing agent for control of microbial pathogens. OG-mediated heat sensitization will improve the efficacy of antimicrobial practices, achieving safe, rapid, and cost-effective pathogen control in agriculture/food industry settings.
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Affiliation(s)
- Jong H. Kim
- Foodborne Toxin Detection and Prevention Research Unit, Western Regional Research Center, Agricultural Research Service, United States Department of Agriculture (USDA-ARS), Albany, CA, United States
| | - Kathleen L. Chan
- Foodborne Toxin Detection and Prevention Research Unit, Western Regional Research Center, Agricultural Research Service, United States Department of Agriculture (USDA-ARS), Albany, CA, United States
| | - William M. Hart-Cooper
- Bioproducts Research Unit, Western Regional Research Center, Agricultural Research Service, United States Department of Agriculture (USDA-ARS), Albany, CA, United States
| | - Jeffrey D. Palumbo
- Foodborne Toxin Detection and Prevention Research Unit, Western Regional Research Center, Agricultural Research Service, United States Department of Agriculture (USDA-ARS), Albany, CA, United States
| | - William J. Orts
- Bioproducts Research Unit, Western Regional Research Center, Agricultural Research Service, United States Department of Agriculture (USDA-ARS), Albany, CA, United States
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Ramírez-Camacho I, Correa F, El Hafidi M, Silva-Palacios A, Ostolga-Chavarría M, Esparza-Perusquía M, Olvera-Sánchez S, Flores-Herrera O, Zazueta C. Cardioprotective strategies preserve the stability of respiratory chain supercomplexes and reduce oxidative stress in reperfused ischemic hearts. Free Radic Biol Med 2018; 129:407-417. [PMID: 30316780 DOI: 10.1016/j.freeradbiomed.2018.09.047] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 09/20/2018] [Accepted: 09/30/2018] [Indexed: 12/25/2022]
Abstract
Electron leakage from dysfunctional respiratory chain and consequent superoxide formation leads to mitochondrial and cell injury during ischemia and reperfusion (IR). In this work we evaluate if the supramolecular assembly of the respiratory complexes into supercomplexes (SCs) is associated with preserved energy efficiency and diminished oxidative stress in post-ischemic hearts treated with the antioxidant N-acetylcysteine (NAC) and the cardioprotective maneuver of Postconditioning (PostC). Hemodynamic variables, infarct size, oxidative stress markers, oxygen consumption and the activity/stability of SCs were compared between groups. We found that mitochondrial oxygen consumption and the activity of respiratory complexes are preserved in mitochondria from reperfused hearts treated with both NAC and PostC. Both treatments contribute to recover the activity of individual complexes. NAC reduced oxidative stress and maintained SCs assemblies containing Complex I, Complex III, Complex IV and the adapter protein SCAFI more effectively than PostC. On the other hand, the activities of CI, CIII and CIV associated to SCs assemblies were preserved by this maneuver, suggesting that the activation of other cardioprotective mechanisms besides oxidative stress contention might participate in maintaining the activity of the mitochondrial respiratory complexes in such superstructures. We conclude that both the monomeric and the SCs assembly of the respiratory chain contribute to the in vivo functionality of the mitochondria. However, although the ROS-induced damage and the consequent increased production of ROS affect the assembly of SCs, other levels of regulation as those induced by PostC, might participate in maintaining the activity of the respiratory complexes in such superstructures.
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Affiliation(s)
- I Ramírez-Camacho
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología. I. Ch., 14080 Mexico, D.F., Mexico
| | - F Correa
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología. I. Ch., 14080 Mexico, D.F., Mexico
| | - M El Hafidi
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología. I. Ch., 14080 Mexico, D.F., Mexico
| | - A Silva-Palacios
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología. I. Ch., 14080 Mexico, D.F., Mexico
| | - M Ostolga-Chavarría
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología. I. Ch., 14080 Mexico, D.F., Mexico
| | - M Esparza-Perusquía
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico, D.F., Mexico
| | - S Olvera-Sánchez
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico, D.F., Mexico
| | - O Flores-Herrera
- Departamento de Bioquímica, Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico, D.F., Mexico
| | - C Zazueta
- Departamento de Biomedicina Cardiovascular, Instituto Nacional de Cardiología. I. Ch., 14080 Mexico, D.F., Mexico.
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Matuz-Mares D, Matus-Ortega G, Cárdenas-Monroy C, Romero-Aguilar L, Villalobos-Rocha JC, Vázquez-Meza H, Guerra-Sánchez G, Peña-Díaz A, Pardo JP. Expression of alternative NADH dehydrogenases (NDH-2) in the phytopathogenic fungus Ustilago maydis. FEBS Open Bio 2018; 8:1267-1279. [PMID: 30221129 PMCID: PMC6134880 DOI: 10.1002/2211-5463.12475] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/27/2018] [Accepted: 06/11/2018] [Indexed: 11/17/2022] Open
Abstract
Type 2 alternative NADH dehydrogenases (NDH‐2) participate indirectly in the generation of the electrochemical proton gradient by transferring electrons from NADH and NADPH into the ubiquinone pool. Due to their structural simplicity, alternative NADH dehydrogenases have been proposed as useful tools for gene therapy of cells with defects in the respiratory complex I. In this work, we report the presence of three open reading frames, which correspond to NDH‐2 genes in the genome of Ustilago maydis. These three genes were constitutively transcribed in cells cultured in YPD and minimal medium with glucose, ethanol, or lactate as carbon sources. Proteomic analysis showed that only two of the three NDH‐2 were associated with isolated mitochondria in all culture media. Oxygen consumption by permeabilized cells using NADH or NADPH was different for each condition, opening the possibility of posttranslational regulation. We confirmed the presence of both external and internal NADH dehydrogenases, as well as an external NADPH dehydrogenase insensitive to calcium. Higher oxygen consumption rates were observed during the exponential growth phase, suggesting that the activity of NADH and NADPH dehydrogenases is coupled to the dynamics of cell growth.
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Affiliation(s)
- Deyamira Matuz-Mares
- Departamento de Bioquímica Facultad de Medicina Universidad Nacional Autónoma de México Ciudad de México México
| | - Genaro Matus-Ortega
- Departamento de Genética Molecular Instituto de Fisiología Celular Universidad Nacional Autónoma de México Ciudad de México México
| | - Christian Cárdenas-Monroy
- Departamento de Bioquímica Facultad de Medicina Universidad Nacional Autónoma de México Ciudad de México México
| | - Lucero Romero-Aguilar
- Bioquímica de hongos Escuela Nacional de Ciencias Biológicas Instituto Politécnico Nacional Ciudad de México México
| | | | - Héctor Vázquez-Meza
- Departamento de Bioquímica Facultad de Medicina Universidad Nacional Autónoma de México Ciudad de México México
| | - Guadalupe Guerra-Sánchez
- Bioquímica de hongos Escuela Nacional de Ciencias Biológicas Instituto Politécnico Nacional Ciudad de México México
| | - Antonio Peña-Díaz
- Departamento de Genética Molecular Instituto de Fisiología Celular Universidad Nacional Autónoma de México Ciudad de México México
| | - Juan Pablo Pardo
- Departamento de Bioquímica Facultad de Medicina Universidad Nacional Autónoma de México Ciudad de México México
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Steven A, Leisz S, Sychra K, Hiebl B, Wickenhauser C, Mougiakakos D, Kiessling R, Denkert C, Seliger B. Hypoxia-mediated alterations and their role in the HER-2/neuregulated CREB status and localization. Oncotarget 2018; 7:52061-52084. [PMID: 27409833 PMCID: PMC5239535 DOI: 10.18632/oncotarget.10474] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 06/17/2016] [Indexed: 01/16/2023] Open
Abstract
The cAMP-responsive element-binding protein (CREB) is involved in the tumorigenicity of HER-2/neu-overexpressing murine and human tumor cells, but a link between the HER-2/neu-mediated CREB activation, its posttranslational modification and localization and changes in the cellular metabolism, due to an altered (tumor) microenvironment remains to be established. The present study demonstrated that shRNA-mediated silencing of CREB in HER-2/neu-transformed cells resulted in decreased tumor formation, which was associated with reduced angiogenesis, but increased necrotic and hypoxic areas in the tumor. Hypoxia induced pCREBSer133, but not pCREBSer121 expression in HER-2/neu-transformed cells. This was accompanied by upregulation of the hypoxia-inducible genes GLUT1 and VEGF, increased cell migration and matrix metalloproteinase-mediated invasion. Treatment of HER-2/neu+ cells with signal transduction inhibitors targeting in particular HER-2/neu was able to revert hypoxia-controlled CREB activation. In addition to changes in the phosphorylation, hypoxic response of HER-2/neu+ cells caused a transient ubiquitination and SUMOylation as well as a co-localization of nuclear CREB to the mitochondrial matrix. A mitochondrial localization of CREB was also demonstrated in hypoxic areas of HER-2/neu+ mammary carcinoma lesions. This was accompanied by an altered gene expression pattern, activity and metabolism of mitochondria leading to an increased respiratory rate, oxidative phosphorylation and mitochondrial membrane potential and consequently to an enhanced apoptosis and reduced cell viability. These data suggest that the HER-2/neu-mediated CREB activation caused by a hypoxic tumor microenvironment contributes to the neoplastic phenotype of HER-2/neu+ cells at various levels.
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Affiliation(s)
- André Steven
- Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Sandra Leisz
- Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | | | - Bernhard Hiebl
- Centre for Basic Medical Research, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Claudia Wickenhauser
- Institute of Pathology, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Dimitrios Mougiakakos
- Department of Internal Medicine 5, Hematology and Oncology, University of Erlangen-Nuremberg, Erlangen, Germany
| | | | | | - Barbara Seliger
- Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle, Germany
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Robles-Martínez L, Guerra-Sánchez MG, Hernández-Lauzardo AN, Pardo JP, Velázquez-del Valle MG. Effects of chitosan and oligochitosan on development and mitochondrial function of Rhizopus stolonifer. J Basic Microbiol 2014; 54 Suppl 1:S42-9. [PMID: 24771597 DOI: 10.1002/jobm.201300790] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 12/25/2013] [Indexed: 11/08/2022]
Abstract
The antifungal activities of chitosan and oligochitosan have been used to control postharvest decay of the fruits. The effect of chitosan and oligochitosan on mycelium growth, spore germination, and mitochondrial function of Rhizopus stolonifer was evaluated in order to establish a connection between fungus development and the main organelle in charge to provide energy to the cell. The mycelium growth of R. stolonifer was significantly reduced on minimum media amended with chitosan or oligochitosan. The highest antifungal indexes were obtained on media containing chitosan or oligochitosan at 2.0 mg ml(-1). Microscopic observation showed that chitosan and oligochitosan affected the spore germination and hyphae morphology. Both polymers increased oxygen consumption of R. stolonifer. Respiratory activity was restored with NADH in permeabilized treated and untreated cells, and was inhibited with rotenone and flavones. Complex III and IV were inhibited by antimycin A and cyanide, respectively, in treated and untreated cells. Chitosan and oligochitosan increased NADH dehydrogenase activity in isolated mitochondria. However, there were not changes in the cytochrome c oxidase and ATPase activities by effect of these polymers. These results suggest that both chitosan and oligochitosan affect the development of R. stolonifer and might be implicated in the mitochondrial dysfunction.
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Kim JH, Mahoney N, Chan KL, Campbell BC, Haff RP, Stanker LH. Use of benzo analogs to enhance antimycotic activity of kresoxim methyl for control of aflatoxigenic fungal pathogens. Front Microbiol 2014; 5:87. [PMID: 24639673 PMCID: PMC3945611 DOI: 10.3389/fmicb.2014.00087] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 02/18/2014] [Indexed: 01/27/2023] Open
Abstract
The aim of this study was to examine two benzo analogs, octylgallate (OG) and veratraldehyde (VT), as antifungal agents against strains of Aspergillus parasiticus and A.flavus (toxigenic or atoxigenic). Both toxigenic and atoxigenic strains used were capable of producing kojic acid, another cellular secondary product. A. fumigatus was used as a genetic model for this study. When applied independently, OG exhibits considerably higher antifungal activity compared to VT. The minimum inhibitory concentrations (MICs) of OG were 0.3–0.5 mM, while that of VT were 3.0–5.0 mM in agar plate-bioassays. OG or VT in concert with the fungicide kresoxim methyl (Kre-Me; strobilurin) greatly enhanced sensitivity of Aspergillus strains to Kre-Me. The combination with OG also overcame the tolerance of A. fumigatus mitogen-activated protein kinase (MAPK) mutants to Kre-Me. The degree of compound interaction resulting from chemosensitization of the fungi by OG was determined using checkerboard bioassays, where synergistic activity greatly lowered MICs or minimum fungicidal concentrations. However, the control chemosensitizer benzohydroxamic acid, an alternative oxidase inhibitor conventionally applied in concert with strobilurin, did not achieve synergism. The level of antifungal or chemosensitizing activity was also “compound—strain” specific, indicating differential susceptibility of tested strains to OG or VT, and/or heat stress. Besides targeting the antioxidant system, OG also negatively affected the cell wall-integrity pathway, as determined by the inhibition of Saccharomyces cerevisiae cell wall-integrity MAPK pathway mutants. We concluded that certain benzo analogs effectively inhibit fungal growth. They possess chemosensitizing capability to increase efficacy of Kre-Me and thus, could reduce effective dosages of strobilurins and alleviate negative side effects associated with current antifungal practices. OG also exhibits moderate antiaflatoxigenic activity.
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Affiliation(s)
- Jong H Kim
- Foodborne Toxin Detection and Prevention Research Unit, Western Regional Research Center, USDA-ARS Albany, CA, USA
| | - Noreen Mahoney
- Foodborne Toxin Detection and Prevention Research Unit, Western Regional Research Center, USDA-ARS Albany, CA, USA
| | - Kathleen L Chan
- Foodborne Toxin Detection and Prevention Research Unit, Western Regional Research Center, USDA-ARS Albany, CA, USA
| | - Bruce C Campbell
- Foodborne Toxin Detection and Prevention Research Unit, Western Regional Research Center, USDA-ARS Albany, CA, USA
| | - Ronald P Haff
- Foodborne Toxin Detection and Prevention Research Unit, Western Regional Research Center, USDA-ARS Albany, CA, USA
| | - Larry H Stanker
- Foodborne Toxin Detection and Prevention Research Unit, Western Regional Research Center, USDA-ARS Albany, CA, USA
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Kim JH, Haff RP, Faria NCG, Martins MDL, Chan KL, Campbell BC. Targeting the mitochondrial respiratory chain of Cryptococcus through antifungal chemosensitization: a model for control of non-fermentative pathogens. Molecules 2013; 18:8873-94. [PMID: 23892633 PMCID: PMC6270351 DOI: 10.3390/molecules18088873] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 07/19/2013] [Accepted: 07/22/2013] [Indexed: 11/16/2022] Open
Abstract
Enhanced control of species of Cryptococcus, non-fermentative yeast pathogens, was achieved by chemosensitization through co-application of certain compounds with a conventional antimicrobial drug. The species of Cryptococcus tested showed higher sensitivity to mitochondrial respiratory chain (MRC) inhibition compared to species of Candida. This higher sensitivity results from the inability of Cryptococcus to generate cellular energy through fermentation. To heighten disruption of cellular MRC, octyl gallate (OG) or 2,3-dihydroxybenzaldehyde (2,3-DHBA), phenolic compounds inhibiting mitochondrial functions, were selected as chemosensitizers to pyraclostrobin (PCS; an inhibitor of complex III of MRC). The cryptococci were more susceptible to the chemosensitization (i.e., PCS + OG or 2,3-DHBA) than the Candida with all Cryptococcus strains tested being sensitive to this chemosensitization. Alternatively, only few of the Candida strains showed sensitivity. OG possessed higher chemosensitizing potency than 2,3-DHBA, where the concentration of OG required with the drug to achieve chemosensitizing synergism was much lower than that required of 2,3-DHBA. Bioassays with gene deletion mutants of the model yeast Saccharomyces cerevisiae showed that OG or 2,3-DHBA affect different cellular targets. These assays revealed mitochondrial superoxide dismutase or glutathione homeostasis plays a relatively greater role in fungal tolerance to 2,3-DHBA or OG, respectively. These findings show that application of chemosensitizing compounds that augment MRC debilitation is a promising strategy to antifungal control against yeast pathogens.
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Affiliation(s)
- Jong H. Kim
- Plant Mycotoxin Research Unit, Western Regional Research Center, USDA-ARS, 800 Buchanan St., Albany, CA 94710, USA; E-Mails: (R.P.H.); (K.L.C.); (B.C.C.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-510-559-5841; Fax: +1-510-559-5737
| | - Ronald P. Haff
- Plant Mycotoxin Research Unit, Western Regional Research Center, USDA-ARS, 800 Buchanan St., Albany, CA 94710, USA; E-Mails: (R.P.H.); (K.L.C.); (B.C.C.)
| | - Natália C. G. Faria
- Instituto de Higiene e Medicina Tropical/CREM, Universidade Nova de Lisboa, Portugal; E-Mails: (N.C.G.F.); (M.L.M.)
| | - Maria de L. Martins
- Instituto de Higiene e Medicina Tropical/CREM, Universidade Nova de Lisboa, Portugal; E-Mails: (N.C.G.F.); (M.L.M.)
| | - Kathleen L. Chan
- Plant Mycotoxin Research Unit, Western Regional Research Center, USDA-ARS, 800 Buchanan St., Albany, CA 94710, USA; E-Mails: (R.P.H.); (K.L.C.); (B.C.C.)
| | - Bruce C. Campbell
- Plant Mycotoxin Research Unit, Western Regional Research Center, USDA-ARS, 800 Buchanan St., Albany, CA 94710, USA; E-Mails: (R.P.H.); (K.L.C.); (B.C.C.)
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Shirazi F, Kontoyiannis DP. Mitochondrial respiratory pathways inhibition in Rhizopus oryzae potentiates activity of posaconazole and itraconazole via apoptosis. PLoS One 2013; 8:e63393. [PMID: 23696824 PMCID: PMC3656966 DOI: 10.1371/journal.pone.0063393] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 04/03/2013] [Indexed: 11/19/2022] Open
Abstract
The incidence of mucormycosis has increased drastically in immunocompromised patients. Also the array of targets whose inhibition results in Mucorales death is limited. Recently, researchers identified mitochondria as important regulators of detoxification and virulence mechanisms in fungi. In this context, targeting the mitochondrial respiratory chain may provide a new platform for antifungal development. We hypothesized that targeting respiratory pathways potentiates triazoles activity via apoptosis. We found that simultaneous administration of antimycin A (AA) and benzohydroxamate (BHAM), inhibitors of classical and alternative mitochondrial pathways respectively, resulted in potent activity of posaconazole (PCZ) and itraconazole (ICZ) against Rhizopus oryzae. We observed cellular changes characteristic of apoptosis in R. oryzae cells treated with PCZ or ICZ in combination with AA and BHAM. The fungicidal activity of this combination against R. oryzae was correlated with intracellular reactive oxygen species accumulation (ROS), phosphatidylserine externalization, mitochondrial membrane depolarization, and increased caspase like activity. DNA fragmentation and condensation assays also revealed apoptosis of R. oryzae cells. These apoptotic features were prevented by the addition of the ROS scavenger N-acetyl-cysteine. Taken together, these findings suggest that the use of PCZ or ICZ in combination with AA and BHAM makes R. oryzae exquisitely sensitive to treatment with triazoles via apoptosis. This strategy may serve as a new model for the development of improved or novel antifungal agents.
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Affiliation(s)
- Fazal Shirazi
- Department of Infectious Diseases, Infection Control and Employee Health, Unit 402, University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Dimitrios P. Kontoyiannis
- Department of Infectious Diseases, Infection Control and Employee Health, Unit 402, University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
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