Insights into the modulatory effect of magnesium on efflux mechanisms of Candida albicans reveal inhibition of ATP binding cassette multidrug transporters and dysfunctional mitochondria

Magnesium impairs Candida albicans immune evasion by reduced hyphal damage, enhanced β-glucan exposure and altered vacuole homeostasis

With a limited arsenal of available antifungal drugs and drug-resistance emergence, strategies that seek to reduce Candida immune evasion and virulence could be a promising alternative option. Harnessing metal homeostasis against C. albicans has gained wide prominence nowadays as a feasible antifungal strategy. Herein, the effect of magnesium (Mg) deprivation on the immune evasion mechanisms of C. albicans is demonstrated. We studied host pathogen interaction by using the THP-1 cell line model and explored the avenue that macrophage-mediated killing was enhanced under Mg deprivation, leading to altered cytokine (TNFα, IL-6 and IL10) production and reduced pyroptosis. Insights into the mechanisms revealed that hyphal damage inside the macrophage was diminished under Mg deprivation. Additionally, Mg deprivation led to cell wall remodelling; leading to enhanced β-1,3-glucan exposure, crucial for immune recognition, along with concomitant alterations in chitin and mannan levels. Furthermore, vacuole homeostasis was disrupted under Mg deprivation, as revealed by abrogated morphology and defective acidification of the vacuole lumen. Together, we demonstrated that Mg deprivation affected immune evasion mechanisms by: reduced hyphal damage, enhanced β-1,3-glucan exposure and altered vacuole functioning. The study establishes that Mg availability is indispensable for successful C. albicans immune evasion and specific Mg dependent pathways could be targeted for therapy.

A state-of-the-art review and prospective therapeutic applications of prenyl flavonoids as chemosensitizers against antifungal multidrug resistance in Candida albicans

Multidrug resistance (MDR) in the opportunistic pathogen Candida albicans is defined as non-susceptibility to at least one agent in two or more drug classes. This phenomenon has been increasingly reported since the rise in the incidence of fungal infections in immunocompromised patients at the end of the last century. After the discovery of efflux pump overexpression as a principal mechanism causing MDR in Candida strains, drug discovery targeting fungal efflux transporters has had a growing impact. Chemosensitization aims to enhance azole intracellular concentrations through combination therapy with transporter inhibitors. Consequently, the use of drug efflux inhibitors combined with the antifungal agent will sensitize the pathogen. As a result, the use of lower drug concentrations will reduce possible adverse effects on the host. Through an extensive revision of the literature, this review aims to provide an exhaustive and critical analysis of the studies carried out in the past two decades, regarding the chemosensitization strategy to cope with multidrug resistance in C. albicans. This work provides a deep analysis of the research about the inhibition of drug-efflux membrane transporters by prenylated flavonoids and the interactions of these phytocompounds with azole antifungals as an approach to chemosensitize multidrug-resistant C. albicans strains. We highlight the importance of prenylflavonoids and their particular chemical and pharmacological characteristics that make them excellent candidates with therapeutic potential as chemosensitizers. Finally, we propose the need for further research of prenyl flavonoids as inhibitors of drug-efflux mediated fungal resistance.

Mass spectrometry-based untargeted lipidomics reveals new compositional insights into membrane dynamics of Candida albicans under magnesium deprivation

AIMS

There is growing appreciation in adopting new approaches to disrupt multidrug resistance in human fungal pathogen, Candida albicans. The plasma membrane of C. albicans comprises potential lipid moieties that contribute towards the survival of pathogen and could be utilized as antifungal targets. Considering promising applications of developments in mass spectrometry (MS)-based lipidomics technology, the aim of the study was to analyse lipidome profile and expose lipid-dependent changes in response to Mg deprivation.

METHODS AND RESULTS

We found that both phosphatidylcholine (PC) and lysophosphatidylcholine (LysoPC) were decreased. Increased flip (inward translocation) in the fluorophore labelled NBD-PC was ascribed to enhanced PC-specific flippase activity. Furthermore, a decrease in phosphatidylethanolamine (PE) leading to altered membrane fluidity and loss of cellular material was prominent. Additionally, we observed decreased phosphatidylglycerol (PG) and phosphatidylinositol (PI) leading to genotoxic stress. Besides, we could detect enhanced levels of phosphatidylserine (PS), diacylglycerol (DAG) and triacylglycerides (TAG). The altered gene expressions of lipid biosynthetic pathway by RT-PCR correlated with the lipidome profile. Lastly, we explored abrogated ionic (Na⁺ and K⁺ ) transport across the plasma membrane.

CONCLUSIONS

We propose that C. albicans exposed to Mg deprivation could reorganize plasma membrane (lipid species, membrane fluidity and ionic transport), and possibly redirected carbon flux to store energy in TAGs as an adaptive stress response. This work unravels several vulnerable targets governing lipid metabolism in C. albicans and pave way for better antifungal strategies.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study demonstrates that magnesium availability is important when one considers dissecting drug resistance mechanisms in Candida albicans. Through mass spectrometry (MS)-based lipidomics technology, the study analyses lipidome profile and exposes lipid-dependent changes that are vulnerable to magnesium availability and presents an opportunity to employ this new information in improving treatment strategies.