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Deng R, Wang X, Li R. Dermatophyte infection: from fungal pathogenicity to host immune responses. Front Immunol 2023; 14:1285887. [PMID: 38022599 PMCID: PMC10652793 DOI: 10.3389/fimmu.2023.1285887] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Dermatophytosis is a common superficial infection caused by dermatophytes, a group of pathogenic keratinophilic fungi. Apart from invasion against skin barrier, host immune responses to dermatophytes could also lead to pathologic inflammation and tissue damage to some extent. Therefore, it is of great help to understand the pathogenesis of dermatophytes, including fungal virulence factors and anti-pathogen immune responses. This review aims to summarize the recent advances in host-fungal interactions, focusing on the mechanisms of anti-fungal immunity and the relationship between immune deficiency and chronic dermatophytosis, in order to facilitate novel diagnostic and therapeutic approaches to improve the outcomes of these patients.
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Affiliation(s)
- Ruixin Deng
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China
- Research Center for Medical Mycology, Peking University, Beijing, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Xiaowen Wang
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China
- Research Center for Medical Mycology, Peking University, Beijing, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
| | - Ruoyu Li
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, China
- Research Center for Medical Mycology, Peking University, Beijing, China
- National Clinical Research Center for Skin and Immune Diseases, Beijing, China
- Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, China
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2
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Tham KC, Lefferdink R, Duan K, Lim SS, Wong XFCC, Ibler E, Wu B, Abu-Zayed H, Rangel SM, Del Duca E, Chowdhury M, Chima M, Kim HJ, Lee B, Guttman-Yassky E, Paller AS, Common JEA. Distinct skin microbiome community structures in congenital ichthyosis. Br J Dermatol 2022; 187:557-570. [PMID: 35633118 PMCID: PMC10234690 DOI: 10.1111/bjd.21687] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 03/28/2022] [Accepted: 05/21/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The ichthyoses are rare genetic keratinizing disorders that share the characteristics of an impaired epidermal barrier and increased risk of microbial infections. Although ichthyotic diseases share a T helper (Th) 17 cell immune signature, including increased expression of antimicrobial peptides, the skin microbiota of ichthyoses is virtually unexplored. OBJECTIVES To analyse the metagenome profile of skin microbiome for major congenital ichthyosis subtypes. METHODS Body site-matched skin surface samples were collected from the scalp, upper arm and upper buttocks of 16 healthy control participants and 22 adult patients with congenital forms of ichthyosis for whole metagenomics sequencing analysis. RESULTS Taxonomic profiling showed significant shifts in bacteria and fungi abundance and sporadic viral increases across ichthyosis subtypes. Cutibacterium acnes and Malassezia were significantly reduced across body sites, consistent with skin barrier disruption and depletion of lipids. Microbial richness was reduced, with specific increases in Staphylococcus and Corynebacterium genera, as well as shifts in fungal species, including Malassezia. Malassezia globosa was reduced at all body sites, whereas M. sympodialis was reduced in the ichthyotic upper arm and upper buttocks. Malassezia slooffiae, by contrast, was strikingly increased at all body sites in participants with congenital ichthyosiform erythroderma (CIE) and lamellar ichthyosis (LI). A previously undescribed Trichophyton species was also detected as sporadically colonizing the skin of patients with CIE, LI and epidermolytic ichthyosis subtypes. CONCLUSIONS The ichthyosis skin microbiome is significantly altered from healthy skin with specific changes predominating among ichthyosis subtypes. Skewing towards the Th17 pathway may represent a response to the altered microbial colonization in ichthyosis. What is already known about this topic? The skin microbiome of congenital ichthyoses is largely unexplored. Microbes play an important role in pathogenesis, as infections are common. The relative abundances of staphylococci and corynebacteria is increased in the cutaneous microbiome of patients with Netherton syndrome, but extension of these abundances to all congenital ichthyoses is unexplored. What does this study add? A common skin microbiome signature was observed across congenital ichthyoses. Distinct microbiome features were associated with ichthyosis subtypes. Changes in microbiome may contribute to T helper 17 cell immune polarization. What is the translational message? These data provide the basis for comparison of the microbiome with lipidomic and transcriptomic alterations in these forms of ichthyosis and consideration of correcting the dysbiosis as a therapeutic intervention.
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Affiliation(s)
- Khek-Chian Tham
- A*STAR Skin Research Labs, Agency for Science, Technology and Research, 8A Biomedical Grove, #06-10 Immunos, Singapore, 138648, Singapore
| | - Rachel Lefferdink
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kaibo Duan
- Singapore Immunology Network, Agency for Science, Technology and Research, 8A Biomedical Grove, #03 Immunos, Singapore, 138648, Singapore
| | - Seong Soo Lim
- A*STAR Skin Research Labs, Agency for Science, Technology and Research, 8A Biomedical Grove, #06-10 Immunos, Singapore, 138648, Singapore
| | - X F Colin C Wong
- A*STAR Skin Research Labs, Agency for Science, Technology and Research, 8A Biomedical Grove, #06-10 Immunos, Singapore, 138648, Singapore
| | - Erin Ibler
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Benedict Wu
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hajar Abu-Zayed
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Ester Del Duca
- Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
| | - Mashkura Chowdhury
- Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
| | - Margot Chima
- Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
| | - Hee Jee Kim
- Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
| | - Bernett Lee
- Singapore Immunology Network, Agency for Science, Technology and Research, 8A Biomedical Grove, #03 Immunos, Singapore, 138648, Singapore
| | | | - Amy S Paller
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - John E A Common
- A*STAR Skin Research Labs, Agency for Science, Technology and Research, 8A Biomedical Grove, #06-10 Immunos, Singapore, 138648, Singapore
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3
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Nabeela S, Date A, Ibrahim AS, Uppuluri P. Antifungal activity of alexidine dihydrochloride in a novel diabetic mouse model of dermatophytosis. Front Cell Infect Microbiol 2022; 12:958497. [PMID: 36118019 PMCID: PMC9478942 DOI: 10.3389/fcimb.2022.958497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022] Open
Abstract
Dermatophytosis is one of the most prevalent fungal infections and a major public health problem worldwide. Recent years have seen a change in the epidemiological patterns of infecting fungi, corresponding to an alarming rise in the prevalence of drug-recalcitrant dermatophyte infections. In patients with diabetes mellitus, dermatophytosis is more severe and recurrent. The potency of promising new antifungal drugs in the pipeline must be expanded to include dermatophytosis. To facilitate this effort, we established a clinically pertinent mouse model of dermatophyte infections, in which diabetic mice were infected with Trichophyton mentagrophytes on abraded skin. The diabetic mouse model was optimized as a simple and robust system for simulating dermatophytoses in diabetic patients. The outcome of infection was measured using clinical and mycological parameters. Infected mice with fungal lesions were treated with oral and topical formulations of terbinafine or topical administration of the FDA-approved and repurposed pan-antifungal drug alexidine dihydrochloride (AXD). In this model, AXD was found to be highly effective, with outcomes comparable to those of the standard of care drug terbinafine.
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Affiliation(s)
- Sunna Nabeela
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California Los Angeles (UCLA) Medical Center, Torrance, CA, United States
| | - Abhijit Date
- Department of Pharmacology and Toxicology, R. Ken (R. K.) Coit College of Pharmacy, University of Arizona, Tucson, AZ, United States
- Department of Ophthalmology and Vision Science, University of Arizona College of Medicine, Tucson, AZ, United States
| | - Ashraf S. Ibrahim
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California Los Angeles (UCLA) Medical Center, Torrance, CA, United States
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Priya Uppuluri
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California Los Angeles (UCLA) Medical Center, Torrance, CA, United States
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
- *Correspondence: Priya Uppuluri,
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Wang L, Zhu J, Zhang Y, Wu J, Guo H, Wu X. Thymic stromal lymphopoietin participates in the TLR2-and TLR4-dependent immune response triggered by Aspergillus fumigatus in human corneal cells. Exp Eye Res 2021; 209:108644. [PMID: 34081998 DOI: 10.1016/j.exer.2021.108644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/30/2021] [Accepted: 05/24/2021] [Indexed: 12/16/2022]
Abstract
Fungal keratitis constitutes a serious vision-threatening disease. Toll-like receptors (TLRs) comprise key mediators of innate immunity triggered by Aspergillus fumigatus (AF) in the cornea, but the messenger between innate and adaptive immunity remained unknown. Thymic stromal lymphopoietin (TSLP) represents a critical factor of adaptive immunity. Here we investigated the expression of TSLP in corneal epithelial and stromal cells challenged by AF and its relationship with TLRs. We stimulated corneal cells with TLR ligands zymosan or lipopolysaccharide (LPS), human recombinant TSLP, or AF hyphae for various periods, with or without prior TLR2, TLR4, or TSLP inhibition. TLR2, TLR4, TSLP, IL-8, and TNF-α release and expression were measured via enzyme-linked immunosorbent analysis, quantitative polymerase chain reaction, or western blot. Corneal cell stimulation with zymosan or LPS induced up-regulated TSLP expression. Enhanced TSLP expression was associated with AF treatment in human corneal cells; TLR2 or TLR4 inhibition impaired the AF-induced TSLP levels. Human recombinant TSLP augmented TLR2 and TLR4 expression; RNA interference of TSLP attenuated TLR, IL-8, and TNF-α expression stimulated by AF hyphae. These findings indicated that TSLP participates in the immune response of corneal cells triggered by AF, which is closely related to TLR function, and the innate immunity mediated by TLRs could be enhanced by TSLP. Innate immunity may therefore transmit inflammatory signals to adaptive immunity through activation of TSLP; in turn, adaptive immunity likely exerts certain regulatory effects on innate immunity via TSLP. That is, TSLP could interact with innate immunity mediated by TLR2 and TLR4 in human corneal cells challenged by AF and thus may serve as a messenger between the innate and adaptive immune responses in AF keratitis.
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Affiliation(s)
- Leyi Wang
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, 250012, PR China; Key Laboratory of Cardiovascular Remodeling and Function Research, Shandong University, Jinan, 250012, PR China.
| | - Jing Zhu
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, 250012, PR China; Key Laboratory of Cardiovascular Remodeling and Function Research, Shandong University, Jinan, 250012, PR China.
| | - Yuting Zhang
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, 250012, PR China; Key Laboratory of Cardiovascular Remodeling and Function Research, Shandong University, Jinan, 250012, PR China.
| | - Jiayin Wu
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, 250012, PR China; Key Laboratory of Cardiovascular Remodeling and Function Research, Shandong University, Jinan, 250012, PR China.
| | - Hui Guo
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, 250012, PR China; Key Laboratory of Cardiovascular Remodeling and Function Research, Shandong University, Jinan, 250012, PR China.
| | - Xinyi Wu
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, 250012, PR China.
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Celestrino GA, Verrinder Veasey J, Benard G, Sousa MGT. Host immune responses in dermatophytes infection. Mycoses 2021; 64:477-483. [PMID: 33480106 DOI: 10.1111/myc.13246] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 01/07/2023]
Abstract
Dermatophytosis is a skin infection caused by keratinophilic, filamentous fungi. These are highly prevalent, common mycoses, affecting approximately 20% of the population. These fungi invade the stratum corneum, and other keratinised tissues, like nails and hair, where they grow by secreting enzymes and degrading keratin to obtain nutrients. Clinical presentation is variable and may depend on many factors, such as the infection site, the host's immunity and the dermatophyte's virulence. Generally, patients with acute superficial dermatophytosis mount cell-mediated immune responses. However, those suffering from chronic or recurrent infections are unable to develop this response, for reasons yet unknown. Several reports have described severe and occasionally life-threatening invasive diseases (deep dermatophytosis) associated with genetic mutations in the innate immunity-associated molecule CARD9, displaying the need to better understand its immune response. These dermatoses have substantial clinical consequences, producing chronic and difficult to treat skin lesions. They also lead to a decline in the patient's quality of life and impact their self-esteem. This review summarises findings on the immune response against dermatophytes.
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Affiliation(s)
- Giovanna Azevedo Celestrino
- Laboratório de Micologia Médica - LIM-53, Divisão de Dermatologia Clínica, Faculdade de Medicina, Hospital das Clínicas and Instituto de Medicina Tropical de São Paulo, USP, São Paulo, Brazil
| | | | - Gil Benard
- Laboratório de Micologia Médica - LIM-53, Divisão de Dermatologia Clínica, Faculdade de Medicina, Hospital das Clínicas and Instituto de Medicina Tropical de São Paulo, USP, São Paulo, Brazil
| | - Maria Glória Teixeira Sousa
- Laboratório de Micologia Médica - LIM-53, Divisão de Dermatologia Clínica, Faculdade de Medicina, Hospital das Clínicas and Instituto de Medicina Tropical de São Paulo, USP, São Paulo, Brazil
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6
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The interplay among Th17 and T regulatory cells in the immune dysregulation of chronic dermatophytic infection. Microb Pathog 2019; 139:103921. [PMID: 31830582 DOI: 10.1016/j.micpath.2019.103921] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 12/07/2019] [Accepted: 12/09/2019] [Indexed: 01/26/2023]
Abstract
The delineation of the pathogenic interaction between the host skin immune responses and dermatophytes has remained indigent. The obscure enigma in host-dermatophyte immunopathogenic interactions is the T regulatory (Treg) and T-helper (Th) 17 cell role in maintaining immune homeostasis. We attempted to understand the regulation and recognition of lineage-specific response in chronic dermatophytic skin infection patients. The percentages of Th17 (CD4+CD161+IL23R+) and Treg (CD4+CD25+FoxP3+) cell subpopulations in the peripheral circulation of thirty chronic dermatophytic skin infection patients and twenty healthy individuals was determined. The serum cytokine levels were estimated for disease correlation. The mean duration of the disease was 10.68 ± 8.72 months, with Trichophyton mentagrophytes complex as the major pathogen. Total serum IgE level of patients was significantly higher compared to healthy controls (305 ± 117 vs 98.53 ± 54.55 IU/ml; p < 0.01). Expression of Th17 and Treg cell markers on CD4+ T cells was significantly elevated in patients than controls (p < 0.05). Comparatively, serum interleukin (IL)-4 and interferon (IFN)-γ levels were increased, with low IL-10 levels in patients. Our data envisages a complex immune dysfunction in chronic dermatophytosis, arising either as a result of dermatophyte exposure or paradoxical precedence of disease establishment. Designing new treatment strategies and preventing recurrences are challenges for future research.
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7
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Nakamura T, Yoshida N, Nishibu A, Mochizuki T. A Mouse Model of Trichophyton Inflammation Based on Trichophytin-induced Contact Hypersensitivity. Med Mycol J 2019; 60:65-70. [PMID: 31474692 DOI: 10.3314/mmj.19.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The prevalence of Trichophyton-induced superficial skin mycosis is very high among human patients. Dermatophytes generally infect the epidermis, especially the stratum corneum, forming scales, hyperkeratosis, and vesicles. The important roles played by the immune system in Trichophyton infection are detection of fungal invasion and elimination of fungi.These immune mechanisms are presumed to involve not only innate immunity but also acquired immunity. Therefore, there is a substantial need for studies on treatment methods based on new basic knowledge, and the elucidation of immunological mechanisms of Trichophyton-induced inflammatory reactions is especially important.However, since Trichophyton cannot colonize on the mouse skin, we tried to develop a model for Trichophyton inflammation induced by trichophytin extracted from Trichophyton mentagrophytes using a method based on contact hypersensitivity.Trichophytin is a crude extract that mainly contains fungal cell wall constituents including β-glucan and zymosan. In this model, TLR2, TLR4, and dectin-1 were highly expressed, and production of IL-17A and IL23 was observed. This indicates that we succeeded in inducing fungal-specific inflammation in the mice.In this review, we introduce a mouse Trichophyton inflammation model developed to investigate the immunological mechanisms of Trichophyton-induced inflammatory reactions. In addition, we report results of evaluation of anti-inflammatory and anti-itching effects of anti-fungal agents using the inflammation model.
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Affiliation(s)
- Tomoya Nakamura
- Department of R&D Center, Ikeda Mohando Co., Ltd.,Department of Dermatology, Kanazawa Medical University
| | | | - Akiko Nishibu
- Department of Dermatology, Kanazawa Medical University
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8
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Nakamura T, Yoshida N, Anzawa K, Nishibu A, Mochizuki T. Itching in a trichophytin contact dermatitis mouse model and the antipruritic effect of antifungal agents. Clin Exp Dermatol 2018; 44:381-389. [PMID: 30187507 DOI: 10.1111/ced.13719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Tinea is an infectious disease by dermatophytes, of which Trichophyton species accounts for the overwhelming majority of case. Tinea often causes itching with inflammation. In terms of pruritus by fungal infection, however, tinea has not been investigated sufficiently to date. AIM To evaluate itch caused by Trichophyton infection and the effect of antifungal agents on the infection, by measuring scratch behaviour and profiles of inflammatory cytokines and chemokines. METHODS We used a previously established mouse model of contact hypersensitivity induced by trichophytin, a crude extract from Trichophyton mentagrophytes. Scratching behaviour was recorded using a counting device that measured an electric current induced in a coil by movement of magnets that had been inserted into the hind paws of each animal. We investigated expression of various genes in lesional skin of mice and in normal human epidermal keratinocytes. We also investigated the antipruritic effects of the corticosteroid dexamethasone (DEX) and three antifungal agents: ketoconazole (KCZ), terbinafine (TBF) and liranaftate (LNF). RESULTS Biphasic peaks of scratching were observed at 1 h and at 6-7 h during an observation period of 14 h after trichophytin induction. For lesional skin, RNA was extracted 24 h after trichophytin challenge, and increased expression was seen in the genes for interleukin (IL)-17A, interferon-γ, tumour necrosis factor (TNF)-α, macrophage inflammatory protein (MIP)-2 and Dectin-1, whereas there was no obvious change in the genes for IL-31 and prostaglandin (PG)E2. Furthermore, KCZ inhibited histidine decarboxylase (HDC) expression in vitro and in vivo, and inhibited scratching in the very early phase. LNF inhibited expression of thymic stromal lymphopoietin (TSLP) and IL-8 in vitro, and TSLP, TNF-α, IL-1α and MIP2 in vivo, and also scratching in the early phase. TBF did not induce any significant alterations in either gene expression or scratching. DEX suppressed expression of all the chemical mediators except HDC in vitro and in vivo, and inhibited scratching. CONCLUSION Antifungals can inhibit itching induced by fungal infection through different mechanisms.
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Affiliation(s)
- T Nakamura
- Department of R&D Center, Ikeda Mohando Co. Ltd, Toyama, Japan.,Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
| | - N Yoshida
- Department of R&D Center, Ikeda Mohando Co. Ltd, Toyama, Japan
| | - K Anzawa
- Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
| | - A Nishibu
- Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
| | - T Mochizuki
- Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
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Goyal S, Castrillón-Betancur JC, Klaile E, Slevogt H. The Interaction of Human Pathogenic Fungi With C-Type Lectin Receptors. Front Immunol 2018; 9:1261. [PMID: 29915598 PMCID: PMC5994417 DOI: 10.3389/fimmu.2018.01261] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/18/2018] [Indexed: 01/19/2023] Open
Abstract
Fungi, usually present as commensals, are a major cause of opportunistic infections in immunocompromised patients. Such infections, if not diagnosed or treated properly, can prove fatal. However, in most cases healthy individuals are able to avert the fungal attacks by mounting proper antifungal immune responses. Among the pattern recognition receptors (PRRs), C-type lectin receptors (CLRs) are the major players in antifungal immunity. CLRs can recognize carbohydrate ligands, such as β-glucans and mannans, which are mainly found on fungal cell surfaces. They induce proinflammatory immune reactions, including phagocytosis, oxidative burst, cytokine, and chemokine production from innate effector cells, as well as activation of adaptive immunity via Th17 responses. CLRs such as Dectin-1, Dectin-2, Mincle, mannose receptor (MR), and DC-SIGN can recognize many disease-causing fungi and also collaborate with each other as well as other PRRs in mounting a fungi-specific immune response. Mutations in these receptors affect the host response and have been linked to a higher risk in contracting fungal infections. This review focuses on how CLRs on various immune cells orchestrate the antifungal response and on the contribution of single nucleotide polymorphisms in these receptors toward the risk of developing such infections.
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Affiliation(s)
- Surabhi Goyal
- Institute for Microbiology and Hygiene, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Septomics Research Center, Jena University Hospital, Jena, Germany
| | - Juan Camilo Castrillón-Betancur
- Septomics Research Center, Jena University Hospital, Jena, Germany.,International Leibniz Research School for Microbial and Biomolecular Interactions, Leibniz Institute for Natural Product Research and Infection Biology/Hans Knöll Institute, Jena, Germany
| | - Esther Klaile
- Septomics Research Center, Jena University Hospital, Jena, Germany
| | - Hortense Slevogt
- Septomics Research Center, Jena University Hospital, Jena, Germany
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Khosravi AR, Shokri H, Hassan Al-Heidary S, Ghafarifar F. Evaluation of murine lung epithelial cells (TC-1 JHU-1) line to develop Th2-promoting cytokines IL-25/IL-33/TSLP and genes Tlr2/Tlr4 in response to Aspergillus fumigatus. J Mycol Med 2018. [PMID: 29525270 DOI: 10.1016/j.mycmed.2018.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of this study were to determine the role of live and heat-killed Aspergillus fumigatus conidia in releasing interleukin (IL)-25, IL-33 and thymic stromal lymphopoietin (TSLP) and to express Toll-like receptor (Tlr)2 and Tlr4 genes. MATERIALS AND METHODS Murine lung epithelial cells were incubated with live and heat-killed A. fumigatus conidia at 37°C for 6, 24 and 48h. After treatments, ELISA was performed to measure the concentrations of IL-25, IL-33 and TSLP in the supernatants. Quantitative real-time PCR (qPCR) was performed to assess the expression levels of Tlr2 and Tlr4 genes. RESULTS The concentrations of IL-25 and IL-33 significantly increased after exposure to live and heat-killed conidia for various times when compared with untreated control (P<0.05). The secretion of TSLP at different concentrations of heat-killed conidia was significantly higher than both live conidia and untreated control (P<0.05). qRT-PCR results indicated a up-regulation from 1.08 to 3.60-fold for Tlr2 gene expression and 1.20 to 1.80-fold for Tlr4 gene expression exposed to heat-killed conidia. CONCLUSION A. fumigatus has a potential ability to stimulate murine lung epithelial cells to produce IL-25/IL-33/TSLP, as well as to express Tlr2/Tlr4 genes, indicating an important role of lung epithelial cells in innate immune responses to A. fumigatus interaction.
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Affiliation(s)
- A R Khosravi
- Mycology Research Center, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.
| | - H Shokri
- Department of Pathobiology, Faculty of Veterinary Medicine, Amol University of Special Modern Technologies, Amol, Iran
| | - S Hassan Al-Heidary
- Mycology Research Center, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - F Ghafarifar
- Department of Parasitology, Faculty of Medical Sciences, University of Tarbiat Modarres, Tehran, Iran
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Heinen MP, Cambier L, Fievez L, Mignon B. Are Th17 Cells Playing a Role in Immunity to Dermatophytosis? Mycopathologia 2016; 182:251-261. [PMID: 27878642 DOI: 10.1007/s11046-016-0093-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 11/13/2016] [Indexed: 12/24/2022]
Abstract
Despite their superficial localization in the skin, pathogenic dermatophytes can induce a complex but still misunderstood immune response in their hosts. The cell-mediated immunity (CMI) is correlated with both clinical recovery and protection against reinfection, and CD4+ T lymphocytes have been recognized as a crucial component of the immune defense against dermatophytes. Before the discovery of the Th17 pathway, CMI was considered to be only dependent of Th1 cells, and thus most studies on the immunology of dermatophytosis have focused on the Th1 pathway. Nevertheless, the fine comparative analysis of available scientific data on immunology of dermatophytosis in one hand and on the Th17 pathway mechanisms involved in opportunistic mucosal fungal infections in the other hand reveals that some key elements of the Th17 pathway can be activated by dermatophytes. Stimulation of the Th17 pathway could occur through the activation of some C-type lectin-like receptors and inflammasome in antigen-presenting cells. The Th17 cells could go back to the affected skin and by the production of signature cytokines could induce the effector mechanisms like the recruitment of polymorphonuclear neutrophils and the synthesis of antimicrobial peptides. In conclusion, besides the Th1 pathway, which is important to the immune response against dermatophytes, there are also growing evidences for the involvement of the Th17 pathway.
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Affiliation(s)
- Marie-Pierre Heinen
- Veterinary Mycology, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, Avenue de Cureghem 6, B-43a, 4000, Liège, Belgium
| | - Ludivine Cambier
- Veterinary Mycology, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, Avenue de Cureghem 6, B-43a, 4000, Liège, Belgium
| | - Laurence Fievez
- Laboratory of Cellular and Molecular Immunology, GIGA Research, Quartier Hôpital, University of Liège, Avenue de l'Hôpital 11, B-34, 4000, Liège, Belgium
| | - Bernard Mignon
- Veterinary Mycology, Fundamental and Applied Research for Animals & Health (FARAH), Faculty of Veterinary Medicine, University of Liège, Quartier Vallée 2, Avenue de Cureghem 6, B-43a, 4000, Liège, Belgium.
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12
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Hau CS, Tada Y, Kanda N, Watanabe S. Immunoresponses in dermatomycoses. J Dermatol 2016; 42:236-44. [PMID: 25736316 DOI: 10.1111/1346-8138.12718] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 10/16/2014] [Indexed: 12/19/2022]
Abstract
Contact with fungal pathogens initiates a series of host responses beginning with innate immunity, which leads to fungal recognition and microbial killing. The innate immune system also modulates the adaptive immune responses, leading to the establishment of immunological memory and protection against pathogens. In the case of dimorphic fungi such as Candida albicans and Malassezia, the immune system plays an important role in tolerance and resistance when managing the organisms either as commensal microbiota or invading pathogens, and disruption of this balance can result in pathological consequences for the host. In addition, Malassezia and dermatophytes have immunomodulatory capabilities that allow them to adapt to their environments and they may exert different effects in healthy and diseased skin. Here, we discuss the host immune responses to dermatomycoses caused by dimorphic fungi such as C. albicans and Malassezia as well as dermatophytes such as Trichophyton spp. and Arthroderma benhamiae to gain a better understanding of the mechanisms of the host-dermatomycosis interaction.
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Affiliation(s)
- Carren Sy Hau
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
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13
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Relevant Animal Models in Dermatophyte Research. Mycopathologia 2016; 182:229-240. [DOI: 10.1007/s11046-016-0079-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 10/04/2016] [Indexed: 10/20/2022]
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14
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Nakamura T, Nishibu A, Yoshida N, Yasoshima M, Anzawa K, Watanabe Y, Nagai Y, Takatsu K, Ogawa K, Mochizuki T. Glycyrrhetinic acid inhibits contact hypersensitivity induced by trichophytin via dectin-1. Exp Dermatol 2016; 25:299-304. [PMID: 26739065 DOI: 10.1111/exd.12931] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 12/28/2022]
Abstract
Trichophyton infection is highly prevalent and tends to be recurrent. Therefore, it is important to develop new therapeutic agents. Previously, we established a mouse model of Trichophyton-induced contact hypersensitivity (CHS) and demonstrated that dectin-1 was involved in inflammation induced by trichophytin, the Trichophyton antigen. Here, we used that model to investigate glycyrrhetinic acid (GA) from plants of the genus Glycyrrhiza as a potential anti-inflammatory agent against superficial mycoses. GA suppressed swelling and the expression of inflammatory cytokines, including macrophage inflammatory protein (MIP)-2, interleukin (IL)-6, tumor necrosis factor (TNF)-α and interferon (IFN)-γ mRNA. Anti-MIP-2 antibody suppressed trichophytin-induced inflammation, and antidectin-1 antibody suppressed zymosan-induced MIP-2 production in keratinocyte cells. These results suggest that MIP-2 is produced by dectin-1 activation and is involved in inflammation associated with CHS to trichophytin. GA also suppressed zymosan-induced MIP-2 and interleukin (IL)-8, production in mouse and human macrophages and keratinocytes. Furthermore, GA suppressed the phosphorylation of spleen tyrosine kinase (Syk) and inhibitor of nuclear factor-kappa B (IκBα) and the degradation of IκBα in zymosan-simulated RAW264.7 cells. The results of this study suggest that GA suppresses inflammation induced by trichophytin, partly by the downregulation of Syk phosphorylation.
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Affiliation(s)
- Tomoya Nakamura
- Department of R&D Center, Ikeda Mohando Co., Ltd, Toyama, Japan.,Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
| | - Akiko Nishibu
- Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
| | - Naoki Yoshida
- Department of R&D Center, Ikeda Mohando Co., Ltd, Toyama, Japan
| | | | - Kazushi Anzawa
- Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
| | - Yasuharu Watanabe
- Department of Immunobiology and Pharmacological Genetics, Graduate School of Medicine and Pharmaceutical Science for Research, University of Toyama, Toyama, Japan
| | - Yoshinori Nagai
- Department of Immunobiology and Pharmacological Genetics, Graduate School of Medicine and Pharmaceutical Science for Research, University of Toyama, Toyama, Japan.,Japan Science and Technology Agency, Precursory Research for Embryonic Science and Technology, Saitama, Japan
| | - Kiyoshi Takatsu
- Department of Immunobiology and Pharmacological Genetics, Graduate School of Medicine and Pharmaceutical Science for Research, University of Toyama, Toyama, Japan.,Toyama Prefectural Institute for Pharmaceutical Research, Toyama, Japan
| | - Kazuo Ogawa
- Department of R&D Center, Ikeda Mohando Co., Ltd, Toyama, Japan
| | - Takashi Mochizuki
- Department of Dermatology, Kanazawa Medical University, Ishikawa, Japan
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15
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Ren X, Wang L, Wu X. A potential link between TSLP/TSLPR/STAT5 and TLR2/MyD88/NFκB-p65 in human corneal epithelial cells for Aspergillus fumigatus tolerance. Mol Immunol 2016; 71:98-106. [PMID: 26874828 DOI: 10.1016/j.molimm.2015.12.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/14/2015] [Accepted: 12/23/2015] [Indexed: 12/31/2022]
Abstract
Our previous studies reported that pattern recognition receptors (PRRs), including the cell surface Toll-like receptors (TLRs) and cytoplasmic NOD-like receptors (NLRs), recognize pathogen-associated molecular patterns (PAMPS) to initiate downstream signal cascades to active immunity responses. Thymic stromal lymphopoietin (TSLP) has recently emerged as a key cytokine in the development of type 2 adaptive immune responses. However, the crosstalk between PRRs and TSLP has not been well elucidated in Aspergillus fumigates keratitis. Our studies demonstrated that HCECs not only respond to TSLP, but also initiate immunological regulation through TSLP/TSLPR/STAT5 signaling pathway. In addition, we revealed that zymosan TLR2 agonist enhanced the expression of TSLP and TSLPR and phosphorylation of STAT5. Furthermore, neutralization of TLR2 with monoclonal Ab prevented the production of TSLP and TSLPR and phosphorylation of STAT5 from increasing which induced by A. fumigatus hyphae. Interestingly, we also found that human recombinant TSLP induced the increase of TLR2 downstream signal molecules, and TSLP knockdown could reduce the increase of TLR2 downstream signaling molecules(MyD88 and NF-κB-p65) induced by A. fumigatus hyphae. These studies indicated that HCECs represent a novel target of TSLP, TSLP/TSLPR/STAT5 signaling plays an important role in response to A. fumigatus infection in HCECs, and TLR2 downstream signaling molecules up regulate TSLP/TSLPR/STAT5 signaling as well as TSLP downstream signaling molecules up regulate TLR2/MyD88/NFκB-p65 signaling in this phenomenon.
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Affiliation(s)
- Xiaoxiao Ren
- Key Laboratory of Cardiovascular Remodeling and Function Research, Shandong University, Jinan, Shandong, People's Republic of China; Department of Ophthalmology, Qilu Hospital of Shandong University, Wenhua Xi Road 107, Jinan, Shandong, People's Republic of China
| | - Leyi Wang
- Key Laboratory of Cardiovascular Remodeling and Function Research, Shandong University, Jinan, Shandong, People's Republic of China; Department of Ophthalmology, Qilu Hospital of Shandong University, Wenhua Xi Road 107, Jinan, Shandong, People's Republic of China
| | - Xinyi Wu
- Department of Ophthalmology, Qilu Hospital of Shandong University, Wenhua Xi Road 107, Jinan, Shandong, People's Republic of China.
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16
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Romano C, Gaviria Morales E, Feci L, Trovato E, Fimiani M. Six cases of tinea bullosa in Siena, Italy. J Eur Acad Dermatol Venereol 2016; 30:133-5. [DOI: 10.1111/jdv.12618] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C. Romano
- Dermatology Section; Department of Clinical Medicine and Immunological Sciences; Siena University; Siena Italy
| | - E. Gaviria Morales
- Dermatology Section; Department of Clinical Medicine and Immunological Sciences; Siena University; Siena Italy
| | - L. Feci
- Dermatology Section; Department of Clinical Medicine and Immunological Sciences; Siena University; Siena Italy
| | - E. Trovato
- Dermatology Section; Department of Clinical Medicine and Immunological Sciences; Siena University; Siena Italy
| | - M. Fimiani
- Dermatology Section; Department of Clinical Medicine and Immunological Sciences; Siena University; Siena Italy
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Severe Dermatophytosis and Acquired or Innate Immunodeficiency: A Review. J Fungi (Basel) 2015; 2:jof2010004. [PMID: 29376922 PMCID: PMC5753085 DOI: 10.3390/jof2010004] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 11/16/2015] [Accepted: 12/14/2015] [Indexed: 12/14/2022] Open
Abstract
Dermatophytes are keratinophilic fungi responsible for benign and common forms of infection worldwide. However, they can lead to rare and severe diseases in immunocompromised patients. Severe forms include extensive and/or invasive dermatophytosis, i.e., deep dermatophytosis and Majocchi’s granuloma. They are reported in immunocompromised hosts with primary (autosomal recessive CARD9 deficiency) or acquired (solid organ transplantation, autoimmune diseases requiring immunosuppressive treatments, HIV infection) immunodeficiencies. The clinical manifestations of the infection are not specific. Lymph node and organ involvement may also occur. Diagnosis requires both mycological and histological findings. There is no consensus on treatment. Systemic antifungal agents such as terbinafine and azoles (itraconazole or posaconazole) are effective. However, long-term outcome and treatment management depend on the site and extent of the infection and the nature of the underlying immunodeficiency.
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18
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Wang X, Zhou Y, He S, Ouyang Z, Feng L, Shen Y, Wu X, Sun Y, Wu X, Xu Q. Obaculactone exerts a novel ameliorating effect on contact dermatitis through regulating T lymphocyte. Int Immunopharmacol 2015; 28:1-9. [DOI: 10.1016/j.intimp.2015.05.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 05/06/2015] [Accepted: 05/09/2015] [Indexed: 11/29/2022]
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19
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Shi Y, Niu Q, Yu X, Jia X, Wang J, Lin D, Jin Y. Assessment of the function ofSUB6in the pathogenic dermatophyteTrichophyton mentagrophytes. Med Mycol 2015; 54:59-71. [DOI: 10.1093/mmy/myv071] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 07/09/2015] [Indexed: 02/02/2023] Open
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20
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Baltazar LM, Santos DA. Perspective on animal models of dermatophytosis caused by Trichophyton rubrum. Virulence 2015; 6:372-5. [PMID: 26065321 PMCID: PMC4601506 DOI: 10.1080/21505594.2015.1027480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022] Open
Affiliation(s)
- Ludmila Matos Baltazar
- Department of Microbiology & Immunology; Albert Einstein College of Medicine; Bronx, NY USA
| | - Daniel Assis Santos
- Departamento de Microbiologia; Instituto de Ciências Biológicas; Universidade Federal de Minas Gerais; Belo Horizonte, Brazil
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21
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Cambier L, Weatherspoon A, Defaweux V, Bagut ET, Heinen MP, Antoine N, Mignon B. Assessment of the cutaneous immune response during Arthroderma benhamiae and A. vanbreuseghemii infection using an experimental mouse model. Br J Dermatol 2014; 170:625-33. [PMID: 24116688 DOI: 10.1111/bjd.12673] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND Dermatophytoses are common but poorly understood skin infections. Most in vivo studies have been performed using the guinea pig as the experimental animal model, which has several limitations. OBJECTIVES To develop a mouse model of dermatophytosis suitable for multiple purposes, including the investigation of immunity against dermatophytes. MATERIALS AND METHODS Two peculiar fungal species, Arthroderma benhamiae and A. vanbreuseghemii, isolated from tinea in humans having contact with rodents were used for epicutaneous inoculation. During the infection, clinical and histopathological follow-up were performed. The recruitment of immune cells was evaluated by immunofluorescence staining and the levels of cytokine mRNA were quantified by quantitative reverse transcriptase-polymerase chain reaction in the skin of infected mice. RESULTS The skin symptoms and microscopic lesions, including the colonization of keratinized epidermal and follicular structures by both dermatophytes, were highly similar to those observed in guinea pig infection models and in natural infections, mimicking acute superficial tinea in humans. The dermal inflammatory cellular infiltrate consisted of macrophages, dendritic cells and especially polymorphonuclear neutrophils, which are one of the histological 'clues' to the diagnosis of dermatophytosis. The in situ cytokine profile was characterized by the overexpression of transforming growth factor-β, interleukin (IL)-1β and IL-6 mRNA during infection, suggesting a role of the T-helper 17 pathway in the establishment of immunity. CONCLUSIONS Our new reproducible and validated mouse model of dermatophytosis is a modern in vivo tool that allows a more in-depth understanding of the pathogenesis of human dermatophyte infections.
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Affiliation(s)
- L Cambier
- Veterinary Mycology Laboratory, Department of Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, University of Liège, B-43 Sart Tilman, 4000, Liège, Belgium
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22
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Baltazar LDM, Santos PC, Paula TPD, Rachid MA, Cisalpino PS, Souza DG, Santos DA. IFN-γ impairs Trichophyton rubrum proliferation in a murine model of dermatophytosis through the production of IL-1β and reactive oxygen species. Med Mycol 2014; 52:293-302. [PMID: 24577006 DOI: 10.1093/mmy/myt011] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Trichophyton rubrum is the main etiological agent of dermatophytosis, an infection of the skin that affects millions of people worldwide. In this study, we developed a murine model of the dermatophytosis caused by T. rubrum in which C57BL/6 wild-type, interleukin (IL)-12(-/-), and interferon-gamma (IFN-γ(-/-)) mice were inoculated with 1 × 10(6) conidia/animal. The fungal burden, myeloperoxidase and N-acetylglucosaminidase activities, cytokine and chemokine profiles, and histopathology of the skin were evaluated on the seventh and fourteenth days post infection. Phagocytic indices, intracellular proliferation rates, and oxidative bursts generated by macrophages from WT and IFN-γ(-/-) mice were determined. On day 7 post infection, higher fungal burdens were observed comparison with burdens on day 14 post infection. The IL-12(-/-) and IFN-γ(-/-) mice showed higher fungal burdens on the skin and lower levels of IL-1β. Conversely, the WT mice showed lower fungal burdens with higher production of TNF-α, IL-1β, and chemokine ligand 1/keratinocyte chemoattractant (CXCL1/KC). The macrophages from WT mice proved to be more efficient at engulfing and killing T. rubrum conidia through the production of reactive oxygen species. The results show that our model is a useful tool for understanding the pathogenesis of dermatophytosis caused by T. rubrum and that IL-12 and IFN-γ are pivotal in controlling the infection through the recruitment and activation of neutrophils and macrophages.
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Affiliation(s)
- Ludmila de Matos Baltazar
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte Minas Gerais
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Castriota M, Ricci F, Paradisi A, Fossati B, De Simone C, Capizzi R, Guerriero C. Erythema nodosum induced by kerion celsi of the scalp in a child: a case report and mini-review of literature. Mycoses 2012; 56:200-3. [DOI: 10.1111/myc.12020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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