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Belda E, Capeau J, Zucker JD, Chatelier EL, Pons N, Oñate FP, Quinquis B, Alili R, Fellahi S, Katlama C, Clément K, Fève B, Jaureguiberry S, Goujard C, Lambotte O, Doré J, Prifti E, Bastard JP. Major depletion of insulin sensitivity-associated taxa in the gut microbiome of persons living with HIV controlled by antiretroviral drugs. BMC Med Genomics 2024; 17:209. [PMID: 39138568 PMCID: PMC11320835 DOI: 10.1186/s12920-024-01978-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 08/01/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Persons living with HIV (PWH) harbor an altered gut microbiome (higher abundance of Prevotella and lower abundance of Bacillota and Ruminococcus lineages) compared to non-infected individuals. Some of these alterations are linked to sexual preference and others to the HIV infection. The relationship between these lineages and metabolic alterations, often present in aging PWH, has been poorly investigated. METHODS In this study, we compared fecal metagenomes of 25 antiretroviral-treatment (ART)-controlled PWH to three independent control groups of 25 non-infected matched individuals by means of univariate analyses and machine learning methods. Moreover, we used two external datasets to validate predictive models of PWH classification. Next, we searched for associations between clinical and biological metabolic parameters with taxonomic and functional microbiome profiles. Finally, we compare the gut microbiome in 7 PWH after a 17-week ART switch to raltegravir/maraviroc. RESULTS Three major enterotypes (Prevotella, Bacteroides and Ruminococcaceae) were present in all groups. The first Prevotella enterotype was enriched in PWH, with several of characteristic lineages associated with poor metabolic profiles (low HDL and adiponectin, high insulin resistance (HOMA-IR)). Conversely butyrate-producing lineages were markedly depleted in PWH independently of sexual preference and were associated with a better metabolic profile (higher HDL and adiponectin and lower HOMA-IR). Accordingly with the worst metabolic status of PWH, butyrate production and amino-acid degradation modules were associated with high HDL and adiponectin and low HOMA-IR. Random Forest models trained to classify PWH vs. control on taxonomic abundances displayed high generalization performance on two external holdout datasets (ROC AUC of 80-82%). Finally, no significant alterations in microbiome composition were observed after switching to raltegravir/maraviroc. CONCLUSION High resolution metagenomic analyses revealed major differences in the gut microbiome of ART-controlled PWH when compared with three independent matched cohorts of controls. The observed marked insulin resistance could result both from enrichment in Prevotella lineages, and from the depletion in species producing butyrate and involved into amino-acid degradation, which depletion is linked with the HIV infection.
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Affiliation(s)
- Eugeni Belda
- IRD, Sorbonne Université, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, Bondy, F-93143, France.
- Sorbonne Université, INSERM, Nutrition et Obesities, Systemic Approaches, NutriOmique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.
| | - Jacqueline Capeau
- INSERM UMR_S938, Centre de Recherche Saint-Antoine, Institut Hospitalo-Universitaire de Cardio-Métabolisme et Nutrition (ICAN), Sorbonne Université, Paris, F-75012, France
| | - Jean-Daniel Zucker
- IRD, Sorbonne Université, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, Bondy, F-93143, France
- Sorbonne Université, INSERM, Nutrition et Obesities, Systemic Approaches, NutriOmique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | | | - Nicolas Pons
- Université Paris-Saclay, INRAE, MGP, Jouy-en-Josas, 78350, France
| | | | - Benoit Quinquis
- Université Paris-Saclay, INRAE, MGP, Jouy-en-Josas, 78350, France
| | - Rohia Alili
- Sorbonne Université, INSERM, Nutrition et Obesities, Systemic Approaches, NutriOmique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Soraya Fellahi
- INSERM UMR_S938, Centre de Recherche Saint-Antoine, Institut Hospitalo-Universitaire de Cardio-Métabolisme et Nutrition (ICAN), Sorbonne Université, Paris, F-75012, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Département de biochimie-pharmacologie, FHU-SENEC, INSERM U955 and Université Paris Est (UPEC), UMR U955, Faculté de Santé, Créteil, F-93010 cedex, France
| | - Christine Katlama
- INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, AP-HP, Pitié Salpétrière Hospital, Department of Infectious Diseases, Sorbonne Université, Paris, F-75013, France
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition et Obesities, Systemic Approaches, NutriOmique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Bruno Fève
- INSERM UMR_S938, Centre de Recherche Saint-Antoine, Institut Hospitalo-Universitaire de Cardio-Métabolisme et Nutrition (ICAN), Sorbonne Université, Paris, F-75012, France
| | - Stéphane Jaureguiberry
- AP-HP, Hôpital Bicêtre, Service de Médecine Interne et Immunologie Clinique et Service de Maladies Infectieuses et Transmissibles, Kremlin-Bicêtre, France
| | - Cécile Goujard
- AP-HP, Hôpital Bicêtre, Service de Médecine Interne et Immunologie Clinique et Service de Maladies Infectieuses et Transmissibles, Kremlin-Bicêtre, France
| | - Olivier Lambotte
- AP-HP, Hôpital Bicêtre, Service de Médecine Interne et Immunologie Clinique et Service de Maladies Infectieuses et Transmissibles, Kremlin-Bicêtre, France
- Université Paris Saclay, Inserm, CEA, UMR1184, Le Kremlin Bicêtre, France
| | - Joël Doré
- Université Paris-Saclay, INRAE, MGP, Jouy-en-Josas, 78350, France
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Jouy-en-Josas, 78350, France
| | - Edi Prifti
- IRD, Sorbonne Université, Unité de Modélisation Mathématique et Informatique des Systèmes Complexes, UMMISCO, Bondy, F-93143, France
- Sorbonne Université, INSERM, Nutrition et Obesities, Systemic Approaches, NutriOmique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Philippe Bastard
- INSERM UMR_S938, Centre de Recherche Saint-Antoine, Institut Hospitalo-Universitaire de Cardio-Métabolisme et Nutrition (ICAN), Sorbonne Université, Paris, F-75012, France
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Département de biochimie-pharmacologie, FHU-SENEC, INSERM U955 and Université Paris Est (UPEC), UMR U955, Faculté de Santé, Créteil, F-93010 cedex, France
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Pruksaphon K, Amsri A, Thammasit P, Nosanchuk JD, Aiumurai P, Youngchim S. Diagnostic Performances of an in-House Immunochromatography Test Based on the Monoclonal Antibody 18B7 to Glucuronoxylomannan for Clinical Suspected Cryptococcosis: a Large-Scale Prototype Evaluation in Northern Thailand. Mycopathologia 2024; 189:75. [PMID: 39120647 DOI: 10.1007/s11046-024-00882-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024]
Abstract
OBJECTIVE Cryptococcosis predominantly presents as a meningoencephalitis in Thailand. Early and expeditious diagnosis is essential for reducing both mortality and morbidity associated with cryptococcal meningitis. We aim to define and establish the diagnostic performances between the benchmark commercially available diagnostic kit (CrAg® LFA) and the large-scale prototype of an inexpensive in-house immunochromatographic test (ICT) based on monoclonal antibody (MAb) 18B7. METHODS We have developed the large-scale prototype for the rapid detection of cryptococcal polysaccharide antigens by utilizing a single antibody sandwich ICT format employing MAb 18B7, which is highly specific to Cryptococcus neoformans glucuronoxylomannan (GXM) antigens. An in-house MAb18B7 ICT was manufactured in accordance with industry standards under the control of the International Organization for Standardization (ISO) 13485. RESULTS The diagnostic sensitivity, specificity, and accuracy for the in-house MAb 18B7 ICT were 99.10%, 97.61%, and 97.83%, respectively. The agreement kappa (κ) coefficient was 0.968 based on the retrospective evaluation of 580 specimens from patients living in northern Thailand with clinically suspected cryptococcosis. CONCLUSION The data suggest that this in-house MAb 18B7 ICT will be highly beneficial for addressing the issue of cryptococcal infection in Thailand. Moreover, it is anticipated that this inexpensive ICT can play a pivotal role in various global strategies aimed at eradicating cryptococcal meningitis among individuals living with HIV by 2030.
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Affiliation(s)
- Kritsada Pruksaphon
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, 80160, Thailand
- Center of Excellence Research for Melioidosis and Microorganisms (CERMM), Walailak University, Nakhon Si Thammarat, 80160, Thailand
| | - Artid Amsri
- Office of Research Administration, Chiang Mai University, Chiang Mai, 50200, Thailand
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Patcharin Thammasit
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Joshua D Nosanchuk
- Department of Medicine (Division of Infectious Diseases), Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Pisinee Aiumurai
- Center of Research Excellence in Allergy and Immunology, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand
| | - Sirida Youngchim
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Wei Y, Lin Y, Zhao J, Li D, Yang Z, Chen F, Han L. Development of a TaqMan probe-based multiplex real-time PCR for the simultaneous detection of four clinically important filamentous fungi. Microbiol Spectr 2024:e0063424. [PMID: 39078160 DOI: 10.1128/spectrum.00634-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 06/20/2024] [Indexed: 07/31/2024] Open
Abstract
Filamentous fungi present significant health hazards to immunocompromised individuals globally; however, the prompt and precise identification of them during infection remains challenging. In this study, a TaqMan probe-based multiplex real-time PCR (M-qPCR) assay was developed to detect simultaneously the target genes of four important pathogenic filamentous fungi: ANXC4 gene of Aspergillus fumigatus, EF1-α gene of Fusarium spp., mitochondrial rnl gene of Mucorales, and hcp100 gene of Histoplasma capsulatum. In this M-qPCR assay, the limit of detection (LoD) to all four kinds of fungi was 100 copies and the correlation coefficients (R2) were above 0.99. The specificity of this assay is 100%, and the minimum detection limit is 100 copies/reaction. In conclusion, an M-qPCR detection assay was well established with high specificity and sensitivity for rapid and simultaneous detection on four important filamentous fungi in the clinic. IMPORTANCE World Health Organization developed the first fungal priority pathogens list (WHO FPPL) in 2022. Aspergillus fumigatus, Mucorales, Fusarium spp., and Histoplasma spp. are the four types of pathogenic fungi with filamentous morphology in the critical priority group and high priority group of WHO FPPL. These four filamentous fungal infections have become more common and severe in immunocompromised patients with the increase in susceptible populations in recent decades, which resulted in a substantial burden on the public health system. However, prompt and precise identification of them during infection remains challenging. Our study established successfully a TaqMan probe-based multiplex real-time qPCR assay for four clinically important filamentous fungi, A. fumigatus, Fusarium spp., Mucorales, and Histoplasma capsulatum, with high sensitivity and specificity, which shows promising potential for prompt and precise diagnosis against fungal infection.
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Affiliation(s)
- Yutong Wei
- School of Public Health, Anhui Medical University, Anhui, China
- Department for Disinfection and Infection Control, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yangxuan Lin
- School of Public Health, Anhui Medical University, Anhui, China
- Department for Disinfection and Infection Control, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Jingya Zhao
- Department for Disinfection and Infection Control, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Dingchen Li
- Department for Disinfection and Infection Control, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Zhankui Yang
- Department for Disinfection and Infection Control, Chinese PLA Center for Disease Control and Prevention, Beijing, China
- Zhengzhou University, Zhengzhou, China
| | - Fangyan Chen
- Department for Disinfection and Infection Control, Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Li Han
- School of Public Health, Anhui Medical University, Anhui, China
- Department for Disinfection and Infection Control, Chinese PLA Center for Disease Control and Prevention, Beijing, China
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Pi W, Liu Y, Chen H, Zhao H. Isolated Cryptococcal Infection of the Thoracic Spine in an Immunocompetent Patient. Infect Drug Resist 2024; 17:3219-3224. [PMID: 39076349 PMCID: PMC11284138 DOI: 10.2147/idr.s472521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 07/09/2024] [Indexed: 07/31/2024] Open
Abstract
Cryptococcus neoformans is a type of fungal infection, which primarily affects the central nervous system and lungs of immunocompromised individuals. Spinal infections are known to be a rare manifestation of cryptococcosis. Herein, we report a case of a patient with isolated nonspecific spinal lesions at the T10 vertebra. The patient received non-surgical treatment with antifungal drugs, resulting in satisfactory clinical outcomes.
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Affiliation(s)
- Wensen Pi
- Department of Spine Surgery of Yichang Central People’s Hospital, First Clinical Medical College of China Three Gorges University, Yichang, Hubei, 443000, People’s Republic of China
| | - Yang Liu
- Department of Spine Surgery of Yichang Central People’s Hospital, First Clinical Medical College of China Three Gorges University, Yichang, Hubei, 443000, People’s Republic of China
| | - Haidan Chen
- Department of Spine Surgery of Yichang Central People’s Hospital, First Clinical Medical College of China Three Gorges University, Yichang, Hubei, 443000, People’s Republic of China
| | - Hongwei Zhao
- Department of Spine Surgery of Yichang Central People’s Hospital, First Clinical Medical College of China Three Gorges University, Yichang, Hubei, 443000, People’s Republic of China
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Diehl C, Pinzan CF, de Castro PA, Delbaje E, García Carnero LC, Sánchez-León E, Bhalla K, Kronstad JW, Kim DG, Doering TL, Alkhazraji S, Mishra NN, Ibrahim AS, Yoshimura M, Vega Isuhuaylas LA, Pham LTK, Yashiroda Y, Boone C, dos Reis TF, Goldman GH. Brilacidin, a novel antifungal agent against Cryptococcus neoformans. mBio 2024; 15:e0103124. [PMID: 38916308 PMCID: PMC11253610 DOI: 10.1128/mbio.01031-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/14/2024] [Indexed: 06/26/2024] Open
Abstract
Cryptococcus neoformans causes cryptococcosis, one of the most prevalent fungal diseases, generally characterized by meningitis. There is a limited and not very effective number of drugs available to combat this disease. In this manuscript, we show the host defense peptide mimetic brilacidin (BRI) as a promising antifungal drug against C. neoformans. BRI can affect the organization of the cell membrane, increasing the fungal cell permeability. We also investigated the effects of BRI against the model system Saccharomyces cerevisiae by analyzing libraries of mutants grown in the presence of BRI. In S. cerevisiae, BRI also affects the cell membrane organization, but in addition the cell wall integrity pathway and calcium metabolism. In vivo experiments show BRI significantly reduces C. neoformans survival inside macrophages and partially clears C. neoformans lung infection in an immunocompetent murine model of invasive pulmonary cryptococcosis. We also observed that BRI interacts with caspofungin (CAS) and amphotericin (AmB), potentiating their mechanism of action against C. neoformans. BRI + CAS affects endocytic movement, calcineurin, and mitogen-activated protein kinases. Our results indicate that BRI is a novel antifungal drug against cryptococcosis. IMPORTANCE Invasive fungal infections have a high mortality rate causing more deaths annually than tuberculosis or malaria. Cryptococcosis, one of the most prevalent fungal diseases, is generally characterized by meningitis and is mainly caused by two closely related species of basidiomycetous yeasts, Cryptococcus neoformans and Cryptococcus gattii. There are few therapeutic options for treating cryptococcosis, and searching for new antifungal agents against this disease is very important. Here, we present brilacidin (BRI) as a potential antifungal agent against C. neoformans. BRI is a small molecule host defense peptide mimetic that has previously exhibited broad-spectrum immunomodulatory/anti-inflammatory activity against bacteria and viruses. BRI alone was shown to inhibit the growth of C. neoformans, acting as a fungicidal drug, but surprisingly also potentiated the activity of caspofungin (CAS) against this species. We investigated the mechanism of action of BRI and BRI + CAS against C. neoformans. We propose BRI as a new antifungal agent against cryptococcosis.
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Affiliation(s)
- Camila Diehl
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Camila Figueiredo Pinzan
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Patrícia Alves de Castro
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Endrews Delbaje
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Laura C. García Carnero
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Eddy Sánchez-León
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kabir Bhalla
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - James W. Kronstad
- Michael Smith Laboratories, University of British Columbia, Vancouver, British Columbia, Canada
| | - Dong-gyu Kim
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Tamara L. Doering
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sondus Alkhazraji
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California Los Angeles (UCLA) Medical Center, Torrance, California, USA
| | - Nagendra N. Mishra
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California Los Angeles (UCLA) Medical Center, Torrance, California, USA
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Ashraf S. Ibrahim
- Division of Infectious Diseases, The Lundquist Institute for Biomedical Innovation at Harbor-University of California Los Angeles (UCLA) Medical Center, Torrance, California, USA
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Mami Yoshimura
- RIKEN Center for Sustainable Resource Science, Wako, Saitama, Japan
| | | | | | - Yoko Yashiroda
- RIKEN Center for Sustainable Resource Science, Wako, Saitama, Japan
| | - Charles Boone
- RIKEN Center for Sustainable Resource Science, Wako, Saitama, Japan
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Donnelly Centre for Cellular and Biomolecular Research, University of Toronto, Toronto, Ontario, Canada
| | - Thaila Fernanda dos Reis
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Gustavo H. Goldman
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology in Human Pathogenic Fungi, São Paulo, Brazil
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Wang M, Dong X, Wan H, Zhang B, Yu L, Yu W, Zhang Y, Pan K, Wang M, Xu A, Jin Y. Characteristics and risk factors for death in HIV-positive talaromycosis marneffei patients with sepsis. Heliyon 2024; 10:e34024. [PMID: 39055798 PMCID: PMC11269883 DOI: 10.1016/j.heliyon.2024.e34024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
Objectives This case-control study aimed to analyze the characteristics and risk factors for death in HIV-positive Talaromycosis marneffei (TSM) patients with sepsis. Methods We retrospectively reviewed 173 AIDS patients diagnosed with TSM infection from January 1, 2013, to December 1, 2023, at Hangzhou Xixi Hospital. We collected and analyzed clinical characteristics, laboratory findings, bone marrow cytology results, treatment, and prognosis. Results Out of 173 AIDS-TSM patients, 92 had sepsis while 81 did not. AIDS-TSM patients with sepsis have a higher in-hospital mortality rate (19.6 %) than non-sepsis patients (0 %). The SOFA score showed a significant association with in-hospital mortality in AIDS-TSM patients with sepsis (OR = 1.583, 95 % CI: 1.183-2.118, P = 0.002), indicating an almost linear relationship. After adjusting for the SOFA score, only hemoglobin (Hb) (OR = 0.971, 95 % CI: 0.943-1.000, P = 0.046), international normalized ratio (INR) (OR = 22.33, 95 % CI: 1.84-270.90, P = 0.015), and C-reactive protein (CRP) (OR = 1.014, 95 % CI: 1.001-1.027, P = 0.039) remained significantly associated with in-hospital mortality. The Receiver Operating Characteristic (ROC) curve of the SOFA score, INR, and CRP showed moderately good predictive performance for in-hospital mortality, while Hb had a low predictive performance. The Area Under Curve (AUC) values were 0.834, 0.820, 0.776, and 0.669, respectively. Conclusions AIDS-TSM patients with sepsis have a higher mortality rate. Moreover, the SOFA score, along with Hb, INR, and CRP, are the risk factors for death in AIDS-TSM patients with sepsis.
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Affiliation(s)
- Mengyan Wang
- Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
| | - Xiaotian Dong
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang University, Zhejiang, 310003, China
| | - Hu Wan
- Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
| | - Binhai Zhang
- Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
| | - Lele Yu
- Department II of Infectious Diseases, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
| | - Wenyan Yu
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
| | - Yan Zhang
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
| | - Kenv Pan
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
| | - Miaochan Wang
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
| | - Aifang Xu
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
| | - Yujiao Jin
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou, China
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Li J, Mu X, Li H, Liu X. Clinical course and prognostic factors of Pneumocystis pneumonia with respiratory failure in non-HIV patients. Front Cell Infect Microbiol 2024; 14:1380494. [PMID: 39055982 PMCID: PMC11270599 DOI: 10.3389/fcimb.2024.1380494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024] Open
Abstract
Background Compared with Human Immunodeficiency Virus (HIV) patients, non-HIV patients with Pneumocystis pneumonia (PCP) have more rapid onset, more rapid progression, and higher mortality. Objectives To investigate the predictive value of variables obtained upon hospital admission for in-hospital death and 90-day outcomes in non-HIV-PCP patients with respiratory failure (RF). Methods This was a single center retrospective study in a tertiary care institution over 15 years. It included all adults inpatients (≥18 years old) with laboratory confirmed non-HIV-PCP with RF who were discharged or died from Peking University First Hospital between April 1st, 2007 and November 1st, 2022. Epidemiological, clinical, laboratory, imaging and outcome data were collected from patient records. Results In this study, a total of 146 non-HIV-PCP patients with RF were included. There were 57 patients (39%) died during hospitalization, 44 patients (53%) died in Intensive care unit (ICU). A total of 137 patients completed 90 days of follow-up, of which 58 (42.3%) died. The multivariable regression analysis revealed that a CD8+ T cell count <115/μl (P=0.009), bronchoalveolar lavage fluid (BALF)-neutrophil percentage ≥50% (P=0.047), the time from corticosteroids withdrawal to symptom onset ≤5 days (P=0.012), and the time from visit to initiation of sulfonamides ≥2 days (P=0.011) were independent risk factors for in-hospital death. Furthermore, a CD8+ T cell count < 115/μl (P=0.001) and the time from visit to initiation of sulfonamides therapy ≥2 days (P=0.033) was independently associated with 90-day all-cause death. Conclusions A low CD8+ T cell count in peripheral blood, a high percentage of BALF-neutrophils, a short time from corticosteroids withdrawal to symptom onset, and a long time from visit to initiation of sulfonamides are associated with poor prognosis in non-HIV-PCP patients with RF.
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Affiliation(s)
- Jun Li
- Department of Respiratory and Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
- Department of Geriatrics, Peking University First Hospital, Beijing, China
| | - Xiangdong Mu
- Department of Respiratory and Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Haichao Li
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Xinmin Liu
- Department of Geriatrics, Peking University First Hospital, Beijing, China
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Zhang X, Yao X, Chen H, Yang M, Han D. Clinical usefulness of metagenomic next-generation sequencing for Talaromyces marneffei diagnosis in China: a retrospective study. Eur J Clin Microbiol Infect Dis 2024; 43:1367-1374. [PMID: 38801485 DOI: 10.1007/s10096-024-04856-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/17/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Metagenomic next-generation sequencing (mNGS) has been widely used in the diagnosis of infectious diseases. However, studies on Talaromyces marneffei detection using mNGS remain scarce. Therefore, this study aimed to explore the diagnostic performance of mNGS in T. marneffei. METHODS Between March 2021 and June 2023, patients who were discharged with a final diagnosis of talaromycosis, or confirmed T. marneffei infection by mNGS, culture or pathological examination were included in the study. Culture and mNGS were performed simultaneously for all patients. Clinical data were retrieved for analysis. RESULTS A total of 78 patients were enrolled, with 40 in the talaromycosis group and 38 in the suspected-talaromycosis group. In the talaromycosis group, mNGS showed a higher positivity rate(40/40, 100.0%) compared to culture(34/40, 85.0%)(P = 0.111). All patients in the suspected-talaromycosis group tested negative via culture, while mNGS yielded positive results. The T. marneffei reads in the talaromycosis group were significantly higher than in the suspected-talaromycosis group (4399 vs. 28, P < 0.001). In the suspected-talaromycosis group, of the four patients with low reads who did not receive antifungal therapy, one died and one lung lesion progressed; most patients(31/34, 91.2%) recovered after receiving appropriate antifungal therapy. CONCLUSION mNGS proves to be a rapid and highly sensitive method for detecting T. marneffei. Higher reads of T. marneffei correspond to a higher likelihood of infection. However, cases with low reads necessitate a comprehensive approach, integrating clinical manifestations, laboratory tests, and imaging examinations to confirm T. marneffei infection.
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Affiliation(s)
- Xuan Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, National Medical Center for Infectious Diseases, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xinfei Yao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, National Medical Center for Infectious Diseases, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Huixin Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, National Medical Center for Infectious Diseases, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Meifang Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, National Medical Center for Infectious Diseases, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Dongsheng Han
- Department of Laboratory Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, Hangzhou, Zhejiang, China.
- Institute of Laboratory Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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9
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Gómez-Gaviria M, Contreras-López LM, Aguilera-Domínguez JI, Mora-Montes HM. Strategies of Pharmacological Repositioning for the Treatment of Medically Relevant Mycoses. Infect Drug Resist 2024; 17:2641-2658. [PMID: 38947372 PMCID: PMC11214559 DOI: 10.2147/idr.s466336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/14/2024] [Indexed: 07/02/2024] Open
Abstract
Fungal infections represent a worldwide concern for public health, due to their prevalence and significant increase in cases each year. Among the most frequent mycoses are those caused by members of the genera Candida, Cryptococcus, Aspergillus, Histoplasma, Pneumocystis, Mucor, and Sporothrix, which have been treated for years with conventional antifungal drugs, such as flucytosine, azoles, polyenes, and echinocandins. However, these microorganisms have acquired the ability to evade the mechanisms of action of these drugs, thus hindering their treatment. Among the most common evasion mechanisms are alterations in sterol biosynthesis, modifications of drug transport through the cell wall and membrane, alterations of drug targets, phenotypic plasticity, horizontal gene transfer, and chromosomal aneuploidies. Taking into account these problems, some research groups have sought new therapeutic alternatives based on drug repositioning. Through repositioning, it is possible to use existing pharmacological compounds for which their mechanism of action is already established for other diseases, and thus exploit their potential antifungal activity. The advantage offered by these drugs is that they may be less prone to resistance. In this article, a comprehensive review was carried out to highlight the most relevant repositioning drugs to treat fungal infections. These include antibiotics, antivirals, anthelmintics, statins, and anti-inflammatory drugs.
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Affiliation(s)
- Manuela Gómez-Gaviria
- Departamento de Biología, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato, Gto, México
| | - Luisa M Contreras-López
- Departamento de Biología, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato, Gto, México
| | - Julieta I Aguilera-Domínguez
- Departamento de Biología, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato, Gto, México
| | - Héctor M Mora-Montes
- Departamento de Biología, División de Ciencias Naturales y Exactas, Universidad de Guanajuato, Guanajuato, Gto, México
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10
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Dan J, Wei W, Ou W, Gao G, Song W, Ye L, Liang H, Guo X, Tan L, Jiang J. Excavation of Biomarker Candidates for the Diagnosis of Talaromyces marneffei Infection via Genome-Wide Prediction and Functional Annotation of Secreted Proteins. ACS OMEGA 2024; 9:27093-27103. [PMID: 38947822 PMCID: PMC11209904 DOI: 10.1021/acsomega.4c00571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 05/28/2024] [Accepted: 06/05/2024] [Indexed: 07/02/2024]
Abstract
Talaromyces marneffei is the third most common infectious pathogen in AIDS patients and leads to the highest death rate in Guangxi, China. The lack of reliable biomarkers is one of the major obstacles in current clinical diagnosis, which largely contributes to this high mortality. Here, we present a study that aimed at identifying diagnostic biomarker candidates through genome-wide prediction and functional annotation of Talaromyces marneffei secreted proteins. A total of 584 secreted proteins then emerged, including 382 classical and 202 nonclassical ones. Among them, there were 87 newly obtained functional annotations in this study. The annotated proteins were further evaluated by combining RNA profiling and a homology comparison. Three proteins were ultimately highlighted as biomarker candidates with robust expression and remarkable specificity. The predicted phosphoinositide phospholipase C and the galactomannoprotein were suggested to play an interactive immune game through metabolism of arachidonic acid. Therefore, they hold promise in developing new tools for clinical diagnosis of Talaromyces marneffei and also possibly serve as molecular targets for future therapy.
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Affiliation(s)
- Jing Dan
- Collaborative
Innovation Centre of Regenerative Medicine and Medical BioResource
Development and Application Co-constructed by the Province and Ministry, Guangxi Medical University, Nanning, Guangxi 530021, China
- Guangxi
Key Laboratory of AIDS Prevention and Treatment & Biosafety III
Laboratory, Guangxi Medical University, Nanning, Guangxi 530021, China
- Center
for Energy Metabolism and Reproduction, Institute of Biomedicine and
Biotechnology, Shenzhen Institute of Advanced
Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Wudi Wei
- Guangxi
Key Laboratory of AIDS Prevention and Treatment & Biosafety III
Laboratory, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Weijie Ou
- Center
for Energy Metabolism and Reproduction, Institute of Biomedicine and
Biotechnology, Shenzhen Institute of Advanced
Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Guangshi Gao
- Geekgene
Technology Co. Ltd., Beijing 100091, China
| | - Wanjun Song
- Geekgene
Technology Co. Ltd., Beijing 100091, China
| | - Li Ye
- Guangxi
Key Laboratory of AIDS Prevention and Treatment & Biosafety III
Laboratory, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Hao Liang
- Collaborative
Innovation Centre of Regenerative Medicine and Medical BioResource
Development and Application Co-constructed by the Province and Ministry, Guangxi Medical University, Nanning, Guangxi 530021, China
- Guangxi
Key Laboratory of AIDS Prevention and Treatment & Biosafety III
Laboratory, Guangxi Medical University, Nanning, Guangxi 530021, China
| | - Xuzhen Guo
- Center
for Energy Metabolism and Reproduction, Institute of Biomedicine and
Biotechnology, Shenzhen Institute of Advanced
Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Lei Tan
- Center
for Energy Metabolism and Reproduction, Institute of Biomedicine and
Biotechnology, Shenzhen Institute of Advanced
Technology, Chinese Academy of Sciences, Shenzhen 518055, China
- College
of Life Sciences, University of Chinese
Academy of Sciences, Beijing 100049, China
- Department
of Cardiology, Shenzhen Guangming District
People’s Hospital, Shenzhen 518055, China
| | - Junjun Jiang
- Collaborative
Innovation Centre of Regenerative Medicine and Medical BioResource
Development and Application Co-constructed by the Province and Ministry, Guangxi Medical University, Nanning, Guangxi 530021, China
- Guangxi
Key Laboratory of AIDS Prevention and Treatment & Biosafety III
Laboratory, Guangxi Medical University, Nanning, Guangxi 530021, China
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11
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Zhang Y, Gu K, Du W, Xu A. Risk factors and prediction model for mortality in HIV/Talaromyces marneffei co-infection: A retrospective cohort study. Heliyon 2024; 10:e32560. [PMID: 38961941 PMCID: PMC11219485 DOI: 10.1016/j.heliyon.2024.e32560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 07/05/2024] Open
Abstract
Background This study aimed to identify the risk factors associated with mortality among patients co-infected with human immunodeficiency virus (HIV) and Talaromyces marneffei (TM) in China, and develop a risk prediction model. Methods In this retrospective cohort analysis conducted from 2013 to 2024, comprehensive clinical data from 160 patients were analyzed using a logistic regression model to identify mortality predictors and construct a predictive model. An additional 36 patients constituted the validation cohort, which was specifically designed to evaluate the predictive value of the model. Model performance was assessed using the area under the curve (AUC). Results The overall mortality rate for hospitalized patients with HIV/TM co-infection was 17.35 %. The median age was 35.0 years, and 89.30 % were male. Additionally, 89.80 % of the patients reported fever and 87.76 % presented with lymphadenopathy. Key independent risk factors associated with mortality included age (odds ratio (OR): 1.103, 95 % confidence interval (CI) = 1.033-1.178, P = 0.003), procalcitonin (PCT) levels (OR: 1.270, 95 % CI = 1.052-1.534, P = 0.013), and urea to albumin ratio (UAR) (OR: 1.491, 95 % CI = 1.175-1.892, P < 0.001). Advanced age, elevated PCT levels, and increased UAR were identified as independent risk factors of mortality. Furthermore, the mortality prediction probability combining age, PCT, and UAR exhibited a high predictive value in patients with HIV/TM co-infection. Additionally, the AUC showed a good discrimination ability in the validation group (AUC, 0.898). Conclusions Advanced age, elevated PCT levels, and increased UAR significantly determine mortality in patients with HIV/TM co-infection. These findings underscore the potential of using laboratory parameters as predictive indicators of mortality, facilitating the early identification of HIV/TM co-infection cases in clinical practice.
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Affiliation(s)
- Yan Zhang
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, 310023, Zhejiang, China
| | - Kailong Gu
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, 310023, Zhejiang, China
| | - Wei Du
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, 310023, Zhejiang, China
| | - Aifang Xu
- Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, 310023, Zhejiang, China
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12
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de Matos Silva S, Echeverri CR, Mendes-Giannini MJS, Fusco-Almeida AM, Gonzalez A. Common virulence factors between Histoplasma and Paracoccidioides: Recognition of Hsp60 and Enolase by CR3 and plasmin receptors in host cells. CURRENT RESEARCH IN MICROBIAL SCIENCES 2024; 7:100246. [PMID: 39022313 PMCID: PMC11253281 DOI: 10.1016/j.crmicr.2024.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Over the last two decades, the incidence of Invasive Fungal Infections (IFIs) globally has risen, posing a considerable challenge despite available antifungal therapies. Addressing this, the World Health Organization (WHO) prioritized research on specific fungi, notably Histoplasma spp. and Paracoccidioides spp. These dimorphic fungi have a mycelial life cycle in soil and a yeast phase associated with tissues of mammalian hosts. Inhalation of conidia and mycelial fragments initiates the infection, crucially transforming into the yeast form within the host, influenced by factors like temperature, host immunity, and hormonal status. Survival and multiplication within alveolar macrophages are crucial for disease progression, where innate immune responses play a pivotal role in overcoming physical barriers. The transition to pathogenic yeast, triggered by increased temperature, involves yeast phase-specific gene expression, closely linked to infection establishment and pathogenicity. Cell adhesion mechanisms during host-pathogen interactions are intricately linked to fungal virulence, which is critical for tissue colonization and disease development. Yeast replication within macrophages leads to their rupture, aiding pathogen dissemination. Immune cells, especially macrophages, dendritic cells, and neutrophils, are key players during infection control, with macrophages crucial for defense, tissue integrity, and pathogen elimination. Recognition of common virulence molecules such as heat- shock protein-60 (Hsp60) and enolase by pattern recognition receptors (PRRs), mainly via the complement receptor 3 (CR3) and plasmin receptor pathways, respectively, could be pivotal in host-pathogen interactions for Histoplasma spp. and Paracoccidioides spp., influencing adhesion, phagocytosis, and inflammatory regulation. This review provides a comprehensive overview of the dynamic of these two IFIs between host and pathogen. Further research into these fungi's virulence factors promises insights into pathogenic mechanisms, potentially guiding the development of effective treatment strategies.
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Affiliation(s)
- Samanta de Matos Silva
- Laboratory of Mycology, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Nucleous of Proteomics, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Basic and Applied Microbiology Group (MICROBA), School of Microbiology, Universidad de Antioquia (UdeA), Medellín, Colombia
| | - Carolina Rodriguez Echeverri
- Laboratory of Mycology, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Nucleous of Proteomics, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Basic and Applied Microbiology Group (MICROBA), School of Microbiology, Universidad de Antioquia (UdeA), Medellín, Colombia
| | - Maria José Soares Mendes-Giannini
- Laboratory of Mycology, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Nucleous of Proteomics, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
| | - Ana Marisa Fusco-Almeida
- Laboratory of Mycology, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
- Nucleous of Proteomics, Department of Clinical Analysis, School of Pharmaceutical Science, Paulista State University (UNESP), Araraquara, Brazil
| | - Angel Gonzalez
- Basic and Applied Microbiology Group (MICROBA), School of Microbiology, Universidad de Antioquia (UdeA), Medellín, Colombia
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13
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Castellanos Reynosa ME, Caal ME, Mercado D, Medina N, Pérez JC, Emeto TI, Arathoon E. Clinical characteristics, diagnosis, treatment and outcomes of patients living with HIV and co-infected with tuberculosis and histoplasmosis: a 5-y retrospective case series. Trans R Soc Trop Med Hyg 2024; 118:391-398. [PMID: 38279781 PMCID: PMC11149374 DOI: 10.1093/trstmh/trad104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/18/2023] [Accepted: 01/01/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND In Latin America, tuberculosis (TB) and histoplasmosis are two of the most frequent opportunistic infections affecting people living with human immunodeficiency virus (HIV). However, there are limited data on the clinical characteristics and outcomes of patients with concurrent TB and histoplasmosis infections. METHODS This was a retrospective observational study to describe the clinical, epidemiological and laboratory characteristics and outcomes of 21 patients living with HIV (PLHIV) who were diagnosed with concurrent histoplasmosis and TB between 2017 and 2021 in Guatemala City, Guatemala. RESULTS Most patients were male and were newly diagnosed with HIV. All patients had advanced HIV disease (AHD). They presented with a median CD4 count of 20 cells/µl. The most common symptoms reported by the patients were fever, weight loss, cough and diarrhoea. Twelve patients died within 6 months of baseline evaluation, for a mortality rate of 57.1%. CONCLUSIONS PLHIV with concurrent TB and histoplasmosis infections are characterised by AHD, predominantly presenting with disseminated forms of these infections and with unspecific symptoms and signs. This evidence calls for early HIV and opportunistic infection screening and insights into the challenges and opportunities for the efficient diagnostic and therapeutic management of patients with AHD with concurrent histoplasmosis and TB infections.
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Affiliation(s)
- María Eugenia Castellanos Reynosa
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | | | - Danicela Mercado
- Clínica Familiar Luis Ángel García, Hospital General San Juan de Dios, Guatemala City, Guatemala
| | - Narda Medina
- Asociación de Salud Integral, Guatemala City, Guatemala
| | | | - Theophilus I Emeto
- Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Eduardo Arathoon
- Asociación de Salud Integral, Guatemala City, Guatemala
- Clínica Familiar Luis Ángel García, Hospital General San Juan de Dios, Guatemala City, Guatemala
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14
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Lewis R, Niazi-Ali S, McIvor A, Kanj SS, Maertens J, Bassetti M, Levine D, Groll AH, Denning DW. Triazole antifungal drug interactions-practical considerations for excellent prescribing. J Antimicrob Chemother 2024; 79:1203-1217. [PMID: 38629250 DOI: 10.1093/jac/dkae103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2024] Open
Abstract
Systemic antifungal therapy is critical for reducing the mortality from many invasive and chronic fungal infections. Triazole antifungals are the most frequently prescribed antifungals but require attention to dosing and drug interactions. Nearly 600 severe drug-drug interactions and over 1100 moderate interactions requiring dose modifications are described or anticipated with systemic antifungal agents (see https://www.aspergillus.org.uk/antifungal-drug-interactions/). In this article, we address the common and less common, but serious, drug interactions observed in clinical practice with triazole antifungals, including a group of drugs that cannot be prescribed with all or most triazole antifungals (ivabradine, ranolazine, eplerenone, fentanyl, apomorphine, quetiapine, bedaquiline, rifampicin, rifabutin, sirolimus, phenytoin and carbamazepine). We highlight interactions with drugs used in children and new agents introduced for the treatment of haematological malignancies or graft versus host disease (midostaurin, ibrutinib, ruxolitinib and venetoclax). We also summarize the multiple interactions between oral and inhaled corticosteroids and triazole antifungals, and the strategies needed to optimize the therapeutic benefits of triazole antifungal therapy while minimizing potential harm to patients.
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Affiliation(s)
- Russell Lewis
- Department of Molecular Medicine, University of Padua, Padua, Italy
| | - Saarah Niazi-Ali
- Antifungal Database Consultancy Pharmacist, Fungal Infection Trust, PO Box 482, Macclesfield, Cheshire SK10 9AR, UK
| | - Andrew McIvor
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Souha S Kanj
- Division of Infectious Diseases, Department of Internal Medicine and Center for Infectious Diseases Research, American University of Beirut Medical Center, Beirut, Lebanon
| | - Johan Maertens
- Department of Microbiology, Immunology, and Transplantation, Department of Haematology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Matteo Bassetti
- Department of Health Sciences, Infectious Diseases Clinic, University of Genoa and Ospedale Policlinico San Martino IRCCS, Genoa, Italy
| | - Deborah Levine
- Lung Transplant Program, Division of Pulmonary Critical Care and Allergy, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Andreas H Groll
- Infectious Disease Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology/Oncology, Children's University Hospital, Albert-Schweitzer-Campus 1, Building A1, Münster, 48149, Germany
| | - David W Denning
- Manchester Fungal Infection Group, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK
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Aissaoui H, Bourne-Watrin M, Lemarie B, Guillot G, Aboikoni A, Chhorn P, Gaudard D, Hadj-Amara G, Manasse R, Ouedraogo M, Salloum C, Demar M, Epelboin L, Kallel H, Adenis A, Nacher M, Drak Alsibai K, Louvel D. Histoplasmosis in Non-HIV Infected Patients: Another Neglected Infection in French Guiana. J Fungi (Basel) 2024; 10:400. [PMID: 38921386 PMCID: PMC11205039 DOI: 10.3390/jof10060400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
(1) Background: Only a few studies on histoplasmosis in immunocompetent patients have been reported in French Guiana. Therefore, we conducted a detailed clinical description of hospitalized patients suffering with histoplasmosis among non-HIV patients. (2) Methods: This is a single-center, retrospective study conducted at Cayenne Hospital Center between 2008 and 2022. (3) Results: Our cohort was composed of 31 (91%) adults (>18 years of age) and 3 (9%) children, with a sex ratio, M:F, of 1:2. The median age was higher among the women than among the men (70 versus 54 years). The collection of respiratory samples constituted the majority of the performed examinations (38%). Fever (>37 °C) was found in 56% of patients. Surprisingly, the histoplasmosis was disseminated in 82% of patients with an overall case fatality rate of 14.7%. However, immunosuppressive conditions were found in 52% (16/31) of the adult patients, including lymphoid hemopathies, diabetes and immunosuppressive drugs. Conclusions: This disease, though rare and usually considered a mostly benign disease in non-HIV patients, presented a relatively high mortality rate in our cohort. Thus, histoplasmosis should be suspected, screened and investigated as a first line of defense in highly endemic areas, even in immunocompetent and non-HIV patients, especially those with fever or chronic respiratory symptoms.
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Affiliation(s)
- Houari Aissaoui
- Department of Medicine, Pneumology and Gastroenterology Units, Cayenne Hospital Center, Cayenne F-97300, French Guiana; (H.A.); (G.G.); (A.A.); (D.G.); (D.L.)
| | - Morgane Bourne-Watrin
- Unité des Maladies Infectieuses Tropicales (UMIT), Cayenne Hospital Center, Cayenne F-97300, French Guiana; (M.B.-W.); (L.E.)
| | - Benoit Lemarie
- Pneumology Department, Cochin University Hospital AP-HP, F-75014 Paris, France;
| | - Genevieve Guillot
- Department of Medicine, Pneumology and Gastroenterology Units, Cayenne Hospital Center, Cayenne F-97300, French Guiana; (H.A.); (G.G.); (A.A.); (D.G.); (D.L.)
| | - Alolia Aboikoni
- Department of Medicine, Pneumology and Gastroenterology Units, Cayenne Hospital Center, Cayenne F-97300, French Guiana; (H.A.); (G.G.); (A.A.); (D.G.); (D.L.)
| | | | - Dana Gaudard
- Department of Medicine, Pneumology and Gastroenterology Units, Cayenne Hospital Center, Cayenne F-97300, French Guiana; (H.A.); (G.G.); (A.A.); (D.G.); (D.L.)
| | - Ghazi Hadj-Amara
- Department of Pathology, Cayenne Hospital Center, Cayenne F-97300, French Guiana; (G.H.-A.); (R.M.)
| | - Ricardo Manasse
- Department of Pathology, Cayenne Hospital Center, Cayenne F-97300, French Guiana; (G.H.-A.); (R.M.)
| | - Mahamado Ouedraogo
- Laboratory of Mycology, Cayenne Hospital Center, Cayenne F-97300, French Guiana; (M.O.); (M.D.)
| | - Charles Salloum
- Department of Orthopidic Surgery and Neurosurgery, Cayenne Hospital Center, Cayenne F-97300, French Guiana;
| | - Magalie Demar
- Laboratory of Mycology, Cayenne Hospital Center, Cayenne F-97300, French Guiana; (M.O.); (M.D.)
| | - Loïc Epelboin
- Unité des Maladies Infectieuses Tropicales (UMIT), Cayenne Hospital Center, Cayenne F-97300, French Guiana; (M.B.-W.); (L.E.)
| | - Hatem Kallel
- Intensif Care Unit, Cayenne Hospital Center, Cayenne F-97300, French Guiana;
| | - Antoine Adenis
- Amazin PopHealth, Departement of Research and Innovation in Public Health (DRISP), Clinical Investigation Center (CIC Inserm 1424), Cayenne Hospital Center, Cayenne F-97300, French Guiana; (A.A.); (M.N.)
| | - Mathieu Nacher
- Amazin PopHealth, Departement of Research and Innovation in Public Health (DRISP), Clinical Investigation Center (CIC Inserm 1424), Cayenne Hospital Center, Cayenne F-97300, French Guiana; (A.A.); (M.N.)
| | - Kinan Drak Alsibai
- Department of Pathology, Cayenne Hospital Center, Cayenne F-97300, French Guiana; (G.H.-A.); (R.M.)
- Amazin PopHealth, Departement of Research and Innovation in Public Health (DRISP), Clinical Investigation Center (CIC Inserm 1424), Cayenne Hospital Center, Cayenne F-97300, French Guiana; (A.A.); (M.N.)
- Center of Biological Resources (CRB Amazonie), Cayenne Hospital Center, Cayenne F-97306, French Guiana
| | - Dominique Louvel
- Department of Medicine, Pneumology and Gastroenterology Units, Cayenne Hospital Center, Cayenne F-97300, French Guiana; (H.A.); (G.G.); (A.A.); (D.G.); (D.L.)
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Sharma G, Sharma R. Novel spiro[indoline-3,2'thiazolo[5,4-e]pyrimido[1,2-a] pyrimidine] derivatives as possible anti-dermatophytic and anti-candidiasis agent. BIOMEDITSINSKAIA KHIMIIA 2024; 70:180-186. [PMID: 38940208 DOI: 10.18097/pbmc20247003180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
A novel series of 5'-benzylidene-3'-phenylspiro[indoline-3,2'-thiazolidine]-2,4'(1H)-diones 6a-d and spiro[indoline-3,2'-thiazolo[5,4-e]pyrimido[1,2-a]pyrimidin]-2(1H)-one 9a-d derivatives have been synthesized. All the newly synthesized compounds were evaluated for antifungal and anti-candidiasis activity by using Disc Diffusion and Modified Microdilution methods. The antimicrobial experiments have shown that the synthesized compounds demonstrated broad-spectrum antifungal activity in vitro. Among them, compounds 9a-9d had stronger antifungal activity against Trichophyton rubrum, Trichophyton mentagrophytes, and Candida albicans; compounds 6a-d also showed significant antifungal activity against selected fungal strains as compared to ketoconazole, the reference antifungal drug. The evaluation of antifungal activity against drug-resistant fungal variants showed that the designed compounds had significant antifungal activity against the tested variants. The combination of compounds (6a-d) and (9a-d) exhibited that the synthesized compounds had synergistic effects or additive effects. These results demonstrated that the synthesized compounds were putative chitin synthase inhibitors exhibiting broad spectrum antifungal activities. The present results indicate that novel spiro pyrimidine derivatives can be used as an active pharmaceutical ingredient for novel drug candidate for treatment of dermatophytosis and other fungal agents.
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Affiliation(s)
- G Sharma
- Department of Chemistry, MPS International, Jaipur, India
| | - R Sharma
- Department of Microbiology, Mahatma Gandhi University of Medical Science and Technology
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Yang S, Lou L, Ma S, Wang H, Rong L, Liu Y, Zhang K, Ai Q, Shi X. Disseminated Talaromyces marneffei infection initially presenting as cutaneous and subcutaneous lesion in an HIV-Negative renal transplant recipient: a case report and literature review. BMC Infect Dis 2024; 24:473. [PMID: 38711014 PMCID: PMC11071178 DOI: 10.1186/s12879-024-09351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 04/25/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND The incidence of Talaromyces marneffei (T. marneffei) infection has increased in recent years with the development of organ transplantation and the widespread use of immunosuppressive agents. However, the lack of clinical suspicion leading to delay or misdiagnosis is an important reason for the high mortality rate in non-human immunodeficiency virus (HIV) and non-endemic population. Herein, we report a case of disseminated T. marneffei infection in a non-HIV and non-endemic recipient after renal transplant, who initially presented with skin rashes and subcutaneous nodules and developed gastrointestinal bleeding. CASE PRESENTATION We describe a 54-year-old renal transplantation recipient presented with scattered rashes, subcutaneous nodules and ulcerations on the head, face, abdomen, and right upper limb. The HIV antibody test was negative. The patient had no obvious symptoms such as fever, cough, etc. Histopathological result of the skin lesion sites showed chronic suppurative inflammation with a large number of fungal spores. Subsequent fungal culture suggested T. marneffei infection. Amphotericin B deoxycholate was given for antifungal treatment, and there was no deterioration in the parameters of liver and kidney function. Unfortunately, the patient was soon diagnosed with gastrointestinal bleeding, gastrointestinal perforation and acute peritonitis. Then he rapidly developed multiple organ dysfunction syndrome and abandoned treatment. CONCLUSIONS The risk of fatal gastrointestinal bleeding can be significantly increased in kidney transplant patients with T. marneffei infection because of the long-term side effects of post-transplant medications. Strengthening clinical awareness and using mNGS or mass spectrometry technologies to improve the detection rate and early diagnosis of T. marneffei are crucial for clinical treatment in non-HIV and non-endemic population.
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Affiliation(s)
- Shanshan Yang
- Department of Laboratory Medicine, Lequn Branch, The First Hospital of Jilin University, No. 3302 Jilin Road, Changchun, 130031, Jilin Province, China
| | - Lixin Lou
- Department of Infectious Diseases, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Shuhong Ma
- Department of Laboratory Medicine, Lequn Branch, The First Hospital of Jilin University, No. 3302 Jilin Road, Changchun, 130031, Jilin Province, China
| | - Haoliang Wang
- Department of Hand Surgery, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Lanxiang Rong
- Department of Laboratory Medicine, Lequn Branch, The First Hospital of Jilin University, No. 3302 Jilin Road, Changchun, 130031, Jilin Province, China
| | - Ying Liu
- Department of Laboratory Medicine, Lequn Branch, The First Hospital of Jilin University, No. 3302 Jilin Road, Changchun, 130031, Jilin Province, China
| | - Kaiyu Zhang
- Department of Infectious Diseases, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Qing Ai
- Department of Laboratory Medicine, Lequn Branch, The First Hospital of Jilin University, No. 3302 Jilin Road, Changchun, 130031, Jilin Province, China
| | - Xu Shi
- Department of Laboratory Medicine, Lequn Branch, The First Hospital of Jilin University, No. 3302 Jilin Road, Changchun, 130031, Jilin Province, China.
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18
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Qiu Y, Li ZT, Zeng W, Yang JL, Tang MX, Wang Y, Wang HR, Li Y, Zhan YQ, Li SQ, Zhang JQ, Ye F. Th1 cell immune response in Talaromyces marneffei infection with anti-interferon-γ autoantibody syndrome. Microbiol Spectr 2024; 12:e0364623. [PMID: 38497717 PMCID: PMC11064527 DOI: 10.1128/spectrum.03646-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
Anti-interferon-γ autoantibody (AIGA) syndrome may be the basis of disseminated Talaromyces marneffei infection in human immunodeficiency virus (HIV)-negative adults. However, the pathogenesis of Th1 cell immunity in T. marneffei infection with AIGA syndrome is unknown. A multicenter study of HIV-negative individuals with T. marneffei infection was conducted between September 2018 and September 2020 in Guangdong and Guangxi, China. Patients were divided into AIGA-positive (AP) and AIGA-negative (AN) groups according to the AIGA titer and neutralizing activity. The relationship between AIGA syndrome and Th1 immune deficiency was investigated by using AP patient serum and purification of AIGA. Fifty-five HIV-negative adults with disseminated T. marneffei infection who were otherwise healthy were included. The prevalence of AIGA positivity was 83.6%. Based on their AIGA status, 46 and 9 patients were assigned to the AP and AN groups, respectively. The levels of Th1 cells, IFN-γ, and T-bet were higher in T. marneffei-infected patients than in healthy controls. However, the levels of CD4+ T-cell STAT-1 phosphorylation (pSTAT1) and Th1 cells were lower in the AP group than in the AN group. Both the serum of patients with AIGA syndrome and the AIGA purified from the serum of patients with AIGA syndrome could reduce CD4+ T-cell pSTAT1, Th1 cell differentiation and T-bet mRNA, and protein expression. The Th1 cell immune response plays a pivotal role in defense against T. marneffei infection in HIV-negative patients. Inhibition of the Th1 cell immune response may be an important pathological effect of AIGA syndrome.IMPORTANCEThe pathogenesis of Th1 cell immunity in Talaromyces marneffei infection with anti-interferon-γ autoantibody (AIGA) syndrome is unknown. This is an interesting study addressing an important knowledge gap regarding the pathogenesis of T. marneffei in non-HIV positive patients; in particular patients with AIGA. The finding of the Th1 cell immune response plays a pivotal role in defense against T. marneffei infection in HIV-negative patients, and inhibition of the Th1 cell immune response may be an important pathological effect of AIGA syndrome, which presented in this research could help bridge the current knowledge gap.
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Affiliation(s)
- Ye Qiu
- Department of Respiratory and Critical Medicine, The Cancer Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zheng-Tu Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wen Zeng
- Department of Respiratory and Critical Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jing-Lu Yang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Meng-Xin Tang
- Department of Respiratory and Critical Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Yan Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hao-Ru Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuanxiang Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yang-Qing Zhan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shao-Qiang Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jian-Quan Zhang
- Department of Respiratory and Critical Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Feng Ye
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Boucher MJ, Madhani HD. Convergent evolution of innate immune-modulating effectors in invasive fungal pathogens. Trends Microbiol 2024; 32:435-447. [PMID: 37985333 DOI: 10.1016/j.tim.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023]
Abstract
Invasive fungal infections pose a major threat to human health. Bacterial and protozoan pathogens secrete protein effectors that overcome innate immune barriers to promote microbial colonization, yet few such molecules have been identified in human fungal pathogens. Recent studies have begun to reveal these long-sought effectors and have illuminated how they subvert key cellular pathways, including apoptosis, myeloid cell polarization, Toll-like receptor signaling, and phagosome action. Thus, despite lacking the specialized secretion systems of bacteria and parasites, it is increasingly clear that fungi independently evolved effectors targeting pathways often subverted by other classes of pathogens. These findings demonstrate the remarkable power of convergent evolution to enable diverse microbes to infect humans while also setting the stage for detailed dissection of fungal disease mechanisms.
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Affiliation(s)
- Michael J Boucher
- Department of Biochemistry & Biophysics, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Hiten D Madhani
- Department of Biochemistry & Biophysics, University of California, San Francisco, San Francisco, CA 94158, USA.
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20
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Bongomin F, Kibone W, Atulinda L, Morgan B, Ocansey B, Storer ISR, van Rhijn N, Muzoora C, Denning DW, Hamer DH. Frequency of fungal pathogens in autopsy studies of people who died with HIV in Africa: a scoping review. Clin Microbiol Infect 2024; 30:592-600. [PMID: 38145865 PMCID: PMC11103628 DOI: 10.1016/j.cmi.2023.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Fungal infections are common in HIV-infected individuals and significantly contribute to mortality. However, a substantial number of cases are undiagnosed before death. OBJECTIVE To determine the frequency of fungal pathogens in autopsy studies of people who died with HIV in Africa. METHODS We conducted a scoping review of autopsy studies conducted in Africa. DATA SOURCES PubMed, Scopus, Web of Science, Embase, Google Scholar, and African Journal Online. STUDY ELIGIBILITY CRITERIA The review encompasses studies published from inception to September 2023, and no language restrictions were imposed during the search process. We included studies that reported histopathological or microbiological evidence for the diagnosis of fungal infections and other pathogens. DATA SYNTHESIS Data were summarized using descriptive statistics and no meta-analysis was performed. RESULTS We examined 30 articles reporting studies conducted between 1991 and 2019, encompassing a total of 13 066 HIV-infected decedents across ten African countries. In five studies, the autopsy type was not specified. Among those studies with specified autopsy types, 20 involved complete diagnostic autopsies, whereas 5 were categorized as partial or minimally invasive autopsies. There were 2333 pathogens identified, with 946 (40.5%) being mycobacteria, 856 (36.7%) fungal, 231 (3.8%) viral, 208 (8.9%) parasitic, and 92 (3.9%) bacterial. Of the 856 fungal pathogens identified, 654 (28.0%) were Cryptococcus species, 167 (7.2%) Pneumocystis jirovecii, 16 (0.69%) Histoplasma species, 15 (0.64%) Aspergillus species, and 4 (0.17%) Candida species. Other major non-fungal pathogens identified were cytomegalovirus 172 (7.37%) and Toxoplasma gondii 173 (7.42%). CONCLUSIONS Invasive fungal infections occur in over one-third of people who succumb to HIV in Africa. In addition to cryptococcosis and Pneumocystis jirovecii pneumonia, integrating other priority fungal pathogen detection and management strategies into the broader framework of HIV care in Africa is recommended. This involves increasing awareness regarding the impact of fungal infections in advanced HIV disease and strengthening diagnostic and treatment capacity.
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Affiliation(s)
- Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda; Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
| | - Winnie Kibone
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda; Department of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda
| | - Linda Atulinda
- Department of Internal Medicine, Mulago National Referral Hospital, Kampala, Uganda
| | - Bethan Morgan
- Trust Library Services, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Bright Ocansey
- Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Isabelle S R Storer
- Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Norman van Rhijn
- Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Conrad Muzoora
- Department of Internal Medicine, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - David W Denning
- Manchester Fungal Infection Group, Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA; Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA; National Emerging Infectious Disease Laboratory, Boston, MA, USA; Center for Emerging Infectious Diseases Policy & Research, Boston University, Boston, MA, USA
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21
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Ahammed KS, van Hoof A. Fungi of the order Mucorales express a "sealing-only" tRNA ligase. RNA (NEW YORK, N.Y.) 2024; 30:354-366. [PMID: 38307611 PMCID: PMC10946435 DOI: 10.1261/rna.079957.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/20/2024] [Indexed: 02/04/2024]
Abstract
Some eukaryotic pre-tRNAs contain an intron that is removed by a dedicated set of enzymes. Intron-containing pre-tRNAs are cleaved by tRNA splicing endonuclease, followed by ligation of the two exons and release of the intron. Fungi use a "heal and seal" pathway that requires three distinct catalytic domains of the tRNA ligase enzyme, Trl1. In contrast, humans use a "direct ligation" pathway carried out by RTCB, an enzyme completely unrelated to Trl1. Because of these mechanistic differences, Trl1 has been proposed as a promising drug target for fungal infections. To validate Trl1 as a broad-spectrum drug target, we show that fungi from three different phyla contain Trl1 orthologs with all three domains. This includes the major invasive human fungal pathogens, and these proteins can each functionally replace yeast Trl1. In contrast, species from the order Mucorales, including the pathogens Rhizopus arrhizus and Mucor circinelloides, have an atypical Trl1 that contains the sealing domain but lacks both healing domains. Although these species contain fewer tRNA introns than other pathogenic fungi, they still require splicing to decode three of the 61 sense codons. These sealing-only Trl1 orthologs can functionally complement defects in the corresponding domain of yeast Trl1 and use a conserved catalytic lysine residue. We conclude that Mucorales use a sealing-only enzyme together with unidentified nonorthologous healing enzymes for their heal and seal pathway. This implies that drugs that target the sealing activity are more likely to be broader-spectrum antifungals than drugs that target the healing domains.
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Affiliation(s)
- Khondakar Sayef Ahammed
- Department of Microbiology and Molecular Genetics, UT MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, University of Texas Health Science Center, Houston, Texas 77030, USA
| | - Ambro van Hoof
- Department of Microbiology and Molecular Genetics, UT MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences, University of Texas Health Science Center, Houston, Texas 77030, USA
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22
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Yao Z, Pan Z, Li G, Liao Z, Yu Z, Zhan L, Xia W. Talaromycosis from Wuhan: two-case report and literature review. Front Cell Infect Microbiol 2024; 14:1347677. [PMID: 38533387 PMCID: PMC10964487 DOI: 10.3389/fcimb.2024.1347677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/23/2024] [Indexed: 03/28/2024] Open
Abstract
Background Talaromycosis is a serious opportunistic infectious disease caused by Talaromyces marneffei, which mostly occurs in immunocompromised patients. The disease is mainly prevalent in tropical countries and regions of Southeast Asia and South Asia, but non-endemic areas also have patients with Talaromycosis. The disease has no characteristic clinical manifestations and is difficult to diagnose. Delayed diagnosis often leads to death. Case presentation Both patients had cellular immunodeficiency. Case 1 had a history of acquired immune deficiency syndrome, and case 2 had a history of renal transplantation and glucose-6-phosphate dehydrogenase deficiency. They all had fever, anemia, fatigue, and skin lesions. Case 1 had gastrointestinal bleeding, enlarged lymph nodes, and hepatosplenomegaly. Case 2 had cough and dyspnea. Both patients had thrombocytopenia and hypoalbuminemia; an increased neutrophil ratio, procalcitonin, and C-reactive protein; and abnormal liver function and coagulation dysfunction. Case 1 sputum culture, blood culture, and bronchoalveolar lavage fluid were positive for T. marneffei. T. marneffei was detected in the blood culture of case 2, with infection of Candida parapsilosis and Pneumocystis jirovecii. Chest computed tomography scan mainly showed pulmonary exudative lesions. Although these two patients were actively treated, they died of poor efficacy. Conclusion Talaromycosis has an insidious onset, long course, atypical clinical symptoms, imaging performance and laboratory results, difficult diagnosis, and high mortality. Therefore, it is important to promptly consider and treat Talaromycosis in immunocompromised patients upon infection in order to reduce mortality.
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Affiliation(s)
| | | | | | | | | | | | - Wenfang Xia
- Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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23
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Azar MM. A Diagnostic Approach to Fungal Pneumonia: An Infectious Diseases Perspective. Chest 2024; 165:559-572. [PMID: 37813181 DOI: 10.1016/j.chest.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 10/11/2023] Open
Abstract
Although bacteria significantly exceed fungi as the most common cause of lower respiratory tract infection, the incidence of fungal pneumonia is increasing because of a growing at-risk population of immunocompromised individuals as well as anthropogenic global heating and environmental disruption. When a patient presents with a clinical syndrome of pneumonia, a constellation of factors must be considered to determine the probability of a fungal pneumonia, including host factors, epidemiologic exposures, suggestive radiographic patterns, and the presence of a non-resolving pneumonia. In addition, knowledge of clinically important fungal pathogens, their epidemiology, and associated clinical syndromes are key in guiding appropriate diagnostic testing and result interpretation, and ultimately rendering a correct diagnosis of a fungal pneumonia. This article aims to provide a framework for the evaluation and appropriate diagnostic testing of patients with suspected fungal pneumonia.
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Affiliation(s)
- Marwan M Azar
- Department of Medicine, Section of Infectious Diseases and Department of Laboratory Medicine; Yale School of Medicine, New Haven, CT.
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24
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Liu X, Xing H, Lin J, Sun J, Wang Y, Liu Y, Cao W, Liu Z, Li T. Coexisting of Primary Central Nervous System Lymphoma and Talaromyces marneffei Brain Abscess in an AIDS Patient, A Case Report and Review of the Literature. Infect Drug Resist 2024; 17:709-718. [PMID: 38410795 PMCID: PMC10896102 DOI: 10.2147/idr.s432697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 02/06/2024] [Indexed: 02/28/2024] Open
Abstract
Background Talaromyces marneffei is prevalent in South Asia. Latent Talaromyces marneffei infection of travellers make the diagnosis difficult. There are similarities in clinical manifestations between Talaromyces marneffei infection and lymphoma. Brain abscess is a rare form of Talaromyces marneffei infection. Case Presentation We reported a very rare case of a 19-year-old man with HIV infection who suffered from a brain mass and lymphadenopathy. His blood culture, bone marrow culture and sputum culture all grew Talaromyces marneffei. One month after treatment with voriconazole, the symptoms improved except brain mass. Surgical incision of the brain mass showed a compact mass, and pathological analysis showed the coexisting Talaromyces marneffei abscess and lymphoma. The patient is currently in a stable condition after receiving antifungal therapy and chemotherapy. Conclusion Based on a case report of a traveller who suffered from a brain mass of Talaromyces marneffei abscess and lymphoma after a visit to an endemic area, this review summarized the cases where there was confusion between lymphoma and the brain abscess of Talaromyces marneffei. Talaromyces marneffei infection can be found globally due to the increasing number of international travels. Talaromyces marneffei infection and lymphoma had similar characteristics which is easy to misdiagnose in clinic. Infection may also be accompanied by tumors, especially in patients infected with HIV. The manifestations and imaging of brain abscess of Talaromyces marneffei were not characteristic in different patients.
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Affiliation(s)
- Xinchao Liu
- Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China
| | - Hao Xing
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Jing Lin
- Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Jian Sun
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China
| | - Yu Wang
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China
| | - Yaxu Liu
- Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China
| | - Wei Cao
- Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
| | - Zhengyin Liu
- Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China
| | - Taisheng Li
- Department of Infectious Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China
- Tsinghua-Peking Center for Life Sciences, Beijing, People’s Republic of China
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Kapoor N, Dietz C, Buettner BP. An Incarcerated Individual With Weight Loss and Interstitial Pulmonary Infiltrates. JAMA 2024; 331:522-523. [PMID: 38190148 DOI: 10.1001/jama.2023.24260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
A man with HIV had syncopal episodes and hypoxemia after recent exposure to SARS-CoV-2; computed tomography revealed diffuse bilateral pulmonary micronodular opacities, a 2.2-cm nodule in the lingula, and mediastinal and hilar lymphadenopathy. What is the diagnosis and what would you do next?
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Affiliation(s)
- Nilesh Kapoor
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Christina Dietz
- Division of Hospital Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
| | - Benjamin P Buettner
- Division of Hospital Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus
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26
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Boira Enrique I, Delgado Sánchez E, Esteban Ronda V, Chiner Vives E. Acute disseminated histoplasmosis with immune reconstitution syndrome after initiation of antiretroviral therapy in a patient with HIV. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2024; 42:110-111. [PMID: 37980190 DOI: 10.1016/j.eimce.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 11/20/2023]
Affiliation(s)
- Ignacio Boira Enrique
- Servicio de Neumología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Spain.
| | - Elisabet Delgado Sánchez
- Servicio de Enfermedades Infecciosas, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Spain
| | - Violeta Esteban Ronda
- Servicio de Neumología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Spain
| | - Eusebi Chiner Vives
- Servicio de Neumología, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Spain
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Yang H, Liu M, Xu N, Yang L, Wen S, Wang S, Qu C, Xu K, Sun E, Cui W, Liu H, Wang G. Disseminated Talaromyces marneffei infection associated with haemophagocytic syndrome in an HIV-negative patient in northern China: a case report. BMC Infect Dis 2024; 24:63. [PMID: 38191312 PMCID: PMC10775672 DOI: 10.1186/s12879-023-08953-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/26/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Talaromyces marneffei is endemic to eastern India, Southeast Asia, and Guangdong and Guangxi provinces in China. It is common in immunocompromised individuals, especially in HIV-infected patients. CASE PRESENTATION A 66-year-old male who had a history of hypertension and resided in Shandong Province (Northern China) was admitted for recurrent fever for one month. The patient had recurrent fever, multiple lymphadenopathies, hepatosplenomegaly, a back rash, and a progressive decrease in white blood cells and platelets. Talaromyces marneffei was isolated from peripheral blood and bone marrow after admission, and suspected fungal cells were found via lymph node pathology. The patient's infection secondary to haemophagocytic syndrome continued to worsen despite antifungal, anti-inflammatory, and symptomatic treatment, leading to death due to multiple-organ failure. CONCLUSION Although rare, infection due to Talaromyces marneffei in HIV-negative patients has been increasing in recent years, and we should be vigilant about "new" infections in nonendemic areas.
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Affiliation(s)
- Hui Yang
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China
| | - Ming Liu
- Jinan Center for Disease Control and Prevention, 250021, Jinan, Shandong, China
| | - Nannan Xu
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China
| | - Lulu Yang
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China
| | - Sai Wen
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China
| | - Shanshan Wang
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China
| | - Chunmei Qu
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China
| | - Ke Xu
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China
| | - Enhua Sun
- Microbiology Laboratory, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China
| | - Wen Cui
- Jinan Center for Disease Control and Prevention, 250021, Jinan, Shandong, China
| | - Hui Liu
- Jinan Center for Disease Control and Prevention, 250021, Jinan, Shandong, China.
| | - Gang Wang
- Department of Infectious Disease, Qilu Hospital, Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, China.
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Aderibigbe BA. Nanotherapeutics for the delivery of antifungal drugs. Ther Deliv 2024. [PMID: 38174574 DOI: 10.4155/tde-2023-0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
The treatment of fungal infections is challenging with high death rates reported among immunocompromised patients. The currently available antifungals suffer from poor bioavailability and solubility, pharmacokinetics, and drug resistance, with limited cellular uptake. The clinical pipeline of new antifungals is dry. The incorporation of antifungal drugs into polymer-based nanocarriers to form nanotherapeutics is a promising approach to enhance the therapeutic outcomes of the available antifungal drugs. This review summarizes different polymer-based nanotherapeutics strategies that have been explored for the delivery of antifungals, resulting in enhanced therapeutic outcomes, such as improved pharmacokinetics, targeted/sustained delivery, prolonged drug circulation, retention of the drugs at the localized site of action, and overcoming drug resistance when compared with the free antifungal drugs.
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Han M, Chae M, Han S. Assessment of fungal contamination and biosecurity risk factors in duck-breeding farms in South Korea. Poult Sci 2024; 103:103197. [PMID: 37925771 PMCID: PMC10652118 DOI: 10.1016/j.psj.2023.103197] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 11/07/2023] Open
Abstract
Fungi are pathogens that infect all types of poultry and farmers, leading to economic losses in poultry production. Fungi can be isolated from environmental samples and are ubiquitous in the air. This study aimed to evaluate fungal contamination in domestic duck farm environments and analyze biosecurity risk factors associated with fungal infection incidence to assess the vulnerability of the farms to fungal infection. The average fungal concentration was 203 colony-forming units (CFU)/m3 in the air and 365 × 103 CFU/m2 in the wall surface samples. Sixteen fungal genera were recovered from air and wall surface samples from 19 duck-breeding farms, Aspergillus being the most frequently isolated (air: 43.2%; wall surface: 40%). Eleven additional fungal genera (Acrophialophora, Byssochlamys, Fusarium, Lichtheimia, Paecilomyces, Penicillium, Polycephalomyces, Rhizomucor, Scopulariopsis, Talaromyces, and Thermoascus) were isolated from air samples. Also, 8 additional fungal genera (Chaetomium, Lichtheimia, Penicillium, Petriella, Rhizomucor, Rhizopus, Talaromyces, and Trichosporon) were isolated from wall surface samples. The characteristics of the poultry farms (geographic region, stocking density, breeding house type, affiliate, duck age, and season) and fungal concentrations in the air and wall surface samples were analyzed to evaluate the biosecurity risk of the farms. Fungal infections were significantly affected by high stocking density (>2 ducks/m2), duck age (18-25 wk and >60 wk), and high fungal concentration in the wall surface samples (>300 × 103 CFU/m2).
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Affiliation(s)
- Mina Han
- Institute of Chungbuk Provincial Veterinary Service and Research, Cheongju 28153, South Korea.
| | - Munhui Chae
- Institute of Chungbuk Provincial Veterinary Service and Research, Cheongju 28153, South Korea
| | - Seongtae Han
- Institute of Chungbuk Provincial Veterinary Service and Research, Cheongju 28153, South Korea
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Bai J, Qiao J. Multiple Umbilicated Papules on the Face. JAMA Dermatol 2024; 160:103-104. [PMID: 37966830 DOI: 10.1001/jamadermatol.2023.4162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
A man in his 20s presented to the dermatology department with a monthlong history of gradually progressing papules and nodules on the face, accompanied by fever, fatigue, and weight loss. What is your diagnosis?
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Affiliation(s)
- Juan Bai
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianjun Qiao
- Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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31
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Tadesse BT, Keddy KH, Rickett NY, Zhusupbekova A, Poudyal N, Lawley T, Osman M, Dougan G, Kim JH, Lee JS, Jeon HJ, Marks F. Vaccination to Reduce Antimicrobial Resistance Burden-Data Gaps and Future Research. Clin Infect Dis 2023; 77:S597-S607. [PMID: 38118013 PMCID: PMC10732565 DOI: 10.1093/cid/ciad562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
Antimicrobial resistance (AMR) poses an immediate danger to global health. If unaddressed, the current upsurge in AMR threatens to reverse the achievements in reducing the infectious disease-associated mortality and morbidity associated with antimicrobial treatment. Consequently, there is an urgent need for strategies to prevent or slow the progress of AMR. Vaccines potentially contribute both directly and indirectly to combating AMR. Modeling studies have indicated significant gains from vaccination in reducing AMR burdens for specific pathogens, reducing mortality/morbidity, and economic loss. However, quantifying the real impact of vaccines in these reductions is challenging because many of the study designs used to evaluate the contribution of vaccination programs are affected by significant background confounding, and potential selection and information bias. Here, we discuss challenges in assessing vaccine impact to reduce AMR burdens and suggest potential approaches for vaccine impact evaluation nested in vaccine trials.
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Affiliation(s)
- Birkneh Tilahun Tadesse
- International Vaccine Institute, Seoul, Republic of Korea
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Center for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | | | - Nimesh Poudyal
- International Vaccine Institute, Seoul, Republic of Korea
| | - Trevor Lawley
- Wellcome Sanger Institute and Microbiotica, Cambridge, United Kingdom
| | - Majdi Osman
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Gordon Dougan
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Jerome H Kim
- International Vaccine Institute, Seoul, Republic of Korea
- Seoul National University, College of Natural Sciences, Seoul, Republic of Korea
| | - Jung-Seok Lee
- International Vaccine Institute, Seoul, Republic of Korea
| | - Hyon Jin Jeon
- International Vaccine Institute, Seoul, Republic of Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar
| | - Florian Marks
- International Vaccine Institute, Seoul, Republic of Korea
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
- Madagascar Institute for Vaccine Research, University of Antananarivo, Antananarivo, Madagascar
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
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Shahid M, Alrumayyan BF, Ramzan M, Jalees Ahmed F, Malik A, Khuroo T, Alaofi AL. Impact of miconazole nitrate ferrying cationic and anionic nanoemulsion and gels on permeation profiles of across EpiDerm, artificial membrane, and skin: Instrumental evidences. Int J Pharm 2023; 648:123593. [PMID: 37956722 DOI: 10.1016/j.ijpharm.2023.123593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/15/2023]
Abstract
Based on our previous report, the study was extended to investigate the impact of miconazole nitrate (MCN) loaded cationic/anionic nanoemulsions and nanoemulsion gels on permeation behaviour across artificial-membrane, EpiDerm, and rat skin. Nanoemulsions and gels were evaluated for size, charge, viscosity, size-distribution, pH, and percent entrapment efficiency (%EE). In vitro drug diffusion across artificial membrane and EpiDerm were conducted to get diffusion coefficients. Permeation profiles were studied using rat skin to investigate mechanistic insight of formulated mediated permeation followed by CLSM (confocal laser scanning microscopy), SEM (scanning electron microscopy), AFM (atomic force microscopy), and irritation studies. Results showed that MCNE11-Rh (probed cationic nanoemulsion at pH ∼ 7.2) and MNE11-Rh (probed anionic nanoemulsion at pH ∼ 7.2) showed size values of 158 nm and 145 nm, respectively whereas MCNE11-GR (probed cationic nanoemulsion gel at pH ∼ 6.8) and MNE11-GR (probed anionic nanoemulsion gel at pH ∼ 6.8) exhibited size values 257 nm and 243 nm, respectively. The %EE values were found to be as 91.5 % and 89.6 % for MCNE11-Rh and MNE11-Rh, respectively. The gels (∼6000 cP) elicited relatively high viscosity than nanoemulsions (∼3300 - 3500 cP). MCNE11-GR showed the highest values of permeation flux, diffusion rate, diffusion coefficient (D), and permeation coefficient (P) across artificial membrane, EpiDerm, and rat skin which may be attributed to three potential factors (cationic charge, composition, and hydration by the hydrophilic gel) working in tandem. Transepidermal water loss (TEWL) by the MCNE11-GR was maximum (14.4 g/m2h) than control (6.1 g/m2h) indicating augmented interaction of MCNE11-Rh with skin components. Conclusively, cationic nanoemulsion gel was promising carrier for enhanced permeation and the drug access to the dermal region to treat deep seated fungal infections.
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Affiliation(s)
- Mudassar Shahid
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia.
| | | | - Mohhammad Ramzan
- Department of Pharmaceutics, UIPS, Panjab University, Chandigarh, Punjab, India.
| | - Farhan Jalees Ahmed
- Department of Pharmaceutics, School of Pharmaceutical Education and Research (SPER), Jamia Hamdard, New Delhi 110062, India
| | - Abdul Malik
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Tahir Khuroo
- Department of Pharmaceutics, PGx Global Foundation, 5600 S Willow Dr Houston, Duarte, TX 77035, USA.
| | - Ahmed L Alaofi
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
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Pan L, Shao H. Ultrasound characterization of superficial lymph nodes in HIV patients with Talaromyces marneffei infection. Front Med (Lausanne) 2023; 10:1243599. [PMID: 38148912 PMCID: PMC10750475 DOI: 10.3389/fmed.2023.1243599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/10/2023] [Indexed: 12/28/2023] Open
Abstract
Objectives This study aimed at exploring the ultrasound characteristics of superficial lymph nodes (LNs) in HIV patients with Talaromyces marneffei infection to provide assistance and understanding for diagnosis and therapy. Methods A retrospective analysis was conducted on 26 patients with confirmed HIV and T.marneffei coinfection. These patients underwent ultrasound examination and ultrasound-guided puncture biopsies at our hospital from March 2015 to March 2023. Results In all 26 patients, lymphadenectasis was observed. Among the 21 cases (80.76%), LNs showed a diffusely hyperechoic appearance with a tulle-like change, and 6 cases (23.07%) showed liquefaction. When the hila were present or thinned, the blood flow signals were primarily hilar, whether rich or poor, and when the hila were absent, the blood flow signals were peripheral or poor. The axillary LN long-to-short diameter (L/S) ratios exhibited a significant positive correlation with CD4+T cell counts (r = 0.8214, p = 0.0341). Patients with retroperitoneal lymphadenectasis showed decreased NK cell counts (p = 0.03). Conclusion In summary, the T.marneffei infection of LNs in HIV patients often manifests with superficial LN enlargement, mostly affecting the cervical LNs. The T.marneffei-infected LNs exhibit several characteristics such as echogenicity, hilum, and blood flow signal. Furthermore, there might be associations between lymphocyte subsets and enlarged superficial LNs. Ultrasound examinations should be paid attention to if patients have superficial LN enlargement, and the diagnosis of the T.marneffei infection is considered.
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Affiliation(s)
- Lin Pan
- Department of Ultrasound, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Huaguo Shao
- Institute of Hepatology and Epidemiology, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Zhu X, Chen Y, Yu D, Fang W, Liao W, Pan W. Progress in the application of nanoparticles for the treatment of fungal infections: A review. Mycology 2023; 15:1-16. [PMID: 38558835 PMCID: PMC10977003 DOI: 10.1080/21501203.2023.2285764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 10/28/2023] [Indexed: 04/04/2024] Open
Abstract
The burden of fungal infections on human health is increasing worldwide. Aspergillus, Candida, and Cryptococcus are the top three human pathogenic fungi that are responsible for over 90% of infection-related deaths. Moreover, effective antifungal therapeutics are lacking, primarily due to host toxicity, pathogen resistance, and immunodeficiency. In recent years, nanomaterials have proved not only to be more efficient antifungal therapeutic agents but also to overcome resistance against fungal medication. This review will examine the limitations of standard antifungal therapy as well as focus on the development of nanomaterials.
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Affiliation(s)
- Xinlin Zhu
- Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Youming Chen
- Department of Infectious Diseases and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Dan Yu
- Department of General Practice, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Wenjie Fang
- Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Wanqing Liao
- Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Weihua Pan
- Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Second Affiliated Hospital of Naval Medical University, Shanghai, China
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Bourne-Watrin M, Adenis A, Doppelt G, Zappa M, Epelboin L, Nacher M, Bigot J, Drak Alsibai K, Blaizot R, Blanchet D, Demar M, Guillot G, Djossou F, Couppié P. Pulmonary Histoplasmosis in People Living with Human Immunodeficiency Virus in French Guiana: Clinical Epidemiology, Medical Imaging and Prognostic. Mycopathologia 2023; 188:1065-1078. [PMID: 37839020 PMCID: PMC10687118 DOI: 10.1007/s11046-023-00799-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/19/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Histoplasmosis is mainly described as a disseminated disease in people living with HIV (PLHIV). Compared to historical descriptions in immunocompetent individuals, knowledge is lacking on the detailed clinical and radiological findings and outcomes of pulmonary histoplasmosis (PH). Overlooked or misdiagnosed with other AIDS-defining condition, prognostic of PLHIV may be at risk because of inappropriate care. METHODS A retrospective multicentric study was conducted in PLHIV from French Guiana between January 1988 and October 2019. Proven PH were documented through mycological direct examination, culture, or histology. Patients with concomitant respiratory infections were excluded. RESULTS Among 65 patients, sex ratio M:F was 2.4 with a median age of 39 years [IQR 25-75%: 34-44]. Median CD4 count was 24 cells/mm3 [11-71], with histoplasmosis as the AIDS-defining condition in 88% and concomitant AIDS-defining conditions in 29%. Clinical findings were fever (89%), cough (58%), dyspnea (35%), expectoration (14%), and hemoptysis (5%). Sixty-one X-rays and 24 CT-scans were performed. On X-rays, an interstitial lung disease was mainly found (77%). On CT-scans, a nodular pattern was predominant (83%): mostly miliary disease (63%), but also excavated nodules (35%). Consolidations were present in 46%, associated with miliary disease in 21%. Thoracic lymphadenopathies were found in 58%, mainly hilar and symmetric (33%). Despite antifungal treatment, case-fatality rate at one month was 22%. CONCLUSION When faced with an interstitial lung disease on X-rays or a miliary pattern on CT-scans in advanced PLHIV, physicians in endemic areas, apart from tuberculosis or pneumocystosis, should include histoplasmosis as part of their differential diagnoses.
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Affiliation(s)
- Morgane Bourne-Watrin
- Service de Dermatologie-Vénérologie, Centre Hospitalier de Cayenne, Cayenne, France.
| | - Antoine Adenis
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, Centre Hospitalier de Cayenne, Cayenne, France
| | - Gary Doppelt
- Service de Radiologie, Centre Hospitalier de Cayenne, Cayenne, France
| | - Magaly Zappa
- Service de Radiologie, Centre Hospitalier de Cayenne, Cayenne, France
| | - Loïc Epelboin
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, Centre Hospitalier de Cayenne, Cayenne, France
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, France
| | - Mathieu Nacher
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, Centre Hospitalier de Cayenne, Cayenne, France
| | - Jeanne Bigot
- Service de Parasitologie-Mycologie, Centre Hospitalier Saint Antoine APHP, Paris, France
| | - Kinan Drak Alsibai
- Laboratoire d'Anatomie et Cytologie Pathologique, Centre Hospitalier de Cayenne, Cayenne, France
| | - Romain Blaizot
- Service de Dermatologie-Vénérologie, Centre Hospitalier de Cayenne, Cayenne, France
| | - Denis Blanchet
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, Cayenne, France
| | - Magalie Demar
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, Cayenne, France
| | - Geneviève Guillot
- Service de Médecine B, Centre Hospitalier de Cayenne, Cayenne, France
| | - Félix Djossou
- Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, Cayenne, France
| | - Pierre Couppié
- Service de Dermatologie-Vénérologie, Centre Hospitalier de Cayenne, Cayenne, France
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Wang Q, Zhao H, Tong Y, Qin J, Zhou M, Xu L. Aspartate Aminotransferase/Platelet Ratio Index Upon Admission Predicts 24-Week Mortality in Patients With HIV-Associated Talaromyces marneffei. Open Forum Infect Dis 2023; 10:ofad593. [PMID: 38107017 PMCID: PMC10721445 DOI: 10.1093/ofid/ofad593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
Background A high aspartate aminotransferase/platelet ratio index (APRI) predicts mortality in patients with severe infection. This study aims to assess the potential of APRI as a predictor for mortality in patients with HIV-associated Talaromyces marneffei (HTM). Methods Associations between APRI and CD4 count, white blood cell count, C-reactive protein (CRP) level, procalcitonin (PCT) level, and cytokines were assessed in 119 patients. Univariate and multivariate Cox regression models were used to predict APRI on 24-week mortality. Results APRI was positively associated with CRP (r = 0.190, P = .039), PCT (r = 0.220, P = .018), interleukin 6 (r = 0.723, P < .001), interleukin 10 (r = 0.416, P = .006), and tumor necrosis factor α (r = 0.575, P < .001) and negatively associated with CD4 count (r = -0.234, P = .011). In total, 20.2% (24/119) of patients died within the 24-week follow-up. The 24-week survival rate was 88.0% for patients with APRI <5.6% and 61.1% for those with APRI ≥5.6 (log-rank P < .001). After adjustment for sex, age, body mass index, and CD4 count, as well as serum levels of hemoglobin, APRI ≥5.6 (adjusted hazard ratio [95% CI]; 3.0 [1.2-7.1], P = .015), PCT ≥1.7 ng/mL (3.7 [1.5-9.6], P = .006), and non-amphotericin B deoxycholate treatment (2.8 [1.2-6.6], P = .018) were independent risk factors for 24-week mortality. Conclusions For patients with HTM, APRI is associated with severity and is an independent risk factor for 24-week mortality.
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Affiliation(s)
- Qi Wang
- National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Infectious Diseases, Huzhou Central Hospital of Zhejiang University, Huzhou, China
| | - Handan Zhao
- National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- College of Medicine, Zhejiang University, Hangzhou, China
| | - Yong Tong
- The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- Department of Infectious Diseases, Huzhou Central Hospital of Zhejiang University, Huzhou, China
| | - Jiaying Qin
- College of Medicine, Zhejiang University, Hangzhou, China
| | - Minghan Zhou
- College of Medicine, Zhejiang University, Hangzhou, China
| | - Lijun Xu
- National Clinical Research Center for Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
- The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Dornelles G, Araújo GRDS, Rodrigues M, Alves V, Almeida-Paes R, Frases S. Comparative Analysis of Capsular and Secreted Polysaccharides Produced by Rhodotorula mucilaginosa and Cryptococcus neoformans. J Fungi (Basel) 2023; 9:1124. [PMID: 37998929 PMCID: PMC10672113 DOI: 10.3390/jof9111124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
Fungal infections are a global public health challenge, especially among immunocompromised patients. Basidiomycetous yeasts, such as Rhodotorula mucilaginosa, have emerged as opportunistic pathogens, but have received less attention than Cryptococcus neoformans. This study aimed to characterize the polysaccharides of R. mucilaginosa and compare them with those of C. neoformans, analyzing their clinical implications. Comprehensive physicochemical, mechanical, and ultrastructural analyses of polysaccharides from both species were performed, revealing correlations with virulence and pathogenicity. R. mucilaginosa cells are surrounded by a capsule smaller than that produced by C. neoformans, but with similar polysaccharides. Those polysaccharides are also secreted by R. mucilaginosa. Cross-reactivity with R. mucilaginosa was observed in a diagnostic C. neoformans antigen test, using both in vitro and in vivo samples, highlighting the need for more reliable tests. Some R. mucilaginosa strains exhibited virulence comparable to that of C. neoformans in an invertebrate experimental model (Tenebrio molitor). This study contributes to a deeper understanding of yeast pathogenicity and virulence, highlighting the need for more accurate diagnostic tests to improve the differential diagnosis of infections caused by basidiomycetous yeasts.
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Affiliation(s)
- Gustavo Dornelles
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (G.D.); (G.R.d.S.A.); (M.R.); (V.A.)
| | - Glauber R. de S. Araújo
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (G.D.); (G.R.d.S.A.); (M.R.); (V.A.)
| | - Marcus Rodrigues
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (G.D.); (G.R.d.S.A.); (M.R.); (V.A.)
| | - Vinicius Alves
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (G.D.); (G.R.d.S.A.); (M.R.); (V.A.)
| | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil;
- Rede Micologia RJ, Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Rio de Janeiro 21040-360, Brazil
| | - Susana Frases
- Laboratório de Biofísica de Fungos, Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (G.D.); (G.R.d.S.A.); (M.R.); (V.A.)
- Rede Micologia RJ, Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Rio de Janeiro 21040-360, Brazil
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Ahammed KS, van Hoof A. Fungi of the order Mucorales express a "sealing-only" tRNA ligase. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.16.567474. [PMID: 38014270 PMCID: PMC10680797 DOI: 10.1101/2023.11.16.567474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Some eukaryotic pre-tRNAs contain an intron that is removed by a dedicated set of enzymes. Intron-containing pre-tRNAs are cleaved by tRNA splicing endonuclease (TSEN), followed by ligation of the two exons and release of the intron. Fungi use a "heal and seal" pathway that requires three distinct catalytic domains of the tRNA ligase enzyme, Trl1. In contrast, humans use a "direct ligation" pathway carried out by RTCB, an enzyme completely unrelated to Trl1. Because of these mechanistic differences, Trl1 has been proposed as a promising drug target for fungal infections. To validate Trl1 as a broad-spectrum drug target, we show that fungi from three different phyla contain Trl1 orthologs with all three domains. This includes the major invasive human fungal pathogens, and these proteins each can functionally replace yeast Trl1. In contrast, species from the order Mucorales, including the pathogens Rhizopus arrhizus and Mucor circinelloides, contain an atypical Trl1 that contains the sealing domain, but lack both healing domains. Although these species contain fewer tRNA introns than other pathogenic fungi, they still require splicing to decode three of the 61 sense codons. These sealing-only Trl1 orthologs can functionally complement defects in the corresponding domain of yeast Trl1 and use a conserved catalytic lysine residue. We conclude that Mucorales use a sealing-only enzyme together with unidentified non-orthologous healing enzymes for their heal and seal pathway. This implies that drugs that target the sealing activity are more likely to be broader-spectrum antifungals than drugs that target the healing domains.
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Affiliation(s)
- Khondakar Sayef Ahammed
- Department of Microbiology and Molecular Genetics. UT MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences. University of Texas Health Science Center at Houston
| | - Ambro van Hoof
- Department of Microbiology and Molecular Genetics. UT MD Anderson Cancer Center UTHealth Houston Graduate School of Biomedical Sciences. University of Texas Health Science Center at Houston
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Sati H, Alastruey-Izquierdo A, Perfect J, Govender NP, Harrison TS, Chiller T, Sorrell TC, Bongomin F, Oladele R, Chakrabarti A, Wahyuningsih R, Colombo AL, Rodriguez-Tudela JL, Beyrer C, Ford N. HIV and fungal priority pathogens. Lancet HIV 2023; 10:e750-e754. [PMID: 37827187 PMCID: PMC7615271 DOI: 10.1016/s2352-3018(23)00174-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 10/14/2023]
Abstract
The burden of invasive fungal infections associated with opportunistic fungal pathogens is a persistent challenge, particularly among people with advanced HIV disease. In October, 2022, WHO published the Fungal Priority Pathogens List (FPPL)-the first global effort to systematically prioritise fungal pathogens. Of the 19 pathogens in the WHO FPPL, four opportunistic pathogens in particular cause invasive diseases in people living with HIV: Cryptococcus neoformans, Histoplasma spp, Pneumocystis jirovecii, and Talaromyces marneffei. These four fungal pathogens are major causes of illness and death in people with advanced HIV and overwhelmingly affect those in low-income and middle-income countries. Access to diagnostics, improved surveillance, targeted support for innovation, and an enhanced public health focus on these diseases are needed in the effort to reduce HIV-associated deaths.
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Affiliation(s)
- Hatim Sati
- Antimicrobial Resistance Division, WHO, Geneva, Switzerland
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - John Perfect
- Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Nelesh P Govender
- National Institute for Communicable Diseases, Division of the National Health Laboratory Service, School of Pathology, University of the Witwatersrand, Johannesburg, South Africa; MRC Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Tom S Harrison
- Centre for Global Health, Institute of Infection and Immunity, St George's University of London, London, UK; MRC Centre for Medical Mycology, University of Exeter, Exeter, UK
| | - Tom Chiller
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tania C Sorrell
- Sydney Infectious Disease Institute, University of Sydney, Sydney, NSW, Australia
| | - Felix Bongomin
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda
| | - Rita Oladele
- Department of Medical Microbiology and Parasitology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | | | - Retno Wahyuningsih
- Department of Parasitology, Universitas Indonesia and Universitas Kristen Indonesia, Indonesia
| | - Arnaldo Lopes Colombo
- Department of Medicine, Division of Infectious Diseases, Federal University of São Paulo, São Paulo, Brazil
| | | | - Chris Beyrer
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Nathan Ford
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organization, Geneva, Switzerland; Centre for Infectious Disease and Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
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40
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Gong D, Lin W, Zhang H, Ou X, Li L, Guo P, He Y, Liu C, Cai W, Tang X, Li L. An evaluation of Mp1p antigen screening for talaromycosis in HIV-infected antiretroviral therapy-naïve population in Guangdong, China. PLoS Negl Trop Dis 2023; 17:e0011785. [PMID: 38011216 PMCID: PMC10703259 DOI: 10.1371/journal.pntd.0011785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 12/07/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Talaromycosis is one of the most common opportunistic infections in human immunodeficiency virus (HIV) infected patients. However, few researches have explored the prevalence in Southern China and fully assessed the value of the Mp1p antigen screening for the diagnosis of talaromycosis. METHODOLOGY/PRINCIPAL FINDINGS We performed a cross-sectional study of HIV-infected antiretroviral therapy (ART)-naïve adult patients who were seen in 2018 at Guangzhou Eighth People's Hospital, Guangzhou Medical University. Serum samples collected from all the 784 enrolled patients were tested for Mp1p antigen using double-antibody sandwich enzyme-linked immunosorbent assay. A culture of pathogen was conducted in 350 clinically suspected patients to confirm talaromycosis. The overall prevalence of talaromycosis based on the Mp1p antigen detection was 11.4% (89/784) and peaked at 32.2% (75/233) in patients with CD4+ ≤50 Nr/μl. Logistic regression analysis found Mp1p antigen positive rate decreased with the increase in CD4+ counts (OR 0.982, 95% CI 0.977-0.987, P<0.01). The optimal cut-off point of the CD4+ count was 50 Nr/μl or less. Among the 350 patients received both fungal culture and Mp1p antigen detection, 95/350 (27.1%) patients were culture-positive for a Talaromyces marneffei, 75/350 (21.4%) patients were Mp1p antigen positive. The Mp1p antigen assay showed a good agreement to the culture of pathogen, and the sensitivity, specificity, positive predictive value, negative predictive value and kappa value was 71.6% (68/95), 97.3% (248/255), 90.7% (68/75), 90.2% (248/275), and 0.737, respectively. The screening accuracy of the Mp1p antigen assay in patients with CD4+ counts of ≤50 Nr/μl was superior to that in those with higher CD4+ counts. CONCLUSIONS/SIGNIFICANCE Mp1p antigen screening can be an effective tool for more efficient diagnosis of Talaromycosis, especially in HIV/AIDS patients with low CD4+ counts. Future validation studies are needed.
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Affiliation(s)
- Dandan Gong
- Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Weiyin Lin
- Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Huihua Zhang
- Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xu Ou
- Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Liya Li
- Research Institute, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Pengle Guo
- Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yaozu He
- Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Cong Liu
- Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Weiping Cai
- Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaoping Tang
- Research Institute, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Linghua Li
- Infectious Disease Center, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
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41
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Özcan E, Vagolu SK, Gündüz MG, Stevanovic M, Kökbudak Z, Tønjum T, Nikodinovic-Runic J, Çetinkaya Y, Doğan ŞD. Novel Quinoline-Based Thiosemicarbazide Derivatives: Synthesis, DFT Calculations, and Investigation of Antitubercular, Antibacterial, and Antifungal Activities. ACS OMEGA 2023; 8:40140-40152. [PMID: 37929089 PMCID: PMC10620885 DOI: 10.1021/acsomega.3c03018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/12/2023] [Indexed: 11/07/2023]
Abstract
The discovery of new antimicrobial agents as a means of treating drug-resistant microbial pathogens is of utmost significance to overcome their immense risk to human well-being. The current investigation involves the development, synthesis, and assessment of the antimicrobial efficacy of novel quinoline derivatives incorporating a thiosemicarbazide functionality. To design the target compounds (QST1-QST14), we applied the molecular hybridization approach to link various thiosemicarbazides to the quinoline core with a sulfonyl group. Upon the synthesis and completion of structural characterization via spectroscopic techniques (1H NMR, 13C NMR, 15N NMR, IR, and HRMS), the title molecules were extensively evaluated for their potential antitubercular, antibacterial, and antifungal activities. N-(3-Chlorophenyl)-2-(quinolin-8-ylsulfonyl)hydrazine-1-carbothioamide (QST4), the most effective compound against Mycobacterium tuberculosis H37Rv, was also tested on isoniazid-resistant clinical isolates with katG and inhA promoter mutations. Based on molecular docking studies, QST4 was also likely to demonstrate its antimycobacterial activity through inhibition of the InhA enzyme. Furthermore, three derivatives (QST3, QST4, and QST10) with preferable antimicrobial and drug-like profiles were also shown to be nontoxic against human embryonic kidney (HEK) cells. All compounds were optimized by the density functional theory method using B3LYP with the 6-31+G(d,p) basis set. Structural analysis, natural bond orbital calculations of donor-acceptor interactions, molecular electrostatic potential analysis, and frontier molecular orbital analysis were carried out. Quantum chemical descriptors and charges on the atoms were determined to compare the strengths of the intramolecular hydrogen bonds formed and their stabilities. We determined that the sulfur atom forms a stronger intramolecular hydrogen bond than the nitrogen, oxygen, and fluorine atoms in these sulfonyl thiosemicarbazide derivatives.
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Affiliation(s)
- Esma Özcan
- Department
of Chemistry, Faculty of Science, Erciyes
University, 38039 Kayseri, Turkey
- Department
of Basic Sciences, Faculty of Pharmacy, Erciyes University, 38039 Kayseri, Turkey
| | - Siva Krishna Vagolu
- Unit
for Genome Dynamics, Department of Microbiology, University of Oslo, 0316 Oslo, Norway
| | - Miyase Gözde Gündüz
- Department
of Pharmaceutical Chemistry, Faculty of Pharmacy, Hacettepe University, Sıhhiye, 06100 Ankara, Turkey
| | - Milena Stevanovic
- Institute
of Molecular Genetics and Genetic Engineering, University of Belgrade, 11000 Belgrade, Serbia
| | - Zülbiye Kökbudak
- Department
of Chemistry, Faculty of Science, Erciyes
University, 38039 Kayseri, Turkey
| | - Tone Tønjum
- Unit
for Genome Dynamics, Department of Microbiology, University of Oslo, 0316 Oslo, Norway
- Unit for
Genome Dynamics, Department of Microbiology, Oslo University Hospital, 0316 Oslo, Norway
| | - Jasmina Nikodinovic-Runic
- Institute
of Molecular Genetics and Genetic Engineering, University of Belgrade, 11000 Belgrade, Serbia
| | - Yasin Çetinkaya
- Department
of Chemistry, Faculty of Science, Atatürk
University, 25240 Erzurum, Turkey
| | - Şengül Dilem Doğan
- Department
of Basic Sciences, Faculty of Pharmacy, Erciyes University, 38039 Kayseri, Turkey
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42
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Wang F, Wu J, Yuan M, Yan Z, Liu X, Li W, Zhang Y, Sheng C, Liu N, Huang Z. Novel Nitric Oxide Donor-Azole Conjugation Strategy for Efficient Treatment of Cryptococcus neoformans Infections. J Med Chem 2023; 66:14221-14240. [PMID: 37820326 DOI: 10.1021/acs.jmedchem.3c01308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Invasive fungal infections (IFIs) such as cryptococcal meningitis (CM) remain a serious health issue worldwide due to drug resistance closely related to biofilm formation. Unfortunately, available antifungal drugs with ideal safety and promising potency are still lacking; thus, the research of new candidate and therapeutic approach is urgently needed. As an important gas messenger molecule, nitric oxide (NO) shows vital inhibition on various microorganism biofilms. Hence, three series of novel NO-donating azole derivatives were designed and synthesized, and the in vitro antifungal activity as well as the mechanism of action was investigated. Among them, 3a and 3e displayed excellent antifungal activity against Cryptococcus neoformans and biofilm depending on the release of NO. Moreover, a more stable analogue 3h of 3a demonstrated markedly anti-CM effects via intranasal dropping, avoiding the first-pass effects and possessing a better brain permeability bypass blood-brain barrier. These results present a promising antifungal candidate and intranasal dropping approach for the treatment of CM, warranting further studies.
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Affiliation(s)
- Fangfang Wang
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University (Naval Medical University), Shanghai 200433, P. R. China
- Naval Medical Center, Second Military Medical University, Shanghai 200433, P. R. China
| | - Jianbing Wu
- Center of Drug Discovery, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 211198, P. R. China
| | - Mingke Yuan
- Center of Drug Discovery, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 211198, P. R. China
| | - Zhengsheng Yan
- Center of Drug Discovery, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 211198, P. R. China
| | - Xin Liu
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University (Naval Medical University), Shanghai 200433, P. R. China
| | - Wang Li
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University (Naval Medical University), Shanghai 200433, P. R. China
| | - Yihua Zhang
- Center of Drug Discovery, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 211198, P. R. China
| | - Chunquan Sheng
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University (Naval Medical University), Shanghai 200433, P. R. China
| | - Na Liu
- The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Second Military Medical University (Naval Medical University), Shanghai 200433, P. R. China
| | - Zhangjian Huang
- Center of Drug Discovery, State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing 211198, P. R. China
- School of Pharmacy, Xinjiang Medical University, Urumqi 830054, P. R. China
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43
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Wei W, Wang G, Zhang H, Bao X, An S, Luo Q, He J, Chen L, Ning C, Lai J, Yuan Z, Chen R, Jiang J, Ye L, Liang H. Talaromyces marneffei suppresses macrophage inflammation by regulating host alternative splicing. Commun Biol 2023; 6:1046. [PMID: 37845378 PMCID: PMC10579421 DOI: 10.1038/s42003-023-05409-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/02/2023] [Indexed: 10/18/2023] Open
Abstract
Talaromyces marneffei (T. marneffei) immune escape is essential in the pathogenesis of talaromycosis. It is currently known that T. marneffei achieves immune escape through various strategies. However, the role of cellular alternative splicing (AS) in immune escape remains unclear. Here, we depict the AS landscape in macrophages upon T. marneffei infection via high-throughput RNA sequencing and detect a truncated protein of NCOR2 / SMRT, named NCOR2-013, which is significantly upregulated after T. marneffei infection. Mechanistic analysis indicates that NCOR2-013 forms a co-repression complex with TBL1XR1 / TBLR1 and HDAC3, thereby inhibiting JunB-mediated transcriptional activation of pro-inflammatory cytokines via the inhibition of histone acetylation. Furthermore, we identify TUT1 as the AS regulator that regulates NCOR2-013 production and promotes T. marneffei immune evasion. Collectively, these findings indicate that T. marneffei escapes macrophage killing through TUT1-mediated alternative splicing of NCOR2 / SMRT, providing insight into the molecular mechanisms of T. marneffei immune evasion and potential targets for talaromycosis therapy.
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Affiliation(s)
- Wudi Wei
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Gang Wang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Hong Zhang
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Xiuli Bao
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Sanqi An
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Qiang Luo
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Jinhao He
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Lixiang Chen
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Chuanyi Ning
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Nursing College, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Jingzhen Lai
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Guangxi Biobank, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Zongxiang Yuan
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Rongfeng Chen
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Junjun Jiang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China.
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China.
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China.
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China.
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021, Guangxi, China.
- Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China.
- Guangxi Biobank, Life Sciences Institute, Guangxi Medical University, Nanning, 530021, Guangxi, China.
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Shin WS, Xie F, Chen B, Yu J, Lo KW, Tse GMK, To KF, Kang W. Exploring the Microbiome in Gastric Cancer: Assessing Potential Implications and Contextualizing Microorganisms beyond H. pylori and Epstein-Barr Virus. Cancers (Basel) 2023; 15:4993. [PMID: 37894360 PMCID: PMC10605912 DOI: 10.3390/cancers15204993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/11/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
While previous research has primarily focused on the impact of H. pylori and Epstein-Barr virus (EBV), emerging evidence suggests that other microbial influences, including viral and fungal infections, may also contribute to gastric cancer (GC) development. The intricate interactions between these microbes and the host's immune response provide a more comprehensive understanding of gastric cancer pathogenesis, diagnosis, and treatment. The review highlights the roles of established players such as H. pylori and EBV and the potential impacts of gut bacteria, mainly Lactobacillus, Streptococcus, hepatitis B virus, hepatitis C virus, and fungi such as Candida albicans. Advanced sequencing technologies offer unprecedented insights into the complexities of the gastric microbiome, from microbial diversity to potential diagnostic applications. Furthermore, the review highlights the potential for advanced GC diagnosis and therapies through a better understanding of the gut microbiome.
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Affiliation(s)
- Wing Sum Shin
- State Key Laboratory of Translational Oncology, Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China; (W.S.S.); (F.X.); (B.C.); (K.W.L.); (G.M.K.T.); (K.F.T.)
| | - Fuda Xie
- State Key Laboratory of Translational Oncology, Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China; (W.S.S.); (F.X.); (B.C.); (K.W.L.); (G.M.K.T.); (K.F.T.)
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong 999077, China;
- CUHK—Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen 518000, China
| | - Bonan Chen
- State Key Laboratory of Translational Oncology, Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China; (W.S.S.); (F.X.); (B.C.); (K.W.L.); (G.M.K.T.); (K.F.T.)
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong 999077, China;
- CUHK—Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen 518000, China
| | - Jun Yu
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong 999077, China;
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Kwok Wai Lo
- State Key Laboratory of Translational Oncology, Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China; (W.S.S.); (F.X.); (B.C.); (K.W.L.); (G.M.K.T.); (K.F.T.)
| | - Gary M. K. Tse
- State Key Laboratory of Translational Oncology, Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China; (W.S.S.); (F.X.); (B.C.); (K.W.L.); (G.M.K.T.); (K.F.T.)
| | - Ka Fai To
- State Key Laboratory of Translational Oncology, Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China; (W.S.S.); (F.X.); (B.C.); (K.W.L.); (G.M.K.T.); (K.F.T.)
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong 999077, China;
| | - Wei Kang
- State Key Laboratory of Translational Oncology, Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong 999077, China; (W.S.S.); (F.X.); (B.C.); (K.W.L.); (G.M.K.T.); (K.F.T.)
- State Key Laboratory of Digestive Disease, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong 999077, China;
- CUHK—Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen 518000, China
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45
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Murcia-Galán RA, Durán SM, Leal-Pinto SM, Roa-Cordero MV, Vargas JD, Herrera LV, Muñoz-Castro A, MacLeod-Carey D, Naranjo TW, Rodríguez-Kessler PL, Hurtado JJ. Antifungal activity of Co(II) and Cu(II) complexes containing 1,3-bis(benzotriazol-1-yl)-propan-2-ol on the growth and virulence traits of fluconazole-resistant Candida species: synthesis, DFT calculations, and biological activity. BMC Chem 2023; 17:135. [PMID: 37817173 PMCID: PMC10563319 DOI: 10.1186/s13065-023-01037-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 09/13/2023] [Indexed: 10/12/2023] Open
Abstract
Relevant virulence traits in Candida spp. are associated with dimorphic change and biofilm formation, which became an important target to reduce antifungal resistance. In this work, Co(II) complexes containing a benzotriazole derivative ligand showed a promising capacity of reducing these virulence traits. These complexes exhibited higher antifungal activities than the free ligands against all the Candida albicans and non-albicans strains tested, where compounds 2 and 4 showed minimum inhibitory concentration values between 15.62 and 125 μg mL-1. Moreover, four complexes (2-5) of Co(II) and Cu(II) with benzotriazole ligand were synthesized. These compounds were obtained as air-stable solids and characterized by melting point, thermogravimetric analysis, infrared, Raman and ultraviolet/visible spectroscopy. The analysis of the characterization data allowed us to identify that all the complexes had 1:1 (M:L) stoichiometries. Additionally, Density Functional Theory calculations were carried out for 2 and 3 to propose a probable geometry of both compounds. The conformer Da of 2 was the most stable conformer according to the Energy Decomposition Analysis; while the conformers of 3 have a fluxional behavior in this analysis that did not allow us to determine the most probable conformer. These results provide an important platform for the design of new compounds with antifungal activities and the capacity to attack other target of relevance to reduce antimicrobial resistance.
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Affiliation(s)
- Ricardo A. Murcia-Galán
- Grupo de Investigación en Química Inorgánica, Catálisis y Bioinorgánica, Departamento de Química, Universidad de los Andes, Carrera 1 No. 18A-12, 111711 Bogotá, Colombia
| | - Sandra M. Durán
- Facultad de Ciencias Médicas y de la Salud, Universidad de Santander, Calle 70 No. 55-210, Bucaramanga, Colombia
| | - Sandra M. Leal-Pinto
- Facultad de Ciencias Médicas y de la Salud, Universidad de Santander, Calle 70 No. 55-210, Bucaramanga, Colombia
| | - Martha V. Roa-Cordero
- Facultad de Ciencias Médicas y de la Salud, Universidad de Santander, Calle 70 No. 55-210, Bucaramanga, Colombia
| | - Jose D. Vargas
- Facultad de Ciencias Médicas y de la Salud, Universidad de Santander, Calle 70 No. 55-210, Bucaramanga, Colombia
| | - Laura V. Herrera
- Grupo Sistema Estomatognático Y Morfofisiología (SEMF), Departamento de Ciencias Básicas, Universidad Santo Tomás Seccional Bucaramanga, Carrera 27 No. 180-395, Bucaramanga, Colombia
| | - Alvaro Muñoz-Castro
- Facultad de Ingeniería, Arquitectura y Diseño, Universidad San Sebastián, Bellavista 7, 8420524 Santiago, Chile
| | - Desmond MacLeod-Carey
- Facultad de Ingeniería, Instituto de Ciencias Químicas Aplicadas, Inorganic Chemistry and Molecular Materials Center, Universidad Autónoma de Chile, El Llano Subercaseaux 2801, Santiago, Chile
| | - Tonny W. Naranjo
- Experimental and Medical Micology Group, Corporación para Investigaciones Biológicas (CIB), 050010 Medellin, Colombia
- Facultad de Medicina, Universidad Pontificia Bolivariana, 050034 Medellín, Colombia
| | - Peter L. Rodríguez-Kessler
- Centro de Investigaciones en Óptica A.C., Loma del Bosque 115, Col. Lomas del Campestre, 37150 León, Guanajuato México
| | - John J. Hurtado
- Grupo de Investigación en Química Inorgánica, Catálisis y Bioinorgánica, Departamento de Química, Universidad de los Andes, Carrera 1 No. 18A-12, 111711 Bogotá, Colombia
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Chen G, Ma N, Zhu D, Zhou H, Liang Q, Meng J, Shen Y, Liu H, Liu L, He Z, Qin Z. Accurate diagnosis of bronchopulmonary Talaromyces marneffei infection in an anti-IFN-γ autoantibodies positive patient assisted by endobronchial ultrasound-guided TBNA and mNGS: a case report. Front Cell Infect Microbiol 2023; 13:1186335. [PMID: 37860065 PMCID: PMC10583546 DOI: 10.3389/fcimb.2023.1186335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
RATIONALE T. marneffei is opportunistic and dimorphic fungus, which can cause systemic mycosis in human beings. It's being difficult to obtain histopathological or microbiological evidence in T. marneffei infection. We reported a rare non-HIV case of T. marneffei infection of bronchopulmonary and mediastinal lymph nodes which was diagnosed by EBUS-TBNA combined with mNGS. The high titer of anti-IFN-γ autoantibodies in serum was probably the cause of T. marneffei infection,which has yet to be fully known. PATIENT CONCERNS A 56-year-old Chinese man presented with a 5-month history of intermittent low or high fever and dry cough, followed by fatigue, night sweating, and chest pain when coughing. A large hilar lesion in the left lung and multiple mediastinal lymph node enlargements were found on his chest CT scan. DIAGNOSES The patient received EBUS-TBNA of hilar tissue and lymph node biopsy for mNGS at the second Ultrasonic bronchoscopy. No fungal hyphae or spores were found in the histopathology. There were high sequencing reads of T. marneffei in samples of lymph node fluid and bronchogenesis tissue detected by mNGS. His plasma anti-IFN-γ autoantibodies level was positive with a high titer at 1:2500↑. INTERVENTION The patient went through atrial fibrillation at the first dose of amphotericin B liposomes and treated with voriconazole later. OUTCOMES His fever, cough and dyspnea quickly disappeared since the fourth day of treatment. After six months, there was not any focus in his chest CT scans. But his plasma anti-IFN-γ autoantibodies remained unchanged. LESSONS Complementing the traditional laboratory and bronchoscopy, mNGS combined with EBUS-TBNA facilitate rapid and precise diagnosis of bronchopulmonary mediastinal lymph nodes T. marneffei infection. Clinicians should be aware of anti-INF-γ autoantibodies in opportunistic infections of non-HIV patients.
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Affiliation(s)
- Guirong Chen
- Department of Pulmonary and Critical Care Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Nan Ma
- Department of Pulmonary and Critical Care Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Donglan Zhu
- Department of Pulmonary and Critical Care Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Huaihai Zhou
- Department of Pulmonary and Critical Care Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Qiumei Liang
- Department of Pulmonary and Critical Care Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jianfeng Meng
- Department of Pulmonary and Critical Care Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yin Shen
- Department of International Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Hang Liu
- Department of Pulmonary and Critical Care Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Liu Liu
- Department of International Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Zhiyi He
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhiqiang Qin
- Department of Pulmonary Medicine, Foresea Life Insurance Guangxi Hospital, Nanning, China
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Kawata K, Shima H, Shinjoh M, Yamazaki F, Kurosawa T, Yaginuma M, Takada H, Shimada H. Pneumocystis jirovecii pneumonia after CD4+ T-cell recovery subsequent to CD19-targeted chimeric antigen receptor T-cell therapy: A case report and brief review of literature. Cancer Rep (Hoboken) 2023; 6:e1885. [PMID: 37563749 PMCID: PMC10598253 DOI: 10.1002/cnr2.1885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/20/2023] [Accepted: 07/28/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND CD19-targeted chimeric antigen receptor (CAR)-T cell therapy involves administration of patient-derived T cells that target B cells, resulting in B-cell depletion and aplasia. In immunity against Pneumocystis jirovecii (Pj), CD4+ T cells and, more recently, B cells, are generally considered important. Antigen presentation by B cells to CD4+ T cells is particularly important. Trimethoprim-sulfamethoxazole (TMP/SMX) for Pj pneumonia (PJP) prophylaxis is generally discontinued when the CD4+ T-cell count is >200/μL. Here we report the first case, to our knowledge, of PJP in a patient with a CD4+ T cell count of >200/μL after CAR-T cell therapy. CASE A 14-year-old girl developed hemophagocytic lymphohistiocytosis (HLH) after cord blood transplantation (CBT) for relapsed precursor B-cell acute lymphoblastic leukemia (B-ALL). Twenty-one months after CBT, she was diagnosed with combined second relapse in the bone marrow and central nervous system. The patient was treated with CD19-targeted CAR-T cell therapy for the relapse. After CAR-T cell therapy, the patient remained in remission and continued to receive TMP/SMX for PJP prophylaxis. Seven months after CAR-T cell therapy, CD4+ T cells recovered and TMP/SMX was discontinued. The B-cell aplasia persisted. Ten months after CAR-T cell therapy, the patient developed PJP. The patient was also considered to have macrophage hyperactivation at the onset of PJP. Treatment with immunoglobulin, TMP/SMX, and prednisolone was initiated, and the patient's symptoms rapidly ameliorated. CONCLUSION The patient in the present case developed PJP despite a CD4+ T-cell count of >200/μL after CAR-T cell therapy, probably because of inadequate CD4+ T-cell activation caused by B-cell depletion after CAR-T cell therapy and repeated abnormal macrophage immune responses after CBT. It is important to determine the duration of TMP/SMX for prophylaxis after CAR-T cell therapy according to each case, as well as the CD4+ T-cell count.
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Affiliation(s)
- Kento Kawata
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Haruko Shima
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Masayoshi Shinjoh
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Fumito Yamazaki
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Takumi Kurosawa
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Mizuki Yaginuma
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Hiroshi Takada
- Department of PediatricsKeio University School of MedicineTokyoJapan
| | - Hiroyuki Shimada
- Department of PediatricsKeio University School of MedicineTokyoJapan
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Wang T, Chen S, Niu Q, Xu G, Lu C, Zhang J. Genomic Sequence Resource of Talaromyces albobiverticillius, the Causative Pathogen of Pomegranate Pulp Rot Disease. J Fungi (Basel) 2023; 9:909. [PMID: 37755017 PMCID: PMC10533087 DOI: 10.3390/jof9090909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/02/2023] [Accepted: 09/06/2023] [Indexed: 09/28/2023] Open
Abstract
Talaromyces albobiverticillius, a prominent pathogen responsible for pomegranate pulp rot disease, inflicts significant damage on Punica granatum L. Besides its pathogenicity, this fungus possesses the potential to produce substantial amounts of red pigments, making it promising for industrial applications. This study presents the genome annotation of T. albobiverticillius field strain Tp-2, isolated from pomegranates. The genome assembly, generated through a combination of Oxford Nanopore and Illumina sequencing reads, yielded a high-quality assembly with 14 contigs, featuring an N50 length of 4,594,200 bp. The complete genome of strain Tp-2 spans 38,354,882 bp, with a GC content of 45.78%. Importantly, the assembly exhibits remarkable integrity, with 98.3% of complete Benchmarking Universal Single-Copy Orthologs validating genome completeness. Genome prediction analysis reveals the presence of 10,380 protein-coding genes. To our knowledge, this study is the first report on the genome sequence of T. albobiverticillius, offering valuable insights into its genetic variation and molecular mechanisms of pigment production.
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Affiliation(s)
- Tan Wang
- School of Life Science and Agricultural Engineering, Nanyang Normal University, Nanyang 473061, China
| | - Shuchang Chen
- School of Life Science and Agricultural Engineering, Nanyang Normal University, Nanyang 473061, China
| | - Qiuhong Niu
- School of Life Science and Agricultural Engineering, Nanyang Normal University, Nanyang 473061, China
| | - Guangling Xu
- School of Life Science and Agricultural Engineering, Nanyang Normal University, Nanyang 473061, China
| | - Chenxu Lu
- School of Life Science and Agricultural Engineering, Nanyang Normal University, Nanyang 473061, China
| | - Jin Zhang
- School of Forestry and Biotechnology, Zhejiang A&F University, Hangzhou 311300, China
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49
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Long F, Li T, Zhang Y, Gao X, Huang X. Disseminated Talaromyces marneffei infection in a child with HIV infection. J Hematop 2023; 16:181-183. [PMID: 38175399 DOI: 10.1007/s12308-023-00551-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/08/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Fang Long
- Department of Clinical Laboratory, Sichuan Provincial Maternity and Child Health Care Hospital, The Affiliated Women's and Children's Hospital of Chengdu Medical College, Chengdu, 610000, Sichuan Province, China
| | - Ting Li
- Department of Laboratory Medicine, Beijing Ludaopei Hospital, Beijing, 100176, China
| | - Yun Zhang
- Department of Clinical Laboratory, The District People's Hospital of Zhangqiu, Jinan, 250200, Shandong Province, China
| | - Xiaopeng Gao
- Department of Clinical Laboratory, Xi'an Children's Hospital, Xi'an, 710002, Shaanxi Province, China
| | - Xingqin Huang
- Department of Hematology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400038, China.
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50
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Cen J, Huang J, Zeng W, Pan M, Qiu Y, Zhang J. Clinical features of HIV positive talaromycosis marneffei patients and development of a risk prediction model. Heliyon 2023; 9:e20068. [PMID: 37809964 PMCID: PMC10559804 DOI: 10.1016/j.heliyon.2023.e20068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 09/02/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Aims The purpose of this study was to establish and verify a nomogram to predict the prognosis of patients with human immunodeficiency virus (HIV)-related talaromycosis marneffei and evaluate the prognosis. Methods We examined the acquired immune deficiency syndrome (AIDS) patients hospitalized in the Fourth People's Hospital of Nanning from 2018 to 2020 with an aetiological diagnosis of Talaromyces marneffei infection. Logistic regression analysis was used to identify the independent risk factors for relapse or death of the prognosis of Talaromyces marneffei infection. According to the regression coefficient, the corresponding nomograph prediction model was drawn. Results A total of 400 patients were included, including 321 males and 79 females. Recurrence or death occurred in 70 cases (17.5%). The area under the receiver operator characteristic curve (ROC) of the established model was 0.716 with good discrimination, calibration, and clinical effectiveness. The risks of age between 45 and 60 years old and <40 years old were successively higher than that of >60 years old, and the risks of G test <50 pg/ml and >100 pg/ml were higher than that of 50-100 pg/ml. Respiratory failure, decreased albumin and elevated total bilirubin are risk factors for relapse or death in HIV patients infected with Talaromyces marneffei. Conclusion This model can accurately predict the prognosis of HIV complicated with Talaromyces marneffei infection.
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Affiliation(s)
- Jiemei Cen
- Department of Respiratory Medicine, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518033, China
- Department of Respiratory Medicine, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510630, China
| | - Jie Huang
- Guangxi Nanning Fourth People's Hospital, Department of Tuberculosis Ward, Nanning, Guangxi, China
| | - Wen Zeng
- Department of Respiratory Medicine, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518033, China
| | - Mianluan Pan
- Department of Respiratory Medicine, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518033, China
| | - Ye Qiu
- Department of Respiratory Medicine, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518033, China
| | - Jianquan Zhang
- Department of Respiratory Medicine, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong 518033, China
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