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Abstract
Abstract
Yeasts from the genus Malassezia belongs to normal commensal skin flora of warm-blooded vertebrates. These yeasts may act as opportunistic pathogens and cause skin diseases in humans and animals under certain conditions. The identification of Malassezia species is based on the phenotypic or genotypic diagnostics. The methods used for the phenotypic identification is determined by: the growth on Sabouraud agar, growth on selective media (Leeming-Notman agar, Dixon agar, Chrom Malassezia agar), the ability to utilise different concentrations of Tween, monitoring of the growth on CEL agar (soil enriched with castor oil) and TE agar (Tween-esculine agar), and the catalase test. The genotypic identification uses molecular methods like: the pulsed field gel electrophoresis (PFGE), random amplified polymorphic DNA (RAPD), amplified fragment lenght polymorphism (AFLP), denaturing gradient gel electrophoresis (DGGE), and the DNA sequence analysis.
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Amado Y, Patiño-Uzcátegui A, Cepero de García MC, Tabima J, Motta A, Cárdenas M, Bernal A, Restrepo S, Celis A. Seborrheic dermatitis: predisposing factors and ITS2 secondary structure for Malassezia phylogenic analysis. Med Mycol 2013; 51:868-75. [PMID: 23947747 DOI: 10.3109/13693786.2013.820001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Seborrheic dermatitis (SD) is a chronic, widespread skin condition, which is considered a multifactorial disease influenced, in part, by Malassezia spp. opportunistic activities, as well as various endogenous and exogenous factors. Malassezia species are lipophilic, lipid-dependent yeasts that are members of the normal mycobiota of the human skin. Their isolation from SD lesions varies around the world and the study of the relationship among factors such as gender, age, immunosuppressive condition of the patient and SD development, can lead to a better understanding of this disease. To elucidate the association of age and gender with the development of SD and to precisely determine the Malassezia species involved in the disease, samples were obtained from 134 individuals, including individuals without lesions, human immunodeficiency virus positive patients, individuals with seborrheic dermatitis, and HIV patients with seborrheic dermatitis. Malassezia spp. were identified by phenotypic and genotypic methods and a phylogenetic analysis was performed using Bayesian inference. This study revealed that age and gender are not predisposing factors for SD development, and that the most frequent species of Malassezia related to SD development among the Colombian population is M. restricta. We also report the isolation of M. yamatoensis for the first time in Colombia, and propose an ITS2 secondary structure from Malassezia taxa that can be used for precise identification and to establish more robust phylogenetic relationships.
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Affiliation(s)
- Yulien Amado
- * Laboratorio de Micología y Fitopatología, Departamento de Ciencias Biológicas Universidad de Los Andes , Bogotá
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Youngchim S, Nosanchuk JD, Pornsuwan S, Kajiwara S, Vanittanakom N. The role of L-DOPA on melanization and mycelial production in Malassezia furfur. PLoS One 2013; 8:e63764. [PMID: 23762233 PMCID: PMC3676409 DOI: 10.1371/journal.pone.0063764] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 04/05/2013] [Indexed: 11/18/2022] Open
Abstract
Melanins are synthesized by organisms of all biological kingdoms and comprise a heterogeneous class of natural pigments. Certain of these polymers have been implicated in the pathogenesis of several important human fungal pathogens. This study investigated whether the fungal skin pathogen Malassezia furfur produces melanin or melanin-like compounds. A melanin-binding monoclonal antibody (MAb) labelled in vitro cultivated yeast cells of M. furfur. In addition, melanization of Malassezia yeasts and hyphae was detected by anti-melanin MAb in scrapings from patients with pityriasis versicolor. Treatment of Malassezia yeasts with proteolytic enzymes, denaturant and concentrated hot acid yielded dark particles and electron spin resonance spectroscopy revealed that these particles contained a stable free radical compound, consistent with their identification as melanins. Malassezia yeasts required phenolic compounds, such as L-DOPA, in order to synthesize melanin. L-DOPA also triggered hyphal formation in vitro when combined with kojic acid, a tyrosinase inhibitor, in a dose-dependent manner. In this respect, L-DOPA is thought to be an essential substance that is linked to both melanization and yeast-mycelial transformation in M. furfur. In summary, M. furfur can produce melanin or melanin-like compounds in vitro and in vivo, and the DOPA melanin pathway is involved in cell wall melanization.
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Affiliation(s)
- Sirida Youngchim
- Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Malassezia yeasts produce a collection of exceptionally potent activators of the Ah (dioxin) receptor detected in diseased human skin. J Invest Dermatol 2013; 133:2023-30. [PMID: 23448877 DOI: 10.1038/jid.2013.92] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Revised: 01/19/2013] [Accepted: 02/05/2013] [Indexed: 11/08/2022]
Abstract
Malassezia yeasts are commensal microorganisms, which under insufficiently understood conditions can become pathogenic. We have previously shown that specific strains isolated from diseased human skin can preferentially produce agonists of the aryl hydrocarbon receptor (AhR), whose activation has been linked to certain skin diseases. Investigation of skin scale extracts from patients with Malassezia-associated diseases demonstrated 10- to 1,000-fold higher AhR-activating capacity than control skin extracts. Liquid chromatography-tandem mass spectrometry analysis of the patients' extracts revealed the presence of indirubin, 6-formylindolo[3,2-b]carbazole (FICZ), indolo[3,2-b]carbazole (ICZ), malassezin, and pityriacitrin. The same compounds were also identified in 9 out of 12 Malassezia species culture extracts tested, connecting their presence in skin scales with this yeast. Studying the activity of the Malassezia culture extracts and pure metabolites in HaCaT cells by reverse transcriptase real-time PCR revealed significant alterations in mRNA levels of the endogenous AhR-responsive genes Cyp1A1, Cyp1B1, and AhRR. Indirubin- and FICZ-activated AhR in HaCaT and human HepG2 cells with significantly higher, yet transient, potency as compared with the prototypical AhR ligand, dioxin. In loco synthesis of these highly potent AhR inducers by Malassezia yeasts could have a significant impact on skin homeostatic mechanisms and disease development.
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Abstract
AbstractThe skin of persons with atopic dermatitis (AD) is very susceptible to cutaneous infection, and some yeast species may also aggravate AD. The total yeast population of an AD patient’s skin and its relation with individual age and body part remains poorly characterized. The aim of this study was to clarify the differences in cutaneous yeast flora by age and body parts of AD patients.By swabbing affected body parts (hands, legs, face, neck or trunk), 241 samples were collected from patients with AD (132 children and 109 adults), and as controls, 40 samples were taken from healthy individuals (20 children, 20 adults).In all, 89 (36.9%) of samples were positive; the yeast isolated belonged to three genera: Candida (27.4%), Malassezia (6.6%), and Rhodotorula (2.9%). Cutaneous colonization with yeasts was two-fold higher in the adults than in children (P<0.0001). The distribution of the yeast species was dependent on the body part sampled: Malassezia predominated in the face, neck, and trunk regions (P=0.0047); Candida more frequently colonized hands and legs (P=0.0029).Our study showed that cutaneous yeast flora and distribution of yeast species depends significantly on the age of the AD patient and the body part affected by atopic dermatitis.
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Abstract
PURPOSE OF REVIEW Malassezia yeasts are associated with a number of dermatologic and systemic diseases in humans and animals. Pityriasis versicolor is amongst these diseases and represents one of the most common human skin diseases. Beyond that, the role of Malassezia yeasts in the pathogenesis of other skin diseases such as psoriasis, seborrheic dermatitis and confluent and reticulate papillomatosis is discussed but remains less clear. Clear pathogenetic mechanisms of the above-mentioned diseases are not known so far. The review presents new findings on virulence factors of Malassezia yeasts, shedding light on the pathogenesis of Malassezia-associated diseases. RECENT FINDINGS Several virulence factors in Malassezia yeasts are known, based on their enzymatic lipolytic activity resulting in the production of distinct metabolites and special cell wall features. Recently, a secondary metabolic pathway possibly implicated in the pathogenesis of pityriasis versicolor was described. SUMMARY The article presents virulence factors of Malassezia yeasts ranging from irritant metabolic byproducts to highly bioactive indole derivatives and attempts to clarify their pathogenic implications in the different diseases. Special emphasis is given to the pathogenesis of pityriasis versicolor, as it represents the disease wherein the causative relationship with Malassezia yeasts appears the most obvious.
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Affiliation(s)
- Wiebke Hort
- Department of Dermatology, Justus Liebig University, Giessen, Germany
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Cafarchia C, Gasser RB, Figueredo LA, Latrofa MS, Otranto D. Advances in the identification of Malassezia. Mol Cell Probes 2010; 25:1-7. [PMID: 21193026 DOI: 10.1016/j.mcp.2010.12.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 12/22/2010] [Accepted: 12/22/2010] [Indexed: 11/25/2022]
Abstract
Members of the genus Malassezia are lypophilic and/or lipid-dependent, unipolar budding yeasts that can become pathogenic under the influence of particular predisposing factors (e.g., changes in the cutaneous microenvironment and/or alterations in host defences). This genus comprises at least 14 species, which have been identified traditionally based on their morphology and biochemical features. However, phenetic characteristics often do not allow the identification or delineation of closely related Malassezia spp., such that molecular tools need to be used to assist in fundamental studies of the epidemiology and ecology of Malassezia as well as aspects of the pathogenesis and disease caused by members of this genus. This article briefly reviews the morphological and biochemical methods commonly used for the identification of Malassezia as well as DNA technological methods that have been established for the specific identification of members of this genus and the diagnosis of their infections. New avenues for the development of improved molecular-diagnostic methods to overcome diagnostic limitations and to underpin fundamental investigations of this interesting group of yeasts are proposed.
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Affiliation(s)
- Claudia Cafarchia
- Dipartimento di Sanità Pubblica e Zootecnia, Facoltà di Medicina Veterinaria, Università di Bari, Str. prov. le per Casamassima Km 3, 70010 Valenzano, Bari, Italy
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Lang SK, Hort W, Mayser P. Differentially expressed genes associated with tryptophan-dependent pigment synthesis in Malassezia furfur- a comparison with the recently published genome of Malassezia globosa. Mycoses 2010; 54:e69-83. [DOI: 10.1111/j.1439-0507.2009.01848.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Physiological and molecular characterization of atypical isolates of Malassezia furfur. J Clin Microbiol 2008; 47:48-53. [PMID: 18971363 DOI: 10.1128/jcm.01422-08] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The species constituting the genus Malassezia are considered to be emergent opportunistic yeasts of great importance. Characterized as lipophilic yeasts, they are found in normal human skin flora and sometimes are associated with different dermatological pathologies. We have isolated seven Malassezia species strains that have a different Tween assimilation pattern from the one typically used to differentiate M. furfur, M. sympodialis, and M. slooffiae from other Malassezia species. In order to characterize these isolates of Malassezia spp., we studied their physiological features and conducted morphological and molecular characterization by PCR-restriction fragment length polymorphism and sequencing of the 26S and 5.8S ribosomal DNA-internal transcribed spacer 2 regions in three strains from healthy individuals, four clinical strains, and eight reference strains. The sequence analysis of the ribosomal region was based on the Blastn algorithm and revealed that the sequences of our isolates were homologous to M. furfur sequences. To support these findings, we carried out phylogenetic analyses to establish the relationship of the isolates to M. furfur and other reported species. All of our results confirm that all seven strains are M. furfur; the atypical assimilation of Tween 80 was found to be a new physiological pattern characteristic of some strains isolated in Colombia.
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Hort W, Lang S, Brunke S, Mayser P, Hube B. Analysis of differentially expressed genes associated with tryptophan-dependent pigment synthesis in M. furfur by cDNA subtraction technology. Med Mycol 2008; 47:248-58. [PMID: 18654915 DOI: 10.1080/13693780802238842] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Malassezia species are associated with pityriasis versicolor (PV) and its depigmented variant pityriasis versicolor alba (PVa), widespread fungal skin infections in humans. The pathogenesis of PV and PVa remains unclear, including their clinical and histological symptoms such as hyper- and depigmentation, reduced responsiveness to ultraviolet radiation and lack of inflammatory reaction despite high fungal load. Pigments produced by M. furfur are possibly involved in the pathogenesis of PV. In vitro, M. furfur produces a wide range of pigments and fluorochromes when cultured with tryptophan as the sole nitrogen source. We have begun to analyse the molecular basis of pigment production by searching for genes associated with tryptophan-based pigment production. A suppression subtractive hybridization (SSH) protocol was used to identify genes expressed in M. furfur cells producing pigments, but not in non-induced cells. SSH was performed 3 and 5 h after onset of pigment induction. Up-regulation of genes in the pigment-producing cells was confirmed by reverse northern analysis. More than 1,500 cDNA sequences of both the indicated time points were analysed. We identified a wide variety of genes associated with metabolism and several genes with unknown function are specifically expressed during pigment production. Furthermore, a fraction of genes possibly involved in different steps of the newly discovered indolic pathway of M. furfur were expressed in pigment producing cells. These data provide the first molecular insight into pigment production of M. furfur.
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Affiliation(s)
- W Hort
- Department of Dermatology and Andrology, Justus Liebig University Giessen, Giessen, Germany.
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AhR ligands, malassezin, and indolo[3,2-b]carbazole are selectively produced by Malassezia furfur strains isolated from seborrheic dermatitis. J Invest Dermatol 2008; 128:1620-5. [PMID: 18219281 DOI: 10.1038/sj.jid.5701252] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Malassezia yeasts are connected with seborrheic dermatitis (SD) whereas M. furfur pathogenicity is associated with the production of bioactive indoles. In this study, the production of indoles by M. furfur isolates from healthy and diseased skin was compared, the respective HPLC patterns were analyzed, and substances that are preferentially synthesized by strains isolated from SD lesions were isolated and characterized. Malassezin, pityriacitrin, indole-3-carbaldehyde, and indolo[3,2-b]carbazole (ICZ) were isolated by HPLC from extracts of M. furfur grown in L-tryptophan agar, and identified by nuclear magnetic resonance and mass spectroscopy. Of these, ICZ, a potent ligand of the aryl hydrocarbon receptor (AhR), is described for the first time to our knowledge as a M. furfur metabolite. HPLC-photodiode array detection analysis of strain extracts from 7 healthy subjects and 10 SD patients showed that M. furfur isolates from only SD patients consistently produce malassezin and ICZ. This discriminatory production of AhR agonists provides initial evidence for a previously unreported mechanism triggering development of SD and indicates that the variable pathogenicity patterns recorded for M. furfur-associated SD conditions may be attributed to selective production (P<0.001) of measurable bioactive indoles.
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Rativa DJ, Gomes AL, Benedetti MA, Souza Filho LG, Marsden A, de Araujo RE. Optical spectroscopy on in vitro fungal diagnosis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2008; 2008:4871-4874. [PMID: 19163808 DOI: 10.1109/iembs.2008.4650305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The growing incidence of microbial infections and the increasing ability of such organisms to acquire resistance to antimicrobial treatment lead the requirement of fast bacteria and fungi identification methods. In this work we explored optical spectroscopic techniques on fungal identification. We show that some fungal infections can be identified by ultraviolet optical excitation of fungi fluorescence followed by the spectral analysis of the emitted light. Moreover, we demonstrate that ultraviolet LED and LASER could be applied in fungal identification and a new device for fungal diagnosis is proposed.
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Affiliation(s)
- D J Rativa
- Departamento de Eletrônica e Sistemas, Universidade Federal de Pernambuco, Recife, Brazil
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Hossain H, Landgraf V, Weiss R, Mann M, Hayatpour J, Chakraborty T, Mayser P. Genetic and biochemical characterization ofMalassezia pachydermatiswith particular attention to pigment-producing subgroups. Med Mycol 2007; 45:41-9. [PMID: 17325943 DOI: 10.1080/13693780601003827] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
The aim of the study was the characterization of Malassezia pachydermatis and its pigment-producing subgroup using biochemical tests and RAPD. It was of interest to determine whether particular RAPD patterns could be used to indicate pigment production, as well as a close genetic relatedness to Malassezia furfur. Therefore, 210 strains of M. pachydermatis were examined for morphology, catalase and ss-glucosidase activity, lipid and carbohydrate assimilation and the tryptophan-dependent synthesis of pigments. Of these, 114 strains were subjected to RAPD analyses. A multivariate logistic regression model was applied to classify M. pachydermatis isolates regarding their pigment production by using genetic and biological parameters. Biological and RAPD findings showed a high biological and genetic diversity within the species M. pachydermatis and within pigment producers. RAPD analysis revealed 28 genotypes within 114 strains tested. Pigment producing strains could not be assigned to a common RAPD profile, but a genetic relatedness of pigment-producing M. pachydermatis with M. furfur can be assumed. A particular RAPD pattern allowed statistically significant probability of pigment production (P<0.001) and might be used as a tool to rapidly detect pigment producing M. pachydermatis, e.g. in Malassezia-associated pityriasis versicolor. The reported method is useful for identification of pigment producing M. pachydermatis isolates and has advantages over established tests.
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Affiliation(s)
- Hamid Hossain
- Institute of Medical Microbiology, University of Giessen, Giessen, Germany.
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Kalinowska-Pujdak A, Schmalreck A, Haustein UF, Nenoff P. Speziesdifferenzierung von Hefen der Gattung Malassezia mittels Fourier-Transform-Infrarot-Spektroskopie. Hautarzt 2006; 57:127-36. [PMID: 16170542 DOI: 10.1007/s00105-005-1018-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND 83 Malassezia strains (65 wild isolates and 18 reference strains) were differentiated to the species level using conventional methods including morphological and biochemical features. These strains were further analyzed by Fourier transform infrared spectroscopy (FT-IRS). RESULTS FT-IRS analysis allowed a clear separation of Malassezia strains according to species-specific cluster formation. The main differences were found between Malassezia furfur and other Malassezia species. In addition, within the species Malassezia furfur, a separation in two similar groups could be demonstrated. A disadvantage of FT-IRS is the relatively expensive apparatus. A great advantage is the speed and simplicity of the procedure, producing results within minutes. CONCLUSION In pityriasis versicolor, Malassezia globosa was the dominant species found in 62% of cases. In addition, Malassezia furfur was found in 60% of dandruff cases.
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Affiliation(s)
- A Kalinowska-Pujdak
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig
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Krämer HJ, Podobinska M, Bartsch A, Battmann A, Thoma W, Bernd A, Kummer W, Irlinger B, Steglich W, Mayser P. Malassezin, a novel agonist of the aryl hydrocarbon receptor from the yeast Malassezia furfur, induces apoptosis in primary human melanocytes. Chembiochem 2006; 6:860-5. [PMID: 15812864 DOI: 10.1002/cbic.200400247] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Pityriasis versicolor is the most common skin mycosis in humans worldwide. Yeasts of the genus Malassezia, particularly M. furfur, a saprophyte occurring widely on human skin, are generally regarded as the causative agents. Pityriasis versicolor is often accompanied by a long-lasting depigmentation that persists even after successful antimycotic therapy. M. furfur is able to convert tryptophan into a variety of indole alkaloids, some of them showing biological properties that correlate well with certain clinical features of pityriasis versicolor. This suggests a possible role for these compounds in the depigmentation process. We now report that human melanocytes undergo apoptosis when exposed to the crude mixture of tryptophan metabolites from M. furfur. The active compound was identified as malassezin, previously isolated by us from the same source and characterized as an agonist of the aryl hydrocarbon (Ah) receptor. The compound could, therefore, contribute to the marked depigmentation observed during the course of pityriasis versicolor.
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Affiliation(s)
- Hans-Joachim Krämer
- Center of Andrology and Dermatology, Justus Liebig-Universität, Gaffkystrasse 14, 35385 Giessen, Germany.
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Krämer HJ, Kessler D, Hipler UC, Irlinger B, Hort W, Bödeker RH, Steglich W, Mayser P. Pityriarubins, Novel Highly Selective Inhibitors of Respiratory Burst from Cultures of the Yeast Malassezia furfur: Comparison with the Bisindolylmaleimide Arcyriarubin A. Chembiochem 2005; 6:2290-7. [PMID: 16252297 DOI: 10.1002/cbic.200500163] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Pityriasis versicolor is the most common skin mycosis in humans worldwide. Yeasts of the genus Malassezia, particularly M. furfur, a saprophyte occurring widely on human skin, are generally regarded as the causative agents. M. furfur is able to convert tryptophan into a variety of indole alkaloids, some of them showing biological properties that correlate well with certain clinical features of pityriasis versicolor. This suggests a possible role for these compounds in the pathophysiology of the disease. We here report that the novel pityriarubins A, B and C, isolated from cultures of the yeast, inhibit respiratory burst in human neutrophils, activated by various agents, in a highly selective, unexpected manner. The release of 5-lipoxygenase products after challenge of neutrophils with the calcium ionophore A23187 is also inhibited in a dose-dependent manner. These activities reflect the close structural relationship of pityriarubins to bisindolylmaleimides, which have recently gained great interest as protein kinase inhibitors.
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Affiliation(s)
- Hans-Joachim Krämer
- Center of Andrology and Dermatology, Justus Liebig-Universität, Gaffkystrasse 14, 35385 Giessen, Germany.
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Abstract
Pityriasis versicolor alba is a hypopigmented or depigmented variant of pityriasis versicolor characterized by maculous, partly pityriasiform, scaly depigmented lesions occurring particularly in seborrhoeic areas. Long-persisting hypopigmentation after healing of the pityriasis versicolor was first described by Gudden in 1853. Hypopigmentation and depigmentation were later differentiated as an independent variant of the disease. In 1848, Eichstedt recognized the pathogen-related character of pityriasis versicolor in its hyperpigmented form. Today it is generally accepted that the disease is caused by yeasts of the genus Malassezia, of which nine species are differentiated. It is controversial whether a single species is responsible for the disease. The pathogenesis of depigmentation has not been established. A screening effect by the scale layer as well as toxic effects on pigment synthesis by fungal metabolites have been discussed. With regard to the second mechanism, the newly discovered tryptophan-derived metabolites of M. furfur might be significant. Evidence-based data concerning the therapy of pityriasis versicolor alba do not exist. According to current recommendations, pityriasis versicolor should be rapidly treated with antimycotics, followed by ultraviolet therapy to induce maturation of existent melanosomes and accelerate repigmentation. However, depigmented lesions are difficult to improve by ultraviolet therapy.
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Affiliation(s)
- W Thoma
- Center of Dermatology and Andrology, Gaffkystr. 14, D-35385 Giessen, Germany.
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