A detailed lipidomic study of human pathogenic fungi Candida auris

The sphingolipid inhibitor myriocin increases Candida auris susceptibility to amphotericin B

BACKGROUND

The emergence of the pathogenic yeast Candida auris is of global concern due to its ability to cause hospital outbreaks and develop resistance against all antifungal drug classes. Based on published data for baker's yeast Saccharomyces cerevisiae, sphingolipid biosynthesis, which is essential for maintaining membrane fluidity and formation of lipid rafts, could offer a target for additive treatment.

METHODS

We analysed the susceptibility of C. auris to myriocin, which is an inhibitor of the de novo synthesis of sphingolipids in eukaryotic cells in comparison to other Candida species. In addition, we combined sublethal concentrations of myriocin with the antifungal drugs amphotericin B and fluconazole in E-tests. Consequently, the combinatory effects of myriocin and amphotericin B were examined in broth microdilution assays.

RESULTS

Myriocin-mediated inhibition of the sphingolipid biosynthesis affected the growth of C. auris. Sublethal myriocin concentrations increased fungal susceptibility to amphotericin B. Isolates which are phenotypically resistant (≥2 mg/L) to amphotericin B became susceptible in presence of myriocin. However, addition of myriocin had only limited effects onto the susceptibility of C. auris against fluconazole.

CONCLUSIONS

Our results show that inhibition of de novo sphingolipid biosynthesis increases the susceptibility of C. auris to amphotericin B. This may potentially enhance antifungal treatment options fighting this often resistant yeast pathogen.

Old and new strategies in therapy and diagnosis against fungal infections

Fungal infections represent a serious global health threat. The new emerging pathogens and the spread of different forms of resistance are now hardly challenging the tools available in therapy and diagnostics. With the commonly used diagnoses, fungal identification is often slow and inaccurate, and, on the other hand, some drugs currently used as treatments are significantly affected by the decrease in susceptibility. Herein, the antifungal arsenal is critically summarized. Besides describing the old approaches and their mechanisms, advantages, and limitations, the focus is dedicated to innovative strategies which are designed, identified, and developed to take advantage of the discrepancies between fungal and host cells. Relevant pathways and their role in survival and virulence are discussed as their suitability as sources of antifungal targets. In a similar way, molecules with antifungal activity are reported as potential agents/precursors of the next generation of antimycotics. Particular attention was devoted to biotechnological entities, to their novelty and reliability, to drug repurposing and restoration, and to combinatorial applications yielding significant improvements in efficacy. KEY POINTS: • New antifungal agents and targets are needed to limit fungal morbidity and mortality. • Therapeutics and diagnostics suffer of delays in innovation and lack of targets. • Biologics, drug repurposing and combinations are the future of antifungal treatments.

Sphingolipid diversity in Candida auris: unraveling interclade and drug resistance fingerprints

In this study, we explored the sphingolipid (SL) landscape in Candida auris, which plays pivotal roles in fungal biology and drug susceptibility. The composition of SLs exhibited substantial variations at both the SL class and molecular species levels among clade isolates. Utilizing principal component analysis, we successfully differentiated the five clades based on their SL class composition. While phytoceramide (PCer) was uniformly the most abundant SL class in all the isolates, other classes showed significant variations. These variations were not limited to SL class level only as the proportion of different molecular species containing variable number of carbons in fatty acid chains also differed between the isolates. Also a comparative analysis revealed abundance of ceramides and glucosylceramides in fluconazole susceptible isolates. Furthermore, by comparing drug-resistant and susceptible isolates within clade IV, we uncovered significant intraclade differences in key SL classes such as high PCer and low long chain base (LCB) content in resistant strains, underscoring the impact of SL heterogeneity on drug resistance development in C. auris. These findings shed light on the multifaceted interplay between genomic diversity, SLs, and drug resistance in this emerging fungal pathogen.

Effect of 1-alkyl-1-methylpiperidinium bromides on lipids of fungal plasma membrane and lung surfactant

This study aimed to investigate the potential of 1-alkyl-1-methylpiperidinium bromides as fungicides and evaluate their impact on the human respiratory system when spread in the atmosphere. We investigated the behavior of membrane lipids and model membranes in the presence of a series of amphiphilic 1-alkyl-1-methylpiperidinium bromides ([MePipC_n][Br]), differing in the alkyl chain length (n = 4 - 18). The experiments were performed with the Langmuir monolayer technique using 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) and ergosterol (ERG)-the main components of lung surfactant and fungal plasma membrane, respectively and their mixtures with phospholipids and sterols. The mixtures were chosen as the representatives of target and non-target organisms. The surface pressure-area isotherms were obtained by compressing monolayers in the presence of [MePipC_n][Br] in the subphase. The results were analyzed in terms of area expansion/contraction and compressibility. The surface activity of the studied organic salts was also studied. In addition, the monolayers were deposited on a solid surface and their topography was investigated using atomic force microscopy. This research implies that the studied compounds may destabilize efficiently the fungal plasma membrane. At the same time we demonstrated the significant impact of 1-alkyl-1-methylpiperidinium bromides on the lung surfactant layer. The interaction between [MePipCn][Br] and model membranes depends on the concentration and alkyl chain length of organic salt. The key role of contact time has been also revealed. The results may be helpful in the reasonable development of new agrochemical products aiming at the treatment of fungal infections in plants. In addition, our study indicates the significance of proper safety management while spreading the fungicides in the environment.

Farnesol Boosts the Antifungal Effect of Fluconazole and Modulates Resistance in Candida auris through Regulation of the CDR1 and ERG11 Genes

Candida auris is considered a serious fungal pathogen frequently exhibiting a high resistance to a wide range of antifungals. In this study, a combination of the quorum-sensing molecule farnesol (FAR) and fluconazole (FLU) was tested on FLU-resistant C. auris isolates (C. auris S and C. auris R) compared to the susceptible C. auris H261. The aim was to assess the possible synergy between FAR and FLU, by reducing the FLU minimal inhibitory concentration, and to determine the mechanism underlying the conjunct effect. The results confirmed a synergic effect between FAR and FLU with a calculated FIC index of 0.75 and 0.4 for C. auris S and C. auris R, respectively. FAR modulates genes involved in azole resistance. When FAR was added to the cells in combination with FLU, a significant decrease in the expression of the CDR1 gene was observed in the resistant C. auris isolates. FAR seems to block the Cdr1 efflux pump triggering a restoration of the intracellular content of FLU. These results were supported by observed increasing accumulation of rhodamine 6G by C. auris cells. Moreover, C. auris treated with FAR showed an ERG11 gene down-regulation. Overall, these results suggest that FAR is an effective modulator of the Cdr1 efflux pump in C. auris and, in combination with FLU, enhances the activity of this azole, which might be a promising strategy to control infections caused by azole-resistant C. auris.

High-Throughput Phospholipidomics of Candida Cells: From Sample Preparation to Data Analysis

Laboratory identification of Candida species is often complicated by overlapping features. Species specificity is critical to the appropriate use of interventions.Accurate identification and quantification of lipid species in complex lipid mixtures are crucial for assigning biological functions to lipids of fungi. Recently, much has been achieved in the field of mass spectrometry, allowing high-throughput screening of simple and complex lipid structures. The next-generation, high-resolution mass spectrometers allow accurate analysis and a much broader spectrum for lipidomic studies; nonetheless, these are often expensive, and data analysis is complex, which presents a challenge in routine lipid studies. Alternatively, by coupling the ion trap with multiple reaction monitoring (MRM) in an HPLC-ESI-MS/MS (high-performance liquid chromatography-electrospray ionization tandem mass spectrometry) platform, we can achieve rapid, sensitive, and accurate quantification of lipids in Candida extracts. Moreover, the approach is simple and relatively cost-effective. Below, we discuss the key features of ion trap HPLC-ESI-MS/MS-based comparative lipidomics of Candida cells.

Functions of Sphingolipids in Pathogenesis During Host-Pathogen Interactions

Sphingolipids are a class of membrane lipids that serve as vital structural and signaling bioactive molecules in organisms ranging from yeast to animals. Recent studies have emphasized the importance of sphingolipids as signaling molecules in the development and pathogenicity of microbial pathogens including bacteria, fungi, and viruses. In particular, sphingolipids play key roles in regulating the delicate balance between microbes and hosts during microbial pathogenesis. Some pathogens, such as bacteria and viruses, harness host sphingolipids to promote development and infection, whereas sphingolipids from both the host and pathogen are involved in fungus-host interactions. Moreover, a regulatory role for sphingolipids has been described, but their effects on host physiology and metabolism remain to be elucidated. Here, we summarize the current state of knowledge about the roles of sphingolipids in pathogenesis and interactions with host factors, including how sphingolipids modify pathogen and host metabolism with a focus on pathogenesis regulators and relevant metabolic enzymes. In addition, we discuss emerging perspectives on targeting sphingolipids that function in host-microbe interactions as new therapeutic strategies for infectious diseases.