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Gourari-Bouzouina K, Boucherit-Otmani Z, Halla N, Seghir A, Baba Ahmed-Kazi Tani ZZ, Boucherit K. Exploring the dynamics of mixed-species biofilms involving Candida spp. and bacteria in cystic fibrosis. Arch Microbiol 2024; 206:255. [PMID: 38734793 DOI: 10.1007/s00203-024-03967-9] [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: 01/30/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024]
Abstract
Cystic fibrosis (CF) is an inherited disease that results from mutations in the gene responsible for the cystic fibrosis transmembrane conductance regulator (CFTR). The airways become clogged with thick, viscous mucus that traps microbes in respiratory tracts, facilitating colonization, inflammation and infection. CF is recognized as a biofilm-associated disease, it is commonly polymicrobial and can develop in biofilms. This review discusses Candida spp. and both Gram-positive and Gram-negative bacterial biofilms that affect the airways and cause pulmonary infections in the CF context, with a particular focus on mixed-species biofilms. In addition, the review explores the intricate interactions between fungal and bacterial species within these biofilms and elucidates the underlying molecular mechanisms that govern their dynamics. Moreover, the review addresses the multifaceted issue of antimicrobial resistance in the context of CF-associated biofilms. By synthesizing current knowledge and research findings, this review aims to provide insights into the pathogenesis of CF-related infections and identify potential therapeutic approaches to manage and combat these complex biofilm-mediated infections.
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Affiliation(s)
- Karima Gourari-Bouzouina
- Antibiotics Antifungal Laboratory, Physical Chemistry, Synthesis and Biological Activity (LapSab), Department of Biology, Faculty of Sciences, University of Tlemcen, BP 119, 13000, Tlemcen, Algeria.
| | - Zahia Boucherit-Otmani
- Antibiotics Antifungal Laboratory, Physical Chemistry, Synthesis and Biological Activity (LapSab), Department of Biology, Faculty of Sciences, University of Tlemcen, BP 119, 13000, Tlemcen, Algeria
| | - Noureddine Halla
- Laboratory of Biotoxicology, Pharmacognosy and Biological Recovery of Plants, Department of Biology, Faculty of Sciences, University of Moulay-Tahar, 20000, Saida, Algeria
| | - Abdelfettah Seghir
- Antibiotics Antifungal Laboratory, Physical Chemistry, Synthesis and Biological Activity (LapSab), Department of Biology, Faculty of Sciences, University of Tlemcen, BP 119, 13000, Tlemcen, Algeria
| | - Zahira Zakia Baba Ahmed-Kazi Tani
- Antibiotics Antifungal Laboratory, Physical Chemistry, Synthesis and Biological Activity (LapSab), Department of Biology, Faculty of Sciences, University of Tlemcen, BP 119, 13000, Tlemcen, Algeria
| | - Kebir Boucherit
- Antibiotics Antifungal Laboratory, Physical Chemistry, Synthesis and Biological Activity (LapSab), Department of Biology, Faculty of Sciences, University of Tlemcen, BP 119, 13000, Tlemcen, Algeria
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2
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Simmonds NJ, Southern KW, De Wachter E, De Boeck K, Bodewes F, Mainz JG, Middleton PG, Schwarz C, Vloeberghs V, Wilschanski M, Bourrat E, Chalmers JD, Ooi CY, Debray D, Downey DG, Eschenhagen P, Girodon E, Hickman G, Koitschev A, Nazareth D, Nick JA, Peckham D, VanDevanter D, Raynal C, Scheers I, Waller MD, Sermet-Gaudelus I, Castellani C. ECFS standards of care on CFTR-related disorders: Identification and care of the disorders. J Cyst Fibros 2024:S1569-1993(24)00037-7. [PMID: 38508949 DOI: 10.1016/j.jcf.2024.03.008] [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: 11/21/2023] [Revised: 02/06/2024] [Accepted: 03/08/2024] [Indexed: 03/22/2024]
Abstract
This is the third paper in the series providing updated information and recommendations for people with cystic fibrosis transmembrane conductance regulator (CFTR)-related disorder (CFTR-RD). This paper covers the individual disorders, including the established conditions - congenital absence of the vas deferens (CAVD), diffuse bronchiectasis and chronic or acute recurrent pancreatitis - and also other conditions which might be considered a CFTR-RD, including allergic bronchopulmonary aspergillosis, chronic rhinosinusitis, primary sclerosing cholangitis and aquagenic wrinkling. The CFTR functional and genetic evidence in support of the condition being a CFTR-RD are discussed and guidance for reaching the diagnosis, including alternative conditions to consider and management recommendations, is provided. Gaps in our knowledge, particularly of the emerging conditions, and future areas of research, including the role of CFTR modulators, are highlighted.
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Affiliation(s)
- N J Simmonds
- Adult Cystic Fibrosis Centre, Royal Brompton Hospital, London, UK; National Heart and Lung Institute, Imperial College London, UK.
| | - K W Southern
- Department of Women's and Children's Health, University of Liverpool, University of Liverpool, Alder Hey Children's Hospital, Liverpool, UK
| | - E De Wachter
- Cystic Fibrosis Center, Pediatric Pulmonology department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - K De Boeck
- Department of Pediatrics, University of Leuven, Leuven, Belgium
| | - F Bodewes
- Pediatric Gastroenterology and Hepatology, Department of Pediatrics, University of Groningen Medical Center, Groningen, the Netherlands
| | - J G Mainz
- Cystic Fibrosis Center, Brandenburg Medical School (MHB), University, Klinikum Westbrandenburg, Brandenburg an der Havel, Germany
| | - P G Middleton
- Cystic Fibrosis and Bronchiectasis Service, Department of Respiratory and Sleep Medicine, Westmead Hospital, Sydney, News South Wales, Australia
| | - C Schwarz
- HMU-Health and Medical University Potsdam, CF Center Westbrandenburg, Campus Potsdam, Germany
| | - V Vloeberghs
- Brussels IVF, Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - M Wilschanski
- CF Center, Department of Pediatrics, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - E Bourrat
- APHP, Service de Dermatologie, CRMR MAGEC Nord St Louis, Hôpital-Saint Louis, Paris, France
| | - J D Chalmers
- Division of Molecular and Clinical Medicine, University of Dundee, Dundee, UK
| | - C Y Ooi
- a) School of Clinical Medicine, Discipline of Paediatrics and Child Health, Medicine & Health, University of New South Wales, Level 8, Centre for Child Health Research & Innovation Bright Alliance Building Cnr Avoca & High Streets, Randwick, Sydney, NSW, Australia, 2031; b) Sydney Children's Hospital, Gastroenterology Department, High Street, Randwick, Sydney, NSW, Australia, 2031
| | - D Debray
- Pediatric Hepatology unit, Centre de Référence Maladies Rares (CRMR) de l'atrésie des voies biliaires et cholestases génétiques (AVB-CG), National network for rare liver diseases (Filfoie), ERN rare liver, Hôpital Necker-Enfants Malades, AP-HP, Université de Paris, Paris, France; Sorbonne Université, INSERM, Centre de Recherche Saint-Antoine (CRSA), Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
| | - D G Downey
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | | | - E Girodon
- Service de Médecine Génomique des Maladies de Système et d'Organe, APHP.Centre - Université de Paris Cité, Hôpital Cochin, Paris, France
| | - G Hickman
- APHP, Service de Dermatologie, CRMR MAGEC Nord St Louis, Hôpital-Saint Louis, Paris, France
| | - A Koitschev
- Klinikum Stuttgart, Pediatric Otorhinolaryngology, Stuttgart, Germany
| | - D Nazareth
- a) Adult CF Unit, Liverpool Heart and Chest Hospital NHS Foundation Trust, U.K; b) Clinical Infection, Microbiology and Immunology, University of Liverpool, UK
| | - J A Nick
- Department of Medicine, National Jewish Health, Denver, CO, 80206, USA, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - D Peckham
- Leeds Institute of Medical Research, University of Leeds, Leeds, United Kingdom
| | - D VanDevanter
- Department of Pediatrics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - C Raynal
- Laboratory of molecular genetics, University Hospital of Montpellier and INSERM U1046 PHYMEDEXP, Montpellier, France
| | - I Scheers
- Department of Pediatrics, Pediatric Gastroenterology and Hepatology Unit, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
| | - M D Waller
- Adult Cystic Fibrosis and Respiratory Medicine, King's College Hospital NHS Foundation Trust, London, United Kingdom; Honorary Senior Lecturer, King's College London, London, United Kingdom
| | - I Sermet-Gaudelus
- INSERM U1151, Institut Necker Enfants Malades, Paris, France; Université de Paris, Paris, France; Centre de référence Maladies Rares, Mucoviscidose et maladies apparentées, Hôpital Necker Enfants malades, Paris, France
| | - C Castellani
- IRCCS Istituto Giannina Gaslini, Cystic Fibrosis Center, Genoa, Italy
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Abstract
In cystic fibrosis, a new era has started with the approval and use of highly effective cystic fibrosis transport regulator (CFTR) modulator therapy. As pulmonary function is increasing and exacerbation rate significantly decreases, the current meaning of fungal pulmonary diseases is questioned. During the past couple of decades, several studies have been conducted regarding fungal colonization and infection of the airways in people with cystic fibrosis. Although Aspergillus fumigatus for filamentous fungi and Candida albicans for yeasts remain by far the most common fungal species in patients with cystic fibrosis, the pattern of fungal species associated with cystic fibrosis has considerably diversified recently. Fungi such as Scedosporium apiospermum or Exophiala dermatitidis are recognized as pathogenic in cystic fibrosis and therefore need attention in clinical settings. In this article, current definitions are stated. Important diagnostic steps are described, and their usefulness discussed. Furthermore, clinical treatment strategies and recommendations are named and evaluated. In cystic fibrosis, fungal entities can be divided into different subgroups. Besides colonization, allergic bronchopulmonary aspergillosis, bronchitis, sensitization, pneumonia, and aspergilloma can occur as a fungal disease entity. For allergic bronchopulmonary aspergillosis, bronchitis, pneumonia, and aspergilloma, clear indications for therapy exist but this is not the case for sensitization or colonization. Different pulmonary fungal disease entities in people with cystic fibrosis will continue to occur also in an era of highly effective CFTR modulator therapy. Whether the percentage will decrease or not will be the task of future evaluations in studies and registry analysis. Using the established definition for different categories of fungal diseases is recommended and should be taken into account if patients are deteriorating without responding to antibiotic treatment. Drug-drug interactions, in particular when using azoles, should be recognized and therapies need to be adjusted accordingly.
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Affiliation(s)
- Carsten Schwarz
- Department of Education and Research, Health and Medical University-Health and Medical University Potsdam, Potsdam, Germany.,Division of Cystic Fibrosis, Cystic Fibrosis Center West Brandenburg, Postdam, Germany
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Debnath SK, Debnath M, Srivastava R. Opportunistic etiological agents causing lung infections: emerging need to transform lung-targeted delivery. Heliyon 2022; 8:e12620. [PMID: 36619445 PMCID: PMC9816992 DOI: 10.1016/j.heliyon.2022.e12620] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 09/03/2022] [Accepted: 12/16/2022] [Indexed: 12/27/2022] Open
Abstract
Lung diseases continue to draw considerable attention from biomedical and public health care agencies. The lung with the largest epithelial surface area is continuously exposed to the external environment during exchanging gas. Therefore, the chances of respiratory disorders and lung infections are overgrowing. This review has covered promising and opportunistic etiologic agents responsible for lung infections. These pathogens infect the lungs either directly or indirectly. However, it is difficult to intervene in lung diseases using available oral or parenteral antimicrobial formulations. Many pieces of research have been done in the last two decades to improve inhalable antimicrobial formulations. However, very few have been approved for human use. This review article discusses the approved inhalable antimicrobial agents (AMAs) and identifies why pulmonary delivery is explored. Additionally, the basic anatomy of the respiratory system linked with barriers to AMA delivery has been discussed here. This review opens several new scopes for researchers to work on pulmonary medicines for specific diseases and bring more respiratory medication to market.
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de Dios Caballero J, Cantón R, Ponce-Alonso M, García-Clemente MM, Gómez G. de la Pedrosa E, López-Campos JL, Máiz L, del Campo R, Martínez-García MÁ. The Human Mycobiome in Chronic Respiratory Diseases: Current Situation and Future Perspectives. Microorganisms 2022; 10:810. [PMID: 35456861 PMCID: PMC9029612 DOI: 10.3390/microorganisms10040810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/04/2022] [Accepted: 04/09/2022] [Indexed: 12/15/2022] Open
Abstract
Microbes play an important role in the pathogenesis of chronic lung diseases, such as chronic obstructive pulmonary disease, cystic fibrosis, non-cystic fibrosis bronchiectasis, and asthma. While the role of bacterial pathogens has been extensively studied, the contribution of fungal species to the pathogenesis of chronic lung diseases is much less understood. The recent introduction of next-generation sequencing techniques has revealed the existence of complex microbial lung communities in healthy individuals and patients with chronic respiratory disorders, with fungi being an important part of these communities' structure (mycobiome). There is growing evidence that the components of the lung mycobiome influence the clinical course of chronic respiratory diseases, not only by direct pathogenesis but also by interacting with bacterial species and with the host's physiology. In this article, we review the current knowledge on the role of fungi in chronic respiratory diseases, which was obtained by conventional culture and next-generation sequencing, highlighting the limitations of both techniques and exploring future research areas.
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Affiliation(s)
- Juan de Dios Caballero
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute, 28034 Madrid, Spain; (J.d.D.C.); (M.P.-A.); (E.G.G.d.l.P.); (R.d.C.)
- CIBER of Infectious Diseases (CIBERINFEC), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Rafael Cantón
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute, 28034 Madrid, Spain; (J.d.D.C.); (M.P.-A.); (E.G.G.d.l.P.); (R.d.C.)
- CIBER of Infectious Diseases (CIBERINFEC), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Manuel Ponce-Alonso
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute, 28034 Madrid, Spain; (J.d.D.C.); (M.P.-A.); (E.G.G.d.l.P.); (R.d.C.)
- CIBER of Infectious Diseases (CIBERINFEC), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Marta María García-Clemente
- Department of Pneumology, Central Asturias University Hospital, 33011 Oviedo, Spain;
- Principality Asturias Health Research Institute (ISPA), 33011 Oviedo, Spain
| | - Elia Gómez G. de la Pedrosa
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute, 28034 Madrid, Spain; (J.d.D.C.); (M.P.-A.); (E.G.G.d.l.P.); (R.d.C.)
- CIBER of Infectious Diseases (CIBERINFEC), Institute of Health Carlos III, 28029 Madrid, Spain
| | - José Luis López-Campos
- Medical-Surgical Unit for Respiratory Diseases (CIBERES), Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital, University of Seville, 41013 Sevilla, Spain;
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, 28029 Madrid, Spain; (L.M.); (M.Á.M.-G.)
| | - Luis Máiz
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, 28029 Madrid, Spain; (L.M.); (M.Á.M.-G.)
- Department of Pneumology, Ramón y Cajal University Hospital, 28034 Madrid, Spain
| | - Rosa del Campo
- Department of Microbiology, Ramón y Cajal University Hospital, Ramón y Cajal Health Research Institute, 28034 Madrid, Spain; (J.d.D.C.); (M.P.-A.); (E.G.G.d.l.P.); (R.d.C.)
- CIBER of Infectious Diseases (CIBERINFEC), Institute of Health Carlos III, 28029 Madrid, Spain
| | - Miguel Ángel Martínez-García
- CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, 28029 Madrid, Spain; (L.M.); (M.Á.M.-G.)
- Department of Pneumology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
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Yan K, Yin H, Wang J, Cai Y. Subtle relationships between Pseudomonas aeruginosa and fungi in patients with cystic fibrosis. Acta Clin Belg 2022; 77:425-435. [PMID: 33242290 DOI: 10.1080/17843286.2020.1852850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Cystic fibrosis (CF) is one of the most common hereditary lung diseases. Pseudomonas aeruginosa (PA), Aspergillus fumigatus (AF) and Candida albicans (CA) are the principal bacterial and fungal pathogens in the airways of CF patients. The interactions of coexisting bacterial-fungal pathogens are of great interest. In the present work, we reviewed the literature of available in vitro and in vivo studies, whereas most of the reports have shown that PA inhibits the growth of fungi through restriction of iron uptake and secretion of toxic substances. Fungi may also affect the growth or virulence of PA through their secreted molecules. To clarify the bacterial-fungal interaction, more in-depth and detailed studies are still needed, which will provide a better understanding of species, microbial population dynamics, and related mechanisms in CF patients.
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Affiliation(s)
| | | | | | - Yun Cai
- Department of Pharmacy, MedicalSupplies Center of Chinese PLA General Hospital, Beijing, China
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Abstract
In the past three decades, fungal respiratory colonization and fungal respiratory infections increasingly raised concern in cystic fibrosis (CF). Reasons for this are a better knowledge of the pathogenicity of fungi, whereby detection is sought in more and more CF centers, but also improvement of detection methods. However, differences in fungal detection rates within and between geographical regions exist and indicate the need for standardization of mycological examination of respiratory secretions. The still existing lack of standardization also complicates the assessment of fungal pathogenicity, relevance of fungal detection and risk factors for fungal infections. Nevertheless, numerous studies have now been conducted on differences in detection methods, epidemiology, risk factors, pathogenicity and therapy of fungal diseases in CF. Meanwhile, some research groups now have classified fungal disease entities in CF and developed diagnostic criteria as well as therapeutic guidelines.The following review presents an overview on fungal species relevant in CF. Cultural detection methods with their respective success rates as well as susceptibility testing will be presented, and the problem of increasing azole resistance in Aspergillus fumigatus will be highlighted. Next, current data and conflicting evidence on the epidemiology and risk factors for fungal diseases in patients with CF will be discussed. Finally, an overview of fungal disease entities in CF with their current definitions, diagnostic criteria and therapeutic options will be presented.
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Devoto TB, Alava KSH, Pola SJ, Pereda R, Rubeglio E, Finquelievich JL, Cuestas ML. Molecular epidemiology of Aspergillus species and other moulds in respiratory samples from Argentinean patients with cystic fibrosis. Med Mycol 2021; 58:867-873. [PMID: 31915834 DOI: 10.1093/mmy/myz133] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/29/2019] [Accepted: 12/19/2019] [Indexed: 12/29/2022] Open
Abstract
In cystic fibrosis (CF) patients, fungal colonization of the respiratory tract is frequently found. Aspergillus fumigatus is the most frequently recorded and is associated with loss of pulmonary function and allergic disease (ABPA). The knowledge on prevalence rates of filamentous fungi in CF patients in Latin America is scarce. One hundred and seventy-six fungal isolates recovered from the upper respiratory tract of CF patients from Argentina were identified to species by morphology and DNA sequencing. In total, 90% of CF patients were colonized by Aspergillus sp., followed by Exophiala sp. (14%) and Scedosporium sp. (10%). Among Aspergillus, six species complexes (Fumigati, Flavi, Terrei, Nigri, Usti, and Nidulante) and different cryptospecies were found. Among Scedosporium, three species were observed (Scedosporium apiospermum, Scedosporium aurantiacum and Scedosporium boydii). All Exophiala isolates were identified as Exophiala dermatitidis. Rare filamentous fungi were also found. All cases of ABPA were associated to the presence of A. fumigatus. Mixed colonization with other mould or rare fungi was observed in half of them. To our knowledge, this is the first prospective study of mould species in CF using molecular methods in Latin America. This study shows that Aspergillus sp., E. dermatitidis and Scedosporium sp. have a high frequency in CF patients from Argentina, and by far, A. fumigatus was the most commonly cultured species. Continuous clinical surveillance is required to detect the emergence of new fungal pathogens and to detect resistant or difficult-to-treat species capable of chronic colonizing the airways and of hematogenous dissemination in case of lung transplantation.
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Affiliation(s)
- Tomás Brito Devoto
- Universidad de Buenos Aires. CONICET. Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM). Buenos Aires, Argentina
| | - Katherine Stefania Hermida Alava
- Universidad de Buenos Aires. CONICET. Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM). Buenos Aires, Argentina
| | - Santiago J Pola
- Universidad de Buenos Aires. CONICET. Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM). Buenos Aires, Argentina
| | - Rosana Pereda
- Hospital General de Niños Pedro de Elizalde. Sección Microbiología. Buenos Aires, Argentina
| | - Etelvina Rubeglio
- Universidad de Buenos Aires. CONICET. Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM). Buenos Aires, Argentina
| | - Jorge L Finquelievich
- Universidad de Buenos Aires. CONICET. Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM). Buenos Aires, Argentina
| | - María L Cuestas
- Universidad de Buenos Aires. CONICET. Instituto de Investigaciones en Microbiología y Parasitología Médica (IMPaM). Buenos Aires, Argentina
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Eschenhagen P, Grehn C, Schwarz C. Prospective Evaluation of Aspergillus fumigatus-Specific IgG in Patients With Cystic Fibrosis. Front Cell Infect Microbiol 2021; 10:602836. [PMID: 33553006 PMCID: PMC7862129 DOI: 10.3389/fcimb.2020.602836] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 12/03/2020] [Indexed: 11/16/2022] Open
Abstract
Background In Cystic Fibrosis (CF), the airways are often colonized by opportunistic fungi. The most frequently detected mold is Aspergillus fumigatus (Af). Af diseases are associated with significant morbidity and mortality. The most common clinical picture caused by Af is allergic bronchopulmonary aspergillosis (ABPA), triggered by an immunological reaction against Af. Af bronchitis and invasive aspergillosis rarely occur in CF as a result of spore colonization and germination. Since pulmonary mycoses and exacerbations by other pathogens overlap in clinical, radiological, and immunological characteristics, diagnosis still remains a challenge. The search for reliable, widely available biomarkers for Af diseases is therefore still an important task today. Objectives Af-specific IgG m3 is broadly available. Sensitivity and specificity data are contradictory and differ depending on the study population. In our prospective study on pulmonary Af diseases in CF, we determined specific IgG m3 in order to test its suitability as a biomarker for acute Af diseases and as a follow-up parameter. Methods In this prospective single center study, 109 patients with CF were screened from 2016 to 2019 for Af-associated diseases. According to diagnostic criteria, they were divided into four groups (control, bronchitis, ABPA, pneumonia). The groups were compared with respect to the level of Af-specific IgG (ImmunoCAP Gm3). We performed a receiver operating characteristic (ROC) curve analysis to determine cut-off, sensitivity and specificity. Twenty-one patients could be enrolled for a follow-up examination. Results Of the 109 patients, 36 were classified as acute Af-disease (Af bronchitis, ABPA, Af pneumonia). Of these, 21 patients completed follow up-screening. The median Af-specific Gm3 was higher in the acute Af-disease groups. There was a significant difference in Af-specific IgG m3 compared to the control group without acute Af-disease. Overall, there was a large interindividual distribution of Gm3. A cut-off value of 78.05 mg/L for Gm3 was calculated to discriminate controls and patients with ABPA/pneumonia with a specificity of 75% and a sensitivity of 74.6%. The follow up examination of 21 patients showed a decrease of Gm3 in most patients without statistical significance due to the small number of follow up patients. Conclusion Af specific IgG may be a useful biomarker for acute ABPA and Af pneumonia, but not for Af bronchitis in CF. However, due to the large interindividual variability of Gm3, it should only be interpreted alongside other biomarkers. Therefore, due to its broad availability, it could be suitable as a biomarker for ABPA and Af pneumonia in CF, if the results can be supported by a larger multicenter cohort.
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Affiliation(s)
- Patience Eschenhagen
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, CF Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia Grehn
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, CF Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Carsten Schwarz
- Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, CF Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
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10
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de Oliveira EB, Xisto MIDDS, Rollin-Pinheiro R, Rochetti VP, Barreto-Bergter E. Peptidorhamnomannans From Scedosporium and Lomentospora Species Display Microbicidal Activity Against Bacteria Commonly Present in Cystic Fibrosis Patients. Front Cell Infect Microbiol 2020; 10:598823. [PMID: 33251161 PMCID: PMC7673444 DOI: 10.3389/fcimb.2020.598823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/07/2020] [Indexed: 11/13/2022] Open
Abstract
Scedosporium and Lomentospora species are filamentous fungi that cause a wide range of infections in humans. They are usually found in the lungs of cystic fibrosis (CF) patients and are the second most frequent fungal genus after Aspergillus species. Several studies have been recently performed in order to understand how fungi and bacteria interact in CF lungs, since both can be isolated simultaneously from patients. In this context, many bacterial molecules were shown to inhibit fungal growth, but little is known about how fungi could interfere in bacterial development in CF lungs. Scedosporium and Lomentospora species present peptidorhamnomannans (PRMs) in their cell wall that play crucial roles in fungal adhesion and interaction with host epithelial cells and the immune system. The present study aimed to analyze whether PRMs extracted from Lomentospora prolificans, Scedosporium apiospermum, Scedosporium boydii, and Scedosporium aurantiacum block bacterial growth and biofilm formation in vitro. PRM from L. prolificans and S. boydii displayed the best bactericidal effect against methicillin resistant Staphylococcus aureus (MRSA), Burkholderia cepacia, and Escherichia coli, but not Pseudomonas aeruginosa, all of which are the most frequently found bacteria in CF lungs. In addition, biofilm formation was inhibited in all bacteria tested using PRMs at minimal inhibitory concentration (MIC). These results suggest that PRMs from the Scedosporium and Lomentospora surface seem to play an important role in Scedosporium colonization in CF patients, helping to clarify how these pathogens interact to each other in CF lungs.
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Affiliation(s)
- Evely Bertulino de Oliveira
- Laboratório de Química Biológica de Microrganismos, Instituto de Microbiologia Paulo de Góes, Departamento de Microbiologia Geral, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mariana Ingrid Dutra da Silva Xisto
- Laboratório de Química Biológica de Microrganismos, Instituto de Microbiologia Paulo de Góes, Departamento de Microbiologia Geral, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Rodrigo Rollin-Pinheiro
- Laboratório de Química Biológica de Microrganismos, Instituto de Microbiologia Paulo de Góes, Departamento de Microbiologia Geral, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Victor Pereira Rochetti
- Laboratório de Química Biológica de Microrganismos, Instituto de Microbiologia Paulo de Góes, Departamento de Microbiologia Geral, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Eliana Barreto-Bergter
- Laboratório de Química Biológica de Microrganismos, Instituto de Microbiologia Paulo de Góes, Departamento de Microbiologia Geral, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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11
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ER B, ÇELEBİOĞLU E, YALÇIN E, DOĞRU D, ERDEN AKI Ö, UZUN Ö, AKOVA M, ÖZÇELİK U, KİPER N, EMRİ S. Factors associated with severe lung disease in an adult population with cystic fibrosis: a single-center experience. Turk J Med Sci 2020; 50:945-952. [PMID: 32394679 PMCID: PMC7379455 DOI: 10.3906/sag-1912-101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 05/05/2020] [Indexed: 11/03/2022] Open
Abstract
Background/Aim The patients with cystic fibrosis (CF) are living longer compared to the past, but respiratory failure is still the most common cause of mortality. The aim of this study is to investigate factors associated with severe lung disease in a cohort of adult patients with CF. Materials and methods Demographic data, clinical and laboratory findings of the patients aged 18 years and more were collected and the patients were grouped according to forced expiratory volume in 1 s (FEV1) as severe group: <40% and nonsevere ≥40%. Associations were investigated between groups and clinical outcomes. Results A total of 76 patients were enrolled in the study. The mean age was 24.5 ± 5.25 years and 36 (47.4%) patients were female. In the severe group; the mean age was higher (27.1 ± 6.0 vs 23.6 ± 4.7, P = 0.013), the median Chrispin-Norman score of severe lung disease group was higher (14 (6–22) vs 5.5 (0–20), P < 0.001), hospitalization at least once in a year for intravenous antibiotic was more common (12/18 (66%) vs 19/58 (32%), P = 0.014). There was a positive correlation between body mass index (BMI) and lung function, indicating that lower nutritional status was related to lower FEV1, r2 = 0.21, P < 0.001. The median FEV1% was lower in patients with CF-related diabetes (38 (14–95) vs 66 (13–121), P = 0.042). Dornase alpha use and physiotherapy rate were higher in severe lung disease group (P = 0.008 and P < 0.001, respectively). Conclusion Lower BMI, older age, presence of CF-related diabetes, higher radiologic scores, use of dornase alpha and physiotherapy and higher hospitalization rate for intravenous antibiotic therapy are significantly associated with severe lung disease.
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Affiliation(s)
- Berrin ER
- Medical Intensive Care Unit, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Ebru ÇELEBİOĞLU
- Department of Chest Diseases, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Ebru YALÇIN
- Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Deniz DOĞRU
- Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Özlem ERDEN AKI
- Department of Psychiatry, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Ömrüm UZUN
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Murat AKOVA
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Uğur ÖZÇELİK
- Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Nural KİPER
- Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, AnkaraTurkey
| | - Salih EMRİ
- Department of Chest Diseases, Medicana Kadıköy, İstanbulTurkey
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12
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Soret P, Vandenborght LE, Francis F, Coron N, Enaud R, Avalos M, Schaeverbeke T, Berger P, Fayon M, Thiebaut R, Delhaes L. Respiratory mycobiome and suggestion of inter-kingdom network during acute pulmonary exacerbation in cystic fibrosis. Sci Rep 2020; 10:3589. [PMID: 32108159 PMCID: PMC7046743 DOI: 10.1038/s41598-020-60015-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 10/14/2019] [Indexed: 12/12/2022] Open
Abstract
Lung infections play a critical role in cystic fibrosis (CF) pathogenesis. CF respiratory tract is now considered to be a polymicrobial niche and advances in high-throughput sequencing allowed to analyze its microbiota and mycobiota. However, no NGS studies until now have characterized both communities during CF pulmonary exacerbation (CFPE). Thirty-three sputa isolated from patients with and without CFPE were used for metagenomic high-throughput sequencing targeting 16S and ITS2 regions of bacterial and fungal rRNA. We built inter-kingdom network and adapted Phy-Lasso method to highlight correlations in compositional data. The decline in respiratory function was associated with a decrease in bacterial diversity. The inter-kingdom network revealed three main clusters organized around Aspergillus, Candida, and Scedosporium genera. Using Phy-Lasso method, we identified Aspergillus and Malassezia as relevantly associated with CFPE, and Scedosporium plus Pseudomonas with a decline in lung function. We corroborated in vitro the cross-domain interactions between Aspergillus and Streptococcus predicted by the correlation network. For the first time, we included documented mycobiome data into a version of the ecological Climax/Attack model that opens new lines of thoughts about the physiopathology of CF lung disease and future perspectives to improve its therapeutic management.
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Affiliation(s)
- Perrine Soret
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000, Bordeaux, France
- INRIA SISTM Team, F-33405, Talence, France
| | - Louise-Eva Vandenborght
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000, Bordeaux, France
- Genoscreen Society, 59000, Lille, France
| | - Florence Francis
- CHU Bordeaux, Department of Public Health, F-33000, Bordeaux, France
| | - Noémie Coron
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000, Bordeaux, France
- CHU de Bordeaux, Univ. Bordeaux, FHU ACRONIM, F-33000, Bordeaux, France
- CHU de Bordeaux: Laboratoire de Parasitologie-Mycologie, Univ. Bordeaux, F-33000, Bordeaux, France
| | - Raphael Enaud
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000, Bordeaux, France
- CHU de Bordeaux, Univ. Bordeaux, FHU ACRONIM, F-33000, Bordeaux, France
- CHU de Bordeaux, CRCM Pédiatrique, CIC, 1401, Bordeaux, France
| | - Marta Avalos
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000, Bordeaux, France
- INRIA SISTM Team, F-33405, Talence, France
| | | | - Patrick Berger
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000, Bordeaux, France
- CHU de Bordeaux, Univ. Bordeaux, FHU ACRONIM, F-33000, Bordeaux, France
| | - Michael Fayon
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000, Bordeaux, France
- CHU de Bordeaux, Univ. Bordeaux, FHU ACRONIM, F-33000, Bordeaux, France
- CHU de Bordeaux, CRCM Pédiatrique, CIC, 1401, Bordeaux, France
| | - Rodolphe Thiebaut
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000, Bordeaux, France
- INRIA SISTM Team, F-33405, Talence, France
- CHU Bordeaux, Department of Public Health, F-33000, Bordeaux, France
| | - Laurence Delhaes
- Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, F-33000, Bordeaux, France.
- CHU de Bordeaux, Univ. Bordeaux, FHU ACRONIM, F-33000, Bordeaux, France.
- CHU de Bordeaux: Laboratoire de Parasitologie-Mycologie, Univ. Bordeaux, F-33000, Bordeaux, France.
- CHU de Bordeaux, CRCM Pédiatrique, CIC, 1401, Bordeaux, France.
- University and CHU of Lille, F-59000, Lille, France.
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13
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Schwarz C, Brandt C, Melichar V, Runge C, Heuer E, Sahly H, Schebek M, Köster H, Bouchara JP, Biedermann T, Meißner P, Große-Onnebrink J, Skopnik H, Hartl D, Sedlacek L, Tintelnot K. Combined antifungal therapy is superior to monotherapy in pulmonary scedosporiosis in cystic fibrosis. J Cyst Fibros 2019; 18:227-232. [DOI: 10.1016/j.jcf.2018.08.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 08/06/2018] [Accepted: 08/31/2018] [Indexed: 12/13/2022]
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14
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Hong G, Lechtzin N, Hadjiliadis D, Kawut SM. Inhaled antibiotic use is associated with Scedosporium/Lomentospora species isolation in cystic fibrosis. Pediatr Pulmonol 2019; 54:133-140. [PMID: 30549449 PMCID: PMC8115015 DOI: 10.1002/ppul.24210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 10/19/2018] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Prevalence of fungi has been rising in the cystic fibrosis (CF) population. Scedosporium species (spp) is the second most common mold seen in the CF respiratory tract. However, the characteristics associated with Scedosporium isolation and its clinical implications are poorly understood. The goal of this study was to determine clinical factors associated with Scedosporium spp to better understand the mechanisms that may contribute to the emergence of filamentous fungi in CF. METHODS We conducted a retrospective cohort study of subjects followed in the CF Foundation Patient Registry between January 1, 2010 and December 31, 2012. Patients under 6 years of age, history of solid organ transplantation, and insufficient respiratory culture data were excluded. We used a multivariable logistic regression model to determine demographic data and baseline disease characteristics, medications and co-infections associated with Scedosporium spp recovery in CF sputum. RESULTS Among 19 023 subjects, prevalence of Scedosporium spp was 615 (3.2%). Older age (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.07, 1.26) and white race (OR 1.69, 95% CI 1.09, 2.63) were the demographic factors associated with Scedosporium spp isolation. Inhaled antibiotic use had a significant association with Scedosporium isolation (OR 2.01, 95% CI 1.61, 2.52). For every additional course of intravenous antibiotics, the odds of Scedosporium isolation increased by 8% (OR 1.08, 95% CI 1.03, 1.14). CONCLUSIONS The association between inhaled antibiotics and Scedosporium informs us that chronic inhaled antibiotics may be playing a role in Scedosporium isolation. Further investigation to better characterize this relationship is necessary.
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Affiliation(s)
- Gina Hong
- Department of Medicine, Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Noah Lechtzin
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Denis Hadjiliadis
- Department of Medicine, Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Steven M Kawut
- Department of Medicine, Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.,Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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15
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Schwarz C, Vandeputte P, Rougeron A, Giraud S, Dugé de Bernonville T, Duvaux L, Gastebois A, Alastruey-Izquierdo A, Martín-Gomez MT, Mazuelos EM, Sole A, Cano J, Pemán J, Quindos G, Botterel F, Bougnoux ME, Chen S, Delhaès L, Favennec L, Ranque S, Sedlacek L, Steinmann J, Vazquez J, Williams C, Meyer W, Le Gal S, Nevez G, Fleury M, Papon N, Symoens F, Bouchara JP. Developing collaborative works for faster progress on fungal respiratory infections in cystic fibrosis. Med Mycol 2018. [PMID: 29538733 DOI: 10.1093/mmy/myx106] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cystic fibrosis (CF) is the major genetic inherited disease in Caucasian populations. The respiratory tract of CF patients displays a sticky viscous mucus, which allows for the entrapment of airborne bacteria and fungal spores and provides a suitable environment for growth of microorganisms, including numerous yeast and filamentous fungal species. As a consequence, respiratory infections are the major cause of morbidity and mortality in this clinical context. Although bacteria remain the most common agents of these infections, fungal respiratory infections have emerged as an important cause of disease. Therefore, the International Society for Human and Animal Mycology (ISHAM) has launched a working group on Fungal respiratory infections in Cystic Fibrosis (Fri-CF) in October 2006, which was subsequently approved by the European Confederation of Medical Mycology (ECMM). Meetings of this working group, comprising both clinicians and mycologists involved in the follow-up of CF patients, as well as basic scientists interested in the fungal species involved, provided the opportunity to initiate collaborative works aimed to improve our knowledge on these infections to assist clinicians in patient management. The current review highlights the outcomes of some of these collaborative works in clinical surveillance, pathogenesis and treatment, giving special emphasis to standardization of culture procedures, improvement of species identification methods including the development of nonculture-based diagnostic methods, microbiome studies and identification of new biological markers, and the description of genotyping studies aiming to differentiate transient carriage and chronic colonization of the airways. The review also reports on the breakthrough in sequencing the genomes of the main Scedosporium species as basis for a better understanding of the pathogenic mechanisms of these fungi, and discusses treatment options of infections caused by multidrug resistant microorganisms, such as Scedosporium and Lomentospora species and members of the Rasamsonia argillacea species complex.
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Affiliation(s)
- Carsten Schwarz
- Department of Pediatric Pneumology and Immunology, Cystic Fibrosis Center Berlin/Charité -Universitätsmedizin Berlin, Berlin, Germany
| | - Patrick Vandeputte
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France.,Laboratoire de Parasitologie-Mycologie, CHU, Angers, France
| | - Amandine Rougeron
- Université de Bordeaux, Microbiologie Fondamentale et Pathogénicité UMR 5234, Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France; Laboratoire de Parasitologie-Mycologie, CHU, Bordeaux, France
| | - Sandrine Giraud
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France
| | - Thomas Dugé de Bernonville
- Biomolécules et Biotechnologies Végétales (EA 2106), Département de Biologie et Physiologie Végétales, UFR Sciences et Techniques, Université François Rabelais, Tours
| | - Ludovic Duvaux
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France.,Institut de Recherche en Horticulture et Semences (IRHS), UMR INRA 1345, Beaucouzé, France
| | - Amandine Gastebois
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France
| | - Ana Alastruey-Izquierdo
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Maria Teresa Martín-Gomez
- Respiratory Bacteriology Unit & Clinical Mycology Unit, Department of Microbiology, Vall D'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Amparo Sole
- Unidad de Trasplante Pulmonar y Fibrosis Quística, Hospital Universitari la Fe, Valencia, Spain
| | - Josep Cano
- Mycology Unit, Medical School/Oenology School, Universitat Rovira i Virgili, Reus, Spain
| | - Javier Pemán
- Unidad de Micología, Servicio de Microbiología, Universitari la Fe, Valencia, Spain
| | - Guillermo Quindos
- Laboratorio de Micología Médica, Departamento de Inmunología, Microbiología y Parasitología, Facultad de Medicina y Enfermería, Universidad del País Vasco, Bilbao, Spain
| | - Françoise Botterel
- Laboratoire de Parasitologie-Mycologie, CHU Henri Mondor, Créteil, France
| | | | - Sharon Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR - Pathology West, Westmead Hospital, Westmead, New South Wales, Australia
| | - Laurence Delhaès
- Center for Cardiothoracic Research of Bordeaux, Inserm U1045, Bordeaux, France
| | - Loïc Favennec
- Laboratoire de Parasitologie-Mycologie, EA 3800, CHU Charles Nicolle and Université de Rouen, Rouen, France
| | - Stéphane Ranque
- Laboratoire de Parasitologie-Mycologie, AP-HM Timone, Marseille, France
| | - Ludwig Sedlacek
- Institute of Medical Microbiology and Hospital Epidemiology, Medical School Hannover, Hannover, Germany
| | - Joerg Steinmann
- Institute of Medical Microbiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jose Vazquez
- Division of Infectious Diseases, Department of Medicine, Georgia Regents University, Augusta, GA, USA
| | - Craig Williams
- University of the West of Scotland, Institute of Healthcare Associated Infection, University Hospital Crosshouse, Kilmarnock, United Kingdom
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Sydney Medical School, Westmead Clinical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Westmead Hospital, Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - Solène Le Gal
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Brest, France.,Laboratoire de Parasitologie-Mycologie, CHU, Brest, France
| | - Gilles Nevez
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Brest, France.,Laboratoire de Parasitologie-Mycologie, CHU, Brest, France
| | - Maxime Fleury
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France
| | - Nicolas Papon
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France
| | - Françoise Symoens
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France
| | - Jean-Philippe Bouchara
- Host-Pathogen Interaction Study Group (EA 3142), UNIV Angers, UNIV Brest, Université Bretagne-Loire, Angers, France.,Laboratoire de Parasitologie-Mycologie, CHU, Angers, France
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16
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Aspergillus terreus Causing Probable Invasive Aspergillosis in a Patient with Cystic Fibrosis. Mycopathologia 2018; 184:151-154. [DOI: 10.1007/s11046-018-0294-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 08/13/2018] [Indexed: 02/06/2023]
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17
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Abdolrasouli A, Bercusson AC, Rhodes JL, Hagen F, Buil JB, Tang AYY, de Boer LL, Shah A, Milburn AJ, Elborn JS, Jones AL, Meis JF, Fisher MC, Schelenz S, Simmonds NJ, Armstrong-James D. Airway persistence by the emerging multi-azole-resistant Rasamsonia argillacea complex in cystic fibrosis. Mycoses 2018; 61:665-673. [PMID: 29702751 DOI: 10.1111/myc.12789] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 04/19/2018] [Indexed: 11/26/2022]
Abstract
Infections caused by Rasamsonia argillacea complex have been reported in various clinical settings. Cystic fibrosis (CF) is one of the main underlying conditions. An observational cohort study of CF patients with Rasamsonia in respiratory samples was conducted. Eight isolates from 6 patients were identified as R. argillacea complex and tested for antifungal susceptibility. All isolates had high MICs to voriconazole and posaconazole and low MECs to echinocandins. Four patients experienced lung function decline in the year preceding first Rasamsonia isolation. This continued in the year following first isolation in 3 out of 4 cases. Antifungal therapy was initiated in 2 patients, to which only one exhibited a clinical response. Three out of 6 patients died within 3 years of isolating Rasamsonia. Genotyping suggests that similar genotypes of Rasamsonia can persist in CF airways. Consistent with other fungi in CF, the clinical impact of airway colonisation by Rasamsonia is variable. In certain patients, Rasamsonia may be able to drive clinical decline. In others, though a clear impact on lung function may be difficult to determine, the appearance of Rasamsonia acts as a marker of disease severity. In others it does not appear to have an obvious clinical impact on disease progression.
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Affiliation(s)
- Alireza Abdolrasouli
- Fungal Pathogens Laboratory, National Heart and Lung Institute, Imperial College London, London, UK
| | - Amelia C Bercusson
- Fungal Pathogens Laboratory, National Heart and Lung Institute, Imperial College London, London, UK
| | - Johanna L Rhodes
- Department of Infectious Diseases Epidemiology, Imperial College School of Public Health, London, UK
| | - Ferry Hagen
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands.,Centre of Expertise in Mycology Radboud UMC/CWZ and ECMM Excellence Center for Medical Mycology, Nijmegen, The Netherlands.,Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Utrecht, The Netherlands
| | - Jochem B Buil
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands.,Centre of Expertise in Mycology Radboud UMC/CWZ and ECMM Excellence Center for Medical Mycology, Nijmegen, The Netherlands
| | - Alison Y Y Tang
- Fungal Pathogens Laboratory, National Heart and Lung Institute, Imperial College London, London, UK
| | - Leonard L de Boer
- Fungal Pathogens Laboratory, National Heart and Lung Institute, Imperial College London, London, UK
| | - Anand Shah
- Adult Cystic Fibrosis Centre, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Andrew J Milburn
- Adult Cystic Fibrosis Centre, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - J Stuart Elborn
- Adult Cystic Fibrosis Centre, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Andrew L Jones
- Adult Cystic Fibrosis Centre, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Jacques F Meis
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital (CWZ), Nijmegen, The Netherlands.,Centre of Expertise in Mycology Radboud UMC/CWZ and ECMM Excellence Center for Medical Mycology, Nijmegen, The Netherlands
| | - Matthew C Fisher
- Department of Infectious Diseases Epidemiology, Imperial College School of Public Health, London, UK
| | - Silke Schelenz
- Department of Microbiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Nicholas J Simmonds
- Adult Cystic Fibrosis Centre, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Darius Armstrong-James
- Fungal Pathogens Laboratory, National Heart and Lung Institute, Imperial College London, London, UK.,Department of Microbiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
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18
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Scheffold A, Schwarz C, Bacher P. Fungus-Specific CD4 T Cells as Specific Sensors for Identification of Pulmonary Fungal Infections. Mycopathologia 2017; 183:213-226. [PMID: 29168073 DOI: 10.1007/s11046-017-0229-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 11/14/2017] [Indexed: 12/24/2022]
Abstract
Patients with cystic fibrosis (CF) suffer from chronic lung infections, caused by bacterial, viral or fungal pathogens, which determine morbidity and mortality. The contribution of individual pathogens to chronic disease and acute lung exacerbations is often difficult to determine due to the complex composition of the lung microbiome in CF. In particular, the relevance of fungal pathogens in CF airways remains poorly understood due to limitations of current diagnostics to identify the presence of fungal pathogens and to resolve the individual host-pathogen interaction status. T-lymphocytes play an essential role in host defense against pathogens, but also in inappropriate immune reactions such as allergies. They have the capacity to specifically recognize and discriminate the different pathogens and orchestrate a diverse array of effector functions. Thus, the analysis of the fungus-specific T cell status of an individual can in principle provide detailed information about the identity of the fungal pathogen(s) encountered and the actual fungus-host interaction status. This may allow to classify patients, according to appropriate (protective) or inappropriate (pathology-associated) immune reactions against individual fungal pathogens. However, T cell-based diagnostics are currently not part of the clinical routine. The identification and characterization of fungus-specific T cells in health and disease for diagnostic purposes are associated with significant challenges. Recent technological developments in the field of fungus-specific T helper cell detection provide new insights in the host T cell-fungus interaction. In this review, we will discuss basic principles and the potential of T cell-based diagnostics, as well as the perspectives and further needs for use of T cells for improved clinical diagnostics of fungal diseases.
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Affiliation(s)
- Alexander Scheffold
- Department of Cellular Immunology, Clinic for Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
- German Rheumatism Research Centre (DRFZ) Berlin, Leibniz Association, Berlin, Germany.
| | - Carsten Schwarz
- Department of Pediatric Pneumology and Immunology, Cystic Fibrosis Centre Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Petra Bacher
- Department of Cellular Immunology, Clinic for Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
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19
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Nazik H, Joubert LM, Secor PR, Sweere JM, Bollyky PL, Sass G, Cegelski L, Stevens DA. Pseudomonas phage inhibition of Candida albicans. MICROBIOLOGY-SGM 2017; 163:1568-1577. [PMID: 28982395 DOI: 10.1099/mic.0.000539] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Pseudomonas aeruginosa (Pa) and Candida albicans (Ca) are major bacterial and fungal pathogens in immunocompromised hosts, and notably in the airways of cystic fibrosis patients. The bacteriophages of Pa physically alter biofilms, and were recently shown to inhibit the biofilms of Aspergillus fumigatus. To understand the range of this viral-fungal interaction, we studied Pa phages Pf4 and Pf1, and their interactions with Ca biofilm formation and preformed Ca biofilm. Both forms of Ca biofilm development, as well as planktonic Ca growth, were inhibited by either phage. The inhibition of biofilm was reversed by the addition of iron, suggesting that the mechanism of phage action on Ca involves denial of iron. Birefringence studies on added phage showed an ordered structure of binding to Ca. Electron microscopic observations indicated phage aggregation in the biofilm extracellular matrix. Bacteriophage-fungal interactions may be a general feature with several pathogens in the fungal kingdom.
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Affiliation(s)
- Hasan Nazik
- Division of Infectious Diseases, Department of Medicine, Stanford University Medical School, Stanford, CA, USA.,California Institute for Medical Research, San Jose, CA, USA
| | - Lydia-Marie Joubert
- Cell Sciences Imaging Facility, Stanford University Medical School, Stanford, CA, USA
| | - Patrick R Secor
- Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Johanna M Sweere
- Division of Infectious Diseases, Department of Medicine, Stanford University Medical School, Stanford, CA, USA.,Immunology Program, Stanford University, Stanford, CA, USA
| | - Paul L Bollyky
- Division of Infectious Diseases, Department of Medicine, Stanford University Medical School, Stanford, CA, USA.,Immunology Program, Stanford University, Stanford, CA, USA
| | - Gabriele Sass
- California Institute for Medical Research, San Jose, CA, USA.,Division of Infectious Diseases, Department of Medicine, Stanford University Medical School, Stanford, CA, USA
| | | | - David A Stevens
- California Institute for Medical Research, San Jose, CA, USA.,Division of Infectious Diseases, Department of Medicine, Stanford University Medical School, Stanford, CA, USA
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20
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Invasive Pulmonary Fungal Infections in Cystic Fibrosis. Mycopathologia 2017; 183:33-43. [DOI: 10.1007/s11046-017-0199-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 08/20/2017] [Indexed: 11/25/2022]
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21
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Pharmacokinetics of Azole Antifungals in Cystic Fibrosis. Mycopathologia 2017; 183:139-150. [DOI: 10.1007/s11046-017-0189-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 07/31/2017] [Indexed: 12/19/2022]
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22
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Proteomics as a Tool to Identify New Targets Against Aspergillus and Scedosporium in the Context of Cystic Fibrosis. Mycopathologia 2017; 183:273-289. [PMID: 28484941 DOI: 10.1007/s11046-017-0139-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/25/2017] [Indexed: 12/26/2022]
Abstract
Cystic fibrosis (CF) is a genetic disorder that increases the risk of suffering microbial, including fungal, infections. In this paper, proteomics-based information was collated relating to secreted and cell wall proteins with potential medical applications from the most common filamentous fungi in CF, i.e., Aspergillus and Scedosporium/Lomentospora species. Among the Aspergillus fumigatus secreted allergens, β-1,3-endoglucanase, the alkaline protease 1 (Alp1/oryzin), Asp f 2, Asp f 13/15, chitinase, chitosanase, dipeptidyl-peptidase V (DppV), the metalloprotease Asp f 5, mitogillin/Asp f 1, and thioredoxin reductase receive a special mention. In addition, the antigens β-glucosidase 1, catalase, glucan endo-1,3-β-glucosidase EglC, β-1,3-glucanosyltransferases Gel1 and Gel2, and glutaminase A were also identified in secretomes of other Aspergillus species associated with CF: Aspergillus flavus, Aspergillus niger, Aspergillus nidulans, and Aspergillus terreus. Regarding cell wall proteins, cytochrome P450 and eEF-3 were proposed as diagnostic targets, and alkaline protease 2 (Alp2), Asp f 3 (putative peroxiredoxin pmp20), probable glycosidases Asp f 9/Crf1 and Crf2, GPI-anchored protein Ecm33, β-1,3-glucanosyltransferase Gel4, conidial hydrophobin Hyp1/RodA, and secreted aspartyl protease Pep2 as protective vaccines in A. fumigatus. On the other hand, for Scedosporium/Lomentospora species, the heat shock protein Hsp70 stands out as a relevant secreted and cell wall antigen. Additionally, the secreted aspartyl proteinase and an ortholog of Asp f 13, as well as the cell wall endo-1,3-β-D-glucosidase and 1,3-β-glucanosyl transferase, were also found to be significant proteins. In conclusion, proteins mentioned in this review may be promising candidates for developing innovative diagnostic and therapeutic tools for fungal infections in CF patients.
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23
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Cowley AC, Thornton DJ, Denning DW, Horsley A. Aspergillosis and the role of mucins in cystic fibrosis. Pediatr Pulmonol 2017; 52:548-555. [PMID: 27870227 PMCID: PMC5396363 DOI: 10.1002/ppul.23618] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/20/2016] [Accepted: 09/20/2016] [Indexed: 01/08/2023]
Abstract
The prevalence of aspergillosis in CF patients has until recently been underestimated, but increasing evidence suggests that it may play an important role in the progression of CF lung disease. In healthy airways, Aspergillus fumigatus can be efficiently removed from the lung by mechanisms such as mucociliary clearance and cough. However, these mechanisms are defective in CF, allowing pathogens such as A. fumigatus to germinate and establish chronic infections within the airways. The precise means by which A. fumigatus contributes to CF lung disease remain largely unclear. As the first point of contact within the lung, and an important component of the innate immune system, it is likely that the mucus barrier plays an important role in this process. Study of the functional interplay between this vital protective barrier, and in particular its principal structural components, the polymeric gel-forming mucins, and CF pathogens such as A. fumigatus, is at an early stage. A. fumigatus protease activity has been shown to upregulate mucus production by inducing mucin mRNA and protein expression, and A. fumigatus proteases and glycosidases are able to degrade mucins. This may allow A. fumigatus to alter mucus barrier properties to promote fungal colonization of the airways and/or utilize mucins as a nutrient source. Moreover, conidial surface lectin binding to mucin glycans is a key aspect of clearance of Aspergillus from the lung in health but may be an important aspect of colonization, where mucociliary clearance is compromised, as in the CF lung. Here we discuss the nature of the mucus barrier and its mucin components in CF, and how they may be implicated in A. fumigatus infection. Pediatr Pulmonol 2017;52:548-555. © 2016 The Authors. Pediatric Pulmonology. Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Abigail C Cowley
- Wellcome Trust Centre for Cell-Matrix Research, University of Manchester, Manchester, United Kingdom.,Faculty of Biology, Medicine and Health, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - David J Thornton
- Wellcome Trust Centre for Cell-Matrix Research, University of Manchester, Manchester, United Kingdom.,Faculty of Biology, Medicine and Health, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - David W Denning
- Faculty of Biology, Medicine and Health, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Alexander Horsley
- Faculty of Biology, Medicine and Health, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, United Kingdom.,Manchester Adult CF Centre, Manchester, United Kingdom
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24
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Abstract
For a long time, the microbiology of cystic fibrosis has been focussed on Pseudomonas aeruginosa and associated Gram-negative pathogens. An increasing body of evidence has been compiled demonstrating an important role for moulds and yeasts within this complex patient group. Whether or not fungi are active participants, spectators or transient passersby remain to be elucidated. However, functionally, they do appear to play a contributory role in pathogenesis, albeit we do not know if this is a direct or indirect effect. The following review examines some of the key evidence for the role of fungi in CF pathogenesis.
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25
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Cystic fibrosis lung environment and Pseudomonas aeruginosa infection. BMC Pulm Med 2016; 16:174. [PMID: 27919253 PMCID: PMC5139081 DOI: 10.1186/s12890-016-0339-5] [Citation(s) in RCA: 225] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/24/2016] [Indexed: 12/20/2022] Open
Abstract
Background The airways of patients with cystic fibrosis (CF) are highly complex, subject to various environmental conditions as well as a distinct microbiota. Pseudomonas aeruginosa is recognized as one of the most important pulmonary pathogens and the predominant cause of morbidity and mortality in CF. A multifarious interplay between the host, pathogens, microbiota, and the environment shapes the course of the disease. There have been several excellent reviews detailing CF pathology, Pseudomonas and the role of environment in CF but only a few reviews connect these entities with regards to influence on the overall course of the disease. A holistic understanding of contributing factors is pertinent to inform new research and therapeutics. Discussion In this article, we discuss the deterministic alterations in lung physiology as a result of CF. We also revisit the impact of those changes on the microbiota, with special emphasis on P. aeruginosa and the influence of other non-genetic factors on CF. Substantial past and current research on various genetic and non-genetic aspects of cystic fibrosis has been reviewed to assess the effect of different factors on CF pulmonary infection. A thorough review of contributing factors in CF and the alterations in lung physiology indicate that CF lung infection is multi-factorial with no isolated cause that should be solely targeted to control disease progression. A combinatorial approach may be required to ensure better disease outcomes. Conclusion CF lung infection is a complex disease and requires a broad multidisciplinary approach to improve CF disease outcomes. A holistic understanding of the underlying mechanisms and non-genetic contributing factors in CF is central to development of new and targeted therapeutic strategies.
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26
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Ralhan A, Laval J, Lelis F, Ballbach M, Grund C, Hector A, Hartl D. Current Concepts and Controversies in Innate Immunity of Cystic Fibrosis Lung Disease. J Innate Immun 2016; 8:531-540. [PMID: 27362371 PMCID: PMC6738757 DOI: 10.1159/000446840] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/17/2016] [Accepted: 05/17/2016] [Indexed: 12/11/2022] Open
Abstract
Cystic fibrosis (CF) lung disease is characterized by chronic infection and inflammation. The inflammatory response in CF is dominated by the activation of the innate immune system. Bacteria and fungi represent the key pathogens chronically colonizing the CF airways. In response, innate immune pattern recognition receptors, expressed by airway epithelial and myeloid cells, sense the microbial threat and release chemoattractants to recruit large numbers of neutrophils into CF airways. However, neutrophils fail to efficiently clear the invading pathogens, but instead release harmful proteases and oxidants and finally cause tissue injury. Here, we summarize and discuss current concepts and controversies in the field of innate immunity in CF lung disease, facing the ongoing questions of whether inflammation is good or bad in CF and how innate immune mechanisms could be harnessed therapeutically.
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Affiliation(s)
- Anjali Ralhan
- Department of Pediatrics I, University of Tübingen, Tübingen, Germany
| | - Julie Laval
- Department of Pediatrics I, University of Tübingen, Tübingen, Germany
| | - Felipe Lelis
- Department of Pediatrics I, University of Tübingen, Tübingen, Germany
| | - Marlene Ballbach
- Department of Pediatrics I, University of Tübingen, Tübingen, Germany
| | - Charlotte Grund
- Department of Pediatrics I, University of Tübingen, Tübingen, Germany
| | - Andreas Hector
- Department of Pediatrics I, University of Tübingen, Tübingen, Germany
| | - Dominik Hartl
- Department of Pediatrics I, University of Tübingen, Tübingen, Germany
- Immunology, Inflammation and Infectious Diseases (I3) Discovery and Translational Area, Roche Pharma Research and Early Development (pRED), Roche Innovation Center Basel, Basel, Switzerland
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27
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Effect of Media Modified To Mimic Cystic Fibrosis Sputum on the Susceptibility of Aspergillus fumigatus, and the Frequency of Resistance at One Center. Antimicrob Agents Chemother 2016; 60:2180-4. [PMID: 26810647 DOI: 10.1128/aac.02649-15] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 01/17/2016] [Indexed: 01/07/2023] Open
Abstract
Studies of cystic fibrosis (CF) patient exacerbations attributed toPseudomonas aeruginosainfection have indicated a lack of correlation of outcome within vitrosusceptibility results. One explanation is that the media used for testing do not mimic the airway milieu, resulting in incorrect conclusions. Therefore, media have been devised to mimic CF sputum.Aspergillus fumigatusis the leading fungal pathogen in CF, and susceptibility testing is also used to decide therapeutic choices. We assessed whether media designed to mimic CF sputa would give different fungal susceptibility results than those of classical methods, assaying voriconazole, the most utilized anti-Aspergillusdrug in this setting, and 30 CFAspergillusisolates. The frequency of marked resistance (defined as an MIC of >4 μg/ml) in our CF unit by classical methods is 7%. Studies performed with classical methods and with digested sputum medium, synthetic sputum medium, and artificial sputum medium revealed prominent differences inAspergillussusceptibility results, as well as growth rate, with each medium. Clinical correlative studies are required to determine which results are most useful in predicting outcome. Comparison of MICs with non-CF isolates also indicated the CF isolates were generally more resistant.
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28
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Neerincx AH, Geurts BP, Habets MFJ, Booij JA, van Loon J, Jansen JJ, Buydens LMC, van Ingen J, Mouton JW, Harren FJM, Wevers RA, Merkus PJFM, Cristescu SM, Kluijtmans LAJ. Identification of
Pseudomonas aeruginosa
and
Aspergillus fumigatus
mono- and co-cultures based on volatile biomarker combinations. J Breath Res 2016; 10:016002. [DOI: 10.1088/1752-7155/10/1/016002] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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29
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Scharf DH, Brakhage AA, Mukherjee PK. Gliotoxin--bane or boon? Environ Microbiol 2015; 18:1096-109. [PMID: 26443473 DOI: 10.1111/1462-2920.13080] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/30/2015] [Accepted: 10/04/2015] [Indexed: 12/31/2022]
Abstract
Gliotoxin (GT) is the most important epidithiodioxopiperazine (ETP)-type fungal toxin. GT was originally isolated from Trichoderma species as an antibiotic substance involved in biological control of plant pathogenic fungi. A few isolates of GT-producing Trichoderma virens are commercially marketed for biological control and widely used in agriculture. Furthermore, GT is long known as an immunosuppressive agent and also reported to have anti-tumour properties. However, recent publications suggest that GT is a virulence determinant of the human pathogen Aspergillus fumigatus. This compound is thus important on several counts - it has medicinal properties, is a pathogenicity determinant, is a potential diagnostic marker and is important in biological crop protection. The present article addresses this paradox and the ecological role of GT. We discuss the function of GT as defence molecule, the role in aspergillosis and suggest solutions for safe application of Trichoderma-based biofungicides.
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Affiliation(s)
- Daniel H Scharf
- Department of Molecular and Applied Microbiology, Leibniz-Institute for Natural Product Research and Infection Biology, Hans Knoell Institute (HKI) and Institute for Microbiology, Friedrich Schiller University Jena, Beutenbergstr. 11a, 07745, Jena, Germany
| | - Axel A Brakhage
- Department of Molecular and Applied Microbiology, Leibniz-Institute for Natural Product Research and Infection Biology, Hans Knoell Institute (HKI) and Institute for Microbiology, Friedrich Schiller University Jena, Beutenbergstr. 11a, 07745, Jena, Germany
| | - Prasun K Mukherjee
- Nuclear Agriculture and Biotechnology Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
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30
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Kaur J, Pethani BP, Kumar S, Kim M, Sunna A, Kautto L, Penesyan A, Paulsen IT, Nevalainen H. Pseudomonas aeruginosa inhibits the growth of Scedosporium aurantiacum, an opportunistic fungal pathogen isolated from the lungs of cystic fibrosis patients. Front Microbiol 2015; 6:866. [PMID: 26379643 PMCID: PMC4547459 DOI: 10.3389/fmicb.2015.00866] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/07/2015] [Indexed: 12/25/2022] Open
Abstract
The filamentous fungus Scedosporium aurantiacum and the bacterium Pseudomonas aeruginosa are opportunistic pathogens isolated from lungs of the cystic fibrosis (CF) patients. P. aeruginosa has been known to suppress the growth of a number of CF related fungi such as Aspergillus fumigatus, Candida albicans, and Cryptococcus neoformans. However, the interactions between P. aeruginosa and S. aurantiacum have not been investigated in depth. Hence we assessed the effect of P. aeruginosa reference strain PAO1 and two clinical isolates PASS1 and PASS2 on the growth of two clinical S. aurantiacum isolates WM 06.482 and WM 08.202 using solid plate assays and liquid cultures, in a synthetic medium mimicking the nutrient condition in the CF sputum. Solid plate assays showed a clear inhibition of growth of both S. aurantiacum strains when cultured with P. aeruginosa strains PASS1 and PAO1. The inhibitory effect was confirmed by confocal microscopy. In addition to using chemical fluorescent stains, strains tagged with yfp (P. aeruginosa PASS1) and mCherry (S. aurantiacum WM 06.482) were created to facilitate detailed microscopic observations on strain interaction. To our knowledge, this is the first study describing successful genetic transformation of S. aurantiacum. Inhibition of growth was observed only in co-cultures of P. aeruginosa and S. aurantiacum; the cell fractions obtained from independent bacterial monocultures failed to initiate a response against the fungus. In the liquid co-cultures, biofilm forming P. aeruginosa strains PASS1 and PAO1 displayed higher inhibition of fungal growth when compared to PASS2. No change was observed in the inhibition pattern when direct cell contact between the bacterial and fungal strains was prevented using a separation membrane suggesting the involvement of extracellular metabolites in the fungal inhibition. However, one of the most commonly described bacterial virulence factors, pyocyanin, had no effect against either of the S. aurantiacum strains. This study shows that P. aeruginosa has a substantial inhibitory effect on the growth of the recently described CF fungal pathogen S. aurantiacum. The findings also highlighted that P. aeruginosa biofilm formation is important but not crucial for inhibiting the growth of S. aurantiacum in a lung- mimicking environment.
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Affiliation(s)
- Jashanpreet Kaur
- Department of Chemistry and Biomolecular Sciences, Macquarie University Sydney, NSW, Australia ; Biomolecular Frontiers Research Centre, Macquarie University Sydney, NSW, Australia
| | - Bhavin P Pethani
- Department of Chemistry and Biomolecular Sciences, Macquarie University Sydney, NSW, Australia ; Biomolecular Frontiers Research Centre, Macquarie University Sydney, NSW, Australia
| | - Sheemal Kumar
- Department of Chemistry and Biomolecular Sciences, Macquarie University Sydney, NSW, Australia ; Biomolecular Frontiers Research Centre, Macquarie University Sydney, NSW, Australia
| | - Minkyoung Kim
- Department of Chemistry and Biomolecular Sciences, Macquarie University Sydney, NSW, Australia ; Biomolecular Frontiers Research Centre, Macquarie University Sydney, NSW, Australia
| | - Anwar Sunna
- Department of Chemistry and Biomolecular Sciences, Macquarie University Sydney, NSW, Australia ; Biomolecular Frontiers Research Centre, Macquarie University Sydney, NSW, Australia
| | - Liisa Kautto
- Department of Chemistry and Biomolecular Sciences, Macquarie University Sydney, NSW, Australia ; Biomolecular Frontiers Research Centre, Macquarie University Sydney, NSW, Australia
| | - Anahit Penesyan
- Department of Chemistry and Biomolecular Sciences, Macquarie University Sydney, NSW, Australia ; Biomolecular Frontiers Research Centre, Macquarie University Sydney, NSW, Australia
| | - Ian T Paulsen
- Department of Chemistry and Biomolecular Sciences, Macquarie University Sydney, NSW, Australia ; Biomolecular Frontiers Research Centre, Macquarie University Sydney, NSW, Australia
| | - Helena Nevalainen
- Department of Chemistry and Biomolecular Sciences, Macquarie University Sydney, NSW, Australia ; Biomolecular Frontiers Research Centre, Macquarie University Sydney, NSW, Australia
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31
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Abstract
PURPOSE OF REVIEW Fungal spores are ubiquitously present in indoor and outdoor air. A number can act as aeroallergens in Immunoglobulin E (IgE)-sensitized individuals and some thermotolerant fungi germinate in the lung where they can cause a combined allergic and infective stimulus leading to a number of clinical presentations characterized by evidence of lung damage. We discuss which biomarkers are useful in helping to guide diagnosis, prognosis and treatment of allergic fungal airway disease (AFAD). RECENT FINDINGS Diagnostic biomarkers, such as specific IgEs and fungal culture, for AFAD are limited by sensitivity, although this may be improved with novel agents such as specific IgEs to fungal components and quantitative PCR. Total IgE and hypereosinophilia are nonspecific and do not clearly relate to disease activity. High attenuation mucus and proximal bronchiectasis are specific, albeit insensitive markers of AFAD. Biomarkers that predict prognosis and treatment response are yet to be defined. SUMMARY This review summarizes the fungi involved and the current debate regarding the diagnostic criteria to define fungal-associated lung disease. We advocate the phasing out of the term allergic bronchopulmonary aspergillosis and the use of a more inclusive term such as AFAD, together with a more liberal set of criteria based largely on IgE sensitization to thermotolerant fungi, which identifies those patients at risk of developing lung damage.
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32
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Ghamrawi S, Gastebois A, Zykwinska A, Vandeputte P, Marot A, Mabilleau G, Cuenot S, Bouchara JP. A Multifaceted Study of Scedosporium boydii Cell Wall Changes during Germination and Identification of GPI-Anchored Proteins. PLoS One 2015; 10:e0128680. [PMID: 26038837 PMCID: PMC4454578 DOI: 10.1371/journal.pone.0128680] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 04/29/2015] [Indexed: 12/02/2022] Open
Abstract
Scedosporium boydii is a pathogenic filamentous fungus that causes a wide range of human infections, notably respiratory infections in patients with cystic fibrosis. The development of new therapeutic strategies targeting S. boydii necessitates a better understanding of the physiology of this fungus and the identification of new molecular targets. In this work, we studied the conidium-to-germ tube transition using a variety of techniques including scanning and transmission electron microscopy, atomic force microscopy, two-phase partitioning, microelectrophoresis and cationized ferritin labeling, chemical force spectroscopy, lectin labeling, and nanoLC-MS/MS for cell wall GPI-anchored protein analysis. We demonstrated that the cell wall undergoes structural changes with germination accompanied with a lower hydrophobicity, electrostatic charge and binding capacity to cationized ferritin. Changes during germination also included a higher accessibility of some cell wall polysaccharides to lectins and less CH3/CH3 interactions (hydrophobic adhesion forces mainly due to glycoproteins). We also extracted and identified 20 GPI-anchored proteins from the cell wall of S. boydii, among which one was detected only in the conidial wall extract and 12 only in the mycelial wall extract. The identified sequences belonged to protein families involved in virulence in other fungi like Gelp/Gasp, Crhp, Bglp/Bgtp families and a superoxide dismutase. These results highlighted the cell wall remodeling during germination in S. boydii with the identification of a substantial number of cell wall GPI-anchored conidial or hyphal specific proteins, which provides a basis to investigate the role of these molecules in the host-pathogen interaction and fungal virulence.
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Affiliation(s)
- Sarah Ghamrawi
- L'UNAM Université, Université d'Angers, Groupe d'Etude des Interactions Hôte-Pathogène, EA 3142, Angers, France
- * E-mail:
| | - Amandine Gastebois
- L'UNAM Université, Université d'Angers, Groupe d'Etude des Interactions Hôte-Pathogène, EA 3142, Angers, France
| | - Agata Zykwinska
- L'UNAM Université, Université de Nantes, Institut des Matériaux Jean Rouxel, Nantes, France
| | - Patrick Vandeputte
- L'UNAM Université, Université d'Angers, Groupe d'Etude des Interactions Hôte-Pathogène, EA 3142, Angers, France
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Angers, France
| | - Agnès Marot
- L'UNAM Université, Université d'Angers, Groupe d'Etude des Interactions Hôte-Pathogène, EA 3142, Angers, France
| | - Guillaume Mabilleau
- L'UNAM Université, Service Commun d'Imageries et Analyses microscopiques, Angers, France
| | - Stéphane Cuenot
- L'UNAM Université, Université de Nantes, Institut des Matériaux Jean Rouxel, Nantes, France
| | - Jean-Philippe Bouchara
- L'UNAM Université, Université d'Angers, Groupe d'Etude des Interactions Hôte-Pathogène, EA 3142, Angers, France
- Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire, Angers, France
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33
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Kamath KS, Kumar SS, Kaur J, Venkatakrishnan V, Paulsen IT, Nevalainen H, Molloy MP. Proteomics of hosts and pathogens in cystic fibrosis. Proteomics Clin Appl 2015; 9:134-46. [DOI: 10.1002/prca.201400122] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/27/2014] [Accepted: 11/18/2014] [Indexed: 12/13/2022]
Affiliation(s)
| | - Sheemal Shanista Kumar
- Department of Chemistry and Biomolecular Sciences; Macquarie University; Sydney Australia
| | - Jashanpreet Kaur
- Department of Chemistry and Biomolecular Sciences; Macquarie University; Sydney Australia
| | | | - Ian T. Paulsen
- Department of Chemistry and Biomolecular Sciences; Macquarie University; Sydney Australia
| | - Helena Nevalainen
- Department of Chemistry and Biomolecular Sciences; Macquarie University; Sydney Australia
| | - Mark P. Molloy
- Department of Chemistry and Biomolecular Sciences; Macquarie University; Sydney Australia
- Australian Proteome Analysis Facility; Macquarie University; Sydney Australia
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34
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Caballero JDD, del Campo R, Tato M, Gómez G de la Pedrosa E, Cobo M, López-Causapé C, Gómez-Mampaso E, Oliver A, Cantón R. Microbiological diagnostic procedures for respiratory cystic fibrosis samples in Spain: towards standard of care practices. BMC Microbiol 2014; 14:335. [PMID: 25927861 PMCID: PMC4302700 DOI: 10.1186/s12866-014-0335-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 12/18/2014] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The microbiological procedures for cystic fibrosis (CF) samples of 17 participating Spanish centers were examined to verify their compliance with current international and national guidelines and to implement the best standards of care for microbiology practices. A 47-item questionnaire covering different CF microbiology aspects was sent to participant laboratories. Telephone interviews were performed when necessary. Data about samples processing for bacteria, mycobacteria and fungi were collected. RESULTS Gene sequencing (71%), MALDI-TOF (59%) or both (94%) were available for most laboratories. Susceptibility testing was performed by automated microdilution systems (94%) and manual diffusion methods (59%). However, a low use of selective media for Staphylococcus aureus (59%) and Burkholderia cepacia complex (71%), and of epidemiological typing methods (41%) was reported. CONCLUSIONS Most Spanish laboratories are in agreement with consensus guidelines for the processing of CF respiratory samples, but need to improve in the use of specific selective media and typing methods for epidemiologic studies.
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Affiliation(s)
- Juan de Dios Caballero
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, 28034, Spain.
- Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
| | - Rosa del Campo
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, 28034, Spain.
- Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
| | - Marta Tato
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, 28034, Spain.
- Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
| | - Elia Gómez G de la Pedrosa
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, 28034, Spain.
- Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
| | - Marta Cobo
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, 28034, Spain.
| | - Carla López-Causapé
- Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
- Servicio de Microbiología y Unidad de Investigación, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de Palma (IdISPa), Palma de Mallorca, Spain.
| | - Enrique Gómez-Mampaso
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, 28034, Spain.
| | - Antonio Oliver
- Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
- Servicio de Microbiología y Unidad de Investigación, Hospital Universitario Son Espases, Instituto de Investigación Sanitaria de Palma (IdISPa), Palma de Mallorca, Spain.
| | - Rafael Cantón
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS), Madrid, 28034, Spain.
- Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain.
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35
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Sabino R, Ferreira JAG, Moss RB, Valente J, Veríssimo C, Carolino E, Clemons KV, Everson C, Banaei N, Penner J, Stevens DA. Molecular epidemiology of Aspergillus collected from cystic fibrosis patients. J Cyst Fibros 2014; 14:474-81. [PMID: 25459562 DOI: 10.1016/j.jcf.2014.10.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 10/16/2014] [Accepted: 10/19/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Aspergillus respiratory infection is a common complication in cystic fibrosis (CF) and is associated with loss of pulmonary function and allergic disease. METHODS Fifty-three Aspergillus isolates recovered from CF patients were identified to species by Internal Transcribed Spacer Region (ITS), β-tubulin, and calmodulin sequencing. RESULTS Three species complexes (Terrei, Nigri, and Fumigati) were found. Identification to species level gave a single Aspergillus terreus sensu stricto, one Aspergillus niger sensu stricto and 51 Aspergillus fumigatus sensu stricto isolates. No cryptic species were found. CONCLUSIONS To our knowledge, this is the first prospective study of Aspergillus species in CF using molecular methods. The paucity of non-A. fumigatus and of cryptic species of A. fumigatus suggests a special association of A. fumigatus sensu stricto with CF airways, indicating it likely displays unique characteristics making it suitable for chronic residence in that milieu. These findings could refine an epidemiologic and therapeutic approach geared to this pathogen.
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Affiliation(s)
- Raquel Sabino
- National Institute of Health Dr. Ricardo Jorge-Infectious Diseases Department, Lisbon, Portugal; Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, United States; California Institute for Medical Research, San Jose, CA, United States.
| | - Jose A G Ferreira
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, United States; California Institute for Medical Research, San Jose, CA, United States; School of Medicine, Faculdade da Saúde e Ecologia Humana-FASEH, Vespasiano, Brazil
| | - Richard B Moss
- Department of Pediatrics, Division of Pulmonology, Stanford University, Stanford, CA, United States
| | - Joana Valente
- National Institute of Health Dr. Ricardo Jorge-Infectious Diseases Department, Lisbon, Portugal
| | - Cristina Veríssimo
- National Institute of Health Dr. Ricardo Jorge-Infectious Diseases Department, Lisbon, Portugal
| | - Elisabete Carolino
- Scientific Area of Mathematics, Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Lisbon, Portugal
| | - Karl V Clemons
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, United States; California Institute for Medical Research, San Jose, CA, United States
| | - Cassie Everson
- Department of Pediatrics, Division of Pulmonology, Stanford University, Stanford, CA, United States
| | - Niaz Banaei
- Clinical Microbiology Laboratory, Stanford University, Stanford, CA, United States
| | - John Penner
- California Institute for Medical Research, San Jose, CA, United States
| | - David A Stevens
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, United States; California Institute for Medical Research, San Jose, CA, United States
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36
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Abstract
Survival has improved in patients with cystic fibrosis (CF), in part because of aggressive antimicrobial management. Two multidrug-resistant environmental bacteria, the Burkholderia cepacia group and nontuberculous mycobacteria, have emerged. Improving genomic and proteomic technologies are allowing better identification of bacteria and fungi found in the CF lung and detection of viral agents that may be associated with pulmonary exacerbations. Anaerobic bacteria and Streptococcus angionsus group organisms may play a role in chronic CF lung infections. The diversity of organisms declines perhaps as a result of aggressive antimicrobial therapy, and an apex predator, Pseudomonas aeruginosa, may emerge in many patients with CF.
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