Fluconazole treatment hyperpolarizes the plasma membrane ofCandidacells

Rapid Antifungal Susceptibility Testing Based on Single-Cell Metabolism Analysis Using Stimulated Raman Scattering Imaging

Rapid antifungal susceptibility testing (AFST) is urgently needed in clinics to treat invasive fungal infections with the appropriate antifungal drugs and to slow the emergence of antifungal resistance. However, current AFST methods are time-consuming (24-48 h) due to the slow growth of fungal cells and the methods not being able to work directly for clinical samples. Here, we demonstrate rapid AFST by measuring the metabolism in single fungal cells using stimulated Raman scattering imaging and deuterium probing. Distinct metabolic responses were observed in Candida albicans to different classes of antifungal drugs: while the metabolism was inhibited by amphotericin B, it was stimulated by azoles (fluconazole and voriconazole) and micafungin. Accordingly, we propose metabolism change as a biomarker for rapid AFST. The results were obtained in 4 h with 100% categorical agreement with the gold standard broth microdilution test. In addition, a protocol was developed for direct AFST from positive blood cultures. This method overcomes the limitation of slow growth in conventional methods and has the potential for the rapid diagnosis of candidemia and other clinical fungal infections.

Rapid and high-throughput testing of antifungal susceptibility using an AIEgen-based analytical system

The increasing resistance among fungi to antimicrobials are posing global threats to health. Early treatment with appropriate antifungal drugs guided by the antifungal susceptibility testing (AFST) can dramatically reduce the mortality of severe fungal infections. However, the long test time (24-48 h) of the standard AFSTs cannot provide timely results due to the slow growth of the pathogen. Herein, we report a new AFST that is independent of growth rate analysis using a luminogen with aggregation-induced emission characteristics (AIEgen) named DMASP. DMASP is a water-soluble small-molecule probe that can readily penetrate the dense fungal cell wall. Based on its mitochondria-targeting ability and AIE characteristics, fungal activity can be dynamically indicated via real-time fluorescence monitoring. This allows fungal susceptibility to various antimicrobials to be assessed within 12 h in a wash-free, one-step manner. This method may serve as a promising tool to rapidly detect possible drug-resistant fungal strain and guide the precise use of antimicrobial against fungal diseases.

Zap1 is required for Candida glabrata response to fluconazole

The increasing prevalence of fluconazole-resistant clinical isolates of Candida spp. strongly hinders the widespread use of the drug. To tackle this problem, great efforts have been made to fully understand the fungal response to fluconazole. In this work, we show that the role of Zap1 in Candida glabrata goes beyond regulating yeast adaptation to zinc deficiency. In line with our previous observation that deletion of ZAP1 makes yeast cells more sensitive to fluconazole, we found that the mutant CgΔzap1 accumulates higher levels of the drug, which correlates well with its lower levels of ergosterol. Surprisingly, Zap1 is a negative regulator of the drug efflux transporter gene CDR1 and of its regulator, PDR1. The apparent paradox of drug accumulation in cells where genes encoding transporters relevant for drug extrusion are being overexpressed led us to postulate that their activity could be impaired. In agreement, Zap1-depleted cells present, in addition to decreased ergosterol levels, an altered composition of membrane phospholipids, which together should impact membrane function and impair the detoxification of fluconazole. Overall, our study brings to light Zap1 as an important hub in Candida glabrata response to fluconazole.

Mass spectrometry-based untargeted lipidomics reveals new compositional insights into membrane dynamics of Candida albicans under magnesium deprivation

AIMS

There is growing appreciation in adopting new approaches to disrupt multidrug resistance in human fungal pathogen, Candida albicans. The plasma membrane of C. albicans comprises potential lipid moieties that contribute towards the survival of pathogen and could be utilized as antifungal targets. Considering promising applications of developments in mass spectrometry (MS)-based lipidomics technology, the aim of the study was to analyse lipidome profile and expose lipid-dependent changes in response to Mg deprivation.

METHODS AND RESULTS

We found that both phosphatidylcholine (PC) and lysophosphatidylcholine (LysoPC) were decreased. Increased flip (inward translocation) in the fluorophore labelled NBD-PC was ascribed to enhanced PC-specific flippase activity. Furthermore, a decrease in phosphatidylethanolamine (PE) leading to altered membrane fluidity and loss of cellular material was prominent. Additionally, we observed decreased phosphatidylglycerol (PG) and phosphatidylinositol (PI) leading to genotoxic stress. Besides, we could detect enhanced levels of phosphatidylserine (PS), diacylglycerol (DAG) and triacylglycerides (TAG). The altered gene expressions of lipid biosynthetic pathway by RT-PCR correlated with the lipidome profile. Lastly, we explored abrogated ionic (Na⁺ and K⁺ ) transport across the plasma membrane.

CONCLUSIONS

We propose that C. albicans exposed to Mg deprivation could reorganize plasma membrane (lipid species, membrane fluidity and ionic transport), and possibly redirected carbon flux to store energy in TAGs as an adaptive stress response. This work unravels several vulnerable targets governing lipid metabolism in C. albicans and pave way for better antifungal strategies.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study demonstrates that magnesium availability is important when one considers dissecting drug resistance mechanisms in Candida albicans. Through mass spectrometry (MS)-based lipidomics technology, the study analyses lipidome profile and exposes lipid-dependent changes that are vulnerable to magnesium availability and presents an opportunity to employ this new information in improving treatment strategies.

Repurposing of respiratory drug theophylline against Candida albicans: mechanistic insights unveil alterations in membrane properties and metabolic fitness

AIMS

Drug repurposing is an attractive chemotherapeutic strategy that serves to make up for the inadequacy of current antifungal drugs. The present study aims to repurpose theophylline (THP) against Candida albicans. THP is a methylxanthine derived from cocoa beans and tea extracts, generally used as the first-line drug for asthma and other respiratory disorders.

METHODS AND RESULTS

We investigated the antifungal activity of THP against C. albicans and non-albicans species. Mechanistic insights revealed that THP induces membrane damage. Enhanced ionic disturbances and depleted ergosterol levels with the concomitant rise in membrane fluidity due to elevated flippase activity confirmed the membrane damaging effect. THP impeded the metabolic adaptability of C. albicans by inhibiting malate synthase and isocitrate lyase enzymes of the glyoxylate cycle. In vivo efficacy of THP was depicted by increased survival of C. albicans infected Caenorhabditis elegans model.

CONCLUSIONS

This study elucidates the antifungal potential of THP with mechanistic insights.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study unveils the antifungal potential of THP, a known respiratory drug that can be further utilized for a wider range of applications such as combating fungal infections. The effect of THP with the known antifungal drugs can be exploited in the combinatorial drug approach for treating candidiasis.

Candida parapsilosis: from Genes to the Bedside

Patients with suppressed immunity are at the highest risk for hospital-acquired infections. Among these, invasive candidiasis is the most prevalent systemic fungal nosocomial infection. Over recent decades, the combined prevalence of non-albicans Candida species outranked Candida albicans infections in several geographical regions worldwide, highlighting the need to understand their pathobiology in order to develop effective treatment and to prevent future outbreaks. Candida parapsilosis is the second or third most frequently isolated Candida species from patients. Besides being highly prevalent, its biology differs markedly from that of C. albicans, which may be associated with C. parapsilosis' increased incidence. Differences in virulence, regulatory and antifungal drug resistance mechanisms, and the patient groups at risk indicate that conclusions drawn from C. albicans pathobiology cannot be simply extrapolated to C. parapsilosis Such species-specific characteristics may also influence their recognition and elimination by the host and the efficacy of antifungal drugs. Due to the availability of high-throughput, state-of-the-art experimental tools and molecular genetic methods adapted to C. parapsilosis, genome and transcriptome studies are now available that greatly contribute to our understanding of what makes this species a threat. In this review, we summarize 10 years of findings on C. parapsilosis pathogenesis, including the species' genetic properties, transcriptome studies, host responses, and molecular mechanisms of virulence. Antifungal susceptibility studies and clinician perspectives are discussed. We also present regional incidence reports in order to provide an updated worldwide epidemiology summary.

Expression patterns of SRB1 and other stress-related genes in Candida albicans under oxidative, hyperosmotic and thermal stress

Candida albicans, a human fungal pathogen, is able to tolerate certain levels of environmental stresses. Its cell wall plays an important role in cellular homeostasis, responding to environmental stimuli. SRB1 gene encodes a GDP-mannose pyrophosphorylase that catalyzes the formation of the major cell wall component, mannan. The exact relationship between SRB1 and various stresses is not yet fully understood. In current study, C. albicans SC5314 cells were exposed to oxidative, hyperosmotic, and thermal stresses. The expression of SRB1 and related stress response genes, HOG1, CAP1, MKC1, and HSP90, was systematically evaluated in cells exposed to various levels of stress. In addition, the apoptosis and ultrastructural changes of the cells were examined. We found that the expression of SRB1 and related stress response genes significantly increased under oxidative, hyperosmotic, and thermal stresses, and the increased gene expression was correlated with higher percentages of apoptosis and ultrastructural changes in C. albicans cells. We propose that protein glycosylation is associated with stress response that involves SRB1 in C. albicans. Further in-depth studies of SRB1 function should aid our understanding of C. albicans pathogenesis, and provide important clues about the development of novel antifungal compounds for drug resistant C. albicans.

Influence of phenothiazines, phenazines and phenoxazine on cation transport in Candida albicans

AIMS

(i) To analyse the increase in calcium ion uptake caused by several cationic dyes on Candida albicans, (ii) to postulate a mechanism, (iii) to define the effects of Zn ions on the phenomenon, and (iv) to propose the use of the dyes or their derivatives against C. albicans.

METHODS AND RESULTS

Cells were grown in yeast peptone dextrose medium and starved. We measured the hydrophobic solvent/water partition coefficients and the dyes uptake by the cells and found no correlation with their hydrophobicity. Most of the dyes caused an increase in K+ efflux (in correlation with a decrease in 86 Rb+ uptake), and a raise in Ca2+ uptake except for those used as Zn salts, but not of their HCl salts. Respiration and acidification of the medium were modified only with few dyes and interestingly, when exposing cultures to nile blue, neutral red and toluidine blue ZnCl2 a decrease in C. albicans growth was observed.

CONCLUSIONS

We propose a general mechanism for the stimulation of Ca2+ uptake by the dyes used. Some of the dyes tested might be used as agents against C. albicans, probably combined with other agents. Moreover, the effects of Zn ions on Ca2+ uptake and on cell growth open possibilities of further studies, not only of their effects, but also of the mechanism of Ca2+ transport in C. albicans and other yeasts.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study, in conjunction with previously published results, contribute to the basic research regarding ion transport in C. albicans and the role of zinc in this process. Besides, suggests the additional use of dyes, along with other antifungals agents, as combined therapy against candidiasis. Derived dyes from those used also might be possible therapeutic agents against this disease.

Fluconazole affects the alkali-metal-cation homeostasis and susceptibility to cationic toxic compounds of Candida glabrata

Candida glabrata is a salt-tolerant and fluconazole (FLC)-resistant yeast species. Here, we analyse the contribution of plasma-membrane alkali-metal-cation exporters, a cation/proton antiporter and a cation ATPase to cation homeostasis and the maintenance of membrane potential (ΔΨ). Using a series of single and double mutants lacking CNH1 and/or ENA1 genes we show that the inability to export potassium and toxic alkali-metal cations leads to a slight hyperpolarization of the plasma membrane of C. glabrata cells; this hyperpolarization drives more cations into the cells and affects cation homeostasis. Surprisingly, a much higher hyperpolarization of C. glabrata plasma membrane was produced by incubating cells with subinhibitory concentrations of FLC. FLC treatment resulted in a substantially increased sensitivity of cells to various cationic drugs and toxic cations that are driven into the cell by negative-inside plasma-membrane potential. The effect of the combination of FLC plus cationic drug treatment was enhanced by the malfunction of alkali-metal-cation transporters that contribute to the regulation of membrane potential and cation homeostasis. In summary, we show that the combination of subinhibitory concentrations of FLC and cationic drugs strongly affects the growth of C. glabrata cells.

Osmotolerant yeast species differ in basic physiological parameters and in tolerance of non-osmotic stresses

Osmotolerance is the ability to grow in an environment with a high osmotic pressure. In this study we compared the physiological parameters and tolerance to osmotic and non-osmotic stresses of three osmotolerant yeast species, Debaryomyces hansenii, Pichia farinosa (sorbitophila) and Zygosaccharomyces rouxii, with those of wild-type Saccharomyces cerevisiae. Although the osmotolerant species did not differ significantly in their basic parameters, such as cell size or growth capacity, they had different abilities to survive anhydrobiosis, potassium limitation or the presence of toxic cationic drugs. When their osmotolerance was compared, the results revealed that some of the species isolated as sugar/polyol-tolerant (e.g.  P. farinosa) are also highly tolerant to salts and, vice versa, some strains isolated from an environment with high concentration of salt (e.g. Z. rouxii ATCC 42981) tolerate high concentrations of sugars. None of the tested strains and species was osmophilic. Taken together, our results showed that P. farinosa (sorbitophila) is the most robust species when coping with various stresses, while Z. rouxii CBS 732, although osmotolerant in general, is not specifically salt-tolerant and is quite sensitive to most of the tested stress conditions.