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Zhou L, Guan Z, Chen C, Zhu Q, Qiu S, Liu Y, Li M, Zeng W, Wang H, Gao Y, Yuan Y, Zhang H, Ruan G, Pan X. The successful treatment of Enterocytozoon bieneusi Microsporidiosis with nitazoxanide in a patient with B-ALL: A Case Report. Front Cell Infect Microbiol 2023; 12:1072463. [PMID: 36699718 PMCID: PMC9868268 DOI: 10.3389/fcimb.2022.1072463] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/19/2022] [Indexed: 01/10/2023] Open
Abstract
Introduction Enterocytozoon bieneusi (E. bieneusi) Microsporidia can cause opportunistic infections in immunocompromised patients and is also an emerging disease in these individuals. Its clinical manifestations are chronic diarrhea and severe wasting syndrome, these can be extremely debilitating and carry a significant risk of death for immunocompromised patients. Often, microsporidia cannot be confirmed immediately by routine examination and culture. Effective and available treatment options are limited for infections caused by E. bieneusi in humans. Such cases are very rare in Chinese Mainland. Case presentation A 47-year-old male had recurrent, profuse watery diarrhea and abdominal discomfort for more than 7 months, with a fever for 5 days. Two years earlier, he received treatment with a modified BFM-90 protocol for acute B cell lymphoblastic leukemia and is currently in the final stages of maintenance therapy with oral methotrexate and mercaptopurine. The leukemia was assessed as still in remission two months ago. PET/CT showed massive peritoneal fluid accumulation and a high uptake area in the diffused peritoneum (SUVmax 12.57), suggesting tumor invasion or microbial infections. However, broad-spectrum antibacterial therapies were ineffective. Metagenomic sequencing of plasma and peritoneal fluid showed no suggestion of the existence of a tumor but instead showed a high sequence number of DNA and RNA of the Microsporidia. His albendazole treatment failed and subsequent treatment with nitazoxanide successfully resolved the infection. Conclusion This case shows that we should consider the possibility of atypical pathogen infection in patients with hematologic malignancy who repeatedly develop unexplained diarrhea with wasting. mNGS can help rule out malignant neoplasms and diagnose infections. Our results suggest that nitazoxanide effectively treats E. bieneusi microsporidia infections.
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Maillard A, Scemla A, Laffy B, Mahloul N, Molina JM. Safety and efficacy of fumagillin for the treatment of intestinal microsporidiosis. A French prospective cohort study. J Antimicrob Chemother 2021; 76:487-494. [PMID: 33128055 DOI: 10.1093/jac/dkaa438] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 09/28/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Intestinal microsporidiosis due to Enterocytozoon bieneusi is a cause of chronic diarrhoea in immunocompromised patients. Fumagillin has been approved in France for its treatment. OBJECTIVES To investigate the efficacy and safety of fumagillin in a real-life setting. METHODS As required by the French Medicine Agency, all patients receiving fumagillin were enrolled in a prospective study to evaluate its efficacy and safety. Stool examination with identification of E. bieneusi by PCR was performed at baseline, end of treatment and monthly thereafter for 6 months. Safety was monitored up to 6 months and full blood counts were monitored up to 42 days after treatment initiation. The primary endpoint was safety. Parasite clearance and relapses were secondary endpoints. RESULTS From 2007 to 2018, 166 patients received fumagillin, including 6 children. Patients were transplant recipients (84%), HIV-infected patients (13%) or had another cause of immunosuppression (5%). Serious adverse events were reported in 41 patients (25%), mainly thrombocytopenia (15%) and neutropenia (5%), with two haemorrhagic events leading to one death. Severe thrombocytopenia (<50 G/L) developed in 50 patients (29.6%), neutropenia (<1 G/L) in 20 patients (11.8%) and severe anaemia (<8 g/dL) in 21 patients (12.4%). At the end of treatment, 94% of patients with available stool examination (n = 132) had no spores detected. Among 99 patients with available follow-up after the end of treatment, three parasite relapses were documented. CONCLUSIONS E. bieneusi microsporidiosis was mainly diagnosed in transplant recipients. Fumagillin was associated with haematological toxicity but showed high efficacy with a low relapse rate.
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Affiliation(s)
- Alexis Maillard
- Department of Infectious Diseases, St-Louis Hospital, APHP and University of Paris, France
| | - Anne Scemla
- Kidney Transplant Unit, Hôpital Necker Enfants Malades, APHP and University of Paris, France
| | - Benjamin Laffy
- Kidney Transplant Unit, Hôpital Saint-Louis, APHP and University of Paris, France
| | - Nadir Mahloul
- Medical Department, Sanofi-Aventis France, Gentilly, France
| | - Jean-Michel Molina
- Department of Infectious Diseases, St-Louis Hospital, APHP and University of Paris, France
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Abstract
Microsporidia are obligate intracellular pathogens identified ∼150 years ago as the cause of pébrine, an economically important infection in silkworms. There are about 220 genera and 1,700 species of microsporidia, which are classified based on their ultrastructural features, developmental cycle, host-parasite relationship, and molecular analysis. Phylogenetic analysis suggests that microsporidia are related to the fungi, being grouped with the Cryptomycota as a basal branch or sister group to the fungi. Microsporidia can be transmitted by food and water and are likely zoonotic, as they parasitize a wide range of invertebrate and vertebrate hosts. Infection in humans occurs in both immunocompetent and immunodeficient hosts, e.g., in patients with organ transplantation, patients with advanced human immunodeficiency virus (HIV) infection, and patients receiving immune modulatory therapy such as anti-tumor necrosis factor alpha antibody. Clusters of infections due to latent infection in transplanted organs have also been demonstrated. Gastrointestinal infection is the most common manifestation; however, microsporidia can infect virtually any organ system, and infection has resulted in keratitis, myositis, cholecystitis, sinusitis, and encephalitis. Both albendazole and fumagillin have efficacy for the treatment of various species of microsporidia; however, albendazole has limited efficacy for the treatment of Enterocytozoon bieneusi. In addition, immune restoration can lead to resolution of infection. While the prevalence rate of microsporidiosis in patients with AIDS has fallen in the United States, due to the widespread use of combination antiretroviral therapy (cART), infection continues to occur throughout the world and is still seen in the United States in the setting of cART if a low CD4 count persists.
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Bao J, Mo B, An G, Luo J, Poncz M, Pan G, Li T, Zhou Z. Von Willebrand Factor Facilitates Intravascular Dissemination of Microsporidia Encephalitozoon hellem. Front Cell Infect Microbiol 2021; 11:694957. [PMID: 34095003 PMCID: PMC8176104 DOI: 10.3389/fcimb.2021.694957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 05/04/2021] [Indexed: 11/20/2022] Open
Abstract
Microsporidia are a group of spore-forming, fungus-related pathogens that can infect both invertebrates and vertebrates including humans. The primary infection site is usually digestive tract, but systemic infections occur as well and cause damages to organs such as lung, brain, and liver. The systemic spread of microsporidia may be intravascular, requiring attachment and colonization in the presence of shear stress. Von Willebrand Factor (VWF) is a large multimeric intravascular protein and the key attachment sites for platelets and coagulation factors. Here in this study, we investigated the interactions between VWF and microsporidia Encephalitozoon hellem (E. hellem), and the modulating effects on E. hellem after VWF binding. Microfluidic assays showed that E. hellem binds to ultra-large VWF strings under shear stress. In vitro germination assay and infection assay proved that E. hellem significantly increased the rates of germination and infection, and these effects would be reversed by VWF blocking antibody. Mass spectrometry analysis further revealed that VWF-incubation altered various aspects of E. hellem including metabolic activity, levels of structural molecules, and protein maturation. Our findings demonstrated that VWF can bind microsporidia in circulation, and modulate its pathogenicity, including promoting germination and infection rate. VWF facilitates microsporidia intravascular spreading and systemic infection.
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Affiliation(s)
- Jialing Bao
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, China.,Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China
| | - Biying Mo
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, China.,Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China
| | - Guozhen An
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, China.,Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China
| | - Jian Luo
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, China.,Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China
| | - Mortimer Poncz
- Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Guoqing Pan
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, China.,Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China
| | - Tian Li
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, China.,Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China
| | - Zeyang Zhou
- State Key Laboratory of Silkworm Genome Biology, Southwest University, Chongqing, China.,Chongqing Key Laboratory of Microsporidia Infection and Control, Southwest University, Chongqing, China.,College of Life Sciences, Chongqing Normal University, Chongqing, China
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Messaoud M, Abbes S, Gnaien M, Rebai Y, Kallel A, Jemel S, Cherif G, Skhairia MA, Marouen S, Fakhfekh N, Mardassi H, Belhadj S, Znaidi S, Kallel K. High Frequency of Enterocytozoon bieneusi Genotype WL12 Occurrence among Immunocompromised Patients with Intestinal Microsporidiosis. J Fungi (Basel) 2021; 7:jof7030161. [PMID: 33668221 PMCID: PMC7996336 DOI: 10.3390/jof7030161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 11/25/2022] Open
Abstract
Microsporidiosis is an emerging opportunistic infection causing severe digestive disorders in immunocompromised patients. The aim of this study was to investigate the prevalence of intestinal microsporidia carriage among immunocompromised patients hospitalized at a major hospital complex in the Tunis capital area, Tunisia (North Africa), and perform molecular epidemiology and population structure analyses of Enterocytozoon bieneusi, which is an emerging fungal pathogen. We screened 250 stool samples for the presence of intestinal microsporidia from 171 patients, including 81 organ transplant recipients, 73 Human Immunodeficiency Virus (HIV)-positive patients, and 17 patients with unspecified immunodeficiency. Using a nested PCR-based diagnostic approach for the detection of E. bieneusi and Encephalitozoon spp., we identified 18 microsporidia-positive patients out of 171 (10.5%), among which 17 were infected with E. bieneusi. Microsporidia-positive cases displayed chronic diarrhea (17 out of 18), which was associated more with HIV rather than with immunosuppression other than HIV (12 out of 73 versus 6 out of 98, respectively, p = 0.02) and correlated with extended hospital stays compared to microsporidia-negative cases (60 versus 19 days on average, respectively; p = 0.001). Strikingly, internal transcribed spacer (ITS)-based genotyping of E. bieneusi strains revealed high-frequency occurrence of ITS sequences that were identical (n = 10) or similar (with one single polymorphic site, n = 3) to rare genotype WL12. Minimum-spanning tree analyses segregated the 17 E. bieneusi infection cases into four distinct genotypic clusters and confirmed the high prevalence of genotype WL12 in our patient population. Phylogenetic analyses allowed the mapping of all 17 E. bieneusi strains to zoonotic group 1 (subgroups 1a and 1b/1c), indicating loose host specificity and raising public health concern. Our study suggests a probable common source of E. bieneusi genotype WL12 transmission and prompts the implementation of a wider epidemiological investigation.
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Affiliation(s)
- Mariem Messaoud
- Laboratoire de Parasitologie et Mycologie, UR17SP03, La Rabta Hospital, Tunis 1007, Tunisia; (M.M.); (S.A.); (A.K.); (S.J.); (G.C.); (S.M.); (N.F.); (S.B.)
| | - Salma Abbes
- Laboratoire de Parasitologie et Mycologie, UR17SP03, La Rabta Hospital, Tunis 1007, Tunisia; (M.M.); (S.A.); (A.K.); (S.J.); (G.C.); (S.M.); (N.F.); (S.B.)
| | - Mayssa Gnaien
- Institut Pasteur de Tunis, University of Tunis El Manar, Laboratoire de Microbiologie Moléculaire, Vaccinologie et Développement Biotechnologique, Tunis 1002, Tunisia; (M.G.); (Y.R.); (M.A.S.); (H.M.)
| | - Yasmine Rebai
- Institut Pasteur de Tunis, University of Tunis El Manar, Laboratoire de Microbiologie Moléculaire, Vaccinologie et Développement Biotechnologique, Tunis 1002, Tunisia; (M.G.); (Y.R.); (M.A.S.); (H.M.)
| | - Aicha Kallel
- Laboratoire de Parasitologie et Mycologie, UR17SP03, La Rabta Hospital, Tunis 1007, Tunisia; (M.M.); (S.A.); (A.K.); (S.J.); (G.C.); (S.M.); (N.F.); (S.B.)
- Institut Pasteur de Tunis, University of Tunis El Manar, Laboratoire de Microbiologie Moléculaire, Vaccinologie et Développement Biotechnologique, Tunis 1002, Tunisia; (M.G.); (Y.R.); (M.A.S.); (H.M.)
| | - Sana Jemel
- Laboratoire de Parasitologie et Mycologie, UR17SP03, La Rabta Hospital, Tunis 1007, Tunisia; (M.M.); (S.A.); (A.K.); (S.J.); (G.C.); (S.M.); (N.F.); (S.B.)
| | - Ghaya Cherif
- Laboratoire de Parasitologie et Mycologie, UR17SP03, La Rabta Hospital, Tunis 1007, Tunisia; (M.M.); (S.A.); (A.K.); (S.J.); (G.C.); (S.M.); (N.F.); (S.B.)
| | - Mohamed Amine Skhairia
- Institut Pasteur de Tunis, University of Tunis El Manar, Laboratoire de Microbiologie Moléculaire, Vaccinologie et Développement Biotechnologique, Tunis 1002, Tunisia; (M.G.); (Y.R.); (M.A.S.); (H.M.)
| | - Sonia Marouen
- Laboratoire de Parasitologie et Mycologie, UR17SP03, La Rabta Hospital, Tunis 1007, Tunisia; (M.M.); (S.A.); (A.K.); (S.J.); (G.C.); (S.M.); (N.F.); (S.B.)
| | - Najla Fakhfekh
- Laboratoire de Parasitologie et Mycologie, UR17SP03, La Rabta Hospital, Tunis 1007, Tunisia; (M.M.); (S.A.); (A.K.); (S.J.); (G.C.); (S.M.); (N.F.); (S.B.)
| | - Helmi Mardassi
- Institut Pasteur de Tunis, University of Tunis El Manar, Laboratoire de Microbiologie Moléculaire, Vaccinologie et Développement Biotechnologique, Tunis 1002, Tunisia; (M.G.); (Y.R.); (M.A.S.); (H.M.)
| | - Slaheddine Belhadj
- Laboratoire de Parasitologie et Mycologie, UR17SP03, La Rabta Hospital, Tunis 1007, Tunisia; (M.M.); (S.A.); (A.K.); (S.J.); (G.C.); (S.M.); (N.F.); (S.B.)
| | - Sadri Znaidi
- Institut Pasteur de Tunis, University of Tunis El Manar, Laboratoire de Microbiologie Moléculaire, Vaccinologie et Développement Biotechnologique, Tunis 1002, Tunisia; (M.G.); (Y.R.); (M.A.S.); (H.M.)
- Institut Pasteur, INRA, Département Mycologie, Unité Biologie et Pathogénicité Fongiques, 75015 Paris, France
- Correspondence: (S.Z.); (K.K.)
| | - Kalthoum Kallel
- Laboratoire de Parasitologie et Mycologie, UR17SP03, La Rabta Hospital, Tunis 1007, Tunisia; (M.M.); (S.A.); (A.K.); (S.J.); (G.C.); (S.M.); (N.F.); (S.B.)
- Correspondence: (S.Z.); (K.K.)
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Ou Y, Jiang W, Roellig DM, Wan Z, Li N, Guo Y, Feng Y, Xiao L. Characterizations of Enterocytozoon bieneusi at new genetic loci reveal a lack of strict host specificity among common genotypes and the existence of a canine-adapted Enterocytozoon species. Int J Parasitol 2020; 51:215-223. [PMID: 33275946 DOI: 10.1016/j.ijpara.2020.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 10/22/2022]
Abstract
Molecular characterizations of the microsporidian pathogen Enterocytozoon bieneusi at the ribosomal internal transcribed spacer (ITS) locus have identified nearly 500 genotypes in 11 phylogenetic groups with different host ranges. Among those, one unique group of genotypes, Group 11, is commonly found in dogs. Genetic characterizations of those and many divergent E. bieneusi genotypes at other genetic loci are thus far impossible. In this study, we sequenced 151 E. bieneusi isolates from several ITS genotype groups at the 16S rRNA locus and two new semi-conservative genetic markers (casein kinase 1 (ck1) and spore wall protein 1 (swp1)). Comparison of the near full (~1,200 bp) 16S rRNA sequences showed mostly two to three nucleotide substitutions between Group 1 and Group 2 genotypes, while Group 11 isolates differed from those by 26 (2.2%) nucleotides. Sequence analyses of the ck1 and swp1 loci confirmed the genetic uniqueness of Group 11 genotypes, which produced sequences very divergent from other groups. In contrast, genotypes in Groups 1 and 2 produced similar nucleotide sequences at these genetic loci, and there was discordant placement of ITS genotypes among loci in phylogenetic analyses of sequences. These results suggest that the canine-adapted Group 11 genotypes are genetically divergent from other genotype groups of E. bieneusi, possibly representing a different Enterocytozoon sp. They also indicate that there is no clear genetic differentiation of ITS Groups 1 and 2 at other genetic loci, supporting the conclusion on the lack of strict host specificity in both groups. Data and genetic markers from the study should facilitate population genetic characterizations of E. bieneusi isolates and improve our understanding of the zoonotic potential of E. bieneusi in domestic animals.
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Affiliation(s)
- Yonglin Ou
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong 510642, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, Guangdong 510642, China
| | - Wen Jiang
- State Key Laboratory of Bioreactor Engineering, School of Resource and Environmental Engineering, East China University of Science and Technology, Shanghai 200237, China
| | - Dawn M Roellig
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, United States
| | - Zhuowei Wan
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong 510642, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, Guangdong 510642, China
| | - Na Li
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong 510642, China
| | - Yaqiong Guo
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong 510642, China
| | - Yaoyu Feng
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong 510642, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, Guangdong 510642, China.
| | - Lihua Xiao
- Center for Emerging and Zoonotic Diseases, College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong 510642, China; Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, Guangdong 510642, China.
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Li W, Feng Y, Xiao L. Diagnosis and molecular typing of Enterocytozoon bieneusi: the significant role of domestic animals in transmission of human microsporidiosis. Res Vet Sci 2020; 133:251-261. [PMID: 33035931 DOI: 10.1016/j.rvsc.2020.09.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/15/2020] [Accepted: 09/25/2020] [Indexed: 12/30/2022]
Abstract
Enterocytozoon bieneusi is an obligate intracellular fungus-like parasite with high genetic diversity among mammalian and avian hosts. Based on polymorphism analysis of the ribosomal internal transcribed spacer (ITS), nearly 500 genotypes were identified within E. bieneusi. Those genotypes form several genetic groups that exhibit phenotypic differences in host specificity and zoonotic potential and probably have varying public health implications. Some of the genotypes in Group 1 (e.g., D, EbpC, and Type IV) and Group 2 (e.g., BEB4, BEB6, I, and J) are the most common ones that infect a variety of hosts including humans and thus are of public health importance. By contrast, those genotypes in other genetic groups (Groups 3-11) are mostly restricted to the hosts from which they were originally isolated, which would have unknown or limited impacts on public health. Advances on diagnosis and molecular typing of E. bieneusi are introduced in this review. Genotype distribution pattern of E. bieneusi in major domestic animal groups (pigs, cattle, sheep, goats, cats, and dogs), the role of those animals in zoonotic transmission of microsporidiosis, and food and water as potential vehicles for transmission are interpreted here as well. This review highlights the importance of including more genetic or epidemiological data obtained in the same geographical areas and using more reliable genetic markers to analyze the actual extent of host specificity in E. bieneusi, for the purpose of fully appreciating zoonotic risks of those domestic animals in close contacts with men and enhancing our understanding of the modes of transmission.
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Affiliation(s)
- Wei Li
- Heilongjiang Key Laboratory for Zoonosis, College of Veterinary Medicine, Northeast Agricultural University, Harbin, Heilongjiang, China.
| | - Yaoyu Feng
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China
| | - Lihua Xiao
- Key Laboratory of Zoonosis of Ministry of Agriculture, College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong, China.
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Guruceaga X, Perez-Cuesta U, Abad-Diaz de Cerio A, Gonzalez O, Alonso RM, Hernando FL, Ramirez-Garcia A, Rementeria A. Fumagillin, a Mycotoxin of Aspergillus fumigatus: Biosynthesis, Biological Activities, Detection, and Applications. Toxins (Basel) 2019; 12:E7. [PMID: 31861936 PMCID: PMC7020470 DOI: 10.3390/toxins12010007] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/26/2022] Open
Abstract
Fumagillin is a mycotoxin produced, above all, by the saprophytic filamentous fungus Aspergillus fumigatus. This mold is an opportunistic pathogen that can cause invasive aspergillosis, a disease that has high mortality rates linked to it. Its ability to adapt to environmental stresses through the production of secondary metabolites, including several mycotoxins (gliotoxin, fumagillin, pseurotin A, etc.) also seem to play an important role in causing these infections. Since the discovery of the A. fumigatus fumagillin in 1949, many studies have focused on this toxin and in this review we gather all the information currently available. First of all, the structural characteristics of this mycotoxin and the different methods developed for its determination are given in detail. Then, the biosynthetic gene cluster and the metabolic pathway involved in its production and regulation are explained. The activity of fumagillin on its target, the methionine aminopeptidase type 2 (MetAP2) enzyme, and the effects of blocking this enzyme in the host are also described. Finally, the applications that this toxin and its derivatives have in different fields, such as the treatment of cancer and its microsporicidal activity in the treatment of honeybee hive infections with Nosema spp., are reviewed. Therefore, this work offers a complete review of all the information currently related to the fumagillin mycotoxin secreted by A. fumigatus, important because of its role in the fungal infection process but also because it has many other applications, notably in beekeeping, the treatment of infectious diseases, and in oncology.
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Affiliation(s)
- Xabier Guruceaga
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain; (X.G.); (U.P.-C.); (A.A.-D.d.C.); (F.L.H.)
| | - Uxue Perez-Cuesta
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain; (X.G.); (U.P.-C.); (A.A.-D.d.C.); (F.L.H.)
| | - Ana Abad-Diaz de Cerio
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain; (X.G.); (U.P.-C.); (A.A.-D.d.C.); (F.L.H.)
| | - Oskar Gonzalez
- FARMARTEM Group, Department of Analytical Chemistry, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain; (O.G.); (R.M.A.)
| | - Rosa M. Alonso
- FARMARTEM Group, Department of Analytical Chemistry, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain; (O.G.); (R.M.A.)
| | - Fernando Luis Hernando
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain; (X.G.); (U.P.-C.); (A.A.-D.d.C.); (F.L.H.)
| | - Andoni Ramirez-Garcia
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain; (X.G.); (U.P.-C.); (A.A.-D.d.C.); (F.L.H.)
| | - Aitor Rementeria
- Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain; (X.G.); (U.P.-C.); (A.A.-D.d.C.); (F.L.H.)
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Greigert V, Pfaff AW, Abou-Bacar A, Candolfi E, Brunet J. Intestinal microsporidiosis in Strasbourg from 2014 to 2016: emergence of an Enterocytozoon bieneusi genotype of Asian origin. Emerg Microbes Infect 2018; 7:97. [PMID: 29872051 PMCID: PMC5988701 DOI: 10.1038/s41426-018-0099-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/16/2018] [Accepted: 04/29/2018] [Indexed: 11/09/2022]
Abstract
Microsporidia cause opportunistic infections in highly immunodeficient individuals. Few studies on the epidemiology of these infections have been conducted in France. Between 2014 and 2016, we undertook a study to estimate the prevalence and circulating genotypes of this fungus-related micro-organism among the population of Strasbourg University Hospital. Samples were collected from hospitalized patients and analyzed using microscopy and molecular assays. Strains from positive subjects were sequenced for genotyping. Only 7/661 patients (1.1%) were positive for microsporidia, and the only species identified was Enterocytozoon bieneusi. Two patients presented immunodeficiency linked to AIDS, and five transplant recipients presented immunodeficiency linked to immunosuppressive therapies. Only five patients received specific antimicrosporidial treatment, but clinical outcomes were good in all cases. We identified four genotypes: A and D in patients with AIDS, and C and S9 in transplant recipients. To date, genotype S9 has been described only once. This genotype is similar to those found in farm animals in China. Because some of these animals have been introduced to Central Europe, we postulate that this genotype might be of Asian origin. Thus, genotyping microsporidial strains may be of epidemiological and clinical interest to identify potential outbreak sources depending on the infecting strains.
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Affiliation(s)
- Valentin Greigert
- Infectious Diseases Department, Hôpitaux Civils de Colmar, 39 Avenue de la Liberté, Colmar, France. .,Institute of Parasitology and Tropical Diseases, EA 7292, University of Strasbourg, 3 rue Koeberlé, Strasbourg, France.
| | - Alexander W Pfaff
- Institute of Parasitology and Tropical Diseases, EA 7292, University of Strasbourg, 3 rue Koeberlé, Strasbourg, France.,Department of Parasitology and Mycology, University Hospital of Strasbourg, 3 rue Koeberlé, Strasbourg, France
| | - Ahmed Abou-Bacar
- Institute of Parasitology and Tropical Diseases, EA 7292, University of Strasbourg, 3 rue Koeberlé, Strasbourg, France.,Department of Parasitology and Mycology, University Hospital of Strasbourg, 3 rue Koeberlé, Strasbourg, France
| | - Ermanno Candolfi
- Institute of Parasitology and Tropical Diseases, EA 7292, University of Strasbourg, 3 rue Koeberlé, Strasbourg, France.,Department of Parasitology and Mycology, University Hospital of Strasbourg, 3 rue Koeberlé, Strasbourg, France
| | - Julie Brunet
- Institute of Parasitology and Tropical Diseases, EA 7292, University of Strasbourg, 3 rue Koeberlé, Strasbourg, France.,Department of Parasitology and Mycology, University Hospital of Strasbourg, 3 rue Koeberlé, Strasbourg, France
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