1
|
Hartuis S, Ourliac-Garnier I, Robert E, Albassier M, Duchesne L, Beaufils C, Kuhn J, Le Pape P, Morio F. Precise genome editing underlines the distinct contributions of mutations in ERG11, ERG3, MRR1, and TAC1 genes to antifungal resistance in Candida parapsilosis. Antimicrob Agents Chemother 2024:e0002224. [PMID: 38624217 DOI: 10.1128/aac.00022-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/21/2024] [Indexed: 04/17/2024] Open
Abstract
Candida parapsilosis has recently emerged as a major threat due to the worldwide emergence of fluconazole-resistant strains causing clonal outbreaks in hospitals and poses a therapeutic challenge due to the limited antifungal armamentarium. Here, we used precise genome editing using CRISPR-Cas9 to gain further insights into the contribution of mutations in ERG11, ERG3, MRR1, and TAC1 genes and the influence of allelic dosage to antifungal resistance in C. parapsilosis. Seven of the most common amino acid substitutions previously reported in fluconazole-resistant clinical isolates (including Y132F in ERG11) were engineered in two fluconazole-susceptible C. parapsilosis lineages (ATCC 22019 and STZ5). Each mutant was then challenged in vitro against a large array of antifungals, with a focus on azoles. Any possible change in virulence was also assessed in a Galleria mellonella model. We successfully generated a total of 19 different mutants, using CRISPR-Cas9. Except for R398I (ERG11), all remaining amino acid substitutions conferred reduced susceptibility to fluconazole. However, the impact on fluconazole in vitro susceptibility varied greatly according to the engineered mutation, the stronger impact being noted for G583R acting as a gain-of-function mutation in MRR1. Cross-resistance with newer azoles, non-medical azoles, but also non-azole antifungals such as flucytosine, was occasionally noted. Posaconazole and isavuconazole remained the most active in vitro. Except for G583R, no fitness cost was associated with the acquisition of fluconazole resistance. We highlight the distinct contributions of amino acid substitutions in ERG11, ERG3, MRR1, and TAC1 genes to antifungal resistance in C. parapsilosis.
Collapse
Affiliation(s)
- Sophie Hartuis
- Nantes Université, CHU Nantes, Cibles et Médicaments des Infections et de l'Immunité, Nantes, France
| | | | - Estelle Robert
- Nantes Université, Cibles et Médicaments des Infections et de l'Immunité, Nantes, France
| | - Marjorie Albassier
- Nantes Université, Cibles et Médicaments des Infections et de l'Immunité, Nantes, France
| | - Léa Duchesne
- Department Public Health, Nantes Université, CHU Nantes, Nantes, France
| | - Clara Beaufils
- Nantes Université, Cibles et Médicaments des Infections et de l'Immunité, Nantes, France
| | - Joséphine Kuhn
- Nantes Université, Cibles et Médicaments des Infections et de l'Immunité, Nantes, France
| | - Patrice Le Pape
- Nantes Université, CHU Nantes, Cibles et Médicaments des Infections et de l'Immunité, Nantes, France
| | - Florent Morio
- Nantes Université, CHU Nantes, Cibles et Médicaments des Infections et de l'Immunité, Nantes, France
| |
Collapse
|
2
|
Lavergne RA, Albassier M, Hardouin JB, Alvarez-Moreno C, Pagniez F, Morio F, Le Pape P, Ourliac-Garnier I. Impact of TR 34/L98H, TR 46/Y121F/T289A and TR 53 Alterations in Azole-Resistant Aspergillus fumigatus on Sterol Composition and Modifications after In Vitro Exposure to Itraconazole and Voriconazole. Microorganisms 2022; 10:microorganisms10010104. [PMID: 35056552 PMCID: PMC8778474 DOI: 10.3390/microorganisms10010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/22/2021] [Accepted: 12/27/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sterols are the main components of fungal membranes. Inhibiting their biosynthesis is the mode of action of azole antifungal drugs that are widely used to treat fungal disease including aspergillosis. Azole resistance has emerged as a matter of concern but little is known about sterols biosynthesis in azole resistant Aspergillus fumigatus. METHODS We explored the sterol composition of 12 A. fumigatus isolates, including nine azole resistant isolates with TR34/L98H, TR46/Y121F/T289A or TR53 alterations in the cyp51A gene and its promoter conferring azole resistance. Modifications in sterol composition were also investigated after exposure to two azole drugs, itraconazole and voriconazole. RESULTS Overall, under basal conditions, sterol compositions were qualitatively equivalent, whatever the alterations in the target of azole drugs with ergosterol as the main sterol detected. Azole exposure reduced ergosterol composition and the qualitative composition of sterols was similar in both susceptible and resistant isolates. Interestingly TR53 strains behaved differently than other strains. CONCLUSIONS Elucidating sterol composition in azole-susceptible and resistant isolates is of interest for a better understanding of the mechanism of action of these drugs and the mechanism of resistance of fungi.
Collapse
Affiliation(s)
- Rose-Anne Lavergne
- Nantes Université, CHU de Nantes, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR 1155, F-44000 Nantes, France; (R.-A.L.); (F.M.); (P.L.P.)
| | - Marjorie Albassier
- Nantes Université, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR 1155, F-44000 Nantes, France; (M.A.); (F.P.)
| | - Jean-Benoît Hardouin
- Nantes Université, Univ Tours, INSERM, Methods in Patients-Centered Outcomes and Health Research, SPHERE, UMR 1246, F-44000 Nantes, France;
- Service de Santé Publique et Plateforme de Méthodologie et Biostatistique, CHU de Nantes, F-44000 Nantes, France
| | - Carlos Alvarez-Moreno
- Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogota 111176, Colombia;
- Clínica Colsanitas Groupo Keralty, Clínica Universitaria Colombia, Bogotá 111176, Colombia
| | - Fabrice Pagniez
- Nantes Université, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR 1155, F-44000 Nantes, France; (M.A.); (F.P.)
| | - Florent Morio
- Nantes Université, CHU de Nantes, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR 1155, F-44000 Nantes, France; (R.-A.L.); (F.M.); (P.L.P.)
| | - Patrice Le Pape
- Nantes Université, CHU de Nantes, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR 1155, F-44000 Nantes, France; (R.-A.L.); (F.M.); (P.L.P.)
| | - Isabelle Ourliac-Garnier
- Nantes Université, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR 1155, F-44000 Nantes, France; (M.A.); (F.P.)
- Correspondence:
| |
Collapse
|
3
|
Alvarez-Rueda N, Rouges C, Touahri A, Misme-Aucouturier B, Albassier M, Pape PL. In vitro immune responses of human PBMCs against Candida albicans reveals fungal and leucocyte phenotypes associated with fungal persistence. Sci Rep 2020; 10:6211. [PMID: 32277137 PMCID: PMC7148345 DOI: 10.1038/s41598-020-63344-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 03/30/2020] [Indexed: 11/09/2022] Open
Abstract
Although there is a growing understanding of immunity against Candida albicans, efforts need to be pursued in order to decipher the cellular mechanisms leading to an uncontrolled immune response that eventually oppose disease eradication. We describe here significant intra- and inter-subject variations in immune response patterns of major human leucocyte subsets following an in vitro challenge with C. albicans clinical isolates. We also observed that there are Candida isolate-dependent changes in leucocyte phenotypes. Through a combination of multiple fungal growth and flow cytometric measurements, coupled to the tSNE algorithm, we showed that significant proliferation differences exist among C. albicans isolates, leading to the calculation of a strain specific persistent index. Despite substantial inter-subject differences in T cells and stability of myeloid cells at baseline, our experimental approach highlights substantial immune cell composition changes and cytokine secretion profiles after C. albicans challenge. The significant secretion of IL-17 by CD66+ cells, IFN-γ and IL-10 by CD4+ T cells 2 days after C. albicans challenge was associated with fungal control. Fungal persistence was associated with delayed secretion of IFN-γ, IL-17, IL-4, TNF-α and IL-10 by myeloid cells and IL-4 and TNF-α secretion by CD4+ and CD8+ T cells. Overall, this experimental and analytical approach is available for the monitoring of such fungal and human immune responses.
Collapse
Affiliation(s)
- Nidia Alvarez-Rueda
- Nantes Université, CHU de Nantes, Cibles et médicaments des infections et du cancer, IICiMed, EA 1155, F-44000, Nantes, France.
| | - Célia Rouges
- Nantes Université, CHU de Nantes, Cibles et médicaments des infections et du cancer, IICiMed, EA 1155, F-44000, Nantes, France
| | - Adel Touahri
- Nantes Université, CHU de Nantes, Cibles et médicaments des infections et du cancer, IICiMed, EA 1155, F-44000, Nantes, France
| | - Barbara Misme-Aucouturier
- Nantes Université, CHU de Nantes, Cibles et médicaments des infections et du cancer, IICiMed, EA 1155, F-44000, Nantes, France
| | - Marjorie Albassier
- Nantes Université, CHU de Nantes, Cibles et médicaments des infections et du cancer, IICiMed, EA 1155, F-44000, Nantes, France
| | - Patrice Le Pape
- Nantes Université, CHU de Nantes, Cibles et médicaments des infections et du cancer, IICiMed, EA 1155, F-44000, Nantes, France.
| |
Collapse
|
4
|
Alvarez-Rueda N, Albassier M, Allain S, Deknuydt F, Altare F, Le Pape P. Premier modèle humain de granulome à Candida albicans pour l’étude in vitro des interactions hôte–agent fongique. J Mycol Med 2013. [DOI: 10.1016/j.mycmed.2012.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
5
|
Alvarez-Rueda N, Albassier M, Allain S, Deknuydt F, Altare F, Le Pape P. First human model of in vitro Candida albicans persistence within granuloma for the reliable study of host-fungi interactions. PLoS One 2012; 7:e40185. [PMID: 22768252 PMCID: PMC3387014 DOI: 10.1371/journal.pone.0040185] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 06/01/2012] [Indexed: 01/09/2023] Open
Abstract
Backgound The balance between human innate immune system and Candida albicans virulence signaling mechanisms ultimately dictates the outcome of fungal invasiveness and its pathology. To better understand the pathophysiology and to identify fungal virulence-associated factors in the context of persistence in humans, complex models are indispensable. Although fungal virulence factors have been extensively studied in vitro and in vivo using different immune cell subsets and cell lines, it is unclear how C. albicans survives inside complex tissue granulomas. Methodology/Principal Finding We developed an original model of in vitro human granuloma, reproducing the natural granulomatous response to C. albicans. Persistent granulomas were obtained when the ratio of phagocytes to fungi was high. This in vitro fungal granuloma mimics natural granulomas, with infected macrophages surrounded by helper and cytotoxic T lymphocytes. A small proportion of granulomas exhibited C. albicans hyphae. Histological and time-lapse analysis showed that C. albicans blastoconidia were located within the granulomas before hyphae formation. Using staining techniques, fungal load calculations, as well as confocal and scanning electron microscopy, we describe the kinetics of fungal granuloma formation. We provide the first direct evidence that C. albicans are not eliminated by immunocompetent cells inside in vitro human granulomas. In fact, after an initial candicidal period, the remaining yeast proliferate and persist under very complex immune responses. Conclusions/Significance Using an original in vitro model of human fungal granuloma, we herein present the evidence that C. albicans persist and grow into immunocompetent granulomatous structures. These results will guide us towards a better understanding of fungal invasiveness and, henceforth, will also help in the development of better strategies for its control in human physiological conditions.
Collapse
Affiliation(s)
- Nidia Alvarez-Rueda
- Département de Parasitologie et de Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155– IICiMed, Faculté de Pharmacie de Nantes, France
- * E-mail: (PLP); (NAR)
| | - Marjorie Albassier
- Département de Parasitologie et de Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155– IICiMed, Faculté de Pharmacie de Nantes, France
| | - Sophie Allain
- CRCNA, Inserm U892, CNRS 6299, Université de Nantes, Nantes, France
| | | | - Frédéric Altare
- CRCNA, Inserm U892, CNRS 6299, Université de Nantes, Nantes, France
| | - Patrice Le Pape
- Département de Parasitologie et de Mycologie Médicale, Université de Nantes, Nantes Atlantique Universités, EA1155– IICiMed, Faculté de Pharmacie de Nantes, France
- Laboratoire de Parasitologie-Mycologie, CHU de Nantes, Nantes, France
- * E-mail: (PLP); (NAR)
| |
Collapse
|