Bet-hedging antimicrobial strategies in macrophage phagosome acidification drive the dynamics of Cryptococcus neoformans intracellular escape mechanisms

The fungus Cryptococcus neoformans is a major human pathogen with a remarkable intracellular survival strategy that includes exiting macrophages through non-lytic exocytosis (Vomocytosis) and transferring between macrophages (Dragotcytosis) by a mechanism that involves sequential events of non-lytic exocytosis and phagocytosis. Vomocytosis and Dragotcytosis are fungal driven processes, but their triggers are not understood. We hypothesized that the dynamics of Dragotcytosis could inherit the stochasticity of phagolysosome acidification and that Dragotcytosis was triggered by fungal cell stress. Consistent with this view, fungal cells involved in Dragotcytosis reside in phagolysosomes characterized by low pH and/or high oxidative stress. Using fluorescent microscopy, qPCR, live cell video microscopy, and fungal growth assays we found that the that mitigating pH or oxidative stress reduced Dragotcytosis frequency, whereas ROS susceptible mutants of C. neoformans underwent Dragotcytosis more frequently. Dragotcytosis initiation was linked to phagolysosomal pH, oxidative stresses, and macrophage polarization state. Dragotcytosis manifested stochastic dynamics thus paralleling the dynamics of phagosomal acidification, which correlated with the inhospitality of phagolysosomes in differently polarized macrophages. Hence, randomness in phagosomal acidification randomly created a population of inhospitable phagosomes where fungal cell stress triggered stochastic C. neoformans non-lytic exocytosis dynamics to escape a non-permissive intracellular macrophage environment.

[Late health sequelae of accidental bromine exposure]

Health and environmental assessment of the consequences of accidental contamination of an area in the Negev desert is described and the effects of exposure to bromine vapor in 6 persons evaluated. They were only mildly affected during the acute spillage of the bromine, with some respiratory symptoms and first and second degree skin burns of small exposed areas on the legs. All were treated in hospital and were released within 1-4 days. 6-8 weeks later they demonstrated a complex array of complaints, including cough, shortness of breath, chest tightness, eye irritation, headache, dizziness, fatigue, memory disturbances, sleep and sexual disturbances. These complaints could not be substantiated by objective clinical or laboratory examination. There was thus obvious magnification of the complaints 1-2 months after the accident.