白念珠菌黏附基因的研究进展

白念珠菌能引起免疫力低下患者的皮肤黏膜和全身系统性持续感染,对宿主组织的黏附是其侵入和感染的先决条件。对白念珠菌黏附相关基因的研究有助于揭示白念珠菌的致病机制。近年来,越来越多的研究者从黏附基因的结构、影响其表达的因素以及黏附机制等方面进行了研究。本文就黏附基因的相关研究进展进行综述,旨在为新型抗真菌药物和白念珠菌疫苗的研究提供参考。     

抗系统性白念珠菌感染的先天性免疫

白念珠菌是引起浅部、深部真菌感染常见的病原菌.先天免疫反应在宿主抗系统性白念珠菌感染中起主导作用.介导宿主抗念珠菌感染的先天性免疫包括一系列真菌识别受体及免疫效应细胞.宿主对系统性白念珠菌感染的免疫反应是决定患者预后的关键.本文就宿主抗系统性白念珠菌感染的先天性免疫机制进行综述.     

白念珠菌致病因素及抗真菌药物研究进展

白念珠菌是常驻人体的条件致病真菌,当机体免疫力下降时会引起皮肤黏膜浅层乃至全身系统性真菌感染。目前,念珠菌血症是引起院内血源性感染的第4位因素。随着经典药物耐药性的出现,因侵袭性念珠菌病死亡的患者也日渐增多。为解决真菌感染及耐药性的问题,越来越多从白念珠菌致病因素出发的新型抗真菌药物正在火热研发。该文对抗真菌药物的研究进展作一综述。     

白念珠菌生物膜及其研究进展

白念珠菌生物对多种传统抗真菌药物高度耐药,日益增多的白念珠菌生物膜相关感染引起抗真菌药物治疗的失败加重了患者及社会的经济负担,这已经成为临床医生所面临的重要问题.该文旨在阐明白念珠菌生物膜的临床重要性,并从多方面阐述白念珠菌生物膜的结构特点、形成机制、防治现状的最新研究进展,为白念珠菌的研究及临床防治策略提供参考.     

体液免疫抗白念珠菌感染的研究

探讨抗白念珠菌IgY及其免疫血清对多种动物模型感染白念珠菌的保护作用。制备烧伤继发感染白念珠菌大鼠、白念珠菌性阴道炎小鼠及免疫功能低下小鼠多种动物感染模型 ,分别应用抗白念珠菌IgY、鼠免疫血清和生理盐水对照 ,观察比较各自的作用。抗白念珠菌IgY对烧伤继发感染白念珠菌大鼠及白念珠菌性阴道炎小鼠均有明显的保护作用 ;鼠免疫血清则对阻止远程靶器官的白念珠菌扩散有较好的作用。体液免疫成份抗白念珠菌IgY及其免疫血清对烧伤继发感染白念珠菌大鼠、白念珠菌性阴道炎小鼠及免疫功能低下小鼠均有良好的保护作用。     

Ridaforolimus体外单独或联合氟康唑抗念珠菌作用的研究

由念珠菌感染引起的侵袭性念珠菌病治疗困难、死亡率高,是临床一大难题。氟康唑是目前治疗该病的一线用药,但近年来耐药菌株逐渐增多,治疗困难。因此,开发新的有效抗真菌药物或发现可提高现有抗真菌药物活性的化合物十分必要。通过体外抗真菌药物敏感性试验,我们发现TOR通路抑制剂ridaforolimus具有抗念珠菌作用。随后我们通过纸片法及微量液基稀释法评价该化合物单独或与氟康唑联合对念珠菌的抗菌效果。结果表明ridaforolimus对念珠菌有杀伤作用,在与氟康唑联合时增强了氟康唑的抗念珠菌能力,逆转了白念珠菌对氟康唑的耐药,并将氟康唑由抑菌剂转化为杀菌剂。本研究为ridaforolimus作为新型抗真菌药及氟康唑增敏剂提供了一定理论基础。     

固有免疫系统识别白念珠菌的分子机制研究进展

白念珠菌是引起机体浅部和深部真菌感染的主要致病菌。机体通过固有免疫细胞表面的模式识别受体(pattern recognition receptors,PRRs),与白念珠菌细胞壁表面的病原相关模式分子(pathogen associated molecular patterns,PAMPs)结合,激活机体固有免疫应答。机体和白念珠菌的相互作用可以有效抵抗白念珠菌侵袭,清除白念珠菌感染,但当机体免疫力低下时,白念珠菌会持续引发感染,引起慢性黏膜念珠菌病,严重时可以引发系统性白念珠菌感染危及生命。部分模式识别受体如Dectin-1还通过影响Th17细胞的分化,对白念珠菌的适应性免疫应答发挥一定的作用。该文将对已发现的能够识别白念珠菌的模式识别受体,以及这些受体在机体抗白念珠菌感染中的作用进行讨论。     

中草药抗白念珠菌作用研究进展

白念珠菌,是人类最常见的真菌病原体,可引起各种浅表及深部真菌病,对常用抗真菌药物易产生耐药.文章就近年来有关中草药抗白念珠菌的相关临床及实验研究进行综述,主要从中草药抗白念珠菌的作用机制及其活性成分、单味及复方中草药制剂抗白念珠菌作用、中西药协同抗白念珠菌作用几个方面进行阐述.     

系统性白色念珠菌感染的免疫应答反应及疫苗研究进展

由于肿瘤化疗药物和免疫抑制剂的广泛应用,使系统性念珠菌感染的发病率明显升高,该病严重地威胁着住院患者的生命。在白色念珠菌感染过程中,特异性抗体、Th细胞和一些非特异性免疫细胞存在着复杂的调节机制。先天性免疫应答和获得性免疫应答机制的研究,对开发出有效的抗真菌疫苗具有重要意义。     

皮肤念珠菌病诊治进展

皮肤念珠菌病是由念珠菌属的某些致病菌种引起的皮肤浅表念珠菌感染.临床类型多样化,直接涂片检查见到念珠菌特有的假菌丝和孢子即可确诊.必要时进行真菌培养并体外药敏试验、组织病理检查和血清学检查.大多需要局部外用抗真菌药物治疗,部分需要系统抗真菌药物治疗.     

Proteomics-based identification of novel Candida albicans antigens for diagnosis of systemic candidiasis in patients with underlying hematological malignancies

Systemic candidiasis remains a major cause of disease and death, particularly among patients suffering from hematological malignancies. In an attempt to contribute to the discovery of useful biomarkers for its diagnosis and therapeutic monitoring, we embarked on a mapping of Candida albicans immunogenic proteins specifically recognized by antibodies produced during the natural course of systemic Candida infection in this high-risk population. About 85 immunoreactive protein species were detected with systemic candidiasis patients' serum specimens by using immunoproteomics (i.e., two-dimensional electrophoresis followed by Western blotting), and identified through a combination of peptide mass fingerprinting by matrix-assisted laser desorption/ionization-time of flight-mass spectrometry (MALDI-TOF-MS), de novo peptide sequencing using nano-electrospray ionization-ion trap (ESI-IT) MS, and genomic database searches. This proteomic approach has led to the characterization of 42 different housekeeping enzymes as C. albicans antigens. Their biological significance is also discussed. Furthermore, this study is the first to report that 26 of them exhibit antigenic properties in C. albicans, and 35 of them become targets of the human antibody response to systemic candidiasis. Our findings suggest that the production of antibodies to C. albicans phosphoglycerate kinase and alcohol dehydrogenase during systemic candidiasis could be associated with a differentiation of the human immune response. We also highlight the relationship between changes in maintenance of circulating levels of specific anti-Candida antibodies and patients' outcome. Some of these variations, especially the rise of high anti-enolase antibody concentrations, appear to be related to recovery from systemic candidiasis in these patients, which might serve as markers for predicting their outcome. This approach could therefore provide new challenges for diagnosis and clinical follow-up of these fungal infections, and even for antifungal drug or vaccine design.     

Plant production of anti-β-glucan antibodies for immunotherapy of fungal infections in humans

There is an increasing interest in the development of therapeutic antibodies (Ab) to improve the control of fungal pathogens, but none of these reagents is available for clinical use. We previously described a murine monoclonal antibody (mAb 2G8) targeting β-glucan, a cell wall polysaccharide common to most pathogenic fungi, which conferred significant protection against Candida albicans, Aspergillus fumigatus and Cryptococcus neoformans in animal models. Transfer of this wide-spectrum, antifungal mAb into the clinical setting would allow the control of most frequent fungal infections in many different categories of patients. To this aim, two chimeric mouse-human Ab derivatives from mAb 2G8, in the format of complete IgG or scFv-Fc, were generated, transiently expressed in Nicotiana benthamiana plants and purified from leaves with high yields (approximately 50 mg Ab/kg of plant tissues). Both recombinant Abs fully retained the β-glucan-binding specificity and the antifungal activities of the cognate murine mAb against C. albicans. In fact, they recognized preferentially β1,3-linked glucan molecules present at the fungal cell surface and directly inhibited the growth of C. albicans and its adhesion to human epithelial cells in vitro. In addition, both the IgG and the scFv-Fc promoted C. albicans killing by isolated, human polymorphonuclear neutrophils in ex vivo assays and conferred significant antifungal protection in animal models of systemic or vulvovaginal C. albicans infection. These recombinant Abs represent valuable molecules for developing novel, plant-derived immunotherapeutics against candidiasis and, possibly, other fungal diseases.     

HIV aspartyl protease inhibitors as promising compounds against Candida albicans André Luis Souza dos Santos

Cells of Candida albicans (C. albicans) can invade humans and may lead to mucosal and skin infections or to deep-seated mycoses of almost all inner organs, especially in immunocompromised patients. In this context, both the host immune status and the ability of C. albicans to modulate the expression of its virulence factors are relevant aspects that drive the candidal susceptibility or resistance; in this last case, culminating in the establishment of successful infection known as candidiasis. C. albicans possesses a potent armamentarium consisting of several virulence molecules that help the fungal cells to escape of the host immune responses. There is no doubt that the secretion of aspartyl-type proteases, designated as Saps, are one of the major virulence attributes produced by C. albicans cells, since these hydrolytic enzymes participate in a wide range of fungal physiological processes as well as in different facets of the fungal-host interactions. For these reasons, Saps clearly hold promise as new potential drug targets. Corroborating this hypothesis, the introduction of new anti-human immunodeficiency virus drugs of the aspartyl protease inhibitor-type (HIV PIs) have emerged as new agents for the inhibition of Saps. The introduction of HIV PIs has revolutionized the treatment of HIV disease, reducing opportunistic infections, especially candidiasis. The attenuation of candidal infections in HIV-infected individuals might not solely have resulted from improved immunological status, but also as a result of direct inhibition of C. albicans Saps. In this article, we review updates on the beneficial effects of HIV PIs against the human fungal pathogen C. albicans, focusing on the effects of these compounds on Sap activity, growth behavior, morphological architecture, cellular differentiation, fungal adhesion to animal cells and abiotic materials, modulation of virulence factors, experimental candidiasis infection, and their synergistic actions with classical antifungal agents.     

Th17 cells in immunity to Candida albicans

Our understanding of immunity to fungal pathogens has advanced considerably in recent years. Particularly significant have been the parallel discoveries in the C-type lectin receptor family and the Th effector arms of immunity, especially Th17 cells and their signature cytokine, IL-17. Many of these studies have focused on the most common human fungal pathogen, Candida albicans, which is typically a commensal microbe in healthy individuals but causes various disease manifestations in immunocompromised hosts, ranging from mild mucosal infections to lethal disseminated disease. Here, we discuss emerging fundamental discoveries with C.?albicans that have informed our overall molecular understanding of fungal immunity. In particular, we focus on the importance of pattern recognition receptor-mediated fungal recognition and subsequent IL-17 responses in host defense against mucosal candidiasis. In light of these recent advances, we also discuss the implications for anticytokine biologic therapy and vaccine development.     

In vivo characterization of A-192411: a novel fungicidal lipopeptide (II)

The ability of the novel antifungal cyclic hexalipopetide A-192411 to treat fungal infections in rodents is presented. Efficacy was demonstrated against Candida albicans as both prolonged survival of systemically infected mice and clearance of viable yeasts from kidneys. The efficacy of A-192411, administered intraperitoneally, was equivalent to amphotercin B at a 4-fold lower dose by weight in the systemic candidiasis models in mice, while the efficacy of A-192441 administered intravenously was equivalent to amphotercin B by weight in the Candida pyelonephritis model in rats. A-192411 also slightly prolonged the survival of immunocompromised mice infected systemically with Aspergillus fumigatus.     

Neutrophil Fc gamma RI as target for immunotherapy of invasive candidiasis

Invasive candidiasis represents a life-threatening disease for immunocompromised patients. This study focused on new immunotherapeutic approaches for systemic Candida albicans infections in a human FcgammaRI-transgenic mouse model. FcgammaRI (CD64) is a potent immunoactivating receptor on phagocytic and dendritic cells. In vivo targeting of C. albicans toward neutrophil-FcgammaRI by bispecific Abs and G-CSF effectively protected FcgammaRI-transgenic mice from lethal candidiasis. Nontransgenic mice were not protected, and treatment with bispecific Ab or G-CSF alone did not reduce mortality. Furthermore, infected FcgammaRI-transgenic mice developed high titers of anti-C. albicans IgG, and survival was extended on secondary infection without further treatment. These findings document the capacity of FcgammaRI to initiate potent anti-C. albicans immunity and support the development of FcgammaRI-directed immunotherapy of invasive fungal disease.     

Development of a new real-time TaqMan PCR assay for quantitative analyses of Candida albicans resistance genes expression

Candida albicans is an important opportunistic pathogen that can cause serious fungal diseases in immunocompromised patients including cancer patients, transplant patients, and patients receiving immunosuppressive therapy in general, those with human immunodeficiency virus infections and undergoing major surgery. Its emergence spectrum varies from mucosal to systemic infections and the first line treatment is still based on fluconazole, a triazole derivate with a potent antifungal activity against most of C. albicans strains. Nevertheless the emergence of fluconazole-resistant C. albicans strains can lead to treatment failures and thus become a clinical problem in the management of such infections. For that reason we consider it important to study mechanisms inducing azole resistance and the possibilities to influence this process. In this work we give a short report on a real-time PCR (TaqMan) assay, which can be used for quantitative analyses of gene expression levels of MDR1, CDR1 and ERG11, genes supposed to contribute to development of the resistance mechanisms. We show some results achieved with that assay in fluconazole susceptible and resistant strains that confirm results seen earlier in experiments using Northern blot hybridisation and prove that the comparative DeltaCt method is valid for our system.     

A proteomic-based approach for the identification of Candida albicans protein components present in a subunit vaccine that protects against disseminated candidiasis

Candidiasis has become a prevalent infection in different types of immunocompromised patients. The cell wall of Candida albicans plays important functions during the host-fungus interactions. Cell wall (surface) proteins of C. albicans are major elicitors of host immune responses during candidiasis, and represent candidates for vaccine development. Groups of mice were vaccinated subcutaneously with a beta-mercaptoethanol (beta-ME) extract from C. albicans containing cell wall proteins. Vaccinated mice were then infected with a lethal dose of C. albicans. Increased survival and decreased fungal burden were observed in vaccinated mice as compared to a control group, and 75% of vaccinated mice with the beta-ME extract survived this otherwise lethal infection. We used a proteomic approach (2-DE followed by immunoblotting) to demonstrate a complex polypeptidic pattern associated with the beta-ME extract used in the vaccine formulation and to detect immunogenic components recognized by antibodies in immune sera from vaccinated animals. Reactive protein spots were identified by MALDI-TOF-MS and searches in genomic databases. As a conclusion, vaccination strategies using C. albicans cell wall proteins induce protective responses. These antigens can be identified by proteomic approaches and may be used as components of subcellular vaccines against candidiasis.     

The role of voriconazole in the treatment of emerging mycoses

Voriconazole is a broad-spectrum antifungal drug belonging to triazoles class. Recently, it has been recommended for the treatment of invasive candidiasis in non neutropenic patients. In addition, this drug has showed clinical efficacy in the treatment of fungal infections caused by Candida species other than Candida albicans, and also in several other infections caused by less common fungi, such as Aspergillus terreus, Fusarium and Scedosporium.     

Modulation of morphogenesis in Candida albicans by various small molecules

The pathogenic yeast Candida albicans, a member of the mucosal microbiota, is responsible for a large spectrum of infections, ranging from benign thrush and vulvovaginitis in both healthy and immunocompromised individuals to severe, life-threatening infections in immunocompromised patients. A striking feature of C. albicans is its ability to grow as budding yeast and as filamentous forms, including hyphae and pseudohyphae. The yeast-to-hypha transition contributes to the overall virulence of C. albicans and may even constitute a target for the development of antifungal drugs. Indeed, impairing morphogenesis in C. albicans has been shown to be a means to treat candidiasis. Additionally, a large number of small molecules such as farnesol, fatty acids, rapamycin, geldanamycin, histone deacetylase inhibitors, and cell cycle inhibitors have been reported to modulate the yeast-to-hypha transition in C. albicans. In this minireview, we take a look at molecules that modulate morphogenesis in this pathogenic yeast. When possible, we address experimental findings regarding their mechanisms of action and their therapeutic potential. We discuss whether or not modulating morphogenesis constitutes a strategy to treat Candida infections.