光滑念珠菌致病性和耐药机制研究进展

<正>光滑念珠菌(Candida glabrata)是一种黏膜表面定植的机会致病菌,可引起侵袭性念珠菌病。光滑念珠菌是仅次于白念珠菌的念珠菌病相关第二大病原体^[1]。其高发病率与HIV、肿瘤、糖尿病患者数量的增加有关,人口老龄化和侵入性治疗也会增加感染风险。光滑念珠菌与致病性相关的毒力因子包括对宿主细胞及医疗器械黏附性、生物膜形成、逃避宿主防御、复制性老化、分泌水解酶(包括蛋白酶、磷脂酶、酯酶和溶血素等)等,在感染过程中发挥重要作用^[2]。此外,光滑念珠菌对抗真菌药物具有普遍耐受性,常常导致治疗的失败^[3]。由于致病性与耐药性的完美组合,使光滑念珠菌感染呈现出“发病率高、病死率高、耐药率高”的现象,需引起足够重视^[4]。本文就光滑念珠菌致病相关毒力因子和耐药机制研究进展进行综述。     

白念珠菌RIM101途径与环境pH的应答反应

白念珠菌(Candida albicans)是一种重要条件致病菌,近年来引起人们的关注,大量的研究由此展开。对环境的改变积极做出应答是白念珠菌致病的重要条件。外界环境尤其是pH的变化影响着白念珠菌的形态和毒力。RIM101途经是真菌中一种保守的信号转导途径,白念珠菌也存在RIM101途经,并且该途径至少部分地控制着细胞对pH的应答。这里主要综述了近年来有关白念珠菌RIM101途径、pH应答及两者相互关系的研究。     

环境及遗传调控机制对白念珠菌菌丝形成过程调控的研究进展

<正>白念珠菌(Candida albicans)是最常见的真菌病原体,可定植于口腔、泌尿生殖道以及健康人的皮肤表面,在大多人群中,白念珠菌是正常微生物菌群中的一部分^[1]。由于微生物菌群变化、免疫功能障碍和皮肤屏障破坏,白念珠菌可能会从共生转变为致病性^[2],这种转变导致白念珠菌在不同组织和器官中引起浅部感染(如皮肤感染),以及甚至危及生命的深部真菌感染^[3]。     

光滑念珠菌的毒力表达特征研究进展

引言由于免疫功能低下的患者的数量增加和抗生素的广泛使用,真菌感染已成为医院中的重要问题,目前真菌引起的感染已影响到全世界数百万人口,根据统计调查,每年约有140万人死于真菌感染[1];最新的全球监视和多中心研究表明,超过90%的侵入性真菌感染(invasive fungal infections,IFI)的病因是由念珠菌属(Candida spp.)感染引起的[2-3]。其中,光滑念珠菌(Candida glabrata)占所有病例的近15%,且其占比有稳步上升的趋势,是仅次于白念珠菌(Candida albicans)的第二大常见的念珠菌病的病原体[4-6]。     

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。     

光滑念珠菌的生物学、流行病学以及耐药机制研究进展

随着HIV感染患者的增多、器官移植、放疗化疗及抗真菌药物的广泛使用,近年来全世界范围内念珠菌感染趋势发生了明显变化,除白念珠菌外,光滑念珠菌在临床上的检出率逐年增加,在部分国家和地区已成为第二常见的侵袭性念珠菌。光滑念珠菌临床分离株通常对一线抗真菌药物高度耐药,由于目前治疗策略匮乏,其造成的系统感染死亡率可高达50%。为了进一步加深人们对光滑念珠菌的认识,研发遏制其感染的诊疗策略,本文综述了近年来光滑念珠菌的流行病学、毒力因子以及耐药机制等方面的进展,为国内同行深入探究其耐药特性和致病机理提供参考。     

一氧化氮:植物体内一种新的生长调控因子

一氧化氮是具有生物活性,自然界存在的10种最小分子之一。越来越多的证据显示,一氧化氮是生物体内一种广泛分布的信号传导分子。一氧化氮参与植物生长发育调控和对生物与非生物环境胁迫的应答反应。该文重点讨论一氧化氮在植物体内的产生,基本功能以及在信号传导网络系统中与Ca^2 的相互作用。     

住院患者光滑念珠菌检出的回顾性分析

目的调查住院患者光滑念珠菌检出的特征。方法回顾性调查分析白求恩国际和平医院2008年1月～2009年4月住院患者中光滑念珠菌检出阳性者的临床资料,以同期白念珠菌检出患者为对照。结果其间共有52例详细病史资料记录的光滑念珠菌检出患者,以60岁以上老年人为主,占65.4%;主要分离自痰标本,占76.9%。患者患有多种基础疾病,以肺部感染(28例,53.8%)、恶性肿瘤(20例,38.5%)、脑梗死(15例,28.8%)常见。使用抗生素(52例,100%)、留置导尿管(15例,28.8%)是光滑念珠菌检出者的主要实施医疗措施。氟康唑是临床最常用的治疗光滑念珠菌感染药物(23例,44.2%)。光滑念珠菌检出患者死亡率高(14例,26.9%),高于同期白念珠菌检出对照组(6.2%,P=0.004)。结论光滑念珠菌检出患者与白念珠菌检出具有相似的临床流行病学特征。     

副溶血弧菌的毒力基因表达调控的分子机制

副溶血弧菌是革兰氏阴性嗜盐细菌,是海洋脊椎动物和无脊椎动物中主要致病菌,也是引起人类急性肠胃炎、败血症和坏死性筋膜炎等疾病的主要病原体。在过去,由副溶血弧菌引起的致病感染在世界范围内有不断增加的趋势。副溶血弧菌的致病性与其自身产生的多种毒力因子有关,这些毒力因子包括粘附因子、脂多糖、溶血素、III型分泌系统、VI型分泌系统、铁摄取系统、蛋白酶、外膜蛋白等。然而,这些毒力因子的表达都受到环境因子以及宿主体内信号因子的调控。副溶血弧菌通过感知外界生存环境的各种信号因子,从而激活体内不同的信号通路,进而诱导不同的毒力因子的表达。本文主要对副溶血弧菌毒力因子表达调控的分子机制进行综述,为更好地理解宿主与病原体的相互作用对副溶血弧菌的致病机制的影响,以及为今后预防和治疗由副溶血弧菌所引起的疾病提供理论参考。     

肌肉生长抑制因子对肌细胞发育的调控研究

肌肉生长抑制因子（MSTN）是动物肌肉生长发育的一个重要的负调控主效基因。它的表达受其他肌肉发育的调控因子如MyoD,FoxO等的调控。MSTN原蛋白经蛋白酶修饰变成的活性蛋白存在于血液循环系统中,它可以结合到细胞膜表面受体,激活细胞内信号通路,与其他因子的协同作用对肌肉发育和脂肪生成产生不同生理效应。本文将对MSTN基因及其蛋白的结构特点,表达调控因子,细胞内信号传导,及其对组织发育的影响进行探讨。     

Proteomic analysis of the pH response in the fungal pathogen Candida glabrata

Micro-organisms must adapt to environmental change to survive, and this is particularly true for fungal pathogens such as Candida glabrata. C. glabrata is found both in the environment and in diverse niches in its human host. The ambient pH of these niches varies considerably, and therefore we have examined the response of C. glabrata to changes in ambient pH using a proteomic approach. Proteins expressed in C. glabrata cells growing at pH 4.0, 7.4 or 8.0 were compared by 2-DE, and 174 spots displaying reproducible and statistically significant changes in expression level were identified by peptide mass fingerprinting, thereby extending our 2-DE map of the C. glabrata proteome to a total of 272 identified spots. Proteins involved in glucose metabolism, the TCA cycle, respiration and protein synthesis were expressed at lower levels during growth at pH 7.4 and/or 8.0, whereas proteins involved in stress responses and protein catabolism were expressed at higher levels under these alkaline conditions. Our data suggest that C. glabrata perceives low pH as less stressful than higher pH. This contrasts with another opportunistic fungal pathogen of humans, Candida albicans.     

Silver nanoparticles: influence of stabilizing agent and diameter on antifungal activity against Candida albicans and Candida glabrata biofilms

Aim: The purpose of this work was to evaluate the size‐dependent antifungal activity of different silver nanoparticles (SN) colloidal suspensions against Candida albicans and Candida glabrata mature biofilms. Methods and Results: The research presented herein used SN of three different average sizes (5, 10 and 60 nm), which were synthesized by the reduction of silver nitrate through sodium citrate and which were stabilized with ammonia or polyvinylpyrrolidone. Minimal inhibitory concentration (MIC) assays were performed using the microdilution methodology. The antibiofilm activity of SN was determined by total biomass quantification (by crystal violet staining) and colony forming units enumeration. MIC results showed that all SN colloidal suspensions were fungicidal against the tested strains at very low concentrations (0·4–3·3 μg ml^?1). With regard to biomass quantification, SN colloidal suspensions were very effective only against C. glabrata biofilms, achieving biomass reductions around 90% at a silver concentration of 108 μg ml^?1. In general, all SN suspensions promoted significant log₁₀ reduction of the mean number of cultivable biofilm cells after exposure to silver concentrations at or higher than 108 μg ml^?1. Moreover, the results showed that the particle size and the type of stabilizing agent used did not interfere in the antifungal activity of SN against Candida biofilms. Conclusions: This study suggests that SN have antifungal therapeutic potential, but further studies are still required namely regarding formulation and delivery means. Significance and Impact of the Study: SN may contribute to the development of new strategies for the improvement of oral health and quality of life particularly of the complete denture wearers.     

Pyruvate production in Candida glabrata: manipulation and optimization of physiological function

Candida glabrata, a multi-vitamin auxotrophic yeast, can accumulate a large amount of pyruvate extracellularly using glucose as the carbon source, a characteristic that has facilitated the cost-effective biotechnological production of pyruvate on an industrial scale. In this review, we describe the current advances in further improving the performance of C. glabrata for efficient pyruvate production, which includes: optimization of the vitamin and dissolved oxygen concentrations, regulation of intracellular cofactor levels and improvement of the environmental robustness of C. glabrata. We also discuss the current efforts using systems biology to understand the metabolism of C. glabrata. Finally, perspectives on engineering and exploiting C. glabrata as a cell factory for efficiently producing various chemicals and materials are discussed.     

FKS与光滑念珠菌棘白菌素耐药

近年来,光滑念珠菌侵入性感染及其耐棘白菌素治疗失败的病例不断增多,深入研究其耐药机制十分有必要。Fks突变在光滑念珠菌棘白菌素耐药发生的过程中有着极其重要的地位,其与棘白菌素的MIC值及体内治疗结果密切相关,且有很多因素可以对Fks突变的发生及其作用产生影响。     

Yeasts in the gastrointestinal tract of preweaned calves and possible involvement of Candida glabrata in neonatal calf diarrhea

To examine the possibility of a mycotic involvement in neonatal calf diarrhea (NCD) the presence of fungi was assessed in (a) the intestinal contents of dead calves and fecal samples submitted for routine laboratory examination, (b) fecal specimens, sampled once in winter and once in summer, of calves raised on 2 farms with different management systems, and (c) mucosal scrapings of various segments of the digestive tract of a diarrheic calf, massively shedding Candida glabrata.C. glabrata was the most prevalent fungal species isolated from the routine samples. It was the only fungus which was shed by the calves on the 2 farms, for continuous, more or less prolonged periods, but exclusively in the winter months. Diarrhea and C. glabrata shedding seemed to be associated. C. glabrata colonized the abomasum (the functional equivalent of the monogastric stomach) but not the other segments of the digestive tract of the euthanized calfBased on the findings of this study it seems that while some yeast species may be considered as commensals of the digestive tract of calves, and consequently their isolation from intestinal contents or fecal samples has no clinical significance, others, such as C. glabrata may be involved in enteric pathogenic processes. Moreover, characteristics of the culture, previous chemotherapeutic treatments, the animal's age and possibly climatic conditions should be taken into account before deciding on the fungal isolate's clinical relevance. Determination of mycotic involvement in NCD by routine mycological examination of intestinal contents and fecal samples of diarrheic calves may be useful to avoid unnecessary and potentially harmful antibacterial therapy.This revised version was published online in October 2005 with corrections to the Cover Date.     

Structural Hot Spots Determine Functional Diversity of the Candida glabrata Epithelial Adhesin Family

For host colonization, the human fungal pathogen Candida glabrata is known to utilize a large family of highly related surface-exposed cell wall proteins, the lectin-like epithelial adhesins (Epas). To reveal the structure-function relationships within the entire Epa family, we have performed a large scale functional analysis of the adhesion (A) domains of 17 Epa paralogs in combination with three-dimensional structural studies of selected members with cognate ligands. Our study shows that most EpaA domains exert lectin-like functions and together recognize a wide variety of glycans with terminal galactosides for conferring epithelial cell adhesion. We further identify several conserved and variable structural features within the diverse Epa ligand binding pockets, which affect affinity and specificity. These features rationalize why mere phylogenetic relationships within the Epa family are weak indicators for functional classification and explain how Epa-like adhesins have evolved in C. glabrata and related fungal species.     

Susceptibility of Candida glabrata biofilms to echinocandins: alterations in the matrix composition

Candidiases are the most recurrent fungal infections, especially among immunosuppressed patients. Although Candida albicans is still the most widespread isolated species, non-Candida albicans Candida species have been increasing. The goal of this work was to determine the susceptibility of C. glabrata biofilms to echinocandins and to evaluate their effect on the biofilm matrix composition, comparing the results with other Candida species. Drug susceptibilities were assessed through the determination of minimum inhibitory concentration (MIC), minimum fungicidal concentration (MFC) and minimum biofilm eradication concentration (MBEC) of caspofungin (Csf) and micafugin (Mcf). The β-1,3 glucans content of the matrices was assessed after contact with the drugs. The data suggest that, generally, after contact with echinocandins, the concentration of β-1,3 glucans increased. These adjustments in the matrix composition of C. glabrata biofilms and the chemical differences between Csf and Mcf, seem responsible and may determine the effectivity of the drug responses.