The fungi in Century 21. The XXI Fungal Genetics Conference, Pacific Grove, California, March 13-18, 2001

As an important opportunistic pulmonary pathogen, Pneumocystis carinii has been the focus of extensive research over the decades. The use of laboratory animal models has permitted a detailed understanding of the host-parasite interaction but an understanding of the basic biology of P. carinii has lagged due in large part to the inability of the organism to grow well in culture and to the lack of a tractable genetic system. Molecular techniques have demonstrated extensive heterogeneity among P. carinii organisms isolated from different host species. Characterization of the genes and genomes of the Pneumocystis family has supported the notion that the family comprises different species rather than strains within the genus Pneumocystis and contributed to the understanding of the pathophysiology of infection. Many of the technical obstacles in the study of the organisms have been overcome in the past decade and the pace of research into the basic biology of the organism has accelerated. Biochemical pathways have been inferred from the presence of key enzyme activities or gene sequences, and attempts to dissect cellular pathways have been initiated. The Pneumocystis genome project promises to be a rich source of information with regard to the functional activity of the organism and the presence of specific biochemical pathways. These advances in our understanding of the biology of this organism should provide for future studies leading to the control of this opportunistic pathogen.     

反转录转座子TCA4与白念珠菌耐药性的研究

目的研究高温刺激下白念珠菌中反转录转座子的表达情况与耐药性产生的关系,探寻白念珠菌耐药的分子机制。方法微量液基稀释法测定氟康唑对高温诱导的白念珠菌的最低抑菌浓度（minimal inhibitory concentration,MIC）;斑点法（spotassay）考察诱导菌株对药物的耐受能力;实时定量PCR（RT-PCR）方法检测诱导菌株中反转录转座子TCA4中开放阅读框的表达水平。结果长期高温刺激能降低白念珠菌对氟康唑（16μg／mE）的耐受能力;高温诱导菌株中反转录转座子TCA4中Orf19．2668和Orf19．2669的表达水平相比于亲本菌ATCC10231发生高表达。结论高温刺激能使反转录转座子TCA4发生转座激活,反转录转座子TCA4的转座激活与白念珠菌耐药性形成相关,与此同时可能还有其他机制参与白念珠菌耐药性的形成。     

Monocyte responses to Candida albicans are enhanced by antibody in cooperation with antibody-independent pathogen recognition

Although most individuals are colonized with Candida albicans, only patients with insufficient or nonfunctional phagocytes develop life-threatening C. albicans disease. Because recognition of bacterial pathogens through phagocyte receptors for IgG (FcgammaR) is known to augment phagocyte responses, we postulated that antibody opsonization would enhance monocyte damage to C. albicans and subsequent tumor necrosis factor-alpha (TNF-alpha) production. After exposure to the human monocytic cell line THP-1, opsonized yeast showed an 89% decrease in metabolic activity, compared with 40% for unopsonized yeast (P<0.05). Culture supernatants contained 1316 pg mL(-1) of TNF-alpha after monocytes were exposed to opsonized yeast vs. 341 pg mL(-1) for unopsonized yeast (P=0.003). Similar results were obtained using peripheral blood mononuclear cells. Antibody opsonization of C. albicans germ tubes enhanced TNF-alpha production but did not affect organism damage. Antibody-dependent and antibody-independent factors were found to act synergistically to increase TNF-alpha production. ERK activation was important for both antibody-dependent and antibody-independent stimulation of TNF-alpha production, but not for monocyte-mediated organism damage. These data suggest that FcgammaR cooperates positively with antibody-independent recognition mechanisms in what may be a novel link between innate and adaptive immunity to C. albicans.     

Fungal fatal attraction: a mechanistic review on targeting liposomal amphotericin B (AmBisome®) to the fungal membrane

Abstract

Liposomal amphotericin B (AmBisome^®) is a lipid-based nanotherapeutic that is used successfully worldwide to treat a broad range of life-threatening invasive fungal infections. In subtropical regions, AmBisome is emerging as the treatment of choice for human parasitic protozoan pathogens such as those from the genus Leishmania. The key to the remarkable efficacy of AmBisome is attributed to its liposome based formulation to deliver a potent drug at high dosage with significantly reduced toxicity in patients with immunocompromised systems. In spite of the rising frequency of AmBisome usage globally, the mechanisms underlying its ability to target to the sites of infection remain largely unknown. This review provides an overview of the current mechanistic understanding of AmBisome, discusses potential challenges and opportunities for the development of clinically effective, refractory resistant antifungal agents.     

致病性念珠菌对常见抗真菌药物的耐药性研究进展

近年来,致病性念珠菌感染引起的侵袭性念珠菌病患者人数逐年增多。白念珠菌仍是引起感染的主要致病菌,但是由非白念念珠菌引起的感染比例显著升高。致病性念珠菌对常见抗真菌药物的耐药现象呈上升趋势,这是导致临床治疗其所致的侵袭性感染失败的重要原因之一。本文就致病性念珠菌耐药性的流行病学以及其耐药机制方面的研究进展进行了介绍。     

耳念珠菌耐药机制研究进展

耳念珠菌感染及其耐药问题已愈演愈烈,其临床耐药机制的研究已刻不容缓。本文整理了国内外耳念珠菌临床菌株对三大类抗真菌药物的耐药情况,并从外排泵异常表达、靶标蛋白突变、生物被膜和基因组可塑性4个方面总结了耳念珠菌已报道的或潜在的耐药机制,并与其他念珠菌耐药机制进行了对比。     

白念珠菌耐药机制新进展

近年来对于深部真菌感染的研究报道越来越多,其已日益成为一些重要疾病临床治疗过程中的常见并发症,其中,白念珠菌病的发病率仍居高不下.虽然目前有多种抗真菌药物应用于临床,但其耐药现象愈来愈严重,给临床治疗带来了极大的挑战.近来有关白念珠菌耐药机制的研究有了较新的进展.该文就新发现的白念珠菌的耐药机制,作一概述.     

Increased potency of a novel d-β-naphthylalanine-substituted antimicrobial peptide against fluconazole-resistant fungal pathogens

The antifungal activities of the known antimicrobial peptide, P-113, as well as a new type of Trp-rich peptide, Ac-KWRRWVRWI-NH₂, Pac-525, and its modified peptide, d -Nal-Pac-525, were determined using the broth microdilution method in three different media. All peptides had similar activities against yeast pathogens in low-salt LYM media. However, only d -Nal-Pac-525 retained its antifungal activity in the media containing high concentrations of salt. Hence, d -Nal-Pac-525 has the potential of becoming a promising antifungal agent, especially for fungal pathogens with intrinsic resistance to fluconazole.     

CCH1或MID1基因缺失对白念珠菌药物耐受性及致病性的影响

CCH1和MID1基因编码的钙闸门是外源钙进入细胞内的重要通道,Ca2+作为细胞内重要的第2信使分子,其浓度的升高可激活相应的途径参与各种细胞反应过程。该研究将利用钙通路CCH1和MID1基因的单缺失菌株,并构建其相应的回补菌株,研究CCH1或MID1基因缺失后对白念珠菌药物耐受性和致病性的影响作用。通过药物平板敏感性试验和微量液基稀释法比较不同菌株对唑类药物敏感性的变化,进一步添加钙通道阻滞剂和钙离子螯合剂来分析钙离子浓度变化对药物作用的影响,结果发现CCH1或MID1基因的缺失明显对氟康唑和伊曲康唑表现出敏感性,且药物作用受到钙离子浓度变化的调节。最后建立小鼠感染模型分析不同菌株的毒力变化差异,确定CCH1或MID1基因的缺失显著减弱了白念珠菌的致病性。     

念珠菌致真菌性角膜炎3例报告

真菌性角膜炎是严重的致菌性眼病,本文报告我院于2011年诊治的3例念珠菌致真菌性角膜炎,这有助于了解在本地区该疾病的致病菌及主要特点。     

耐氟康唑念珠菌和耐伊曲康唑烟曲霉对泊沙康唑的敏感性测定

目的：测定耐氟康唑念珠菌和耐伊曲康唑烟曲霉临床分离株对泊沙康唑的敏感性。方法参照美国临床实验室标准化研究所制定的 M27-A3和 M38-A2方案,测定从临床获得的11株耐氟康唑的念珠菌和3株耐伊曲康唑烟曲霉对泊沙康唑的 MIC 值。结果对于氟康唑耐药的念珠菌,泊沙康唑的 MIC 范围是0.125-1μg/ mL。对于伊曲康唑耐药烟曲霉,泊沙康唑的 MIC 范围是0.06-0.5μg/ mL。结论11株耐氟康唑的念珠菌和3株耐伊曲康唑烟曲霉均对泊沙康唑有效。     

白念珠菌对特比萘芬耐药性的体外梯级诱导和回复研究

目的以浓度梯级倍增的特比萘芬在体外诱导白念珠菌标准株获得耐药子代菌株,并观察其耐药稳定性,从细胞水平研究白念珠菌对特比萘芬耐药前后生物学特性的变化,为进一步采用基因芯片在基因表达水平上研究特比萘芬对白念珠菌的药理作用及其诱导耐药机制提供理想的实验模型。方法将白念珠菌ATCC90028株在特比萘芬浓度逐渐梯级倍增的YPD液体培养基中分别转种传代,直到最后转种至含1024μg／ml特比萘芬的YPD液体培养基中培养,分别测定诱导后形成的各子代菌株的MIC值;选用以1024μg／ml特比萘芬诱导形成的耐药菌株,在不含特比萘芬的YPD液体培养基中连续传代10次后,测定其MIC值,观察其耐药表型的稳定性;并分别用肉眼、光镜和电镜观察白念珠菌耐药性产生前后的形态学特征。结果特比萘芬MIC值为8μg／ml的白念珠菌母本菌株（白念珠菌ATCC90028）成功地被诱导成特比萘芬MIC值为≥512μg/ml的子代菌株,进一步的耐药稳定性实验说明诱导后形成的子代菌株的表型是相对稳定的,诱导后的子代耐药菌株与其母本相比,生长繁殖速度减慢,细胞形态不规则,部分细胞胞膜不完整。结论通过在药物浓度梯级倍增的培养基中连续传代培养的方法可成功建立相同基因型的对特比萘芬敏感的白念珠菌母本和对特比萘芬耐药的子代模型,为获取有亲本的耐药白念珠菌菌株提供了一个有效的实验方法,是在基因水平研究白念珠菌对特比萘芬耐药机制的理想实验模型。     

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。