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Harrington, A. A.

Publications and source records attributed to Harrington, A. A..

4 recordsLinked to original sources

A Mechanism Driving Echinocandin Heteroresistance in Candida glabrata

While pathogenic fungi can acquire resistance to the current arsenal of antifungals through genetic mutations, heteroresistance has emerged as an important new cause of therapeutic failures. Heteroresistance is generally thought to arise in small subpopulations that display phenotypic resistance to antifungals without genetic mutations. This study blurs that line by showing gain-of-resistance mutations in FKS2, which encodes a target of echinocandins and fungerps, cause large amounts of heteroresistance in Candida glabrata through heterogeneous expression of the gene even in clonal cell populations. Heteroresistance decreased when stress-responsive transcription factors (Crz1, Rlm1) were eliminated and was nearly abolished when the upstream regulators (calcineurin, Slt2) were mutated or inhibited. Identical gain-of-resistance mutations in FKS1, a paralog of FKS2, showed much less heteroresistance due to its constitutive expression coupled with variable levels of antagonism by wild-type FKS2. A genome-wide screen using Tn-seq revealed additional regulators of heteroresistance and resistance including IRA1, an inhibitor of the Ras1-PKA signaling pathway that senses glucose availability. IRA1 increased expression of FKS2 and decreased expression of FKS1, which increased heteroresistance and decreased resistance, respectively, when these genes carried resistance mutations. Similar principles may govern heteroresistance in other fungal pathogens such as Candida parapsilosis, which naturally carries resistance mutations in FKS1 and frequently exhibits heteroresistance to echinocandins, and Candidozyma auris, which easily acquires such mutations.

microbiology↗

Echinocandin tolerance and persistence in vitro are regulated by calcineurin signaling in Candida glabrata

Upon exposure to echinocandins, growing yeast cells begin to accumulate cell wall damage and eventually die, resulting in therapeutic effects. While resistance to echinocandins is well studied, tolerance and persistence mechanisms that may also contribute to clinical failures and relapses remain understudied. In time-kill assays with micafungin in vitro, the opportunistic pathogen Candida glabrata exhibited biphasic kinetics of cell death. Modeling with exponential decay equations distinguished a fast-dying major population from a slow-dying minor population, indicative of persistence. A genome-wide forward-genetic screen revealed dozens of genes that appeared to regulate persistence and/or tolerance, but not resistance. Several of those genes encoded calcineurin and its upstream regulators. Using individual gene knockout mutants and FK506, we show that calcineurin signaling increases the lifespans of most C. glabrata cells through a process that is largely independent of Crz1, one of its downstream effectors. The formation of long-lived persister-like cells (i.e. persistence) was strongly dependent on calcineurin signaling, independent of Crz1. Pre-activation of calcineurin using genetic or chemical stressors, such as manogepix, strongly increased tolerance and persistence in C. glabrata, suggesting antagonism of echinocandin efficacy by this new antifungal. Calcineurin signaling was also necessary for induction of tolerance and persistence in Candida albicans. The findings suggest that short-term administration of FK506 during the earliest stages of echinocandin treatment may improve clinical outcomes while possibly avoiding long-term immunosuppression. IMPORTANCETreatment of fungal infections is often unsuccessful. Potential causes of antifungal failure include tolerance and persistence, which are poorly understood processes used by fungal pathogens to survive our assaults. This study utilizes detailed experimental protocols and genome-wide screens to discover how Candida glabrata induces tolerance and persistence to a major class of antifungals. The findings suggest that a clinical immunosuppressant may be repurposed to combat tolerance and persistence in this pathogenic yeast as well as Candida albicans and perhaps others.

microbiology↗

Tn-seq of the Candida glabrata reference strain CBS138 reveals epigenetic plasticity, structural variation, and intrinsic mechanisms of resistance to micafungin

C. glabrata is an opportunistic pathogen that can resist common antifungals and rapidly acquire multidrug resistance. A large amount of genetic variation exists between isolates, which complicates generalizations. Portable Tn-seq methods can efficiently provide genome-wide information on strain differences and genetic mechanisms. Using the Hermes transposon, the CBS138 reference strain and a commonly studied derivative termed 2001 were subjected to Tn-seq in control conditions and after exposure to varying doses of the clinical antifungal micafungin. The approach revealed large differences between these strains, including a 131 kb tandem duplication and a variety of fitness differences. Additionally, both strains exhibited up to 1000-fold increased transposon accessibility in subtelomeric regions relative to the BG2 strain, indicative of open subtelomeric chromatin in these isolates and large epigenetic variation within the species. Unexpectedly, the Pdr1 transcription factor conferred resistance to micafungin through targets other than CDR1. Other micafungin resistance pathways were also revealed including mannosyltransferase activity and biosynthesis of the lipid precursor sphingosine, the drugging of which by SDZ 90-215 or myriocin enhanced the potency of micafungin in vitro. These findings provide insights into complexity of the C. glabrata species as well as strategies for improving antifungal efficacy. SummaryCandida glabrata is an emerging pathogen with large genetic diversity and genome plasticity. The type strain CBS138 and a laboratory derivative were mutagenized with the Hermes transposon and profiled using Tn-seq. Numerous genes that regulate innate and acquired resistance to an important clinical antifungal were uncovered, including a pleiotropic drug resistance gene (PDR1) and a duplication of part of one chromosome. Compounds that target PDR1 and other genes may augment the potency of existing antifungals.

microbiology↗

Calcineurin-dependent contributions to fitness in the opportunistic pathogen Candida glabrata

The protein phosphatase calcineurin is vital for virulence of the opportunistic fungal pathogen Candida glabrata. The host-induced stresses that activate calcineurin signaling are unknown, as are the targets of calcineurin relevant to virulence. To potentially shed light on these processes, millions of transposon insertion mutants throughout the genome of C. glabrata were profiled en masse for fitness defects in the presence of FK506, a specific inhibitor of calcineurin. 87 specific gene deficiencies depended on calcineurin signaling for full viability in vitro both in wild type and pdr1{Delta} null strains lacking pleiotropic drug resistance. Three genes involved in cell wall biosynthesis (FKS1, DCW1, FLC1) possess co-essential paralogs whose expression depended on calcineurin and Crz1 in response to micafungin, a clinical antifungal that interferes with cell wall biogenesis. Interestingly, 80% of the FK506-sensitive mutants were deficient in different aspects of vesicular trafficking, such as endocytosis, exocytosis, sorting, and biogenesis of secretory proteins in the ER. In response to the experimental antifungal manogepix that blocks GPI-anchor biosynthesis in the ER, calcineurin signaling increased and strongly prevented cell death independent of Crz1, one of its major targets. Comparisons between manogepix, micafungin, and the ER-stressing tunicamycin reveal a correlation between the degree of calcineurin signaling and the degree of cell survival. These findings suggest that calcineurin plays major roles in mitigating stresses of vesicular trafficking. Such stresses may arise during host infection and in response antifungal therapies.

microbiology↗