Fungal infections Flashcards
types of mycelium
siphonale mycelium -> a multinucleic giant cell -> usual in archemycota
standard mycelium -> cells ae mono, bi or poly-karyotic -> basido- or ascomycota
morphology filamentous fungi
very diverse
can form everything from hyphae to conidia which makes effective immune response and drug development hard
life cycle of filamentous fungi
asexual via mitosis, formation of conidiospores (mitospores)
sexual via meiosis, formation of ascospores (meiospores)
parasexual via cell-fusion
KDACs in filamentous fungi
lysine-deacetylation of histones
responsible for regulation of many secondary metabolites
Class I:
- HosA: reduces e.g. orsellenic acid TK
- RpdA: essential for viability of A. nidulans
Class II:
- HdA: deletion increases seconary metabolite production
- HosB
Class I KDACs in filamentous fungi
Class I:
- HosA: reduces e.g. orsellenic acid TK
- RpdA: essential for viability of A. nidulans
HosA
Class I KDAC
regulation of secondary metabolites
reduces e.g. TK of orsellenic acid
RpdA
Class I KDAC
regulation of secondary metabolite production
essential for A. nidulans
Class II KDACs in filamentous fungi
regulation of secondary metaboolite production
Class II:
- HdA: deletion increases seconary metabolite production
- HosB
HdA
Class II KDAC
deletion especially for biotechnology interesting -> increases 2nd metabolite production (AB)
HosB
Class II KDAC
spectrum of fungal disease
allergic
superficial
mucosal
chronic
acute invasive (life-threatening)
WHO lif-threathening fungi
definition and fungi
based on resistances, treatment and diagnosis options, incidence, complications and squelae
Cryptococcus neoformans
Candida albicans
Candida auris
Aspergillus fumigatus
obligatory pathogenic
also disease causing in immunocompetent
mild manifestation in immunocompetent
serious manifestation in immunocompromised
opportunistic pathogenic
no manifestation in immunocompetent
serious manifestation in immunocompromised
causes for invasion of fungi
comination of risk factors
innate immune status (polymorphisms)
underlying conditions (especially NEUTROPENIA)
environment (house, work, etc)
others (DM, high iron, etc.)
Candidiasis
strain, transmission, manifestation
C. albicans, tropicans or auris (since 2005)
endogenous or exogenous
transmission via contaminated material or personal contact -> nosocomial!
variable morphology
Manifestation: superficial (cutaneous), subcutaneous (locally invasive) or disseminated (invasive)
- CUTANEOUS: sores with white coating, topical antimycotics
- INVASIVE: can manifest in every organ, 2.-4. cause of death in ICU
Virulence traits Candida
morphological switch
adherence: mannans, affinity for plastic
bifilm formation (adherence mediated)
proteases damaging epithelial barriers -> invasion
phospholipases destroy complement and IgG -> immmune evasion
Virulence traits Candida auris
develeoped thermoteolerance and haplotolerance in recent years
intrinsic resistance to most antifungals and desinfectants -> rapid spread
causes prolonged hospital stays
Aspergillosis
strains, manifestation
A. fumigatus, flabvus, terreus and nidulans
MANIFESTATION: allergic, colonisation of body- or lung cavitis, invasive
- INVASIVE: most common in COPD in western world (previously ICU), administration of prophylaxis but break through infections (resistant)
- CHRONIC PULMONARY ASPERGILLOSIS: > 3 months, diagnosis pf post mortem due to mild symptoms -> aspergilloma formation leads mostly to obstruction, formation in lung after tuberculosis (e.g.) or sinus, can become invasive -> rising mortality
most problematic is ACQUIRED AZOLE RESISTANCE
Virulence traits Aspergillus
adaptations to host niche!
morphological switch
thermotolerance
proteases
toxins
immune evasion via RODLET LAYER and MELANIN
Cryptococcosis
risk factor, strains
Immunosuppression as major risk factor –> longterm cortisols, Tx, HIV (AIDS defining disease)
C. NEOFORMANS: only immunosuppressed, worldwide in soil, plants and BIRD DROPPINGS
C. GATTII: typically immunosuppressed, new variants also in competent, high adaptation potential, becomes worldwide endemic
HIV: AIDS defining disease in Africa etc. in western world not via HAART and other new therapies
Cycle of infection Cryptococcus
spore inhalation into lung alveoli
morphological switch from conidia to yeast form
dissemination into various organs (BRAIN,skin, kidney, bone marrow, etc)
Virulence traits Cryptococcus
many -> examples:
capsule
melanin
phenotypic switching
Cerebral infection by fungus
type, mechanism
Cryptococcus
BBB-passaging: 3 theories
- Trojan Horse: phagocytosed in neutrophils, macrophages or monocytes -> transport over BBB
- Transcytosis: hyaluronic acid-mediated endocytosis, exocytosis via Mpn-1 (fungi) and annexin A2 interaction
- Paracelular: host pplasminogen activated (plasmin) -> ECM degradation, fungal Urease degrades tight junctions
Mucormycosis
features, infection, forms
rising death rates
fulminant progresion, angioinvasion and extensive tissue damage (necrosis)
therapy requires OP and antifungals
INFECTION: primary manifestation
- INHALATION: rhino-orbital or rhino-cerebral, here pulmonary via mechanical ventilation
- PENETRATING TRAUMA: primary cutaneous manifestation
- GUT: contaminated food, etc.
SECONDARY MANIFESTATION: cutaneous as first sign of dissemination, high potential!
INVASIVE: rare but rising with high mortality, caused by ineffective long-term antifungal treatment, UNCONTROLLED DIABETES as major risk factor (CAM -> covid associated mucormycosis endemic in India)
Primary metabolism
encoded genes are conserved between species/strains
encode for glycolysis, TCA, respiratory chain etc.
Secondary metabolism
encode genes producing secondary metabolites
not-conserved and differ between strains
produce toxins, proteins etc
are a form of microbial warefare
Diagnostic of fungal infections
testing for cell wall components or genetic material
specifity and sample acquisition is problematic
morphological characteristics of fungi
different morphological stages
CONIDIA: highly stress-resistant infectious propagules, generated for multiplication, no TK response, long-lived and contain DNH-MELANIN and RODLET LAYER
CELL WALL:
- components recognized by Dectin1 and 2
- in conidia masked by rodelt layer and melanin
- used for immune evasion tactics -> shedded galactomannan (diagnostic) and galactosaminogalactan (decoy)
CELL MEMBRANE: contains ergosterol -> target of antifungals, producation activated/controlled by SrbA
Immune evasion by morphology
- rodlet layer
- melanin
- binding of complement regulators (FH, FHL-1, CFHR-1, plasminogen)
morphological characteristics as virulence determinants
- morphological switch
- morphology of conidia (rodlet layer, melanin)
- cell wall shedding -> galactosaminogalatan
- binding of complement regulators (FH, FHL-1, CFHR-1, plasminogen)
metabolic characteristics of fungi
primary and secondary metabolism
linked and can adapt to host via TK response
-> stress resistance to oxidative burst, pH, hypoxia, tarvation
produce host component dagrading enzymes and other secondary metabolites & toxins
virulence factors can be toxins, nutrients (metals), immune evasion tactics, etc.
Gliotoxin
by Aspergillus fumigatus
biosynthesis by gene cluster (12 genes) regulated by gliZ
Target = NEUTROPHILS
IMMUNOSUPPRESSIVE:
- reduced phagocytosis, NFkB
- reduced inflammation and cytokines
- reduced mast cell and neutrophile function
- apoptotic death in immune cells (macrophages, monocytes, others)
- elevated PMN-mediated inflammation
metabolic immune evasion tactics
- secretion of proteases (degrade e.g. complement)
- secretion of gliotoxin
- shedding galacosaminogalatan
- metal acquisition tactics
Copper metabolism in host and fungi
Cu is essential nutrient but also used as toxin in phagolysosomes by host
fungi need Cu UPTAKE and DETOXIFICATION mechanism
- Ctr1&4: high affinity Cu transporters of C. neoformans
- CnMt1&2: Cu binding molecule -> detoxifying
- Cuf1: Cu sensing TF -> induces Ctr1&4 Tk during starvation and CnMt1&2 during Cu-excess
in A. fumigatus 2 separate TF -> MacA for Cu-uptake, AceA for detoxifying plus CrpA for cellular Cu-export
Virulence determinants involving copper
Ctr4 for brain-infection (is Cu starvation niche)
CnMt1/2 in macrophage phagolysosome and lung (Cu excess)
Cuf1 (TF)
Iron metabolism in host
role of iron
iron is essential for haeme, iron sulfurclusters and other proteins
toxic via catalyzation of ROS formation
Iron metabolism in host
mammalian iron homeostasis
- transferrin binds Fe in blood
- transferrin-receptor for uptake into cells
- storage in/as ferritin
- regulation via IRP regulating TL by binding IRE on mRNAs
Iron metabolism in host
Antimicrobial strategies
- Aptoferritin lowers free Fe
- Apolactoferritin in neutrophil granule & body fluids
- chronic inflammation leads to Fe uptake in macrophages
- Siderocalins: bind siderophores -> LIPOCALIN1 (bacterial and fungal siderophores) and LIPOCALIN2 (entero- and carbomyxobactins)
Iron metabolism in Aspergillus
regulation
- SreA-Fe downregulates iron-acquisition pathways
- HapX downregulates iron-consuming pathways
-> HapX and SreA-Fe repress each other - HapX-Fe upregulates iron consuming pathways
Iron metabolism in Aspergillus
components
FetD: low affinity Fe uptake
REDUCTIVE Fe UPTAKE: FreB, Fet C (osidase) and FtrA (Fe permease)
SIDEROPHORE Fe UPTAKE: TATFC-Fe uptake via MirB, TAFC dgradation required for uptake -> EstB, TAFC secretion via Abc transporter
Siderophore Fe STORAGE: FC (siderophore storing Fe), can be released if necessary for metabolic activity
VACUOLAR Fe STORAGE: Fe transported into Fe-vacuole via CccA
Virulence determinants involving iron
siderophore biosynthesis (sidA)
HapX
Zinc metabolism in fungi
high affinity Zn uptake important for virulence
ZrfA&B: high affinity Zn transporter, pH optimum is acidic
ZrfC: high affinity Zn transporter, pH optimum is neutral/alkaline
ZafA: Zn sensing TF, inhibited by Zn, activates transporter TK
PacC: pH sensing TF, activated by OH- (alkaline) -> induces ZrfC and AspF2, represses ZrfA&B
AspF2: secreted Zn bindng protein -> Zincophore, interacts with ZrfC
VIRULENCE DETERMINANTS: ZrfC, AspF2, PacC
Zinc metabolism in host
CALPROTECTIN released in response to inflammation or on Zn shortage
-> Zn/Mn specific chelator
Virulence determinants Zn
ZrfC, AspF2, PacC
ZrfA
acidic Zn transporter
induced by ZafA in low Zn
repressed by PacC in alkaline/neutral conditions
ZrfB
acidic Zn transporter
induced by ZafA in low Zn
repressed by PacC in alkaline/neutral conditions
ZrfC
alkaline/neutral Zn transporter
induced by ZafA in low Zn
induced by PacC in alkaline/neutral conditions
virulence determinant