Sanglard Dominique, Ischer Françoise, Marchetti Oscar, Entenza José, Bille Jacques
Institute of Microbiology, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 44, CH-1011 Lausanne, Switzerland.
Mol Microbiol. 2003 May;48(4):959-76. doi: 10.1046/j.1365-2958.2003.03495.x.
The azole antifungal fluconazole possesses only fungistatic activity in Candida albicans and, therefore, this human pathogen is tolerant to this agent. However, tolerance to fluconazole can be inhibited when C. albicans is exposed to fluconazole combined with the immunosuppressive drug cyclosporin A, which is known to inhibit calcineurin activity in yeast. A mutant lacking both alleles of a gene encoding the calcineurin A subunit (CNA) lost viability in the presence of fluconazole, thus making calcineurin essential for fluconazole tolerance. Consistent with this observation, tolerance to fluconazole was modulated by calcium ions or by the expression of a calcineurin A derivative autoactivated by the removal of its C-terminal inhibitory domain. Interestingly, CNA was also essential for tolerance to other antifungal agents (voriconazole, itraconazole, terbinafine, amorolfine) and to several other metabolic inhibitors (caffeine, brefeldin A, mycophenolic acid, fluphenazine) or cell wall-perturbing agents (SDS, calcofluor white, Congo red), thus indicating that the calcineurin pathway plays an important role in the survival of C. albicans in the presence of external growth inhibitors. Several genes, including PMC1, a vacuolar calcium P-type ATPase, were regulated in a calcineurin- and fluconazole-dependent manner. However, PMC1 did not play a direct role in the survival of C. albicans when exposed to fluconazole. In addition to these different properties, calcineurin was found to affect colony morphology in several media known to modulate the C. albicans dimorphic switch. In particular, calcineurin was found to be essential for C. albicans viability in serum-containing media. Finally, calcineurin was found to be necessary for the virulence of C. albicans in a mice model of infection, thus making calcineurin an important element for adequate adaptation to the conditions of the host environment.
唑类抗真菌药氟康唑对白色念珠菌仅具有抑菌活性,因此,这种人类病原体对该药物具有耐受性。然而,当白色念珠菌暴露于氟康唑与免疫抑制药物环孢素A联合使用时,对氟康唑的耐受性会受到抑制,已知环孢素A可抑制酵母中的钙调神经磷酸酶活性。一个编码钙调神经磷酸酶A亚基(CNA)的基因的两个等位基因均缺失的突变体在氟康唑存在的情况下失去了活力,因此钙调神经磷酸酶对于氟康唑耐受性至关重要。与该观察结果一致,氟康唑耐受性可通过钙离子或通过去除其C末端抑制结构域而自动激活的钙调神经磷酸酶A衍生物的表达来调节。有趣的是,CNA对于对其他抗真菌剂(伏立康唑、伊曲康唑、特比萘芬、阿莫罗芬)以及对其他几种代谢抑制剂(咖啡因、布雷菲德菌素A、霉酚酸、氟奋乃静)或细胞壁干扰剂(十二烷基硫酸钠、荧光增白剂、刚果红)的耐受性也至关重要,因此表明钙调神经磷酸酶途径在白色念珠菌在存在外部生长抑制剂的情况下的存活中起重要作用。包括液泡钙P型ATP酶PMC1在内的几个基因以钙调神经磷酸酶和氟康唑依赖性方式受到调控。然而,当暴露于氟康唑时,PMC1在白色念珠菌的存活中并未发挥直接作用。除了这些不同特性外,还发现钙调神经磷酸酶在几种已知可调节白色念珠菌双态转换的培养基中会影响菌落形态。特别是,发现钙调神经磷酸酶对于白色念珠菌在含血清培养基中的活力至关重要。最后,发现在感染小鼠模型中钙调神经磷酸酶对于白色念珠菌的毒力是必需的,因此钙调神经磷酸酶是充分适应宿主环境条件的重要因素。