Department of Microbiology and Immunology, University of Minnesota Medical School, Minneapolis, Minnesota.
Bioinformatics and Computational Biology Graduate Program, University of Minnesota, Minneapolis, Minnesota.
Mol Biol Evol. 2023 Jan 4;40(1). doi: 10.1093/molbev/msad009.
Invasive fungal infections are a leading global cause of human mortality. Only three major classes of antifungal drugs are widely used, and resistance to all three classes can arise rapidly. The most widely prescribed antifungal drug, fluconazole, disseminates rapidly and reaches a wide range of concentrations throughout the body. The impact of drug concentration on the spectrum and effect of mutations acquired during adaptation is not known for any fungal pathogen, and how the specific level of a given stress influences the distribution of beneficial mutations has been poorly explored in general. We evolved 144 lineages from three genetically distinct clinical isolates of Candida albicans to four concentrations of fluconazole (0, 1, 8, and 64 μg/ml) and performed comprehensive phenotypic and genomic comparisons of ancestral and evolved populations. Adaptation to different fluconazole concentrations resulted in distinct adaptive trajectories. In general, lineages evolved to drug concentrations close to their MIC50 (the level of drug that reduces growth by 50% in the ancestor) tended to rapidly evolve an increased MIC50 and acquired distinct segmental aneuploidies and copy number variations. By contrast, lineages evolved to drug concentrations above their ancestral MIC50 tended to acquire a different suite of mutational changes and increased in drug tolerance (the ability of a subpopulation of cells to grow slowly above their MIC50). This is the first evidence that different concentrations of drug can select for different genotypic and phenotypic outcomes in vitro and may explain observed in vivo drug response variation.
侵袭性真菌感染是导致全球人类死亡的主要原因之一。目前广泛使用的抗真菌药物只有三大类,而这三类药物都可能迅速产生耐药性。目前应用最广泛的抗真菌药物氟康唑在体内迅速扩散,并达到广泛的浓度范围。但目前尚不清楚药物浓度对任何真菌病原体在适应过程中获得的突变谱和效果的影响,以及特定压力水平如何影响有益突变的分布,这些问题在总体上都还没有得到充分的探索。我们从三种遗传上不同的白色念珠菌临床分离株中进化出了 144 个谱系,使其适应氟康唑的四个浓度(0、1、8 和 64μg/ml),并对祖先和进化后的群体进行了全面的表型和基因组比较。适应不同氟康唑浓度导致了不同的适应轨迹。一般来说,适应接近其 MIC50(在祖先中降低生长 50%的药物水平)的药物浓度的谱系往往会迅速进化出更高的 MIC50,并获得独特的片段非整倍体和拷贝数变异。相比之下,适应高于其祖先 MIC50 的药物浓度的谱系往往会获得不同的突变变化,并增加药物耐受性(一小部分细胞在高于其 MIC50 的情况下缓慢生长的能力)。这是第一个证据表明,不同浓度的药物可以在体外选择不同的基因型和表型结果,并可能解释观察到的体内药物反应变异。