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Antifungal drug combinations for Cryptococcus neoformans and Prototheca spp.

Seventy-one isolates of Cryptococcus neoformans and 5 isolates of Prototheca spp. were tested for in vitro susceptibility against amphotericin B alone and against the combination of amphotericin B with each clinically relevant concentration of flucytosine (5-FC) and rifampin by broth dilution methods. The combinations of amphotericin B and rifampin produced greater effect on reduction of the minimal inhibition concentration (MIC) of amphotericin B than did either drug used individually. Flucytosine combined with amphotericin B produced little or no reduction of the MIC compared with amphotericin B alone.

Amphotericin B↗

[Determination of the minimum inhibitory concentration of fluconazole against Cryptococcus neoformans].

The minimum inhibitory concentration of fluconozole was determined in 36 strains of Cryptococcus neoformans var. neoformans by a casitone broth microdilution method, taking into account that it is one of the most used antifungal agents in our country for the treatment of cryptococcal meningitis, the second opportunistic mycosis in order of frequency and that with the highest lethality among AIDS patients. The minimum inhibitory concentration of the studied strains ranged 0.125 to more than 64 micrograms/mL for a geometrical mean of 2.38 micrograms/mL. 50% of the strains were inhibited with 4 micrograms/mL and the least concentration that inhibited 90% was 16 micrograms/mL. It is stressed the importance of continuing this type of in vitro studies to detect the appearance of resistance of C. neoformans to antifungal agents.

Antifungal Agents↗

Geographic grouping of Cryptococcus neoformans var. gattii by random amplified polymorphic DNA fingerprint patterns and ITS sequence divergence.

Eleven reference strains of Cryptococcus neoformans var. gattii were analyzed by random amplified polymorphic DNA (RAPD) patterns using three oligo primers. Three major RAPD pattern profiles (profiles I, II and III) were identified with A-1 oligo primer. Each profile was found to relate to a geographic region. Since the strains which belong to profiles I and II were mainly the isolates from America, and profile III from Asia with A-1 primer, these three profiles were assigned to the geographic grouping of America-1, America-2 and Asia, respectively. Analysis of rDNA sequences coding an internal transcribed spacer (ITS) region of C. neformans var. gattii revealed that the fungus with each RAPD profile has characteristic base sequences at the four positions (10 and 15 positions in ITS1 and 8 and 56 positions at ITS2) of the ITS regions. On the basis of the combinations of the four bases specific for the ITS regions, four ITS types, AAGG (America-1), AAAC (America-2), GGGC (Asia-1) and AGGC (Asia-2) were identified: the geographic group of Asia was further classified into two subgroups of Asia-1 and Asia-2 based on the ITS typing. Clinical isolates from Thailand (6 strains) and Brazil (7 strains) were found to belong to the geographic group of America-1 nd America-2, respectively. Five reference strains of C. neoformans var. gattii from the CBS culture collection were classified into two America-2, one Asia-1 and two Asia-2 groups. This ITS region analysis allowed us to distinguish all isolates of C. neoformans var. gattii into four geographic groups based on the ITS base sequence, and further molecular epidemiological and ecological research on this fungus is recommended.

Base Sequence↗

[Production of beta-xylosidase by the yeast Cryptococcus podzolicus].

In studying the beta-xylosidase production by yeast Cryptococcus podzolicus (Basidiomycetes), it was shown to be an inducible secretory enzyme. Xylooligosaccharides generated from xylan and methyl beta-xyloside were found to induce the beta-xylosidase synthesis. The enzyme activity in the medium containing xylan or methyl beta-xyloside was 1.0 and 1.5 U/ml, respectively; this production level is similar to that achievable at the beta-xylosidase production by mycelial fungi.

Cryptococcus↗

Cytokines and costimulatory molecules: positive and negative regulation of the immune response to Cryptococcus neoformans.

Cytokines are small proteins or glycoproteins that transmit information from one cell to another. Most cells in the body secrete and respond to cytokines and their effects have been described on a myriad of cellular functions. Cytokine interactions may not be linear, thus making the system extremely intricate and with unpredictable features. Therefore, each model of disease may be unique, with its own mechanism of autoregulation dictated by positive and negative feedback involving cytokines and costimulatory molecules. The emergence of some cytokines over others in the course of Cryptococcus neoformans infection may characterize a positive or negative outcome of cryptococcosis. Much less is known about the influence of costimulatory molecules in regulating C. neoformans immune response. The available information indicates a critical role for proinflammatory cytokines such as tumor necrosis factor alpha and interleukin 12 (IL-12). The positive role of interferon gamma in infected tissue as an inducer of antimicrobial function of innate immune cells and as positive feedback for IL-12 induction appears to be indisputable. In vitro studies indicate that costimulatory molecule expression appears to be regulated on antigen-presenting cells by C. neoformans and increased expression of B7-1 and CD40 on these cells may promote a protective response. These studies await confirmation in an in vivo system. The interplay between cytokines and costimulatory molecules has been scarcely explored and additional details are needed to better understand how they convey positive and negative information to immune cells in response to C. neoformans.

Antibody Formation↗

Cryptococcus laurentii cell envelope glycoprotein. Evidence for separate oligosaccharide side chains of different composition and structure.

Particulate enzyme preparations of the fungus imperfectus Cryptococcus laurentii catalyze transfer of mannosyl and galactosyl residues from GDP-[14C]mannose and UDP-[3H]-galactose to the same endogenous acceptor. After solubilization with pronase, the major portion of both labels is retarded on Sepharose columns and forms a symmetrical peak, in which 14C and 3H coincide. Label also coincides with endogenous protein and carbohydrate. Both labels bind to Sepharose-Concanavalin A (Con A) and are eluted with alpha-methylglucoside. After beta elimination with NaOH-NaBH4 only 14C label retains binding to Sepharose-Con A; 3H label representing (6-O-alpha-galactosyl)10-O-beta-galactosyl-O-mannitol as previously reported (Raizada, M. K., Kloepfer, H. G., Schutzbach, J. S., and Ankel, H. (1974) J. Biol. Chem. 249, 6080-6086) no longer binds. The [14C]mannose-containing material after beta elimination yields a pentasaccharide and a trisaccharide. Similar penta- and trisaccharides can be isolated following beta elimination of particulate preparations of the organism after pronase treatment. Analytical data suggest that the structure of the isolated pentasaccharides corresponds to that of a pentasaccharide previously synthesized de novo using cell-free enzyme preparations of the organism: 2-O-alpha-mannosyl-6-O-alpha-mannosyl-3-O-alpha-mannosyl-(2-O-beta-xylosyl)-O-mannose (Schutzbach, J. S., Raizada, M. K., and Ankel, H. (1974) J. Biol. Chem. 249, 2953-2958). The trisaccharide has the structure 2-O-alpha-mannosyl-2-O-alpha-mannosyl-O-mannitol. The data are consistent with a glycoprotein structure in which these three types of oligosaccharides are bound to a common polypeptide core through O-glycosidic linkages to threonyl and seryl residues.

Cell Membrane↗

Cryptococcus neoformans variety gattii.

Cryptococcus neoformans var. gattii is emerging as a primary human pathogen which is distinct genetically and biochemically from C. neoformans var. neoformans. There is increasing evidence that it should be reclassified as a separate species within the Tremellales. In nature, C. n. var. gattii has been consistently isolated from decaying wood in hollows of species of the red gum group of eucalyptus trees (Eucalyptus ser. Exsertae Blakely). The role that trees play in the life-cycle of C. n. var. gattii is not known, but its association with decaying wood is suggestive of an endophytic existence, in common with other wood-rot fungi. Despite the demonstration in the laboratory of sexual reproduction between mating types oc and a of F. neoformans var. gattii, this has not been demonstrated in nature. Human cryptococcosis develops following environmental exposure and inhalation of the infectious propagule. Whether this is the basidiospore or dessicated yeast form is uncertain. The major risk factor for development of disease appears to be exposure, though there is indirect evidence that unidentified host factors may contribute to the relatively high incidence of cryptococcosis in Australian Aboriginals. The rarity of cryptococcosis due to C. n. var. gattii in immunocompromised patients remains unexplained. Virulence determinants of C. neoformans are currently the subject of intensive investigation, especially in C. n. var. neoformans. The best-characterized, major, virulence determinants in this variety, the polysaccharide capsule, products of the laccase enzyme pathway and ability to grow at physiological temperatures, contribute to its survival in the host. They are also present in C. n. var. gattii. A potential determinant of tissue invasion, secreted phospholipase B, is produced in vitro and in vivo by C. n. var. gattii. This enzyme has now been confirmed to play a role in the virulence of C. neoformans serotype A. Disease caused by C. n. var. gattii is distinguished from that due to C. n. var. neoformans by an increased incidence of cryptococcomas in lung and brain, increased neurological morbidity and a slower response to antifungal therapy. The difference in clinical presentation is predominantly due to the effect of underlying immunocompromise in patients infected with C. n. var. neoformans.

Animals↗

Cryptococcus friedmannii, a new species of yeast from the Antarctic.

Cryptococcus friedmannii Vishniac sp. nov. from an Antarctic cryptoendolithic community is a psychrophilic basidioblastomycete characterized by cream-colored colonies of cells with smooth, layered walls, budding monopolarly, producing amylose and extracellular proteinase, utilizing nitrate and D-alanine (inter alia) as nitrogen sources and L-arabinose, arbutin, cellobiose, D-glucuronate, maltose, melezitose, salicin, soluble starch, trehalose, and D-xylose as carbon sources. This species differs from all other basidiomycetous yeasts in possessing the following combination of characters: amylose production (positive), assimilation of cellobiose (positive), D-galactose (negative), myo-inositol (negative), D-mannitol (negative), and sucrose (negative).

Antarctic Regions↗

Ozonation and alkaline-peroxide pretreatment of wheat straw for Cryptococcus curvatus fermentation.

Crop residues in an Advanced Life Support System (ALS) contain many valuable components that could be recovered and used. Wheat is 60% inedible, with approximately 90% of the total sugars in the residue cellulose and hemicellulose. To release these sugars requires pretreatment followed by enzymatic hydrolysis. Cryptococcus curvatus, an oleaginous yeast, uses the sugars in cellulose and hemicellulose for growth and production of storage triglycerides. In this investigation, alkaline-peroxide and ozonation pretreatment methods were compared for their efficiency to release glucose and xylose to be used in the cultivation of C. curvatus. Leaching the biomass with water at 65 degrees C for 4 h prior to pretreatment facilitated saccharification. Alkaline-peroxide and ozone pretreatment were almost 100% and 80% saccharification efficient, respectively. The sugars derived from the hydrolysis of alkaline-peroxide-treated wheat straw supported the growth of C. curvatus and the production of edible single-cell oil.

Biomass↗

Capsule and melanin synthesis in Cryptococcus neoformans.

Melanization is a property that is shared among several human pathogenic fungi, whereas encapsulation is a property unique to Cryptococcus neoformans. Focusing on C. neoformans, the current knowledge of the structure and synthesis of the melanin and polysaccharide capsule is discussed. The importance of such basic biological information is underscored by the involvement of each to the pathogenic ability of the fungus and their potential as drug targets, yet areas where critical data remain elusive are clearly visible. Finally, in recognition of the fact that C. neoformans is a free-living organism, we conclude by examining the possible biological importance of each of these traits for environmental survival of the fungus.

Cell Wall↗

[Cryptococcus neoformans isolation from the soil in Panama].

Reports of Cryptococcus neoformans isolations from patients in Panama have appeared since 1978, but to our knowledge, thIs is the first report of isolation of this organism from soil samples in the Republic. Of 25 soil samples analyzed, two (25%) yielded the organism on birdseed agar medium. Canavanine-glycine-bromthymol blue medium served to identify the isolates as belonging to C. neorformans var neoformans, and not C. Neoformans var. gattii. Initially, isolates did not have capsules, but upon passage through newborn mice, wide capsules developed. This finding has important public health implications, since non-encapsulated environmental organisms, once in the host, can develop capsules, which significantly contribute to virulence.

Cryptococcus neoformans↗

[Physiopathology of meningoencephalitis caused by Cryptococcus neoformans].

Cryptococcus neoformans is an encapsulated yeast mainly responsible for meningoencephalitis, especially in AIDS patients. Recent observations using an experimental model of systemic cryptococcosis that mimics the human infection have reinforced the knowledge on the pathogenesis of cryptococcosis. Cryptococcosis may occur several years after inhalation of infecting particles from the environment. A stage of fungemia that reflects the dissemination of infection usually precedes the development of meningoencephalitis. The capsule mainly composed of glucuronoxylomannan constitutes the main virulence factor of C. neoformans. It has several deleterious effects including the inhibition of the host immune responses. The central nervous system involvement differs between AIDS patients and HIV-negative patients. In AIDS patients, histological studies of the brain show numerous cryptococci without significant inflammatory cell response. In other immunodepressed hosts, a granulomatous inflammation containing few yeasts is usually seen. This may reflect an altered local immunological defect against C. neoformans in AIDS patients with cryptococcosis.

Acquired Immunodeficiency Syndrome↗

[Studies on the methods of mating test for Cryptococcus neoformans].

Six media (MA:Mating agar, HA:Hay agar, HCA:Hay cube agar, RSA:Rice shell agar, IHA:additional nutrition in HA and SDA:Sabouraudia dextrose agar) were compared for their efficiencies of the mating test for Cryptococcus neoformans. The positive rates in 2-week-cultivation were 95% (HCA and RSA), 86% (HA), 38% (MA and SDA) and 24% (IHA). The streaking inoculation was equally replaced by the dot inoculation for the mating tests. However, the dot method saves much more materials, and is suitable for testing in large number of isolates. Additionally, the precultivation of the tester and tested isolates in broth medium (YMPDB) could enhance the positive mating rates.

Agar↗

[Experimental inoculation of Terminalia catappa seedlings with an environmental isolate of Cryptococcus neoformans var. gattii serotype C ].

In 1997, our laboratory reported for the first time the isolation of Cryptococcus neoformans var. gattii serotype C associated with almond tree (Terminalia catappa) detritus. This finding led to a more detailed follow up of the association between the plant and the yeast. Preliminary data have shown that survival of the yeast in almond trees seedlings goes beyond 100 days. The aim of the present study was to establish if under the conditions previously studied, C. neoformans var. gattii would remain viable for longer periods. A total of 83 almond tree seedings, 20-40 cm high, were inoculated with C. neoformans var. gattii serotype C (INS-755). Assays were carried out inoculating the stem or the soil where the seedlings were planted. Observations were undertaken for a period of up to 12 months. As processing techniques we employed the endophytic fungi procedure (stems), maceration (roots, leaves) and standard suspension method (soils). Additionally, microscopic visualization of the yeast in plant tissues was done with trypan blue plus lactophenol. C. neoformans var. gattii was recovered from the inoculated plants for a period of up to 12 months post-inoculation; additionally, the fungus had the capacity to migrate from the stem to the soil and viceversa, without causing macroscopic or microscopic alterations in the plant tissues. This finding suggests that there appears to be an association between the host plant and C. neoformans var. gattii in the environment.

Coloring Agents↗

Iron assimilation in Cryptococcus neoformans.

We studied the effects of iron chelators and of a thallium salt on growth of Cryptococcus neoformans in defined medium. An oxidant-sensitive mutant strain was found to require exogenous ferric iron for growth. Using this strain, we found that the synthetic iron chelator, N-hydroxyethylenediamine triacetate (HEDTA), in several saturation states, stimulated growth as well as the comparably saturated siderophore deferoxamine. This non-specific result makes the existence of a cryptococcal ferrihydroxamate receptor doubtful. The catechols, caffeic acid, L-3, 4-dihydroxyphenylalanine, epinephrine, gallic acid, 3-hydroxytyramine (dopamine) and norepinephrine, were tested for growth stimulation in iron deprivation, under conditions in which deferoxamine was stimulatory. Catechols were found to be either neutral or inhibitory. The ferrous iron chelator, bathophenanthroline disulfonate (BPDS), inhibited growth strongly in the absence of exogenous iron, suggesting that ferric ion must be reduced before it can be internalized. Direct evidence of extracellular reduction was provided by accumulation of red-coloured ferrous-BPDS complex. The inhibition caused by BPDS was relieved by ferric HEDTA, even in the presence of 10-fold increased BPDS, suggesting a second, low-affinity, non-reductive iron uptake pathway. This inference was further supported by the observation that toxicity of the non-reducible ferric analogue, thallium (III), is relieved by iron repletion.

Biological Transport↗

Experimental murine cryptococcal infection results in contamination of bedding with Cryptococcus neoformans.

Cryptococcus neoformans is a fungal pathogen that survives in diverse environments. To determine whether cages of mice infected with C. neoformans posed an infection risk to animal caregivers, we investigated whether the fungus could be isolated from the bedding or stool of mice infected by intratracheal (i.t.), intravenous (i.v.), or intraperitoneal (i.p.) routes. The bedding of mice infected i.t. was contaminated with C. neoformans. In contrast, no contamination of bedding with C. neoformans was detected in cages of mice infected i.v. or i.p. C. neoformans was not isolated from murine feces. The C. neoformans strain recovered from bedding material was indistinguishable from the infecting strain by biochemical and molecular techniques. This result suggests that precautions may be warranted when disposing bedding from cages that housed mice with pulmonary C. neoformans infection.

Animals↗

[An urease negative Cryptococcus neoformans].

We report an urease negative Cryptococcus neoformans derived from pigeon dropping. This isolate produced brown pigmented colonies on cornmeal Tween-80 agar with 300 micrograms/ml caffeic acid, but was failure to hydrolyze urea. More identification tests were performed for this isolate, such as assimilation and fermentation of carbohydrates, nitrate assimilation, production of starch like compound, growth on GCP medium, germ tube formation and inoculation of mice, ect. Most of the results showed that the microbiological characteristics of the isolate were typical of C. neoformans except for negative urease test. Even though there has been a report about an urease negative C. neoformans derived from an AIDS patient, but we have never found any report about isolation from pigeon dropping or nature environment. We should pay attention to the exist of this atypical strain of C. neoformans in nature environment and the possibility of infection to human being. Additionally, we also be aware of the possibility of neglect when this urease negative C. neoformans is identified with urease test.

Animals↗