Effect of rapamycin on Cryptococcus neoformans: cellular organization, biophysics and virulence factors
Abstract
Background:Cryptococcus neoformans is an opportunistic fungal pathogen that causes infections mainly in immunosuppressed individuals, such as transplant recipients. Aims: This study investigated the effects of rapamycin, an immunosuppressant drug, on the cellular organization, biophysical characteristics, and main virulence factors of C. neoformans. Methods: Morphological, structural, physicochemical and biophysical analyses of cells and secreted polysaccharides of the reference H99 C. neoformans strain were investigated under the effect of subinhibitory concentrations of rapamycin. Results: Rapamycin at a minimum inhibitory concentration of 2.5 μM reduced C. neoformans cell viability by 53%, decreased capsule, increased cell size, chitin and lipid body formation, and changed peptidase and urease activity. Conclusion: Further studies are needed to assess how rapamycin affects the virulence factors and pathogenicity of C. neoformans.
Plain language summary
Cryptococcosis is a fungal infection caused by a type of fungus called Cryptococcus. Among the Cryptococcus group, Cryptococcus neoformans is often linked to fungal infections in people who have a weak immune system (known as being immunosuppressed). The main aim of this work was to look at the effect of an immunosuppressant called rapamycin, which is commonly used to prevent organ transplant rejection, on the ability of C. neoformans to cause infection. The results showed that this drug stopped the growth of the fungus, dampening its ability to cause disease.
Papers of special note have been highlighted as: • of interest; •• of considerable interest
References
- 1. . Infections in solid-organ transplant recipients. Clin. Microbiol. Rev. 10(1), 86–124 (1997).
- 2. . Opportunistic infections in transplant patients. Infect. Dis. Clin. North Am. 33(4), 1143–1157 (2019). • Describes the main opportunistic infections in patients who receive an organ transplant.
- 3. Cryptococcosis in human immunodeficiency virus-negative patients in the era of effective azole therapy. Clin. Infect. Dis. 33(5), 690–699 (2001).
- 4. Determinants of disease presentation and outcome during cryptococcosis: the CryptoA/D study. PLoS Med. 4(2), 0297–0308 (2007).
- 5. . Deciphering the model pathogenic fungus Cryptococcus neoformans. Nat. Rev. Microbiol. 3(10), 753–764 (2005).
- 6. . Basic principles of the virulence of Cryptococcus. Virulence 10(1), 490–501 (2019).
- 7. . Cryptococcosis in the immunocompetent patient. Respir. Care 55(11), 1499–1503 (2010).
- 8. . Chapter 14. Cryptococcosis. Infect. Dis. Diagnosis Treament Hum. Mycoses (5), 255–276 (2008).
- 9. . Fungal colonization of the brain: anatomopathological aspects of neurological cryptococcosis epidemic in HIV patients. An. Acad. Bras. Cienc. 87(Suppl. 2), 1293–1309 (2015).
- 10. . Cryptococcosis in solid-organ, hematopoietic stem cell, and tissue transplant recipients: evidence-based evolving trends. Clin. Infect. Dis. 48(11), 1566–1576 (2009).
- 11. . Cryptococcosis in solid organ transplantation – guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin. Transplant. 33(9), e13543 (2019).
- 12. . Cryptococcus. Proc. Am. Thorac. Soc. 7(3), 186–196 (2010).
- 13. . Phenotypic switching in the human pathogenic fungus Cryptococcus neoformans is associated with changes in virulence and pulmonary inflammatory response in rodents. Proc. Natl Acad. Sci. USA 95(25), 14967–14972 (1998).
- 14. . Epidemiology of Cryptococcus and cryptococcosis in Western Africa. Mycoses 64(1), 4–17 (2021).
- 15. . Immunosuppressive therapy in transplantation. Nurs. Clin. North Am. 51(1), 107–120 (2016).
- 16. . Sirolimus: a current perspective. Exp. Clin. Transplant. 1(1), 8–18 (2003).
- 17. . Sirolimus: Its discovery, biological properties, and mechanism of action. Transplant. Proc. 35(Suppl. 3), S7–S14 (2003).
- 18. Activation of Akt and eIF4E survival pathways by rapamycin-mediated mammalian target of rapamycin inhibition. Cancer Res. 65(16), 7052–7058 (2005).
- 19. . Targeting the mammalian target of rapamycin (mTOR): a new approach to treating cancer. Br. J. Cancer 91(8), 1420–1424 (2004). • Describes the cellular actions of rapamycin in mammals.
- 20. . Regulation of innate immune cell function by mTOR. Nat. Rev. Immunol. 15(10), 599–614 (2018).
- 21. Rapamycin and less immunosuppressive analogs are toxic to Candida albicans and Cryptococcus neoformans via FKBP12-dependent inhibition of TOR. Antimicrob. Agents Chemother. 45(11), 3162–3170 (2001). •• Reports that C. neoformans shares a signaling pathway with rapamycin.
- 22. Rapamycin antifungal action is mediated via conserved complexes with FKBP12 and TOR kinase homologs in Cryptococcus neoformans. Mol. Cell. Biol. 19(6), 4101–4112 (1999). •• It provides confirmation of rapamycin's action within the signaling pathway of C. neoformans.
- 23. Capsule growth in Cryptococcus neoformans is coordinated with cell cycle progression. MBio 5(3), 1–13 (2014).
- 24. Environmental factors that contribute to the maintenance of Cryptococcus neoformans pathogenesis. Microorganisms 8(2), 1–19 (2020).
- 25. . Combatting the evolution of antifungal resistance in Cryptococcus neoformans. Mol. Microbiol. 114(5), 721–734 (2020).
- 26. BrCAST – Brazilian Committee on Antimicrobial Susceptibility Testing. https://brcast.org.br
- 27. CyQUANT™ XTT Cell Viability Assay. https://www.thermofisher.com/order/catalog/product/X12223?ef_id=Cj0KCQjwrMKmBhCJARIsAHuEAPSbP0d4wdhp7kuEi0Fu-xM-DYOS9tNoIOFaFLSVaoHNtDzOFuOjsdYaAnEbEALw_wcB:G:s&s_kwcid=AL!3652!3!585656104074!e!!g!!xtt%20viability%20assay!2031782395!114240973391&cid=bid_pca_iva_r01_co_cp1359_pjt0000_bid00000_0se_gaw_nt_pur_con&gclid=Cj0KCQjwrMKmBhCJARIsAHuEAPSbP0d4wdhp7kuEi0Fu-xM-DYOS9tNoIOFaFLSVaoHNtDzOFuOjsdYaAnEbEALw_wcB#/X12223
- 28. Medicines for malaria venture COVID box: A source for repurposing drugs with antifungal activity against human pathogenic fungi. Mem. Inst. Oswaldo Cruz 116(1), 1–10 (2021).
- 29. ImageJ. https://imagej.nih.gov/ij/
- 30. Dexamethasone and methylprednisolone promote cell proliferation, capsule enlargement, and in vivo dissemination of C. neoformans. Front. Fungal Biol. 2(February), 1–13 (2021). • Illustrates the effects of other immunosuppressants on C. neoformans.
- 31. Characterization of a murine monoclonal antibody to Cryptococcus neoformans polysaccharide that is a candidate for human therapeutic studies. Antimicrob. Agents Chemother. 42(6), 1437–1446 (1998).
- 32. Surface, adhesiveness and virulence aspects of Candida haemulonii species complex. Med. Mycol. 58(7), 973–986 (2020).
- 33. . Capsule of Cryptococcus neoformans grows by enlargement of polysaccharide molecules. Proc. Natl Acad. Sci. USA 106(4), 1228–1233 (2009).
- 34. . Rheological properties of cryptococcal polysaccharide change with fiber size, antibody binding and temperature. Future Microbiol. 14(10), 867–884 (2019).
- 35. . Plate method for detection of phospholipase activity in Candida albicans. Sabouraudia: Journal of Medical and Veterinary Mycology 20(1), 7–14 (1982).
- 36. The threat called Candida haemulonii species complex in Rio de Janeiro State, Brazil: focus on antifungal resistance and virulence attributes. J. Fungi 8(6), 574 (2022).
- 37. . A comparison of secretory proteinases from different strains of Candida albicans. Sabouraudia 20(3), 233–244 (1982).
- 38. . Esterase activity in various Candida species. J. Int. Med. Res. 30(3), 322–324 (2002).
- 39. . Differential phytate utilization in Candida species. Mycopathologia 172(6), 473–480 (2011).
- 40. . Candida species exhibit differential in vitro hemolytic activities. J. Clin. Microbiol. 39(8), 2971–2974 (2001).
- 41. . Antifungal susceptibility of emerging yeast pathogens. Enferm. Infecc. Microbiol. Clin. 19(6), 249–256 (2001).
- 42. . Urea decomposition as a means of differentiating proteus and paracolon cultures from each other and from Salmonella and Shigella types. J. Bacteriol. 52(4), 461–466 (1946).
- 43. . Phenotypic characteristics associated with virulence of clinical isolates from the Sporothrix complex. Biomed Res. Int. 2015,
DOI: 10.1155/2015/212308 (2015). - 44. Autophagy inducer rapamycin treatment reduces IFN-I-mediated Inflammation and improves anti-HIV-1 T cell response in vivo. JCI insight 7(22), e159136 (2022).
- 45. . The fungal cell wall: structure, biosynthesis, and function. Microbiol. Spectr. 5(3), 1–25 (2017).
- 46. . Lipid droplet-mediated lipid and protein homeostasis in budding yeast. FEBS Lett. 592(8), 1291–1303 (2018).
- 47. . Hydrolytic enzymes as virulence factors of Candida albicans. Mycoses 48(6), 365–377 (2005).
- 48. . Inhibition of the mechanistic target of rapamycin (mTOR)-rapamycin and beyond. Cold Spring Harb. Perspect. Med. 6(5), 1–14 (2016).
- 49. Immunologic and dose dependent effects of rapamycin and its evolving role in chemoprevention. Clin. Immunol. 245,
DOI: 10.1016/j.clim.2022.109095 (2022). - 50. . Rapamycin (AY-22,989), a new antifungal antibiotic. II. Fermentation, isolation and characterization. J. Antibiot. (Tokyo). 28(10), 727–732 (1975).
- 51. . Rapamycin exerts antifungal activity in vitro and in vivo against Mucor circinelloides via FKBP12-dependent inhibition of TOR. Eukaryot. Cell 11(3), 270–281 (2012).
- 52. . Rapamycin-induced cytotoxic signal transduction pathway. Transplant. Proc. 40(8), 2737–2739 (2008).
- 53. . The capsular dynamics of Cryptococcus neoformans. Trends Microbiol. 14(11), 497–505 (2006).
- 54. . Cryptococcus neoformans. I. Nonencapsulated mutants. J. Bacteriol. 94(5), 1475–1479 (1967).
- 55. Cyclosporine affects the main virulence factors of Cryptococcus neoformans in vitro. J. Fungi 9(4), 487 (2023).
- 56. . Multiple disguises for the same party: the concepts of morphogenesis and phenotypic variations in Cryptococcus neoformans. Front. Microbiol. 2(SEP), 1–9 (2011).
- 57. . Titan cells in Cryptococcus neoformans: cells with a giant impact. Curr. Opin. Microbiol. 16(4), 409–413 (2013).
- 58. . Cryptococcus neoformans CDA1 and its chitin deacetylase activity are required for fungal pathogenesis. MBio 9(6), e02087–18 (2018).
- 59. . The antidepressant sertraline induces the formation of supersized lipid droplets in the human pathogen Cryptococcus neoformans. J. fungi (Basel, Switzerland) 8(6), 1–12 (2022).
- 60. . Urease as a virulence factor in experimental cryptococcosis. Infect. Immun. 68(2), 443–448 (2000).
- 61. Urease expression by Cryptococcus neoformans promotes microvascular sequestration, thereby enhancing central nervous system invasion. Am. J. Pathol. 164(5), 1761–1771 (2004).
- 62. Real-time imaging of trapping and urease-dependent transmigration of Cryptococcus neoformans in mouse brain. J. Clin. Invest. 120(5), 1683–1693 (2010).
- 63. Factors required for activation of urease as a virulence determinant in Cryptococcus neoformans. MBio 4(3), e00220–13 (2013).
- 64. . Real-time in vivo imaging of fungal migration to the central nervous system. Cell. Microbiol. 14(12), 1819–1827 (2012).
- 65. Cryptococcal urease promotes the accumulation of immature dendritic cells and a non-protective T2 immune response within the lung. Am. J. Pathol. 174(3), 932–943 (2009).
- 66. . The capsule of the fungal pathogen Cryptococcus neoformans. Adv. Appl. Microbiol. 68, 133–216 (2009).
- 67. . Capsule structural heterogeneity and antigenic variation in Cryptococcus neoformans. Eukaryot. Cell 6(8), 1464–1473 (2007).
- 68. . Rapamycin-induced G1 cell cycle arrest employs both TGF-β and Rb pathways. Physiol. Behav. 360(2), 134–140 (2015).