Les champignons du genre Aspergillus sont des moisissures banales de l'environnement. Elles sont présentes dans le sol et sur des végétaux en décomposition. Les Aspergillus se propagent par l'intermédiaire de spores microscopiques en suspension dans l'air. L'Homme et les animaux sont exposés en permanence aux spores aspergillaires mais les défenses immunes empêchent leur développement dans l'organisme. Lorsque ces défenses sont amoindries, une aspergillose est possible. Dans ce cas, Aspergillus fumigatus et A. flavus sont le plus souvent incriminés. Les oiseaux sont beaucoup plus sensibles que les mammifères et l'environnement représenté par les élevages aviaires est propice à la prolifération des moisissures du genre Aspergillus. L'objectif de ce travail de thèse a été de caractériser la diversité génétique et la sensibilité aux antifongiques d'isolats d'Aspergillus provenant d'élevages aviaires dans la province du Guangxi en Chine. La première partie de la thèse est une analyse bibliographique sur les champignons du genre Aspergillus, les aspergilloses et les caractéristiques de l'élevage aviaire en Chine. Une première enquête a été réalisée dans 3 élevages près de la ville de Nanning et dans un élevage (incluant un éclosoir) à proximité de la ville de Guilin. Des écouvillonnages pharyngés et des prélèvements d'air ont été réalisés pendant plusieurs semaines. Des prélèvements ont également été faits sur des œufs dans l'éclosoir. Cette enquête a montré que le niveau de contamination fongique dépendait du type d'élevage. De nombreux isolats fongiques ont pu être collectés : 188 isolats d'A. fumigatus et 159 isolats d'A. flavus. La seconde partie du travail expérimental a porté sur la caractérisation de la diversité génétique d'A. fumigatus et d'A. flavus. Pour cela, la technique MLVA (multiple locus VNTR analysis) a été utilisée. Pour A. flavus, 8 marqueurs VNTR (variable-number tandem-repeat) ont été sélectionnés et une réaction PCR multiplex a été mise au point. Au total, 91 isolats d'A. flavus, incluant 6 souches de référence, ont été caractérisées avec le panel des 8 marqueurs VNTR. Cette analyse a permis de définir 78 génotypes distincts et un index de discrimination de 0,993. L'analyse de 188 isolats d'A. fumigatus avec 10 marqueurs VNTR a permis de définir 142 génotypes distincts. Certains génotypes d'A. flavus ou d'A. fumigatus sont clairement regroupés dans le nuage de point généré par l'analyse MST (minimum spanning tree). La troisième partie du travail expérimental a porté sur la sensibilité aux antifongiques de 177 isolats d'A. fumigatus. Ces isolats ont été récupérés dans des élevages aviaires en Chine et en France. Les isolats de Chine sont pour la plupart sensibles avec des valeurs minimales inhibitrices (vis-à-vis de l'itraconazole) comprises entre 0,38 et 0,75 µg/mL. Les isolats de France sont pour la plupart sensibles avec des valeurs minimales inhibitrices (vis-à-vis de l'itraconazole) comprises entre 0.19 and 1 µg/mL. Quatre souches ont été considérées comme résistantes : 2 souches provenant de deux élevages en Chine et 2 souches provenant de deux élevages en France. Des mutations sur le gène Cyp51A ont été détectées pour 11 isolats (3 résistants et 8 sensibles). Vingt et une mutations nucléotidiques ont été identifiées. Onze de ces mutations sont silencieuses et 9 sont à l'origine d'un changement de la composition de la protéine. Sept substitutions ont déjà été décrites dans la littérature ; les mutations A116R, E130D et Q131H sont originales.

Estudos recentes têm sugerido que doença pulmonar obstrutiva crônica (DPOC) possa ser um fator de risco para aspergilose invasiva (AI), particularmente no contexto de ventilação mecânica e uso de esteróides. Neste trabalho, realizamos estudo de coorte prospectivo multicêntrico (2009-2010) em três unidades de terapia intensiva no Sul do Brasil. Foram incluídos no estudo pacientes com DPOC que apresentassem novo infiltrado pulmonar enquanto em ventilação mecânica e sob uso de corticosteróides. Para estes pacientes, foram realizados os seguintes testes, em amostras respiratórias (maioria aspirado traqueal): exame micológico direto, cultura quantitativa para fungos, pesquisa de antígeno galactomanana (GM) (Platelia Aspergillus) e PCR em tempo real para Aspergillus. O DNA das amostras respiratórias foi extraído utilizando-se o kit de extração MycXtra (Myconostica, UK), sendo a amplificação feita com dois kits comerciais de q-PCR: Aspergillus spp q-PCR Alert kit (Nanogen, Itália) e MycAssayTM Aspergillus kit (Myconostica, UK). Foi também obtido soro destes pacientes, onde foi testada GM, precipitinas para Aspergillus e IgE total. O estudo foi aprovado no comitê de ética dos dois hospitais. Foram incluídos no estudo 47 pacientes (40,4% do sexo masculino), sendo a idade média de 68,6 anos (±9,9). A maioria (72,8%) dos pacientes possuía DPOC grave (GOLD III/IV). A dosagem de esteróides (equivalentes de prednisona) variou de 100-4125 mg (mediana: 900 mg). Exame micológico (direto e cultivo) foi positivo para Aspergillus seção Fumigatti em apenas dois pacientes (4,2%). Outros fungos identificados foram Scedosporium apiospermum (n=1) e Histoplasma capsulatum (n=1). Precipitinas para Aspergillus foram positivas em três pacientes, com títulos baixos (<1:2). Os níveis de IgE variaram de 2 a >3000 UI/ml (mediana de 74 UI/ml). Em sua grande maioria, os índices de GM no soro foram <0,5, enquanto que nas amostras respiratórias, os índices de GM foram >0,5, >1,0 e >1,5 em 74,5%, 40,5% e 21,3%, respectivamente. PCR da Myconostica foi positivo em 10 pacientes, enquanto PCR Nanogen detectou apenas um paciente. A mortalidade geral foi de 53,2%. Este estudo prospectivo multicêntrico mostrou uma baixa incidência (4,2%) de AI em pacientes com DPOC. A determinação de GM mostrou altos índices nas amostras analisadas (50% com índices ópticos >1,3), possivelmente necessitando um maior ponto de corte para excluir resultados falso-positivos. A combinação de PCR e GM para o diagnóstico de AI em amostras respiratórias merece investigação adicional, devido à baixa sensibilidade dos métodos de cultivo observados nos estudos clínicos realizados. / Recent data have suggested that chronic obstructive pulmonary disease (COPD) may be an important risk factor for invasive aspergillosis (IA), particularly in the context of mechanical ventilation (MV) and therapy with corticosteroids. Here we present the results of a prospective multicentric study (2009-2010) conducted in three intensive care units (ICUs) in Southern Brazil. COPD patients on steroids showing a new lung infiltrate while on mechanical ventilation were included and the following tests were performed in respiratory samples (mostly tracheal aspirates): microscopy, quantitative fungal culture, galactomannan (GM) (Platelia Aspergillus EIA) and real-time PCR to detect Aspergillus DNA. DNA was extracted using MycXtra kit (Myconostica, UK) and amplification was performed using two q-PCR commercial kits: Aspergillus spp q-PCR Alert kit (Nanogen, Italy) and MycAssayTM Aspergillus kit (Myconostica, UK). Serum was also obtained and tested for Aspergillus precipitins, GM and total IgE levels. Ethical approval was obtained in each of the participant hospitals. A total of 47 patients were enrolled in the study (male 59.6%). Mean age was 68.6 years-old (± 9.9). Most patients had severe COPD (GOLD stages III/IV in 72.8%). Steroid dosage (prednisone equivalent) ranged from 100-4125 mg (median 900 mg). Microscopy and culture were positive for Aspergillus section Fumigatti in only 2 patients (4.2%). Other fungi included H. capsulatum (n=1) and S. apiospermum (n=1). Aspergillus precipitins were positive for three patients, at low titers (<1:2). IgE levels ranged from 2 to >3,000 IU/ml (median 74 IU/ml). All serum GM indexes were <0.5 and respiratory samples, GM indexes of >0.5, >1.0 and >1.5 were observed in 74.5%, 40.5%, and 21.3%, respectively. Myconostica PCR was positive in 10 patients, while Nanogen PCR detected only one patient. Overall mortality was 53.2%. This prospective multicenter study showed a low incidence (4.2%) of IA in critically ill patients with COPD. High optical indices were observed when GM was tested in respiratory samples (50% of the results showed indices of >1.3). Therefore, the test did not discriminate IA and a a higher cutoff would be needed to exclude false-positive results. The combination of PCR and GM for the diagnosis of IA in respiratory samples deserves further investigation due to the low diagnostic sensitivity of the classical mycology methods.

Made available in DSpace on 2016-06-02T20:21:35Z (GMT). No. of bitstreams: 1 6077.pdf: 10672804 bytes, checksum: 8a7ba5e1820e96664e3cbb7f872f6f3e (MD5) Previous issue date: 2013-10-28 / Financiadora de Estudos e Projetos / Over the recent years, the incidence of human fungal infections has shown a significant increase. Aspergillus fumigatus is a filamentous fungus opportunistic pathogen responsible for many human respiratory diseases, including invasive pulmonary aspergillosis, which is the most serious form of infection . Studies show that A. fumigatus virulence has a multifactorial process associated with its structure, capacity for growth, adaptation to stress conditions, evasion mechanisms of the immune system and ability to cause harm to the host. CWI (via cell wall integrity ) is a signaling cascade activated in yeast cells under conditions of cell wall stress and plays a role in the adaptation of various fungal pathogens in the human host . In many fungi , CWI is triggered by activation of protein kinase C ( PKC ) and that this pathway is associated with the transcription of genes related to maintaining the integrity of the cell wall and its redevelopment. In this work, a mutant Gly579Arg (G579R) was constructed by transformation mediated by inserting a gene replacement cassette comprising a G2044C transversion located in the cysteine-rich domain controller C1B pkcA of A. fumigatus. From the phenotypic analysis of the mutant strain was observed in the involvement of pkcAG579R CWI since the mutant showed high sensitivity to agents such as CR (congo red) and CFW (calcofluor white) . Furthermore, pkcA is also involved in tolerance to oxidative stress caused by paraquat and menadione. Additionally it was found to increase the sensitivity of the mutant pkcAG579R temperature variations as well as the inhibitor of Hsp90 radicicol. Como CWI is related to the transcriptional activation of biosynthetic genes and rugged cell wall (such as glucan synthase, glucanosil chitin synthases and transferases) the abundance of major genes coding for these enzymes was analyzed by RT-PCR in real time. Based on the tests can be &#945; -1 ,3 glucan synthase ( agsA-C ) dependent signaling mediated PkcA for correct expression. Furthermore, genes such as &#946;-1,3 glucan synthase (fksA) glucanosyltransferase (gelA-C) and some chitin synthases (chsB-E-C) appear not to be dependent function and CWI PkcA . These data demonstrated the role of pkcA signaling cascade in the maintenance of cell wall and thermotolerance in A. fumigatus. This work was the first in which a systematic analysis of gene pkcA was conducted in the human opportunistic fungal pathogen A. fumigatus. / Ao longo dos últimos anos, a ocorrência de infecções fúngicas humanas vem apresentando um aumento expressivo. Aspergillus fumigatus é um fungo filamentoso patógeno oportunista responsável por diversas doenças respiratórias humanas, incluindo aspergilose pulmonar invasiva, que é a forma de infecção mais grave. Estudos demonstram que o A. fumigatus possui um processo de virulência multifatorial associado a sua estrutura, capacidade de crescimento, adaptação em condições de estresse, mecânismos de evasão do sistema imune e capacidade de causar danos ao hospedeiro. A CWI (via de integridade da parede celular) é uma cascata de sinalização ativada nas células fúngicas sob condições de estresse de parede celular e desempenha um papel na adaptação de vários fungos patogênicos no hospedeiro humano. Em muitos fungos, CWI é desencadeada através da ativação da proteína quinase C (PKC) sendo que esta via está associada à transcrição de genes relacionados com a manutenção da integridade da parede celular e sua remodelação. Neste trabalho o mutante Gly579Arg (G579R) foi construído através da transformação mediada pela inserção de um cassete de substituição gênica que compreende uma transversão G2044C localizado no domínio regulador rico em cisteína C1B da pkcA de A. fumigatus. A partir da análise fenotípica desse mutante foi possível observar o envolvimento de pkcAG579R na CWI uma vez que a linhagem mutante mostrou alta sensibilidade a agentes como o CR (congo red) e CFW (calcofluor white). Além disso, pkcA está envolvido também na tolerância ao estresse oxidativo causado por menadiona e paraquat. Adicionalmente verificou-se o aumento da sensibilidade da linhagem mutante pkcAG579R à variações de temperatura bem como ao inibidor de Hsp90, radicicol. Como a CWI está relacionada à ativação transcricional de genes de biossíntese e reforço de parede celular (como por exemplo glucanas sintases, quitinas sintases e glucanosil transferases), a abundância dos principais genes que codificam essas enzimas foi analisada através de RTPCR em tempo real. Baseado nos testes pode-se verificar que as &#945;-1,3 glucana sintase (agsA-C) dependem da sinalização mediada por PkcA para sua expressão. Por outro lado, genes como a &#946;-1,3 glucana sintase (fksA), glucanosiltransferases (gelA-C) e algumas quitinas sintases (chsB-C-E) parecem não ser dependente da CWI e da função de PkcA. Esses dados demostraram parte do papel de pkcA na cascata de sinalização da manutenção da parede celular e termotolerância em A. fumigatus. Este trabalho foi o primeiro no qual uma análise sistemática do gene pkcA foi conduzida no fungo patógeno oportunista humano A. fumigatus.

No description available.

Estudos recentes têm sugerido que doença pulmonar obstrutiva crônica (DPOC) possa ser um fator de risco para aspergilose invasiva (AI), particularmente no contexto de ventilação mecânica e uso de esteróides. Neste trabalho, realizamos estudo de coorte prospectivo multicêntrico (2009-2010) em três unidades de terapia intensiva no Sul do Brasil. Foram incluídos no estudo pacientes com DPOC que apresentassem novo infiltrado pulmonar enquanto em ventilação mecânica e sob uso de corticosteróides. Para estes pacientes, foram realizados os seguintes testes, em amostras respiratórias (maioria aspirado traqueal): exame micológico direto, cultura quantitativa para fungos, pesquisa de antígeno galactomanana (GM) (Platelia Aspergillus) e PCR em tempo real para Aspergillus. O DNA das amostras respiratórias foi extraído utilizando-se o kit de extração MycXtra (Myconostica, UK), sendo a amplificação feita com dois kits comerciais de q-PCR: Aspergillus spp q-PCR Alert kit (Nanogen, Itália) e MycAssayTM Aspergillus kit (Myconostica, UK). Foi também obtido soro destes pacientes, onde foi testada GM, precipitinas para Aspergillus e IgE total. O estudo foi aprovado no comitê de ética dos dois hospitais. Foram incluídos no estudo 47 pacientes (40,4% do sexo masculino), sendo a idade média de 68,6 anos (±9,9). A maioria (72,8%) dos pacientes possuía DPOC grave (GOLD III/IV). A dosagem de esteróides (equivalentes de prednisona) variou de 100-4125 mg (mediana: 900 mg). Exame micológico (direto e cultivo) foi positivo para Aspergillus seção Fumigatti em apenas dois pacientes (4,2%). Outros fungos identificados foram Scedosporium apiospermum (n=1) e Histoplasma capsulatum (n=1). Precipitinas para Aspergillus foram positivas em três pacientes, com títulos baixos (<1:2). Os níveis de IgE variaram de 2 a >3000 UI/ml (mediana de 74 UI/ml). Em sua grande maioria, os índices de GM no soro foram <0,5, enquanto que nas amostras respiratórias, os índices de GM foram >0,5, >1,0 e >1,5 em 74,5%, 40,5% e 21,3%, respectivamente. PCR da Myconostica foi positivo em 10 pacientes, enquanto PCR Nanogen detectou apenas um paciente. A mortalidade geral foi de 53,2%. Este estudo prospectivo multicêntrico mostrou uma baixa incidência (4,2%) de AI em pacientes com DPOC. A determinação de GM mostrou altos índices nas amostras analisadas (50% com índices ópticos >1,3), possivelmente necessitando um maior ponto de corte para excluir resultados falso-positivos. A combinação de PCR e GM para o diagnóstico de AI em amostras respiratórias merece investigação adicional, devido à baixa sensibilidade dos métodos de cultivo observados nos estudos clínicos realizados. / Recent data have suggested that chronic obstructive pulmonary disease (COPD) may be an important risk factor for invasive aspergillosis (IA), particularly in the context of mechanical ventilation (MV) and therapy with corticosteroids. Here we present the results of a prospective multicentric study (2009-2010) conducted in three intensive care units (ICUs) in Southern Brazil. COPD patients on steroids showing a new lung infiltrate while on mechanical ventilation were included and the following tests were performed in respiratory samples (mostly tracheal aspirates): microscopy, quantitative fungal culture, galactomannan (GM) (Platelia Aspergillus EIA) and real-time PCR to detect Aspergillus DNA. DNA was extracted using MycXtra kit (Myconostica, UK) and amplification was performed using two q-PCR commercial kits: Aspergillus spp q-PCR Alert kit (Nanogen, Italy) and MycAssayTM Aspergillus kit (Myconostica, UK). Serum was also obtained and tested for Aspergillus precipitins, GM and total IgE levels. Ethical approval was obtained in each of the participant hospitals. A total of 47 patients were enrolled in the study (male 59.6%). Mean age was 68.6 years-old (± 9.9). Most patients had severe COPD (GOLD stages III/IV in 72.8%). Steroid dosage (prednisone equivalent) ranged from 100-4125 mg (median 900 mg). Microscopy and culture were positive for Aspergillus section Fumigatti in only 2 patients (4.2%). Other fungi included H. capsulatum (n=1) and S. apiospermum (n=1). Aspergillus precipitins were positive for three patients, at low titers (<1:2). IgE levels ranged from 2 to >3,000 IU/ml (median 74 IU/ml). All serum GM indexes were <0.5 and respiratory samples, GM indexes of >0.5, >1.0 and >1.5 were observed in 74.5%, 40.5%, and 21.3%, respectively. Myconostica PCR was positive in 10 patients, while Nanogen PCR detected only one patient. Overall mortality was 53.2%. This prospective multicenter study showed a low incidence (4.2%) of IA in critically ill patients with COPD. High optical indices were observed when GM was tested in respiratory samples (50% of the results showed indices of >1.3). Therefore, the test did not discriminate IA and a a higher cutoff would be needed to exclude false-positive results. The combination of PCR and GM for the diagnosis of IA in respiratory samples deserves further investigation due to the low diagnostic sensitivity of the classical mycology methods.

Although A. fumigatus strains are generally susceptible to azoles, recently, acquired resistance to a number of antifungal compounds has been reported, especially to triazoles possibly due to widespread clinical use of triazoles or through exposure to azole fungicides in the environment. The significant clinical problem of azole resistance has led to study the antifungal resistance mechanisms for developing effective therapeutic strategies. Of 230 clinical A. fumigatus isolates submitted during 2008 and 2009 to the Mycology Reference Centre Manchester, UK (MRCM), 64 (28%) were azole resistant and 14% and 20% of patients had resistant isolates, respectively. Among the resistant isolates, 62 of 64 (97%) were itraconazole resistant, 2 of 64 (3%) were only voriconazole resistant and 78% were multi-azole resistant. The gene encoding 14-α sterol demethylase (cyp51A) was analyzed in 63 itraconazole resistant (ITR-R) and 16 ITR-susceptible clinical and environmental isolates of A. fumigatus respectively. Amino acid substitutions in the cyp51A, the commonest known mechanism of azole resistance in A. fumigatus, were found in some ITR-R isolates. Fifteen different amino acid substitutions were found in the cyp51A three of which, A284T, M220R and M220W, have not been previously reported. In addition, several mutations were found in the cyp51A gene in one of the A. fumigatus environmental isolates. Importantly, a remarkably increased frequency of azole-resistant isolates without cyp51A mutations was observed in 43% of isolates and 54% of patients. Other mechanisms of resistance must be responsible for resistance. In order to assess the contribution of transporters and other genes to resistance, particular resistant isolates that did not carry a cyp51A mutation were studied. The relative expression of three novel transporter genes; ABC11, MFS56 and M85 as well as cyp51A, cyp51B, AfuMDR1, AfuMDR2 AfuMDR3, AfuMDR4 and atrF were assessed using real-time RT-PCR in both azole susceptible and resistant isolates, without cyp51A mutations. Interestingly, deletion of ABC11, MFS56 and M85 from a wild-type strain increased A. fumigatus susceptibility to azoles and these genes showed changes in expression levels in many ITR-R isolates. Most ITR-R isolates without cyp51A mutations showed either constitutive high-level expression of the three novel genes or induction of expression upon exposure to itraconazole. One isolate highly over-expressed cyp51B, a novel finding. Our results are most consistent with over-expression of one or more of these genes in ITR-R A. fumigatus without cyp51A mutations being at least partially responsible for ITR resistance. Multiple concurrent possible resistance mechanisms were found in some isolates. My work probably explains the mechanism(s) of resistance in A. fumigatus isolates with cyp51A mutations. Other ITR resistance mechanisms are also possible. To determine taxonomic relationships among A. fumigatus clinical and environmental isolates, the sequences of the ITS, β-tubulin, actin and calmodulin gene of 23 clinical and 16 environmental isolates were analyzed phylogenetically. Actin and calmodulin sequences proved to be good for species differentiation of A. fumigatus while both ITS, β-tubulin regions did not, in this dataset. Many cryptic species of A. fumigates (complex) were found. All environmental A. fumigates complex isolates were ITR susceptible and no cross resistance was found.

Le goéland leucophée endémique dans la région méditerranéenne française. Son mycobiote intestinal n'a jamais été étudié. Ce travail visait à décrire le rôle de ces oiseaux comme réservoir et disséminateur de champignons pathogènes pour l’homme. Nous avons collecté 177 guano de goélands dans cinq sites sur le littoral méditerranéen français; La Grande-Motte, Palavas-les-Flots, Pierre-Blanche, Frioul and Riou archipels. Nous avons identifié dix-sept espèces de levure; les plus fréquentes étant Candida krusei, Galactomyces geotrichum, C. glabrata et C. albicans. On notait d’une part une augmentation de la fréquence des espèces anthropiques de levures C. glabrata et C. albicans avec l’anthropisation des biotopes des colonies de goélands dont d’isolats résistants aux antifongiques. Nous avons analysé les communautés de champignons filamenteux aérocontaminants isolés à partir des mêmes échantillons. Nous avons identifié 16 genres de champignons filamenteux. la faible diversité et abondance de champignons filamenteux dans les zones urbaines par rapport aux suburbains ou à un environnement peu affecté par l'anthropisation et l’association claire entre certaines espèces fongiques et des environnements particuliers. nous avons analysé la génétique des populations de la levure C. glabrata. Nous avons typé par MLVA, 111 isolats de goélands et 79 isolats collectés chez des patients des hôpitaux de Nîmes, Montpellier et Marseille. Nous avons observé une diversité génétique similaire entre les populations de C. glabrata isolées chez le goéland ou chez l’homme. Les isolats de C. glabrata résistants au fluconazole se distribuaient uniformément dans les deux populations. / The yellow-legged gull is endemic in the French Mediterranean area. Their gut mycobiota has never been studied. This work aimed to describe their role in the spreading of potentially human pathogenic fungi with antifungal resistance. Therefore, we sampled 177 yellow-legged gull’s faecal samples in five sites along the Mediterranean littoral South of France; La Grande-Motte, Palavas-les-Flots, Pierre-Blanche, Frioul and Riou archipelagos. We identified seventeen yeast species; the most frequent were Candida krusei, Galactomyces geotrichum, C. glabrata, C. albicans and Saccharomyces cerevisiae. The frequency of the anthropic yeast species C. glabrata and C. albicans increased with the synanthropy of the gull’s colonies and antifungal resistance was found in each of the five most frequent yeast species. We further analyzed the airborne filamentous fungi species isolated from the same sample cultures. We identified 35 filamentous fungi species in 16 genera including 35 species. Both fungal diversity and abundance were low in urban area when compared to suburban ecocline or environments that were little affected by anthropogenic impact and particular fungal species were clearly associated with distinct environments. Finally, we analyzed the population genetic of the human pathogenic yeast C. glabrata, which were isolated from gulls (111 isolates) and from patients (79 isolates) in Nimes, Montpellier and Marseille hospitals, via MLVA analysis. We found that the C. glabrata populations isolated from gulls or humans shared a similar genetic diversity. Antifungal-resistant C. glabrata isolates were evenly distributed in both gull and human populations.

No description available.

The opportunistic fungus, Aspergillus fumigatus, is a leading cause of morbidity and mortality among the immunocompromised population. Experimental and clinical findings have established that phagocytic defenses are critical in the recognition and clearance of A. fumigatus. Previous studies found that Toll-like receptors (TLRs), specifically TLR2 and TLR4, were essential in the detection of the mold. Furthermore, one study found that mice deficient in TLR9 lived longer than their wild-type counterparts following challenge with A. fumigatus. We sought to determine the role of TLR9 during A. fumigatus infection. Our results show that A. fumigatus contains unmethylated CpG DNA, the natural ligand of TLR9. Furthermore, A. fumigatus DNA stimulates a potent pro-inflammatory response in mouse bone marrow derived dendritic cells (BMDCs) and human plasmacytoid dendritic cells (pDCs). A genome wide analysis showed that A. fumigatus DNA contains 87 human and 23 mouse putative immunostimulatory motifs. The response to A. fumigatus DNA is TLR9-dependent, as BMDCs from TLR9-/- mice were unresponsive to the fungal DNA. In addition, HEK293 cells cotransfected with human TLR9 and NFκB driven Luciferase conferred responsiveness to A. fumigatus CpG-rich sequences found in the fungal DNA. Our results show that TLR9 detects A. fumigatus DNA, resulting in the secretion of proinflammatory cytokines. While pDCs secrete IFNα in response to A. fumigatus DNA, these cells have been mainly described to play critical roles in the antiviral responses. The role of pDCs during fungal infections remains to be elucidated. Our data show that CD304+ peripheral blood pDCs challenged with A. fumigatus hyphae secrete large concentrations of IFNα and TNFα in response to infection. Furthermore, the response appears to be TLR9- independent. However, pDCs spread over the hyphae and inhibit fungal growth. Furthermore, pDCs undergo cell lysis upon incubation with A. fumigatus. The antifungal activity of the pDCs was retained in the cell lysates, suggesting that this response was mediated by an intracellular factor. Addition of exogenous Zn2+, but not Fe3+, partially restores hyphal growth. In addition, western blot of pDC lysates show that these cells have the Zn2+-binding protein calprotectin. Over 60% cell death is observed in the pDC population following a 2 hour incubation with A. fumigatus. The observed pDC cell death can be partially attributed to gliotoxin, as pDCs challenged with A. fumigatus stains deficient in production of the mycotoxin result in decreased pDC cytotoxicity. Furthermore, pDC cell death occurs independent of contact with the mold, confirming that pDC cell death is mediated by a secreted fungal factor. In addition, our results show that pDCs are required for the host response against A. fumigatus. Mice depleted of their pDCs are more susceptible to A. fumigatus infection than the control counterparts, suggesting that pDCs play a role in the antifungal response. Also, we observe a 5-fold increase in the pDC population in the lungs of infected mice. Therefore, the possibility of these cells playing a role in recruiting and communicating with other immune cells cannot be eliminated. Upon maturation, pDCs acquire characteristics of conventional DCs (cDCs) such as upregulation of major histocompatability complex (MHC) and becoming more phagocytic. Whether mature pDCs are involved in the detection of and responses against fungal pathogens remains to be determined. Here we show that mature pDC secrete IFNα and TNFα in response to A. fumigatus conidia as early as 6 hours post-challenge. While cytokine secretion of mature pDCs against A. fumigatus does not require opsonization, it requires for A. fumigatus being alive and growing. Furthermore, supernatants from conidial growth induced cytokine secretion by the mature pDCs. The work presented in this thesis establishes that the nucleic acids in A. fumigatus serve as a pathogen associated molecular pattern (PAMP) that can induce a TLR9- dependent response. Furthermore, I show that pDCs secrete cytokines and induce an antifungal response against A. fumigatus conidia and hyphae. While the pDC population in the blood appears to be small, our work shows that these cells could be intimately involved in the antifungal responses against A. fumigatus.

No description available.