Thesis (Ph. D.)--Cornell University, August, 2006. / Vita. Includes bibliographical references (leaves 201-220).

Thesis (Ph.D.)--University of Florida, 2005. / Typescript. Title from title page of source document. Document formatted into pages; contains 169 pages. Includes Vita. Includes bibliographical references.

Made available in DSpace on 2014-07-29T15:25:24Z (GMT). No. of bitstreams: 1 CarolinaRodriguesCosta-2009.pdf: 705821 bytes, checksum: 53ed28c3e9fdc5770d04b7c412384968 (MD5) Previous issue date: 2009-06-02 / Adhesion to host tissues, production of hydrolytic enzymes, the resistance to antifungals and ability to production hyphal interfere in the infectious process caused by Candida. Resistance to azole antifungal agents, used to treatment of candidiasis, has been observed to immunocompromised patients. Molecular typing based on RAPD-PCR has been used to discriminate between susceptible and resistant isolates to antifungal agents. In this work, were evaluated the virulence factors and molecular characteristics of Candida isolates obtained of samples from blood, catheter of nosocomial patients and from oral cavity of HIV positive patients. The isolates were identified as: Candida albicans (59) Candida parapsilosis (22), Candida tropicalis (14) Candida guilliermondii (07), Candida. famata (05), Candida krusei (03), Candid. lusitaniae (01) and Candida kefyr (01). The proteinase and phospholipase production and the adherence ability were determined for these yeasts. The effect of fluconazole and itraconazole antifungal agents on hyphal formation were studied to 5 isolates previously classified as either susceptible or resistant. The characterization genotypic of resistant and susceptible isolates to fluconazole was carried out for 13 isolates of C. albicans by RAPD-PCR method. The results showed that proteinase activity was detected in 88.1% of C. albicans isolates and in 69.8% of non C. albicans, while phospholipase was produced in 55.9% of C. albicans isolates and in 37.7% of non C. albicans. Isolates of blood were more proteolitic than catheter and oral cavity, while for phospholipase, there was more production of this enzyme in the oral cavity. The ability of adherence to buccal epithelial cell was higher in C. albicans than non C. albicans, however there was not behavior difference between the isolates from different sources studied. The hyphal formation was higher in resistant isolates than susceptible isolates when used the both drugs. In RAPD-PCR method the formation of two different groups was verified for susceptible and resistant isolates being that only one resistant isolate was clustered in the susceptible group. Thus, in this work, it was verified that the exoenzymes activity and adherence ability depend not only of the specie of Candida, but too of the source from host; the resistant isolates produced more hyphal than susceptible isolates under the antifungal action and the molecular characteristics of the resistant isolates did not suggest unique DNA fingerprints did not predicting their susceptibility to fluconazole / A capacidade de aderência ao tecido do hospedeiro, a produção de exoenzimas, a resistência aos antifúngicos e a formação de hifas são fatores que podem interferir no processo infeccioso causado por Candida. Resistência aos derivados azólicos utilizados no tratamento de candidíase, tem sido observada em pacientes imunocomprometidos. Tipagem molecular como o RAPD-PCR tem sido utilizada para discriminação entre isolados de Candida spp suscetíveis e resistentes aos antifúngicos. Neste trabalho foram avaliados fatores de virulência e características moleculares de leveduras do gênero Candida isoladas de amostras do sangue, de cateter de pacientes nosocomiais e da cavidade bucal de pacientes HIV positivos. Os isolados utilizados foram identificados como: Candida albicans (59) Candida parapsilosis (22), Candida tropicalis (14) Candida guilliermondii (07), Candida famata (05), Candida krusei (03), Candida lusitaniae (01) e Candida kefyr (01). Estas leveduras foram avaliadas quanto à atividade de proteinase, fosfolipase e à sua capacidade de aderência. A ação do fluconazol e itraconazol sobre a formação hifal, foi avaliada em 5 isolados previamente classificados como suscetíveis e resistentes ao fluconazol e ao itraconazol. A caracterização genotípica de 13 isolados de C albicans resistentes e suscetíveis ao fluconazol foi realizada por meio de RAPD-PCR. Os resultados mostraram que a atividade de proteinase foi detectada em 88,1% de isolados de C. albicans e em 69,8% de Candida não albicans, enquanto que a fosfolipase foi detectada em 55,9% de isolados de C. albicans e em 37,7% de Candida não albicans. Isolados do sangue foram mais proteolíticos do que os do cateter e os da cavidade bucal, enquanto para a fosfolipase foi observado maior produção desta enzima em isolados da cavidade bucal. A capacidade de aderência à célula epitelial foi maior em C. albicans que Candida não albicans, no entanto não houve diferença de comportamento entre isolados obtidos dos diferentes locais estudados. A formação de hifas foi maior nos isolados resistentes do que nos isolados suscetíveis quando sob a ação de qualquer um dos dois fármacos. Na análise do RAPD-PCR foi verificada a formação de dois grupos distintos para os isolados suscetíveis e resistentes ao fluconazol, sendo que apenas um isolado resistente foi agrupado com os suscetíveis. Neste trabalho, foi verificado que a atividade de exoenzimas e a habilidade de aderência dependem além da espécie de Candida como também do local onde foi isolada no hospedeiro, que isolados resistentes formaram mais hifas do que os suscetíveis sob a ação de antifúngico e que as características moleculares dos isolados resistentes em mais de um padrão fingerprinting não permitiram predizer a sua suscetibilidade ao fluconazol

Made available in DSpace on 2014-12-17T14:16:31Z (GMT). No. of bitstreams: 1 MarianaAPM_DISSERT.pdf: 2606420 bytes, checksum: 97be52d447dc533f85354f32faddd0ad (MD5) Previous issue date: 2013-03-27 / Funda??o de Apoio ? Pesquisa do Estado do Rio Grande do Norte / Vulvovaginal candidiasis (VVC) is one of the most common causes of vaginitis and affects about 75% of women of reproductive age. The majority of cases (80 to 90%) are due to C. albicans, the most virulent species of the genus Candida. Virulence attributes are scarcely investigated and the source of infection remains uncertain. Objective: This study aimed to evaluate the virulence factors and genotypes of clinical isolates of C. albicans sequentially obtained from the anus and vagina of patients with sporadic and recurrent VVC. Materials and methods: We analyzed 62 clinical isolates of C. albicans (36 vaginal and 26 anal strains). Direct examination of vaginal and anal samples and colony forming units (CFU) counts were performed. Yeasts were identified using the chromogenic media CHROMagar Candida? and by classical methodology, and phenotypically characterized regarding to virulence factors, including the ability to adhere to epithelial cells, proteinase activity, morphogenesis and biofilm formation. The genotypes of the strains were investigated with ABC genotyping, microsatellite genotyping with primer M13 and RAPD. Results: We found 100% agreement between direct examination and culture of vaginal samples. Filamentous forms were present in most of the samples of vaginal secretion, which presented CFU counts significantly higher than the samples of anal secretion. There was no statistically significant difference between virulence factors of infecting vaginal isolates and those presented by colonizing anal isolates; as well as for the comparison of the vaginal isolates from patients with different clinical conditions (sporadic or recurrent VVC). There was a decrease in the ability to adhere to HBEC, morphogenesis and biofilm formation of the vaginal isolates during the progress of infection. There was an association between the ability to express different virulence factors and the clinical manifestations presented by the patients. Genotype A was the most prevalent (93.6%), followed by genotype C (6.4%). We found maintenance of the same ABC genotype and greater prevalence of microevolution for the vaginal strains of C. albicans sequentially obtained. Vaginal and anal isolates of C. albicans obtained simultaneously from the same patient presented the same ABC genotype and high genetic relatedness. Conclusion: It is noteworthy that the proliferation of yeast and bud-to-hypha transition are important for the establishment of CVV. The expression of virulence factors is important for the pathogenesis of VVC, although it does not seem to be determinant in the transition from colonization to infection or to the installation of recurrent condition. Genotype A seems to be dominant over the others in both vaginal and anal isolates of patients with VVC. The most common scenario was microevolution of the strains of C. albicans in the vaginal environment. It is suggested that the anal reservoir constituted a possible source of vaginal infection, in most cases assessed / Candid?ase vulvovaginal (CVV) ? uma das causas mais comuns de vaginite e acomete cerca de 75% das mulheres em idade reprodutiva, sendo a maioria dos casos (80 a 90%) devido ? C. albicans, esp?cie mais virulenta do g?nero. Atributos de virul?ncia em CVV s?o pouco investigados, bem como a fonte da infec??o permanece incerta. Objetivo: Este trabalho teve por finalidade avaliar os fatores de virul?ncia e gen?tipos de isolados cl?nicos de C. albicans sequencialmente obtidos do ?nus e da vagina de pacientes com CVV espor?dica e recorrente. Material e m?todos: Foram analisados 62 isolados cl?nicos de C. albicans (36 isolados vaginais e 26 isolados anais). Realizou-se o exame direto das amostras de secre??o vaginal e anal e contagem de unidades formadoras de col?nia (UFC); as leveduras foram identificadas por meio cromog?nico CHROMagar Candida? e por metodologia cl?ssica e caracterizadas fenotipicamente quanto a fatores de virul?ncia, incluindo a capacidade de ader?ncia a CEBH, a atividade de proteinase, a morfog?nese e a forma??o de biofilme. Para a avalia??o da variabilidade genot?pica, empregou-se a t?cnica de genotipagem ABC, al?m da genotipagem por microssat?lites e RAPD. Resultados: Verificou-se 100% de concord?ncia entre o exame direto e a cultura de amostras vaginais, observando-se a presen?a de formas filamentosas na maioria das amostras de secre??o vaginal, as quais apresentaram contagem de UFC significativamente superior ?quela apresentada pelas amostras de secre??o anal. N?o se observou diferen?a estatisticamente significativa quando se comparou os fatores de virul?ncia dos isolados vaginais infectantes com aqueles apresentados pelos isolados anais colonizantes; bem como comparando-se os isolados vaginais de C. albicans obtidos de grupos de pacientes com diferentes condi??es cl?nicas (CVV espor?dica e com CVVR). Observa-se uma tend?ncia ? diminui??o da capacidade de ader?ncia, morfog?nese e forma??o de biofilme do isolado vaginal infectante ao longo do tempo e sugere-se associa??o entre a capacidade de expressar os diferentes fatores de virul?ncia estudados e as manifesta??es cl?nicas apresentadas pelas pacientes. O gen?tipo A foi o mais prevalente (93,6%), seguido do gen?tipo C (6,4%). Houve manuten??o do mesmo gen?tipo ABC e maior preval?ncia de microevolu??o das cepas vaginais de C. albicans obtidas sequencialmente, bem como se observou o mesmo gen?tipo ABC e alta similaridade gen?tica entre isolados vaginais e anais de C. albicans obtidos simultaneamente da mesma paciente. Conclus?o: Ressalta-se que a prolifera??o da levedura e a transi??o levedura-hifa s?o importantes no estabelecimento da CVV. A express?o dos fatores de virul?ncia ? importante na patog?nese de CVV, contudo n?o parece ser determinante na transi??o de coloniza??o para infec??o nem na instala??o de quadro recorrente de CVV. O gen?tipo A demonstra ser dominante em rela??o aos demais tanto em isolados vaginais quanto em isolados anais de pacientes com CVV. Verifica-se a ocorr?ncia de microevolu??o das cepas de C. albicans no ambiente vaginal como cen?rio mais comum. Sugere-se que o reservat?rio anal constituiu uma poss?vel fonte da infec??o vaginal, na grande maioria dos casos avaliados

Candida albicans, a commensal of gastrointestinal and uro-vaginal tract can cause superficial as well as life threatening disseminated infections under conditions of lowered immunity of the host such as HIV infection, drug induced immune suppression [given during organ transplantation to prevent rejection] and radiation therapy [head and neck cancer patients] (Odds, 1988; Fidel and Sobel, 1996). Candida albicans shows a range of morphologies, it can switch from budding yeast morphology to pseudohyphae (chains of elongated cells with visible constrictions at the sites of septa) and hyphae (linear filaments without visible constrictions at the septa) (Mitchell, 1998). The various factors that contribute to its virulence include its ability to undergo yeast to hyphal transition, formation of biofilms, adhesion and secretion of aspartyl proteinases. Hyphae are considered to be involved in invasive growth as they are frequently identified in infected tissues and strains defective in morphological transition (yeast to hyphal) are avirulent (Leberer et al., 1996; Lo et al., 1997; Stoldt et al., 1997). Morphological switching is not only necessary for successful establishment of infection but important for evading components host defense system like macrophages or dendritic cells. A network of signaling pathways that operate in C. albicans continuously assess the nutrient availability, cell density and other environmental conditions. The integrated output of these pathways determine the response of C. albicans under given set of environmental/media conditions and eventually determines the gene expression and morphogenic transition (Liu., 2001). C. albicans utilizes at least two major signaling pathways besides others for regulating the morphological transition. One of these two pathways uses Cph1 as transcription factor and is the homolog of Ste12 in S. cerevisiae which is shown to be involved in Pseudohyphal growth and mating. The other pathway includes Efg1 (homolog of Phd1 in S. cerevisiae) as transcription factor. Biofilm formation by Candida species is an important virulence factor and has gained considerable interest recently as these specialized survival structures are found in implanted devices such as indwelling catheters and prosthetic heart valves (Hawser and Douglas, 1994; Douglas, 2003). These biofilms lead to the failure of implants besides providing multiple drug resistance (Baillie and Douglas, 1999). A better understanding of the C. albicans interaction with the host at the site of infection and with the components of immune system will help in identifying new potential drug targets. (a) Genome wide expression profile of Candida albicans from patient samples and characterization of CaRPB4/7: To get a better insight in C. albicans response at the site of infection we were interested in mapping the expression profile of Candida albicans in active state of human infections. Patients suffering from head and neck cancer undergoing radiation therapy have high risk of C. albicans infection. We identified five such patients with heavy oral thrush infections and C. albicans samples were collected from them. Candida albicans was confirmed in these samples by various microbiological tests following which the samples were used for RNA isolation. The whole genome expression analysis leads to the identification of 188 up regulated and 88 down regulated genes in patient samples. Our data analysis revealed that Protein Kinase A pathway and many downstream genes of the same were differentially expressed. Analysis of saliva (saliva is known for antifungal and antibacterial activity) from these patients showed that unlike healthy individuals, the patient saliva favours yeast to hyphal transition of C. albicans cells. This might be a reason for high risk of infection. A major class of upregulated genes is found to be functionally involved in transcription which includes some RNA polymeraseII and III subunits. CaRPB4, the forth largest subunit of RNA polymeraseII, was found to be upregulated in patient samples. RPB4 has been shown to form sub complex with RPB7, the seventh largest subunit of RNA polymeraseII, and both subunits are known to play a role in a variety of stress conditions and pseudohyphal development in Saccharomyces cerevisiae. We characterized the CaRPB4 and CaRPB7 (homolog in Candida albicans) for their ability to complement their S. cerevisiae counterparts. CaRPB4 and CaRPB7 were able to complement majority of the phenotypes associated with these subunits in S. cerevisiae. Overexpression of CaRPB7 in S. cerevisiae enhances pseudohyphal growth. Considering the high degree of conservation of signaling pathways between S. cerevisiae and C. albicans it can be speculated that CaRPB7 might be involved in pseudohyphal development in C. albicans. We found that over expression of CaRPB4 in Candida albicans shows enhanced agar invasive growth which can be thought analogous to tissue invasion in host and hence might contribute for establishment of infection. This suggests that both the RNA polII subunits have a role to play in the virulence of C. albicans. (b) Characterization of UDP-Galactose 4-Epimerase (GAL10) from Candida albicans and their role in virulence. Enzyme UDP-Galactose-4-Epimerase [GAL10] is responsible for conversion of UDP-galactose to UDP-glucose which then gets metabolized by the cells through glycolysis and TCA cycle. The enzyme catalyzes a reversible reaction and can convert glucose to galactose in the absence of galactose as shown in Trypanosoma brucei and also involved in its virulence. In this study, we have identified the functional homolog of GAL10 in Candida albicans. S. cerevisiae and C. albicans GAL10 homologs are similar in their domainal organization as the proteins have a mutarotase and an epimerase domain. The former is responsible for conversion of ﾟ-D-galactose to a-D-galactose and the latter for epimerization of UDP-galactose to UDP-glucose. The synteny of galactose metabolizing structural genes is conserved among some fungi. To study the importance of CaGAL10 we generated deletion mutant of the gene in C. albicans. Our studies show that CaGAL10 [C. albicans GAL10] is involved in cell wall organization and in oxidative stress response. The mutant strain of GAL10 is hyperfilamentous in Lee’s and spider medium and the biofilm formed is morphologically different from the wild type strain. These set of results suggests that CaGAL10 plays an important role in organization/integrity of cell wall in C. albicans and speculate that it might be involved in virulence. (c) Study of Candida albicans-macrophage interaction and identification of transcriptional regulator of genes encoding proteins of translation machinery: Macrophages serve as the effector cells of cell mediated immunity in the control of infections. They are considered to be important for resistance to muco-cutaneous and systemic candidiasis. Our studies were aimed at understanding the response of Candida albicans cells to the presence of macrophages for extended period of time. The response was monitored using microarrays. Specifically genes involved in galactose, protein and lipid metabolism and stress response undergo concerted changes in their transcript levels. We analyzed the promoters of coregulated genes to identify common DNA elements present in them which might be involved in their transcriptional regulation. Promoter analysis of differentially expressed genes revealed presence of CPH1 and EFG1 transcription factor binding sites. Besides identifying CPH1 and EFG1 Binding sites, we identified two novel DNA elements in promoters of coregulated gene. A conserved motif TGAAAAGGAAG was identified in the promoters of genes involved in energy generation. Another 18 mer consensus palindromic sequence TAGGGCTNTAGCCCTAAT was identified in the promoters of about 48 genes. Majority of these genes encode ribosomal proteins. With the help of techniques like EMSA (Electophoretic Mobility Shift Assay) and south-western we had shown the presence of a protein of ~66 KDa molecular weight binding to the sequence with high specificity.