Fluconazole alters the polysaccharide capsule of Cryptococcus gattii and leads to distinct behaviors in murine Cryptococcosis

PLoS One. 2014 Nov 13;9(11):e112669. doi: 10.1371/journal.pone.0112669. eCollection 2014.

Abstract

Cryptococcus gattii is an emergent human pathogen. Fluconazole is commonly used for treatment of cryptococcosis, but the emergence of less susceptible strains to this azole is a global problem and also the data regarding fluconazole-resistant cryptococcosis are scarce. We evaluate the influence of fluconazole on murine cryptococcosis and whether this azole alters the polysaccharide (PS) from cryptococcal cells. L27/01 strain of C. gattii was cultivated in high fluconazole concentrations and developed decreased drug susceptibility. This phenotype was named L27/01F, that was less virulent than L27/01 in mice. The physical, structural and electrophoretic properties of the PS capsule of L27/01F were altered by fluconazole. L27/01F presented lower antiphagocytic properties and reduced survival inside macrophages. The L27/01F did not affect the central nervous system, while the effect in brain caused by L27/01 strain began after only 12 hours. Mice infected with L27/01F presented lower production of the pro-inflammatory cytokines, with increased cellular recruitment in the lungs and severe pulmonary disease. The behavioral alterations were affected by L27/01, but no effects were detected after infection with L27/01F. Our results suggest that stress to fluconazole alters the capsule of C. gattii and influences the clinical manifestations of cryptococcosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antifungal Agents / pharmacology*
  • Cryptococcosis / drug therapy*
  • Cryptococcosis / microbiology
  • Cryptococcosis / mortality
  • Cryptococcosis / pathology
  • Cryptococcus gattii / chemistry
  • Cryptococcus gattii / drug effects*
  • Cryptococcus gattii / pathogenicity
  • Drug Resistance, Fungal / drug effects
  • Fluconazole / pharmacology*
  • Fungal Capsules / chemistry
  • Fungal Capsules / drug effects*
  • Fungal Polysaccharides / chemistry*
  • Humans
  • Macrophages / drug effects
  • Macrophages / microbiology
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Microbial Viability
  • Phenotype
  • Severity of Illness Index
  • Survival Analysis

Substances

  • Antifungal Agents
  • Fungal Polysaccharides
  • Fluconazole

Grants and funding

This study was supported by Fundação de Amparo a Pesquisa do Estado de Minas Gerais (FAPEMIG), Conselho Nacional de Pesquisa (CNPq) and Pró-Reitoria de Pesquisa da Universidade Federal de Minas Gerais (UFMG). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.