FUNGAL AGENTS CAUSING INFECTION OF THE LUNG · 2017-10-21 · Aspergillus fumigatus Aspergillus flavus
Top 3 Basic Science Papers on Aspergillus fumigatus 2011Top 3 Basic Science Papers. on Aspergillus...
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2 1. Top 3 Basic Science Papers
on Aspergillus fumigatus 2011
Nir Osherov, Tel-Aviv University, Israel
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Let’s start with a quiz…
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Q1: Which pathogenic fungus has the most scientific papers?
Aspergillus Dermatophytes Candida
Cryptococcus 46,468 32,101
8,648 3,031
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Q2: Is the number of Aspergillus papers increasing?
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1980 1985 1990 1995 2000 2005 2010
313
1742
McNeil MM et al CID 2001
Aspergillosis
400% increase!
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Q3: Basic research or bedside? Who has more A. fumigatus papers?
Bedside (Epidemiology, treatment, clinical resistance etc)
Basic Research
63% of papers 2011 37% of papers 2011
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Q4: How many Aspergillus papers made it to Nature, Science or Cell?
(last 20 years)
2008
2008
1999
2009
2009
2005
2000
1991
1990
9? 19? 29?
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How did I select the three top papers?
1. Pubmed: Aspergillus fumigatus and 2011
2. Sort basic science papers into 4 categories
Choose 3 papers
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Each of the three papers I have chosen was built on the shoulders of many crucial others
Therefore each paper will be represented as part of a larger story
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Disclaimer of Opinion This lecture contains several possibly controversial opinions that you may find offensive. If you are offended by anything in this lecture, please leave a message and I will gladly elaborate. If you feel the need to trash this lecture, at least make it funny. Thank you! [email protected]
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Story 1: What stresses does A. fumigatus encounter in the infected lung?
Can we use this knowledge to improve treatment?
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What conditions does A. fumigatus encounter during lung infection?
I am hungry and unhappy in these lungs! I want to go back to live on dead leaves
in the garden !!!
McDonagh, Elaine Bignell. Plos Path. 4(9), Sept. 2008
Iron uptake genes
Proteases
Toxin biosynthesis
Alkaline response
Nitrogen starvation
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t During infection, A. fumigatus scavenges iron by secreting siderophores
Low affinity uptake
Reductive iron uptake
FtrA
Fe+3
Transferrin-Fe
Schrettl and Haas Curr. Op. Microbiol. 14:400 2011
TAFC
Sit1
ΔSidA= no TAFC= avirulent
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Can we use this knowledge to diagnose Aspergillosis?
Paper #1
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Fe 68Ga
TAFC siderophore
A. fumigatus
The experiment and rationale:
Sit1
Petrik ey al. J. Nucl. Med. 51:639 2010
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The results:
Active 68 Ga-TAFC uptake into AF in vitro
Lung
Rapid uptake into AF infected lungs (PET)
Signal correlates to severity of AF infection
Infection: Severe Mild Negative
Lung
Conclusions: -Sensitive - Low non-specific binding -68Ga easily available -Short half life -68Ga in clinical use -Selective (?)
Petrik ey al. J. Nucl. Med. 51:639 2010
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Th1 response h
IL2, 12, IFN-γ
Story 2: What are the body’s main lines of defense against A. fumigatus?
CMI
Macrophage Neutrophil
Fungus β-glucan Dectin 1 receptor
Introducing:The NK cell, an added line of defence in IA
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What are NK (natural killer) cells?
Viruses Bacteria Parasites
MO DC
NK cell Lymphocyte lineage
IL-12
NK depletion leads to decreased IFN-γ and decreased survival of mice in IPA model
Mehrad group: Morrison et al. J. Clin Invest. 112:1862 2003; Park et al. J. Imm. 182:4306 2009
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Paper #2
HKI, Jena, Germany
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Hyphae
Swollen conidia
Dormant conidia IL-2 stimulated Human NK cells (No APCs!)
Perforins
Schmidt et al. J. Inf. Dis. 203:430 2010
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Hyphae
Swollen conidia
Dormant conidia
IFN-γ
IL-2 stimulated Human NK cells (No APCs!)
How does IFN-γ Kill AF?
Conclusions: -NK cells kill growing AF - Important defence during infection -Possible NK immunotherapy?
Bouzani et al J. Immunol. 187:1369 2011
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Story 3: Are any completely new classes of antifungals being developed?
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•Antifungals: Growing needs, few choices
•$5 billion/year world market • Amphotericin B, Azoles, Candins •Pharma research down •Basic Research up
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Plasma membrane
Cell Wall
Glucan, chitin
Cell wall proteins
Goal: Inhibit CWP cross-linking to the cell wall
Can we develop new classes of antifungals targeting the cell wall?
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Plasma membrane
ER
Cell Wall
Novel inhibitors that block incorporation of cell wall proteins into the fungal cell wall
Kapei Tsukahara Mol Micro 48:1029 2003 Umemura JBC 278:23639 2003 Eisai Co. Japan
BIQ MIC-3 μg/ml
Inositol acylation (Gwp1)
E1210 MIC-0.1 μg/ml
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Paper #3 24.
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E1210 summary
Mode of action (candida)
Inhibits inositol acylation by Gwt1p in vitro Does not inhibit the human homolog Pig-W Gwt1p overexpression/mutation confers resistance Reduces levels of Als1p a cell wall adhesin
Reduces: Switch Biofilm Adhesion
Watanabe et al., AAC in press
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E1210 summary
In vitro
MIC ~ 10 ng/ml Azole R
Fungistatic Low toxicity (mammalian cells)
Orally available Non toxic (10X/1 week) T1/2 = 2.2 h
In vivo
IPA
mg/kg
25
10 4
Hata et al., AAC 55:4543 2011
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Conclusion: Panning for novel antifungals is now attainable at the RESEARCH Lab level
Robot
screen
Gold is hard! Maybe I
should try finding
antifungals
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Thank you for your attention!