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Mechanisms Underlying the Exquisite Sensitivity of Candida albicans to Combinatorial Cationic and Oxidative Stress That Enhances the Potent Fungicidal Activity of Phagocytes

Lookup NU author(s): Dr Miranda Patterson, Professor Janet Quinn



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Immune cells exploit reactive oxygen species (ROS) and cationic fluxes to kill microbial pathogens, such as the fungus Candida albicans. Yet, C. albicans is resistant to these stresses in vitro. Therefore, what accounts for the potent antifungal activity of neutrophils? We show that simultaneous exposure to oxidative and cationic stresses is much more potent than the individual stresses themselves and that this combinatorial stress kills C. albicans synergistically in vitro. We also show that the high fungicidal activity of human neutrophils is dependent on the combinatorial effects of the oxidative burst and cationic fluxes, as their pharmacological attenuation with apocynin or glibenclamide reduced phagocytic potency to a similar extent. The mechanistic basis for the extreme potency of combinatorial cationic plus oxidative stress-a phenomenon we term stress pathway interference- lies with the inhibition of hydrogen peroxide detoxification by the cations. In C. albicans this causes the intracellular accumulation of ROS, the inhibition of Cap1 (a transcriptional activator that normally drives the transcriptional response to oxidative stress), and altered readouts of the stress-activated protein kinase Hog1. This leads to a loss of oxidative and cationic stress transcriptional outputs, a precipitous collapse in stress adaptation, and cell death. This stress pathway interference can be suppressed by ectopic catalase (Cat1) expression, which inhibits the intracellular accumulation of ROS and the synergistic killing of C. albicans cells by combinatorial cationic plus oxidative stress. Stress pathway interference represents a powerful fungicidal mechanism employed by the host that suggests novel approaches to potentiate antifungal therapy.IMPORTANCE The immune system combats infection via phagocytic cells that recognize and kill pathogenic microbes. Human neutrophils combat Candida infections by killing this fungus with a potent mix of chemicals that includes reactive oxygen species (ROS) and cations. Yet, Candida albicans is relatively resistant to these stresses in vitro. We show that it is the combination of oxidative plus cationic stresses that kills yeasts so effectively, and we define the molecular mechanisms that underlie this potency. Cations inhibit catalase. This leads to the accumulation of intracellular ROS and inhibits the transcription factor Cap1, which is critical for the oxidative stress response in C. albicans. This triggers a dramatic collapse in fungal stress adaptation and cell death. Blocking either the oxidative burst or cationic fluxes in human neutrophils significantly reduces their ability to kill this fungal pathogen, indicating that combinatorial stress is pivotal to immune surveillance.

Publication metadata

Author(s): Kaloriti D, Jacobsen M, Yin ZK, Patterson M, Tillmann A, Smith DA, Cook E, You T, Grimm MJ, Bohovych I, Grebogi C, Segal BH, Gow NAR, Haynes K, Quinn J, Brown AJP

Publication type: Article

Publication status: Published

Journal: MBIO

Year: 2014

Volume: 5

Issue: 4

Print publication date: 15/07/2014

Online publication date: 15/07/2014

Acceptance date: 18/06/2014

Date deposited: 23/10/2014

ISSN (electronic): 2150-7511

Publisher: American Society for Microbiology


DOI: 10.1128/mBio.01334-14


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Funder referenceFunder name
086048Wellcome Trust
089930Wellcome Trust
080088Wellcome Trust
097377Wellcome Trust
CA016056NCI Cancer Center
ERC-2009-AdG-249793European Commission
PITN-GA-2008-214004European Commission