Lipid-mediated fungal pathogenesis

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ABSTRACT The long-term goal of this proposal is to study mechanism(s) of pathogenicity of Cryptococcus neoformans (Cn) focusing on how Cn glycolipids regulate fungal virulence and the host immune response. Cn is a fungal pathogen that, upon entering the lung and disseminating through the bloodstream, causes a life- threatening meningo-encephalitis in susceptible patients, leading to high morbidity and mortality. Current therapies for this disease can have intolerable and dose-limiting side effects.1 Thus, new treatment strategies are warranted to better control the high mortality associated with cryptococcosis. Although vaccines have been hailed as one of the greatest achievements in public health during the past century, the development of safe and efficacious vaccines against cryptococcosis, and fungal infections in general, has been a major hurdle mainly due to the lack of knowledge about the mechanisms that underpin protective immunity. Additionally, fungal vaccines need to be effective also in conditions of immunodeficiency, such as CD4+ T cell lymphopenia in AIDS patients, because immunodeficient patients are the most susceptible to cryptococcosis and other invasive fungal infections. In previous studies, we deleted the sterol-glucosidase 1 (Sgl1) gene and the resulting mutant (Dsgl1) is highly enriched in sterol glucosides (SGs), which are otherwise not detectable in wild-type (WT) Cn cells.2 SGs are glycolipids present in a variety of fungi and other microorganisms and are prone to stimulate host immunity.3-5 During the previous funding cycle, we showed that Cn Dsgl1 mutant is not pathogenic in a mouse model and, upon intranasal administration, the mutant cells are rapidly eliminated in the lung environment.2 Very interestingly, mice receiving Cn Dsgl1 mutant are now protected when challenged with virulent Cn WT and this protection is achieved even when mice are CD4+ or CD8+ T cell depleted, mimicking the HIV+ host (Fig.12 and2). We validated the role of Sgl1 in second fungal pathogen, Aspergillus fumigatus (Af). The Af DsglA is also not virulent (Fig. 9) and able to protect against a secondary Af WT infection (Fig. 11). Importantly, we initiated a high throughput screening and found small molecules that inhibit Sgl1 or SglA activity in vitro, accumulates SGs in fungal cells (Fig. 6), exert in vitro antifungal activity against Cn and Af in minimum media with low glucose concentrations (Figs. 2 and 3), and block the dissemination of Cn to the brain (Fig. 5), mimicking the phenotypes observed with the respective Dsgl1 or DsglA mutants. In addition, a key characteristic of Cn is its polysaccharide capsule, mainly made of glucuronic acid, xylose and mannose (GXM). Very interestingly, we found that deletion of GXM totally abrogates the protective phenotype of Cn Dsgl1.6 In fact, the administration of the Cn Dcap59/Dsgl1 double mutant does not protect against a secondary infection (Fig. 8). Based on these observations, we hypothesize that Cn Sgl1 is a major regulator of fungal virulence by modulating the level of SGs, which, through GXM, stimulate the host immune response against cryptococcosis (Fig. 1). To test this hypothesis, we propose the following aims: Aim 1. To determine the role of Cn Sgl1 and Af SglA on fungal virulence. Aim 2. To study the host immune response against Cn accumulating SGs. This proposal will provide novel insights on the role and mechanisms by which fungal SGs regulate the pathobiology in Cn. Importantly, these studies will also potentially lead to the development of novel antifungal strategies to prevent and/or treat invasive fungal infections, such as cryptococcosis and aspergillosis, in immunocompromised hosts.