Csaba Vágvölgyi

Filamentous fungal infections of the cornea: a global overview of epidemiology and drug sensitivity.

Fungal keratitis is a serious suppurative, usually ulcerative corneal infection which may result in blindness or reduced vision. Epidemiological studies indicate that the occurrence of fungal keratitis is higher in warm, humid regions with agricultural economy. The most frequent filamentous fungal genera among the causal agents are Fusarium, Aspergillus and Curvularia. A more successful therapy of fungal keratitis relies on precise identification of the pathogen to the species level using molecular tools. As the sequence analysis of the internal transcribed spacer (ITS) region of the ribosomal RNA gene cluster (rDNA) is not discriminative enough to reveal a species‐level diagnosis for several filamentous fungal species highly relevant in keratitis infections, analysis of other loci is also required for an exact diagnosis. Molecular identifications may also reveal the involvement of fungal species which were not previously reported from corneal infections. The routinely applied chemotherapy of fungal keratitis is based on the topical and systemic administration of polyenes and azole compounds. Antifungal susceptibility testing of the causal agents is of special importance due to the emergence and spread of resistance. Testing the applicability of further available antifungals and screening for new, potential compounds for the therapy of fungal keratitis are of highlighted interest.

Antifungal Susceptibility and Phylogeny of Opportunistic Members of the Genus Fusarium Causing Human Keratomycosis in South India

Fusarium species are reported frequently as the most common causative agents of fungal keratitis in tropical countries such as India. Sixty-five fusaria isolated from patients were subjected to multilocus DNA sequencing to characterize the spectrum of the species associated with keratitis infections in India. Susceptibilities of these fusaria to ten antifungals were determined in vitro by the broth microdilution method. An impressive phylogenetic diversity of fusaria was reflected in susceptibilities differing at species level. Typing results revealed that the isolates were distributed among species in the species complexes (SCs) of F. solani (FSSC; n = 54), F. oxysporum (FOSC; n = 1), F. fujikuroi (FFSC; n = 3), and F. dimerum (FDSC; n = 7). Amphotericin B, voriconazole, and clotrimazole proved to be the most effective drugs, followed by econazole.

In vitro antifungal activity of antipsychotic drugs and their combinations with conventional antifungals against Scedosporium and Pseudallescheria isolates.

In the present study, in vitro antifungal activities of five antipsychotic drugs (i.e., chlorpromazine hydrochloride, CPZ; trifluoperazine hydrochloride, TPZ; amantadine hydrochloride; R-(-)-deprenyl hydrochloride, and valproic acid sodium salt) and five conventional antifungal drugs (i.e., amphotericin B, AMB; caspofungin, CSP; itraconazole; terbinafine, TRB and voriconazole, VRC) were investigated in broth microdilution tests against four clinical and five environmental Scedosporium and Pseudallescheria isolates. When used alone, phenothiazines CPZ and TPZ exerted remarkable antifungal effects. Thus, their in vitro combinations with AMB, CSP, VRC, and TRB were also examined against the clinical isolates. In combination with antifungal agents, CPZ was able to act synergistically with AMB and TRB in cases of one and two isolates, respectively. In all other cases, indifferent interactions were revealed. Antagonism was not observed between the tested agents. These combinations may establish a more effective and less toxic therapy after further in vitro and in vivo studies for Scedosporium and Pseudallescheria infections.

Antifungal Effect of Essential Oils against Fusarium Keratitis Isolates

The present study was carried out to investigate the antifungal effects of Cinnamomum zeylanicum, Citrus limon, Juniperus communis, Eucalyptus citriodora, Gaultheria procumbens, Melaleuca alternifolia, Origanum majorana, Salvia sclarea, and Thymus vulgaris essential oils against Fusarium species, the most common etiologic agents of filamentous fungal keratitis in South India. C. zeylanicum essential oil showed strong anti-Fusarium activity, whereas all the other tested essential oils proved to be less effective. The main component of C. zeylanicum essential oil, trans-cinnamaldehyde, was also tested and showed a similar effect as the oil. The in vitro interaction between trans-cinnamaldehyde and natamycin, the first-line therapeutic agent of Fusarium keratitis, was also investigated; an enhanced fungal growth inhibition was observed when these agents were applied in combination. Light and fluorescent microscopic observations revealed that C. zeylanicum essential oil/trans-cinnamaldehyde reduces the cellular metabolism and inhibits the conidia germination. Furthermore, necrotic events were significantly more frequent in the presence of these two compounds. According to our results, C. zeylanicum essential oil/trans-cinnamaldehyde provides a promising basis to develop a novel strategy for the treatment of Fusarium keratitis.

Ion trap mass spectrometry of surfactins produced by Bacillus subtilis SZMC 6179J reveals novel fragmentation features of cyclic lipopeptides.

RATIONALE Surfactins are mixtures of cyclic lipopeptides consisting of variants of a heptapeptide and a linked β-hydroxy fatty acid with various chain lengths of 13-15 carbon atoms. A lactone bridge between the β-hydroxy functional group of the fatty acid and the carboxy terminal functional component of the peptide chain form their cyclic structures. Such lipopeptides, produced mainly by Bacillus species, possess several remarkable biological effects such as antitumor and antimicrobial activities, some of which are highly promising for utilization in plant disease biocontrol. The strain Bacillus subtilis SZMC 6179J was previously shown to exert significant antifungal properties against various phytopathogenic filamentous fungi; therefore, we characterized the structural features of the surfactins produced by this strain in order to explore the origin of the observed antagonistic effects of this potential biocontrol organism. METHODS Bacillus subtilis SZMC 6179J was used to produce surfactins, which were characterized by high-performance liquid chromatography/electrospray ionisation ion trap mass spectrometry (HPLC/ESI-ITMS) techniques after precipitation and extraction steps. RESULTS The 26 isoforms separated and identified represent three types of known surfactin variants and a fourth, previously unknown group characterised by the replacement of the leucine residue by valine in position 2. The relative amounts of this newly identified surfactin group were below 1%, and their cyclic structures were closed by C13-C15 hydroxy fatty acids. The structural assessment of the isoforms by MS(2) measurements led to the characterisation and description of a new fragmentation mechanism of surfactins. CONCLUSIONS The detected new natural lipoheptapeptide compounds with modified structures have significant potential for biotechnological and biocontrol applications. The complementary ITMS(2) data as well as the described internal fragmentation mechanism obtained from the sodiated surfactin molecules may further facilitate the structural elucidation of cyclic lipopeptides in the future. Copyright

In vitro susceptibility of Scedosporium isolates to N-acetyl-L-cysteine alone and in combination with conventional antifungal agents

In recent years, Scedosporium species have been more commonly recognized from severe, difficult-to-treat human infections, such as upper respiratory tract and pulmonary infections. To select an appropriate therapeutic approach for these infections is challenging, because of the commonly observed resistance of the causative agents to several antifungal drugs. Therefore, to find a novel strategy for the treatment of pulmonary Scedosporium infections the in vitro antifungal effect of a mucolytic agent, N-acetyl-L-cysteine and its in vitro combinations with conventional antifungals were investigated. Synergistic and indifferent interactions were registered in 23 and 13 cases, respectively. Antagonism was not revealed between the compounds.

In Vitro Antifungal Activity of Cysteine Derivatives and their Combinations with Antifungal Agents Against Clinically Relevant Scedosporium species

Background: Members of the genus Scedosporium are emerging human pathogens, causing a wide range of infections. Their treatment means a challenge for clinicians, mostly because of the low susceptibility of these causative agents to conventional antifungal drugs. New alternative therapeutic approaches are required for better clinical outcomes. Cysteine and its derivatives alone or in combinations with antifungal drugs might have improved antifungal effects against Scedosporium species. Methods: The in vitro antifungal effects of two cysteine forms and three of their derivatives (i.e., D-cysteine, L-cysteine, L-cysteine-methyl ester hydrochloride, N-isobutyryl-D-cysteine, and N-isobutyryl-L-cysteine) were determined using the CLSI M38-A2 broth microdilution method. The in vitro drug interactions between the most effective cysteine derivatives and some conventional antifungal drugs were also investigated using checkerboard assays in case of four clinical isolates. Results: L-cysteine-methyl ester hydrochloride proved to be the most effective among the investigated compounds. N-isobutyryl-L-cysteine exhibited antifungal activity against one Scedosporium aurantiacum strain only. D-cysteine, L-cysteine and N-isobutyryl-D-cysteine proved to be ineffective against Scedosporium spp. in the investigated concentration range. No significant differences were found in the susceptibilities between environmental and clinical isolates. L-cysteine-methyl ester hydrochloride could interact synergistically with amphotericin B, caspofungin, terbinafine and voriconazole. Antagonistic interactions were not observed between the investigated compounds. Conclusions: The present study provides an evidence for the in vitro antifungal activity of L-cysteinemethyl ester hydrochloride and the synergistic interactions between this cysteine derivative and conventional antifungal agents. Based on our results, L-cysteine-methyl ester hydrochloride in combination with antifungal drugs could be applicable in the treatment of human Scedosporium infections in the future. However, further studies are required to clarify the antifungal mechanism of L-cysteine-methyl ester hydrochloride and to investigate its activity in vivo.

Molecular identification and antifungal susceptibility of Curvularia australiensis, C. hawaiiensis and C. spicifera isolated from human eye infections

A reliable identification method was developed for three closely related Curvularia species, which are frequently isolated from human keratomycoses. Since the traditionally used morphological method and the increasingly used internal transcribed spacer (ITS)‐based molecular method proved to be insufficient to discern C. australiensis, C. hawaiiensis and C. spicifera, other molecular targets, such as β‐tubulin, translation elongation factor 1‐α and the nuclear ribosomal intergenic spacer (IGS), were tested. Among them, the use of the highly divergent IGS sequence is suggested and the species‐specific discriminating characters were determined in appropriate reference strains. It was also concluded that C. hawaiiensis and C. spicifera can be predominantly isolated from eye infections among the three species. The in vitro antifungal susceptibility of 10 currently used antifungal agents against 32 Curvularia isolates was also investigated. MICs were determined in each case. Isolates of C. spicifera proved to be less susceptible to the tested antifungals than those of C. hawaiiensis, which underline the importance of the correct identification of these species.

Different Candida parapsilosis clinical isolates and lipase deficient strain trigger an altered cellular immune response

Numerous human diseases can be associated with fungal infections either as potential causative agents or as a result of changed immune status due to a primary disease. Fungal infections caused by Candida species can vary from mild to severe dependent upon the site of infection, length of exposure, and past medical history. Patients with impaired immune status are at increased risk for chronic fungal infections. Recent epidemiologic studies have revealed the increasing incidence of candidiasis caused by non-albicans species such as Candida parapsilosis. Due to its increasing relevance we chose two distinct C. parapsilosis strains, to describe the cellular innate immune response toward this species. In the first section of our study we compared the interaction of CLIB 214 and GA1 cells with murine and human macrophages. Both strains are commonly used to investigate C. parapsilosis virulence properties. CLIB 214 is a rapidly pseudohyphae-forming strain and GA1 is an isolate that mainly exists in a yeast form. Our results showed, that the phagocyte response was similar in terms of overall uptake, however differences were observed in macrophage migration and engulfment of fungal cells. As C. parapsilosis releases extracellular lipases in order to promote host invasion we further investigated the role of these secreted components during the distinct stages of the phagocytic process. Using a secreted lipase deficient mutant strain and the parental strain GA1 individually and simultaneously, we confirmed that fungal secreted lipases influence the fungis virulence by detecting altered innate cellular responses. In this study we report that two isolates of a single species can trigger markedly distinct host responses and that lipase secretion plays a role on the cellular level of host–pathogen interactions.

New 19-Residue Peptaibols from Trichoderma Clade Viride

Trichoderma koningiopsis and T. gamsii belong to clade Viride of Trichoderma, the largest and most diverse group of this genus. They produce a wide range of bioactive secondary metabolites, including peptaibols with antibacterial, antifungal, and antiviral properties. The unusual amino acid residues of peptaibols, i.e., α-aminoisobutyric acid (Aib), isovaline (Iva), and the C-terminal 1,2-amino alcohol make them unique among peptides. In this study, the peptaibiomes of T. koningiopsis and T. gamsii were investigated by HPLC-ESI-MS. The examined strains appeared to produce 19-residue peptaibols, most of which are unknown from literature, but their amino acid sequences are similar to those of trikoningins, tricholongins, trichostrigocins, trichorzianins, and trichorzins. A new group of peptaibols detected in T. koningiopsis are described here under the name “Koningiopsin”. Trikoningin KA V, the closest peptaibol compound to the peptaibols produced by these two strains, was selected for structural investigation by short MD simulation, which revealed that many residues show high preference for left handed helix formation. The bioactivity of the peptaibol mixtures produced by T. koningiopsis and T. gamsii was tested on agar plates against bacteria, yeasts, and filamentous fungi. The results revealed characteristic differences in bioactivities towards the different groups of target microorganisms, which can be explained with the differences in their cell wall structures.