Preventing Candida albicans from subverting host plasminogen for invasive infection treatment

Emerg Microbes Infect. 2020 Dec;9(1):2417-2432. doi: 10.1080/22221751.2020.1840927.

Abstract

Candida albicans is a common fungal pathogen in humans that colonizes the skin and mucosal surfaces of the majority healthy individuals. How C. albicans disseminates into the bloodstream and causes life-threatening systemic infections in immunocompromised patients remains unclear. Plasminogen system activation can degrade a variety of structural proteins in vivo and is involved in several homeostatic processes. Here, for the first time, we characterized that C. albicans could capture and "subvert" host plasminogen to invade host epithelial cell surface barriers through cell-wall localized Eno1 protein. We found that the "subverted" plasminogen system plays an important role in development of invasive infection caused by C. albicans in mice. Base on this finding, we discovered a mouse monoclonal antibody (mAb) 12D9 targeting C. albicans Eno1, with high affinity to the 254FYKDGKYDL262 motif in α-helices 6, β-sheet 6 (H6S6) loop and direct blocking activity for C. albicans capture host plasminogen. mAb 12D9 could prevent C. albicans from invading human epithelial and endothelial cells, and displayed antifungal activity and synergistic effect with anidulafungin or fluconazole in proof-of-concept in vivo studies, suggesting that blocking the function of cell surface Eno1 was effective for controlling invasive infection caused by Candida spp. In summary, our study provides the evidence of C. albicans invading host by "subverting" plasminogen system, suggesting a potential novel treatment strategy for invasive fungal infections.

Keywords: C. albicans; Enolase; fungal infection; invasive candidiasis; plasminogen.

MeSH terms

  • Anidulafungin / administration & dosage
  • Anidulafungin / pharmacology
  • Animals
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal / pharmacology
  • Antifungal Agents / administration & dosage*
  • Antifungal Agents / pharmacology
  • Caco-2 Cells
  • Candida albicans / pathogenicity*
  • Candidemia / metabolism
  • Candidemia / prevention & control*
  • Disease Models, Animal
  • Drug Synergism
  • Endothelial Cells / cytology
  • Endothelial Cells / drug effects
  • Endothelial Cells / microbiology
  • Epithelial Cells / cytology
  • Epithelial Cells / drug effects
  • Epithelial Cells / microbiology
  • Female
  • Fluconazole / administration & dosage
  • Fluconazole / pharmacology
  • Fungal Proteins / chemistry
  • Fungal Proteins / metabolism
  • Human Umbilical Vein Endothelial Cells
  • Humans
  • Mice
  • Phosphopyruvate Hydratase / chemistry
  • Phosphopyruvate Hydratase / metabolism*
  • Plasminogen / metabolism*
  • Protein Binding / drug effects
  • Protein Structure, Secondary

Substances

  • Antibodies, Monoclonal
  • Antifungal Agents
  • Fungal Proteins
  • Fluconazole
  • Plasminogen
  • Anidulafungin
  • Phosphopyruvate Hydratase

Grants and funding

This study was supported by the National Natural Science Foundation of China [grant numbers 81671989, 81471924, 81903670, 81601745], Scientific research projects of the Shanghai Science and Technology Committee [grant number 18411951300], Shanghai Youth Medical Talents Training Program (Laboratory Medicine) [grant number [2018]02], China Postdoctoral Science Foundation [grant number 2019M651590], and the Key Projects of the 12th Five Year of the Chinese Army [grant number BWS12J027].