Phaeohyphomycosis in Solid Organ Transplant Recipients: A Case Series and Narrative Review of the Literature

Porto, Davide Lo; Cona, Andrea; Todaro, Francesca; Carolis, Elena De; Cardinale, Francesca; Hafeez, Neha; Martino, Giuseppina; Conaldi, Pier Giulio; Sanguinetti, Maurizio; Grossi, Paolo; Mularoni, Alessandra

doi:10.3390/jof9030283

Cited by 2 publications

(1 citation statement)

References 69 publications

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“…The shift from endophyte to pathogen is thought to occur by abiotic stress (e.g., extreme temperature, nutrient deficiency, radiation, waterlogged stress, salinity) [3] that causes asymptomatic A. alternata infection to shift into parasitism, which further aggravates the plant condition [2]. Interestingly, also in humans Alternaria can co-exist without causing disease [4] on surfaces, such as the skin [5,6] and the conjunctiva [7], but can elicit disease usually in immunocompromised individuals [6,8,9]. Moreover, it is also strongly associated with human respiratory disease, particularly fungal allergic asthma and rhinitis [10].…”

Section: Introductionmentioning

confidence: 99%

Nutritional Provision of Iron Complexes by the Major Allergen Alt a 1 to Human Immune Cells Decreases Its Presentation

Fakhimahmadi,

Hasanaj,

Hofstetter

et al. 2023

IJMS

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Alternaria alternata is a common fungus strongly related with severe allergic asthma, with 80% of affected individuals being sensitized solely to its major allergen Alt a 1. Here, we assessed the function of Alt a 1 as an innate defense protein binding to micronutrients, such as iron–quercetin complexes (FeQ2), and its impact on antigen presentation in vitro. Binding of Alt a 1 to FeQ2 was determined in docking calculations. Recombinant Alt a 1 was generated, and binding ability, as well as secondary and quaternary structure, assessed by UV-VIS, CD, and DLS spectroscopy. Proteolytic functions were determined by casein and gelatine zymography. Uptake of empty apo– or ligand-filled holoAlt a 1 were assessed in human monocytic THP1 cells under the presence of dynamin and clathrin-inhibitors, activation of the Arylhydrocarbon receptor (AhR) using the human reporter cellline AZ-AHR. Human PBMCs were stimulated and assessed for phenotypic changes in monocytes by flow cytometry. Alt a 1 bound strongly to FeQ2 as a tetramer with calculated Kd values reaching pico-molar levels and surpassing affinities to quercetin alone by a factor of 5000 for the tetramer. apoAlt a 1 but not holoAlta 1 showed low enzymatic activity against casein as a hexamer and gelatin as a trimer. Uptake of apo– and holo–Alt a 1 occurred partly clathrin-dependent, with apoAlt a 1 decreasing labile iron in THP1 cells and holoAlt a 1 facilitating quercetin-dependent AhR activation. In human PBMCs uptake of holoAlt a 1 but not apoAlt a 1 significantly decreased the surface expression of the costimulatory CD86, but also of HLADR, thereby reducing effective antigen presentation. We show here for the first time that the presence of nutritional iron complexes, such as FeQ2, significantly alters the function of Alt a 1 and dampens the human immune response, thereby supporting the notion that Alt a 1 only becomes immunogenic under nutritional deprivation.

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Section: Introductionmentioning

confidence: 99%

Nutritional Provision of Iron Complexes by the Major Allergen Alt a 1 to Human Immune Cells Decreases Its Presentation

Fakhimahmadi,

Hasanaj,

Hofstetter

et al. 2023

IJMS

View full text Add to dashboard Cite

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Donor‐derived mold infections in lung transplant recipients: The importance of active surveillance

Mularoni,

Cona,

Coniglione

et al. 2024

Transplant Infectious Dis

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Unexpected donor‐derived fungal infections represent a rare but potentially fatal complication in lung transplant (Tx) recipients. Timely communication of the results of donor cultures and prompt treatment of recipients are crucial to mitigate the consequences of donor‐derived transmissions. In this prospective cohort study, all consecutive patients who underwent lung transplantation from 2015 to 2022 were included. In December 2015, a Local Active Surveillance System has been implemented to provide biovigilance of donor culture results and optimize recipients’ management. The aim of this study is to investigate the incidence of unexpected, mold‐positive cultures among lung donors and the rate of transmission to recipients. Furthermore, management strategies and outcome of recipients with mold transmission are described. In case of isolation of the same mold in donor and recipient cultures, when possible, transmission was confirmed by dendrogram analysis. During the study period, 82 lung Tx were performed from 80 donors. The prevalence of donors with “unexpected” mold isolation from the respiratory tract was 3.75% (3/80). Isolated molds were Aspergillus niger, Rhizopus oryzae, and Aspergillus flavus. Transmissions occurred in all the three cases (100%) with a mean time of 5 days from lung Tx but none of the recipients developed invasive mold disease. Our Local Active Surveillance System allowed prompt recognition of lung donors unexpected mold colonization. Even though transmission occurred, introduction of early targeted antifungal therapy prevented potential catastrophic consequence of mold donor‐derived infection in the immediate post‐Tx period. image

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Phaeohyphomycosis in Solid Organ Transplant Recipients: A Case Series and Narrative Review of the Literature

Cited by 2 publications

References 69 publications

Nutritional Provision of Iron Complexes by the Major Allergen Alt a 1 to Human Immune Cells Decreases Its Presentation

Nutritional Provision of Iron Complexes by the Major Allergen Alt a 1 to Human Immune Cells Decreases Its Presentation

Donor‐derived mold infections in lung transplant recipients: The importance of active surveillance

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