Sterol profiles of samples taken from different sites of a Pneumocystis-infected human lung showed large variations in pneumocysterol similar to those that occur among samples from different patients. Thus, the influence of diet or drugs on pneumocysterol accumulation was ruled out, suggesting distinct phenotypic populations as the basis for the heterogeneity.Pneumocystis carinii synthesizes a number of distinct ⌬ 7 and ⌬ 8 24-alkylsterols but not ergosterol (the target of several antimycotics), and the organism scavenges cholesterol from its mammalian host (5, 6, 14-16, 18, 24). Most fungal sterols have an alkyl group consisting of one carbon at C-24 of the side chain. In contrast, the sterols of P. carinii and many plants have either one or two carbons at that site (C 28 and C 29 sterols). The P. carinii sterols are excellent chemotherapeutic targets because mammals cannot synthesize 24-alkylsterols.The C 32 24-alkylated lanosterol compound pneumocysterol (17) was detected in only trace amounts in organisms isolated from the corticosteroid-immunosuppressesd rat P. carinii pneumonia (PCP) model. The sterol profiles of organisms isolated from this animal model are consistent and reproducible from preparation to preparation (5,14,15,18). In contrast, pneumocysterol was found in various percentages, from trace levels to 50% of the noncholesterol sterols, in organisms isolated from cryopreserved human lungs (16). Replicate analyses of these human-derived samples were consistent and reproducible, suggesting biochemical differences in organism populations. No correlation between human immunodeficiency virus infection (HIV) and high levels of pneumocysterol was found. However, in that earlier study, the possible effects of diet, nonprescribed drugs, or other factors could not be ruled out as the basis for broad variations in the accumulation of this sterol. In the present study, variations in pneumocysterol in samples from the same pair of human lungs were noted, and thus, more than six different sites in the lungs from the same individual were analyzed.A formalin-fixed pair of lungs from an AIDS patient who died from PCP was provided by M. Pereira (Tufts Medical School, Boston, Mass.). Approximately 100-g pieces were excised from different sites and homogenized with distilled water in a Waring blender for 2 min, and total lipids were extracted (2) at room temperature for at least 2 h. The sterols were prepared and analyzed by gas-liquid chromatographic (GLC) methods as previously described (16-18).Formalin does not have functions that would interact with sterols, and it was experimentally shown in a previous study that formalin fixation did not alter the sterols of rat lungs (19). Also, formalin-fixed lung tissue (17, 19) and Pneumocystis organisms isolated from cryopreserved human lungs (16) contained the same steroidal compounds. In the present study, the GLC components designated peaks 13, 16, 19, 20 and 24 were considered the organism's signature sterol profile [24-methylcholest-7-en-3-ol (fungisterol), 24-ethyl...