Polymorphisms involving the Pneumocystis jirovecii-related genes in AIDS patients in eastern China

Wang, Mengyan; Xu, Xiaoping; Guo, Yongzheng; Tao, Ran; Hu, Caiqin; Dong, Xiaotian; Huang, Ying; Zhu, Bin

doi:10.1016/j.meegid.2019.103955

Cited by 5 publications

(17 citation statements)

References 32 publications

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“…Furthermore, the rates of DHPS and DHFR mutations were still very low [12,[35][36][37]. In this study, DHPS WT and DHFR 312C were observed at the DHPS and DHFR locus and no other mutations were detected, consistent with the prior studies reported in PR China [12,34,37]. This low prevalence of DHPS and DHFR mutations was not only demonstrated in China but also in other developing countries such as Brazil, South Africa and Thailand [38][39][40].…”

Section: Discussionsupporting

confidence: 90%

“…Meanwhile, we analyzed the combinations of the multilocus genotype and assessed the association between the genotypes and clinical conditions of patients. The correlations of the clinical characteristics such as the severity of the diseases and geographical origins with the multilocus gene sequences of the P. jirovecii were reported in the previous studies [2,10,12,13]. However, it is di cult to accurately determining their association mentioned above based on the small sample sizes in this study.…”

Section: Discussionmentioning

confidence: 71%

“…Meanwhile, the results in this study provided the partial epidemiological data of P. jirovecii ITS genotypes in China and further demonstrated the new ITS genotype nomenclature system previously reported is a simpler and useful tool to analyze and interpret. SOD mutations of P. jirovecii were commonly observed at two different positions of nucleotide bases (i.e., 110 and 215) and genotypes SOD1 and SOD2 were detected most frequently in previously studies [12,[25][26][27][28]. Genotypes SOD3 and SOD4 were the second most common [7].…”

Section: Discussionmentioning

confidence: 89%

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Genetic Polymorphisms of 3 Cases Pneumocystis jirovecii in Shanxi Province PR China

Xue

Du²,

Dai

et al. 2021

Preprint

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Background Pneumocystis jirovecii (P. jirovecii) is an opportunistic fungus and is a well-known cause of potentially fatal Pneumocystis jirovecii pneumonia (PJP). However, the epidemiology and biology of P. jirovecii is limited because of the lack of a continuous and reliable culture system in vitro. This study was performed with the objectives of investigating the genetic polymorphisms of P. jirovecii from 3 cases in Shanxi Province PR China with the utilizations of molecular biological technique.Methods Analysis of genetic polymorphisms in P. jirovecii including the internal transcribed spacer regions of rRNA operon (ITS), superoxide dismutase (SOD), dihydropteroate synthase (DHPS) and dihydrofolate reductase (DHFR), cytochrome b (CYB) and the mitochondrial large-subunit rRNA (mt LSU rRNA) genes were performed by Nested-PCR amplification, TA clone, sequencing and genotyping. We assessed its correlation with clinical characteristics of patients with P. jirovecii pneumonia (PJP). Results Of three patients with PJP included in the present study, the genetic diversities and polymorphic combinations of SOD 1, DHFR 312C, DHPS WT, mt3 genotypes separately occurred in the two HIV-positive patients, while coinfections with two genotypes of P. jirovecii in the same patient without HIV were detected for different genetic loci including ITS, SOD, CYB and mt LSU rRNA in this study. The pulmonary concurrent infection with other pathogens was detected in this HIV-negative patient.Conclusions The present study is the first analyzed and assessed the genetic polymorphisms of 3 cases P. jirovecii in Shanxi province PR China suggesting that genetic diversities and concurrent infection with other pathogens were possibly associated with the clinical characteristics and outcomes in PJP patients especially those without HIV.Trial registration Not applicable.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 89%

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Genetic Polymorphisms of 3 Cases Pneumocystis jirovecii in Shanxi Province PR China

Xue

Du²,

Dai

et al. 2021

Preprint

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“…In addition, Li and Wang et al did not find mutations in the DHPS gene in P . jirovecii in 10 and 18 HIV-infected patients in Guangzhou[ 32 ] and zhejiang[ 33 ], respectively. And no common DHPS gene mutations of P .…”

Section: Discussionmentioning

confidence: 99%

“…Kazanjian et al revealed a DHPS gene mutation rate of 6.7% (1/15) in AIDS-PCP in Beijing [30], Deng et al identified DHPS mutations in 12.0% (3/25) patients from Guangzhou [31], the prevalence of P. jirovecii DHPS mutations in this study is not significantly higher than those of these previous studies (P = 0.858, P = 0.137, respectively). In addition, Li and Wang et al did not find mutations in the DHPS gene in P. jirovecii in 10 and 18 HIV-infected patients in Guangzhou [32] and zhejiang [33], respectively. And no common DHPS gene mutations of P. jirovecii were detected in the HIV-negative PCP patients in Beijing [34].…”

Section: Plos Onementioning

confidence: 94%

Clinical characteristics and prevalence of dihydropteroate synthase gene mutations in Pneumocystis jirovecii-infected AIDS patients from low endemic areas of China

Zhu

2020

PLoS ONE

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Pneumocystis pneumonia (PCP) is an opportunistic and potentially life-threatening infection of AIDS patients caused by the fungus Pneumocystis jirovecii (P. jirovecii). Trimethoprimsulfamethoxazole (TMP-SMX) is the most commonly used drug combination in the treatment and prophylaxis of PCP. However, with long-term use of this combination, mutations in the dihydropteroate synthase (DHPS) gene of P. jirovecii bring about the development of resistance. Data on the prevalence of P. jirovecii and its DHPS mutants in China, especially in low endemic areas, are still limited. Thus, in the present study, we measured the P. jirovecii infection rate among HIV-positive and AIDS (HIV/AIDS) patients with suspected PCP and investigated the relationship between CD4 + T cell count and PCP occurrence. As well as the polymerase chain reaction (PCR) analysis and sequencing, the restriction fragment length polymorphism (RFLP) method was used to analyze DHPS point mutation in P. jirovecii strains. P. jirovecii was detected in 40.82% of cases. The clinical symptoms and signs of PCP were not typical; with decreasing CD4 + T cell counts, PCP infection in HIV/AIDS patients increased. In only one case (1.67%), the patients' DHPS gene could not be cut by the Acc I restriction enzyme. Furthermore, mutation at codon 171 was detected in 11 cases and no mutation was found at codon 57. Patients treated with sulfamethoxazole combined with Voriconazole or Caspofungin exhibited favorable results. After treatment, the symptoms of dyspnea were alleviated, and chest computed tomography findings showed the improvement of lung shadows. These indicated that the prevalence of DHPS mutations in P. jirovecii isolates in AIDS-PCP patients in the region was low. Thus, the contribution of gene mutations to treatment failure requires further research.

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Advances in Genomics Research of Pneumocystis Species

Porollo

Cushion

2021

Encyclopedia of Mycology

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Polymorphisms involving the Pneumocystis jirovecii-related genes in AIDS patients in eastern China

Cited by 5 publications

References 32 publications

Genetic Polymorphisms of 3 Cases Pneumocystis jirovecii in Shanxi Province PR China

Genetic Polymorphisms of 3 Cases Pneumocystis jirovecii in Shanxi Province PR China

Clinical characteristics and prevalence of dihydropteroate synthase gene mutations in Pneumocystis jirovecii-infected AIDS patients from low endemic areas of China

Advances in Genomics Research of Pneumocystis Species

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