Torulopsis glabrata vaginitis: Clinical aspects and susceptibility to antifungal agents

Redondo-Lopez, Vicente; Lynch, Maria; Schmitt, C; Cook, Ron; Jd, Sobel

doi:10.1016/0020-7292(91)90322-v

Cited by 51 publications

(50 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Increased prevalence of C. glabrata infection in diabetic women has clinical relevance because poor therapeutic response and innate resistance to azoles has been reported for C. glabrata VVC in nondiabetic women (10 -13). Similar information is lacking in diabetic subjects, as they are often excluded in antifungal efficacy studies (8,10,(25)(26)(27). Poor mycological cure in diabetic women with C. glabrata VVC to single-dose oral 150-mg fluconazole, observed in the current study, is in accordance with our earlier case-control study (8).…”

Section: Adverse Effectsmentioning

confidence: 99%

“…Redondo-Lopez et al (10) and other investigators have reported the successful use of vaginal boric acid suppositories in the management of patients with C. glabrata (10,14,15) as well as C. albicans VVC (16 -18). In view of the higher frequency of C. glabrata VVC among diabetic women and their poor response to fluconazole, there is a need for a therapeutic regimen that is effective against both C. glabrata and C. albicans.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of Candida glabrata and Its Response to Boric Acid Vaginal Suppositories in Comparison With Oral Fluconazole in Patients With Diabetes and Vulvovaginal Candidiasis

et al. 2007

View full text Add to dashboard Cite

OBJECTIVE -A large proportion of vulvovaginal candidiasis (VVC) in diabetes is due to non-albicans Candida species such as C. glabrata and C. tropicalis. Observational studies indicate that diabetic patients with C. glabrata VVC respond poorly to azole drugs. We evaluated the response to oral fluconazole and boric acid vaginal suppositories in diabetic patients with VVC. RESEARCH DESIGN AND METHODS-A total of 112 consecutive diabetic patients with VVC were block randomized to receive either single-dose oral 150-mg fluconazole or boric acid vaginal suppositories (600 mg/day for 14 days). The primary efficacy outcome was the mycological cure in patients with C. glabrata VVC in the two treatment arms. The secondary outcomes were the mycological cure in C. albicans VVC, overall mycological cure irrespective of the type of Candida species, frequencies of yeast on direct microscopy, and clinical symptoms and signs of VVC on the 15th day of treatment. Intention-to-treat (ITT; n ϭ 111) and perprotocol (PP; n ϭ 99) analyses were performed. RESULTS -C. glabrata was isolated in 68 (61.3%) and C. albicans in 32 (28.8%) of 111 subjects. Patients with C. glabrata VVC showed higher mycological cure with boric acid compared with fluconazole in the ITT (21 of 33, 63.6% vs. 10 of 35, 28.6%; P ϭ 0.01) and PP analyses (21 of 29, 72.4% vs. 10 of 30, 33.3%; P ϭ 0.01). The secondary efficacy outcomes were not significantly different in the two treatment arms in the ITT and PP analyses.CONCLUSIONS -Diabetic women with C. glabrata VVC show higher mycological cure with boric acid vaginal suppositories given for 14 days in comparison with single-dose oral 150-mg fluconazole.

show abstract

Section: Adverse Effectsmentioning

confidence: 99%

mentioning

confidence: 99%

Prevalence of Candida glabrata and Its Response to Boric Acid Vaginal Suppositories in Comparison With Oral Fluconazole in Patients With Diabetes and Vulvovaginal Candidiasis

et al. 2007

View full text Add to dashboard Cite

show abstract

“…C. glabrata is a mammalian pathogen that can cause candidiasis and is relatively closely related to budding yeast, S. cerevisiae (Redondo-Lopez et al 1990;Cormack and Falkow 1999;Domergue et al 2005). Thus, identifying differences in the PHO pathway between the two species may shed light on their environmental niche.…”

mentioning

confidence: 99%

Novel Acid Phosphatase in Candida glabrata Suggests Selective Pressure and Niche Specialization in the Phosphate Signal Transduction Pathway

et al. 2010

View full text Add to dashboard Cite

Evolution through natural selection suggests unnecessary genes are lost. We observed that the yeast Candida glabrata lost the gene encoding a phosphate-repressible acid phosphatase (PHO5) present in many yeasts including Saccharomyces cerevisiae. However, C. glabrata still had phosphate starvation-inducible phosphatase activity. Screening a C. glabrata genomic library, we identified CgPMU2, a member of a threegene family that contains a phosphomutase-like domain. This small-scale gene duplication event could allow for sub-or neofunctionalization. On the basis of phylogenetic and biochemical characterizations, CgPMU2 has neofunctionalized to become a broad range, phosphate starvation-regulated acid phosphatase, which functionally replaces PHO5 in this pathogenic yeast. We determined that CgPmu2, unlike ScPho5, is not able to hydrolyze phytic acid (inositol hexakisphosphate). Phytic acid is present in fruits and seeds where S. cerevisiae grows, but is not abundant in mammalian tissues where C. glabrata grows. We demonstrated that C. glabrata is limited from an environment where phytic acid is the only source of phosphate. Our work suggests that during evolutionary time, the selection for the ancestral PHO5 was lost and that C. glabrata neofunctionalized a weak phosphatase to replace PHO5. Convergent evolution of a phosphate starvation-inducible acid phosphatase in C. glabrata relative to most yeast species provides an example of how small changes in signal transduction pathways can mediate genetic isolation and uncovers a potential speciation gene.

show abstract

“…Because these species diverged from a common ancestor $10 MYA, share $75% protein sequence identity, and share many signal transduction pathways, we hypothesized C. glabrata would have many similarities to S. cerevisiae, with the notable difference of environment; C. glabrata is a commensal pathogen with mammals ( Redondo-Lopez et al 1990;Domergue et al 2005).…”

mentioning

confidence: 99%

Candida glabrata PHO4 Is Necessary and Sufficient for Pho2-Independent Transcription of Phosphate Starvation Genes

Kerwin

Wykoff

2009

Genetics

View full text Add to dashboard Cite

Comparative genomic analyses of Candida glabrata and Saccharomyces cerevisiae suggest many signal transduction pathways are highly conserved. Focusing on the phosphate signal transduction (PHO) pathway of C. glabrata, we demonstrate that components of the pathway are conserved and confirm the role of CgPHO81, CgPHO80, CgPHO4, and CgMSN5 in the PHO pathway through deletion analysis. Unlike S. cerevisiae, C. glabrata shows little dependence on the transcription factor, Pho2, for induction of phosphate-regulated genes during phosphate limitation. We show that the CgPho4 protein is necessary and sufficient for Pho2-independent gene expression; CgPho4 is capable of driving expression of PHO promoters in S. cerevisiae in the absence of ScPHO2. On the basis of the sequences of PHO4 in the hemiascomycetes and complementation analysis, we suggest that Pho2 dependence is a trait only observed in species closely related to S. cerevisiae. Our data are consistent with trans-regulatory changes in the PHO pathway via the transcription factor Pho4 as opposed to cis-regulatory changes (the promoter).

show abstract

Torulopsis glabrata vaginitis: Clinical aspects and susceptibility to antifungal agents

Cited by 51 publications

References 0 publications

Prevalence of Candida glabrata and Its Response to Boric Acid Vaginal Suppositories in Comparison With Oral Fluconazole in Patients With Diabetes and Vulvovaginal Candidiasis

Prevalence of Candida glabrata and Its Response to Boric Acid Vaginal Suppositories in Comparison With Oral Fluconazole in Patients With Diabetes and Vulvovaginal Candidiasis

Novel Acid Phosphatase in Candida glabrata Suggests Selective Pressure and Niche Specialization in the Phosphate Signal Transduction Pathway

Candida glabrata PHO4 Is Necessary and Sufficient for Pho2-Independent Transcription of Phosphate Starvation Genes

Contact Info

Product

Resources

About