title: Calcineurin is essential for survival during membrane stress in Candida albicans.
abstract: The immunosuppressants cyclosporin A (CsA) and FK506 inhibit the protein phosphatase calcineurin and block T-cell activation and transplant rejection. Calcineurin is conserved in microorganisms and plays a general role in stress survival. CsA and FK506 are toxic to several fungi, but the common human fungal pathogen Candida albicans is resistant. However, combination of either CsA or FK506 with the antifungal drug fluconazole that perturbs synthesis of the membrane lipid ergosterol results in potent, synergistic fungicidal activity. Here we show that the C.albicans FK506 binding protein FKBP12 homolog is required for FK506 synergistic action with fluconazole. A mutation in the calcineurin B regulatory subunit that confers dominant FK506 resistance (CNB1-1/CNB1) abolished FK506-fluconazole synergism. Candida albicans mutants lacking calcineurin B (cnb1/cnb1) were found to be viable and markedly hypersensitive to fluconazole or membrane perturbation with SDS. FK506 was synergistic with fluconazole against azole-resistant C.albicans mutants, against other Candida species, or when combined with different azoles. We propose that calcineurin is part of a membrane stress survival pathway that could be targeted for therapy.
authors.affiliation: Department of Genetics, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: M Cristina
authors.initials: MC
authors.lastname: Cruz
authors.forename: Alan L
authors.initials: AL
authors.lastname: Goldstein
authors.forename: Jill R
authors.initials: JR
authors.lastname: Blankenship
authors.forename: Maurizio
authors.initials: M
authors.lastname: Del Poeta
authors.forename: Dana
authors.initials: D
authors.lastname: Davis
authors.forename: Maria E
authors.initials: ME
authors.lastname: Cardenas
authors.forename: John R
authors.initials: JR
authors.lastname: Perfect
authors.forename: John H
authors.initials: JH
authors.lastname: McCusker
authors.forename: Joseph
authors.initials: J
authors.lastname: Heitman
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology; D001483:Base Sequence; D015152:Blotting, Northern; D019703:Calcineurin / Q000502:physiology*; D002176:Candida albicans / Q000187:drug effects / Q000235:genetics / Q000502:physiology*; D016572:Cyclosporine / Q000494:pharmacology; D017931:DNA Primers; D004352:Drug Resistance, Microbial; D015725:Fluconazole / Q000494:pharmacology; D015966:Gene Expression Regulation, Fungal / Q000502:physiology; D005800:Genes, Fungal; D008780:Methyltransferases / Q000235:genetics; D016559:Tacrolimus / Q000494:pharmacology
chemical_list: D000935:Antifungal Agents; D017931:DNA Primers; D016572:Cyclosporine; D015725:Fluconazole; D008780:Methyltransferases; C022670:delta 24-sterol methyltransferase; D019703:Calcineurin; D016559:Tacrolimus