title: Identification of differentially expressed genes in a Giardia lamblia WB C6 clone resistant to nitazoxanide and metronidazole.
abstract: OBJECTIVE
  The characterization of differential gene expression in Giardia lamblia WB C6 strain C4 resistant to metronidazole and nitazoxanide using microarray technology and quantitative real-time PCR.
  
  
  METHODS
  In a previous study, we created and characterized the G. lamblia WB C6 clone C4 resistant to nitazoxanide and metronidazole. In this study, using a microarray-based approach, we have identified open-reading frames (ORFs) that were differentially expressed in C4 when compared with its wild-type WB C6. Using quantitative real-time PCR, we have validated the expression patterns of some of those ORFs, focusing on chaperones such as heat-shock proteins in wild-type and C4 trophozoites. In order to induce an antigenic shift, trophozoites of both strains were subjected to a cycle of en- and excystation. Expression of selected genes and resistance to nitazoxanide and metronidazole were investigated after this cycle.
  
  
  RESULTS
  Forty of a total of 9115 ORFs were found to be up-regulated and 46 to be down-regulated in C4 when compared with wild-type. After a cycle of en- and excystation, resistance of C4 to nitazoxanide and metronidazole was lost. Resistance formation and en-/excystation were correlated with changes in expression of ORFs encoding for major surface antigens such as the variant surface protein TSA417 or AS7 ('antigenic shift'). Moreover, expression patterns of the cytosolic heat-shock protein HSP70 B2, HSP40, and of the previously identified nitazoxanide-binding proteins nitroreductase and protein disulphide isomerase PDI4 were correlated with resistance and loss of resistance after en-/excystation. C4 trophozoites had a higher thermotolerance level than wild-type trophozoites. After en-/excystation, this tolerance was lost.
  
  
  CONCLUSIONS
  These results suggest that resistance formation in Giardia to nitazoxanide and metronidazole is correlated with altered expression of genes involved in stress response such as heat-shock proteins.
authors.affiliation: Institute of Parasitology, University of Berne, Länggass-Strasse 122, CH-3012 Berne, Switzerland. joachim.mueller@ipa.unibe.ch
authors.forename: Joachim
authors.initials: J
authors.lastname: Müller
authors.forename: Serej
authors.initials: S
authors.lastname: Ley
authors.forename: Ingrid
authors.initials: I
authors.lastname: Felger
authors.forename: Andrew
authors.initials: A
authors.lastname: Hemphill
authors.forename: Norbert
authors.initials: N
authors.lastname: Müller
mesh_terms: D000818:Animals; D000953:Antigens, Protozoan / Q000235:genetics; D000954:Antigens, Surface / Q000235:genetics; D000981:Antiprotozoal Agents / Q000494:pharmacology*; D004351:Drug Resistance / Q000235:genetics*; D020869:Gene Expression Profiling; D016829:Giardia lamblia / Q000187:drug effects* / Q000235:genetics / Q000502:physiology*; D006360:Heat-Shock Proteins / Q000235:genetics; D008795:Metronidazole / Q000494:pharmacology*; D009154:Mutation; D009574:Nitro Compounds; D009601:Nitroreductases / Q000235:genetics; D020411:Oligonucleotide Array Sequence Analysis; D019704:Protein Disulfide-Isomerases / Q000235:genetics; D015800:Protozoan Proteins / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013844:Thiazoles / Q000494:pharmacology*
chemical_list: D000953:Antigens, Protozoan; D000954:Antigens, Surface; D000981:Antiprotozoal Agents; D006360:Heat-Shock Proteins; D009574:Nitro Compounds; D015800:Protozoan Proteins; D013844:Thiazoles; D008795:Metronidazole; D009601:Nitroreductases; D019704:Protein Disulfide-Isomerases; C041747:nitazoxanide