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Turbinmicin inhibits Candida biofilm growth by disrupting fungal vesicle–mediated trafficking
Miao Zhao, … , Tim S. Bugni, David R. Andes
Miao Zhao, … , Tim S. Bugni, David R. Andes
Published December 29, 2020
Citation Information: J Clin Invest. 2021;131(5):e145123. https://doi.org/10.1172/JCI145123.
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Concise Communication Infectious disease

Turbinmicin inhibits Candida biofilm growth by disrupting fungal vesicle–mediated trafficking

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Abstract

The emergence of drug-resistant fungi has prompted an urgent threat alert from the US Centers for Disease Control (CDC). Biofilm assembly by these pathogens further impairs effective therapy. We recently identified an antifungal, turbinmicin, that inhibits the fungal vesicle–mediated trafficking pathway and demonstrates broad-spectrum activity against planktonically growing fungi. During biofilm growth, vesicles with unique features play a critical role in the delivery of biofilm extracellular matrix components. As these components are largely responsible for the drug resistance associated with biofilm growth, we explored the utility of turbinmicin in the biofilm setting. We found that turbinmicin disrupted extracellular vesicle (EV) delivery during biofilm growth and that this impaired the subsequent assembly of the biofilm matrix. We demonstrated that elimination of the extracellular matrix rendered the drug-resistant biofilm communities susceptible to fungal killing by turbinmicin. Furthermore, the addition of turbinmicin to otherwise ineffective antifungal therapy potentiated the activity of these drugs. The underlying role of vesicles explains this dramatic activity and was supported by phenotype reversal with the addition of exogenous biofilm EVs. This striking capacity to cripple biofilm assembly mechanisms reveals a new approach to eradicating biofilms and sheds light on turbinmicin as a promising anti-biofilm drug.

Authors

Miao Zhao, Fan Zhang, Robert Zarnowski, Kenneth Barns, Ryley Jones, Jen Fossen, Hiram Sanchez, Scott R. Rajski, Anjon Audhya, Tim S. Bugni, David R. Andes

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Figure 2

Turbinmicin exhibits vesicle matrix–linked Candida biofilm efficacy alone and in combination with fluconazole.

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Turbinmicin exhibits vesicle matrix–linked Candida biofilm efficacy alon...
(A) Escalating concentrations of turbinmicin reduced the C. albicans SN250 biofilm burden, as determined by XTT assay using an in vitro biofilm format (n = 3). Biofilm activity is expressed as the percentage of biofilm reduction compared with untreated biofilms. (B) Increasing intraluminal doses of turbinmicin eliminated viable C. albicans SN250 in the rat central venous catheter model compared with buffer-treated control animals (n = 3). (C) SEM imaging of the intraluminal surface of the rat central venous catheter C. albicans SN250 model demonstrated a visibly reduced biofilm in a dose-response manner follow turbinmicin exposures compared with buffer-treated control animals (n = 3). Scale bars: 300 μm (D) 3D surface response plot illustrates efficacy enhancement with the combination of turbinmicin and fluconazole compared with monotherapy in a 96-well C. albicans SN250 biofilm assay using an XTT assay (n = 3). The vertical axis represents the percentage of reduction in biofilm growth compared with untreated control biofilms. Areas in yellow and orange represent enhanced activity due the drug combination. (E) Interaction surfaces obtained from response surface analysis of the Bliss independence drug interaction model for the in vitro combination of turbinmicin and fluconazole against C. albicans biofilms. The x and y axes represent the concentrations of turbinmicin and fluconazole, respectively. The z axis is the ΔE. (F) Addition of exogenous vesicles with the antifungal drugs reduced the efficacy of the combination of turbinmicin (8 μg/mL) and fluconazole (1 μg/mL) in a 96-well C. albicans SN250 biofilm assay using an XTT assay (n = 3). Differences among treatments in panels A and C–E were assessed by ANOVA with Tukey’s post hoc HSD (*P < 0.05 and **P < 0.01).

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ISSN: 0021-9738 (print), 1558-8238 (online)

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