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Antimicrobial Agents and Chemotherapy, February 1999, p. 233-239, Vol. 43, No. 2
Department of
Medicine1 and
Department of Microbiology
and Immunology,2 Albert Einstein College of
Medicine, Bronx, NY 10461, and
Department of Pharmacology,
Cornell University, New York, New York 100213
Received 15 July 1998/Returned for modification 8 October
1998/Accepted 9 November 1998
Amphotericin B (AmB) and fluconazole (FLU) are the major antifungal
drugs used in the treatment of cryptococcosis. Both drugs are believed
to exert their antifungal effects through actions on cell membrane
sterols. In this study we investigated whether AmB and FLU had other,
more subtle effects on C. neoformans that could contribute
to their therapeutic efficacy. C. neoformans cells were
grown in media with subinhibitory concentrations of either AmB or FLU
and analyzed for cellular charge, phagocytosis by macrophages with
antibody and complement opsonins, appearance by scanning electron and
light microscopies, and release of the capsular polysaccharide
glucuronoxylomannan into the culture medium. Growth in the presence of
either AmB or FLU resulted in major reductions in cellular charge, as
measured by determination of the zeta potential. Phagocytosis studies
demonstrated that exposure of C. neoformans to
subinhibitory concentrations of AmB or FLU enhanced phagocytosis by
macrophages. Scanning electron microscopy revealed that a large
proportion of cells had an altered capsular appearance. Cells grown in
medium with either AmB or FLU were smaller and released more
glucuronoxylomannan into the culture medium than cells grown without
antibiotics. The results suggest additional mechanisms of action for
AmB and FLU that may be operative in body compartments where drug
levels do not achieve the MICs. Furthermore, the results suggest
mechanisms by which AmB and FLU can cooperate with humoral and cellular
immune defense systems in controlling C. neoformans infections.
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Amphotericin B and Fluconazole Affect Cellular Charge, Macrophage
Phagocytosis, and Cellular Morphology of Cryptococcus
neoformans at Subinhibitory Concentrations
*
Corresponding author. Mailing address: Department of
Medicine, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461. Phone: (718) 430-3659. Fax: (718) 430-8968. E-mail: casadeva{at}aecom.yu.edu.
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