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Antimicrobial Agents and Chemotherapy, March 2008, p. 1144-1146, Vol. 52, No. 3
0066-4804/08/$08.00+0 doi:10.1128/AAC.01542-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.
Increases in SLT2 Expression and Chitin Content Are Associated with Incomplete Killing of Candida glabrata by Caspofungin
Jason M. Cota,1,2
Jodi L. Grabinski,1,2
Robert L. Talbert,1,2
David S. Burgess,1,2
P. David Rogers,3
Thomas D. Edlind,4 and
Nathan P. Wiederhold1,2*
The University of Texas at Austin College of Pharmacy, Austin, Texas,1
The University of Texas Health Science Center at San Antonio, San Antonio, Texas,2
The University of Tennessee College of Pharmacy, Memphis, Tennessee,3
Drexel University College of Medicine, Philadelphia, Pennsylvania4
Received 29 November 2007/
Accepted 8 December 2007

ABSTRACT
Incomplete killing was observed for caspofungin against
Candida glabrata, which was associated with increased
SLT2 expression
and elevated chitin content. In contrast, fungicidal activity
and no chitin increase were observed in an isogenic
slt2 strain,
suggesting a role for
SLT2 and chitin production in the response
of
C. glabrata to caspofungin.

TEXT
Up-regulation of the cell wall integrity (CWI) pathway in
Candida albicans upon damage to the cell wall and increases in chitin
have correlated with the paradoxical attenuation of caspofungin
activity at clinically relevant supra-MIC concentrations (
21,
22). Although this effect has not been observed in
Candida glabrata (
4,
20), studies have reported incomplete killing against some
isolates (
2,
3,
5,
23). In
Saccharomyces cerevisiae,
SLT2 encodes
a mitogen-activated protein kinase of the CWI pathway that confers
protection from damage to the cell wall. An
SLT2 homolog has
been identified in the
C. glabrata genome sequence (
http://cbi.labri.fr/Genolevures/index.php).
Our objective was to evaluate the potential role of
SLT2 and
increases in chitin content in the escape of
C. glabrata from
the fungicidal activity of caspofungin.
A C. glabrata
slt2 strain and its isogenic parent, C. glabrata 200989, were used in all experiments (7). Stock solutions of caspofungin acetate (Merck & Co., Inc., Whitehouse, NJ) were prepared in sterile distilled water and further diluted in RPMI broth buffered with 0.165 M morpholinepropanesulfonic acid (pH 7). The 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) colorimetric assay was conducted at caspofungin concentrations from 0 to 32 µg/ml as previously described (6, 13). The absorbance was read at 492 nm, and readings were converted to percent absorbance with the growth control set at 100% and medium controls at 0%. Time-kill studies were performed using previously reported methods with caspofungin concentrations of 0, 0.125, 1.0, and 16.0 µg/ml (9). Fungicidal activity was defined as a
3-log10 (99.9%) reduction in CFU/ml from the starting inoculum (9).
For gene expression and chitin assays, strains were adjusted to a starting inoculum of
1 x 104 cells/ml and incubated at 37°C with shaking to
1 x 106 cells/ml. Cells were then exposed to caspofungin (0, 0.125, 1.0, and 16.0 µg/ml) for 10 min, 180 min, or 12 h. Cells were then harvested, and total RNA was extracted using MasterPure RNA Purification kits (Epicenter Biotechnologies, Madison, WI). Reverse transcription to cDNA was performed (GeneAmp RNA PCR kit, Applied Biosystems, Inc., Foster City, CA), and relative gene expression was determined by real-time PCR (ABI PRISM 7300 sequence detection system), with primers and probes specific for DNA carrying SLT2 and CHS3 as identified within the C. glabrata genome sequence database (Table 1). Relative gene expression levels were calculated by the 2–
CT method using ACT1 as the housekeeping gene (10). For chitin analysis, cells were exposed to caspofungin (0, 0.125, 1.0, and 16.0 µg/ml) for 12 h, cells were harvested, and chitin content was measured as previously described (18). Chitin content was corrected for pellet weight and expressed as changes from control levels. Each study was conducted in triplicate, and differences in fungal viability, CFU, chitin content, and gene expression were compared using one-way analysis of variance (ANOVA) with Tukey's posttest for multiple comparisons.
Complete growth inhibition did not occur at any caspofungin
concentration tested against the parent strain,
C. glabrata 200989, as measured by the XTT assay (Fig.
1A). Similarly, by
time-kill analysis, fungicidal activity was not achieved at
any concentration tested against strain 200989, with a maximum
1.6-log
10 CFU/ml reduction (Fig.
1B). In contrast, a 100% reduction
in absorbance was observed in the
slt2 strain at concentrations
of

0.5 µg/ml, and fungicidal activity was observed at
1 and 16 µg/ml (maximum 4.2-log
10 CFU/ml reduction) (Fig.
1C). In addition, caspofungin (0.125 µg/ml) had excellent
activity, with a 2.6-log
10 reduction in CFU/ml. Increased expression
of
SLT2 was also observed at each caspofungin concentration
versus control expression following 10 min of exposure (>2-fold;
P < 0.05), and this was most elevated after 180 min (

3.8-fold;
P < 0.05) (Fig.
2A). However,
SLT2 transcription was no longer
increased at 12 h.
These phenotypic and genotypic data are consistent with findings
in previous reports demonstrating a role of the CWI pathway
in the coordination of the response to caspofungin-mediated
cell wall damage. A rapid and transient induction of
SLT2 transcription
in
S. cerevisiae following a brief exposure to caspofungin has
previously been demonstrated (
1,
17), while a 50% decrease in
viable cells was observed in strains lacking Slt2p activity
compared to the isogenic parent (
17). Similarly, increased expression
of the
C. albicans homolog of
SLT2,
MKC1, has also been observed
at elevated drug concentrations, where a paradoxical attenuation
of caspofungin activity occurs, and this paradoxical phenotype
was absent in a
mkc1/
mkc1 homozygous mutant (
22).
We also examined chitin content following a caspofungin challenge. In strain 200989, CHS3 transcript levels increased by >2-fold at each caspofungin concentration after 180 min (P < 0.05) (Fig. 2B), accompanied by a >3.3-fold increase in chitin content versus control levels (P < 0.05) (Fig. 2C). In contrast, CHS3 expression did not significantly increase in the
slt2 strain, nor was chitin content elevated following caspofungin challenge. These data suggest a link between SLT2 and increased chitin content upon cell wall damage by caspofungin in C. glabrata. The increase in chitin content was not unexpected, as other investigators have also demonstrated significant increases in chitin following exposures to different concentrations of echinocandins (16, 21). A link between the CWI pathway and chitin synthesis has also been described for C. albicans. A recent study reported activation of Mkc1p upon exposure to cell wall damaging agents, resulting in an up-regulation in CHS3 transcription and an increase in cell wall chitin (14). However, with the deletion of MKC1, CHS3 expression and chitin content remained unchanged.
While these data indicate an apparent association between SLT2, chitin content, and the response to caspofungin challenge in C. glabrata, further studies involving additional isolates are warranted. Although the CWI pathway appears to be conserved among fungi, this pathway and chitin synthesis have not been fully described for C. glabrata. Additionally, other potential mechanisms for caspofungin tolerance, including up-regulation of 1,3- and 1,6-β-glucan synthesis, increased export of cell wall components for cell wall repair, and the calcineurin pathway, require further investigation (11, 12, 15, 21, 22, 24). These initial data invite further studies since these may lead to strategies that improve outcomes for patients with invasive candidiasis.

ACKNOWLEDGMENTS
Sponsored in part by grants from the American College of Clinical
Pharmacy and the University of Texas at Austin College of Graduate
Studies to N.P.W.
J.M.C., J.L.G., R.L.T., D.S.B, P.D.R., and T.D.E. have no conflicts of interest to disclose.
N.P.W. has received research support from Pfizer, Inc., and Schering-Plough.

FOOTNOTES
* Corresponding author. Mailing address: University of Texas at Austin College of Pharmacy, UTHSCSA, PERC MSC 6220, 7703 Floyd Curl Drive, San Antonio, TX 78229. Phone: (210) 567-8340. Fax: (210) 567-8328. E-mail:
wiederholdn{at}uthscsa.edu 
Published ahead of print on 17 December 2007. 

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Antimicrobial Agents and Chemotherapy, March 2008, p. 1144-1146, Vol. 52, No. 3
0066-4804/08/$08.00+0 doi:10.1128/AAC.01542-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.
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