Farnesol Boosts the Antifungal Effect of Fluconazole and Modulates Resistance in Candida auris through Regulation of the CDR1 and ERG11 Genes

Candida auris is considered a serious fungal pathogen frequently exhibiting a high resistance to a wide range of antifungals. In this study, a combination of the quorum-sensing molecule farnesol (FAR) and fluconazole (FLU) was tested on FLU-resistant C. auris isolates (C. auris S and C. auris R) com...

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Bibliographic Details
Published in:Journal of fungi (Basel) 2022-07, Vol.8 (8), p.783
Main Authors: Dekkerová, Jaroslava, Černáková, Lucia, Kendra, Samuel, Borghi, Elisa, Ottaviano, Emerenziana, Willinger, Birgit, Bujdáková, Helena
Format: Article
Language:English
Subjects:
Antifungal activity
antifungal resistance
Biofilms
Candida auris
CDR1 gene
Complementarity-determining region 1
efflux pumps
ERG11 gene
Experiments
Farnesol
Fluconazole
Infections
Multidrug resistant organisms
Pathogens
Rhodamine 6G
Yeast
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Summary:Candida auris is considered a serious fungal pathogen frequently exhibiting a high resistance to a wide range of antifungals. In this study, a combination of the quorum-sensing molecule farnesol (FAR) and fluconazole (FLU) was tested on FLU-resistant C. auris isolates (C. auris S and C. auris R) compared to the susceptible C. auris H261. The aim was to assess the possible synergy between FAR and FLU, by reducing the FLU minimal inhibitory concentration, and to determine the mechanism underlying the conjunct effect. The results confirmed a synergic effect between FAR and FLU with a calculated FIC index of 0.75 and 0.4 for C. auris S and C. auris R, respectively. FAR modulates genes involved in azole resistance. When FAR was added to the cells in combination with FLU, a significant decrease in the expression of the CDR1 gene was observed in the resistant C. auris isolates. FAR seems to block the Cdr1 efflux pump triggering a restoration of the intracellular content of FLU. These results were supported by observed increasing accumulation of rhodamine 6G by C. auris cells. Moreover, C. auris treated with FAR showed an ERG11 gene down-regulation. Overall, these results suggest that FAR is an effective modulator of the Cdr1 efflux pump in C. auris and, in combination with FLU, enhances the activity of this azole, which might be a promising strategy to control infections caused by azole-resistant C. auris.
ISSN:2309-608X
2309-608X
DOI:10.3390/jof8080783