Yeast -- More of a problem for ADR patients?

[Harrison]

Occasionally, patients will get yeast infections in the hospital. I've learned that there are many different species, and any of them can cause problems just about anywhere in the body. Some can even cause joint arthritis (called fungal arthritis). Below is a recent article that explains CA in the context of biofilms.
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New Mechanism Fundamental To The Spread Of Invasive Yeast Infections Identified
18 Jun 2009

A group of researchers led by Carnegie Mellon University Biological Sciences Professor Aaron Mitchell has identified a novel regulatory gene network that plays an important role in the spread of common, and sometimes deadly, yeast infections. The findings, which establish the role of Zap1 protein in the activation of genes that regulate the synthesis of biofilm matrix, will be published in the June 16, 2009, issue of PLoS Biology, a peer-reviewed open-access journal from the Public Library of Science.

Candida albicans is a fungus, more specifically a yeast, which approximately 80 percent of people have in their gastrointestinal and genitourinary tract with no ill effects. However, at elevated levels it can cause non-life threatening conditions like thrush and yeast infections. A C. albicans infection becomes much more serious, and can be lethal, in those with compromised immune systems who have an implantable medical device, such as a pacemaker or artificial joint, or who use broad-spectrum antibiotics. Approximately 60,000 Americans develop such invasive C. albicans infections each year.

Central to such infections is a substance called biofilm matrix. A biofilm is a population of microbes, in this case C. albicans cells, joined together to form a sheet of cells. The cells in the biofilm produce extracellular components such as proteins and sugars, which form a cement-like substance called matrix. This matrix serves to protect the cells of the biofilm, preventing drugs and other stressors from attacking the cells while acting as a glue that holds the cells together. By doing this, the matrix provides an environment in which yeast cells in the biofilm can thrive, promoting infection and drug resistance.

"Biofilms have a major impact on human health and matrix is such a pivotal component of biofilms. It is important to understand how the production of matrix is regulated," Mitchell said.

In the study published in PLoS, Mitchell and colleagues found that the zinc-responsive regulatory protein Zap1 prevents the production of soluble β-1,3 glucan, a sugar that is a major component of matrix. They also identified other genes whose expression is controlled by Zap1, called Zap1 target genes. They found that these genes encode for two types of enzymes, glucoamylases and alcohol dehydrogenases, which both govern the production and maturation of matrix components.

"Understanding this novel regulatory gene network gives us insight into the metabolic processes that contribute to biofilm formation, and the role the network plays in infection," Mitchell said. "By better understanding the mechanisms by which biofilms develop and grow, we can start to look at targets for combating infection."

According to Mitchell, the next steps will be to determine the mechanisms by which Zap1 target genes regulate matrix production. Understanding and targeting these mechanisms will allow the researchers to develop therapeutic small molecules that will block biofilm formation and diagnostic tools that can detect biofilms before infections spread.

This study was funded by the National Institutes of Health.

Other study authors include: Clarissa J. Nobile, Aaron Hernday, Oliver R. Homann, and Alexander D. Johnson, Department of Microbiology and Immunology, University of California, San Francisco; Jeniel E. Nett and David R. Andes, Department of Medicine, University of Wisconsin; and Jean-Sebastien Deneault, and Andre Nantel, Biotechnology Research Institute, National Research Council of Canada.

Source:
Jocelyn Duffy
Carnegie Mellon University

[ans]

This is disturbing news. I wonder if the pill form of Nystatin (or another anti-fungal) could get rid of this.

ans

[annapurna]

I (Jim here, not Laura) am currently taking Nystatin pills. It is extremely poorly metabolised, so it works well to kill gut fungal infections but poorly for infections elsewhere. Because it is metabolised so poorly, it isn't that detrimental to try a short course as a trial rather than looking for fungal infection hallmarkers from your gut. In fact the doc who put me on it basically said that I had some of the right symptoms and plenty of opportunity to get a fungal infection through numerous courses of oral antibotics, so he just recommended a one month trial to see if it had any effect. I've described the nature of that trial as "if you feel slightly sick taking the stuff (Nystatin causes GI upset), you don't have it. If you feel really sick, you have a fungal infection." Needless to say, I spent more than one night during the trial wishing I could die or my guts would crawl out on their own, either solution would have been acceptable at the time, and now I'm on a multi-month course of it.

[Harrison]

This may be overkill, but this is a good article on the subject. It also offers insights on more "natural" products which are effective at killing candida within the intestinal tract (Mycopryl; which is coconut oil encased in a cal-mag coating).