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Resistance to fluconazole (FLC), the most widely used antifungal drug, is typically achieved by altering the azole drug target and/or drug efflux pumps. Recent reports have suggested a link between vesicular trafficking and antifungal resistance. Here, we identified novel Cryptococcus neoformans regulators of extracellular vesicle (EV) biogenesis that impact FLC resistance. In particular, the transcription factor Hap2 does not affect the expression of the drug target or efflux pumps, yet it impacts the cellular sterol profile. Subinhibitory FLC concentrations also downregulate EV production. Moreover, in vitro spontaneous FLC-resistant colonies showed altered EV production, and the acquisition of FLC resistance was associated with decreased EV production in clinical isolates. Finally, the reversion of FLC resistance was associated with increased EV production. These data suggest a model in which fungal cells can regulate EV production in place of regulating the drug target gene expression as a first line of defense against antifungal assault in this fungal pathogen. IMPORTANCE Extracellular vesicles (EVs) are membrane-enveloped particles that are released by cells into the extracellular space. Fungal EVs can mediate community interactions and biofilm formation, but their functions remain poorly understood. Here, we report the identification of the first regulators of EV production in the major fungal pathogen Cryptococcus neoformans . Surprisingly, we uncover a novel role of EVs in modulating antifungal drug resistance. Disruption of EV production was associated with altered lipid composition and changes in fluconazole susceptibility. Spontaneous azole-resistant mutants were deficient in EV production, while loss of resistance restored initial EV production levels. These findings were recapitulated in C. neoformans clinical isolates, indicating that azole resistance and EV production are coregulated in diverse strains. Our study reveals a new mechanism of drug resistance in which cells adapt to azole stress by modulating EV production., Competing Interests: The authors declare no conflict of interest.

Melanin formation is a promising target for antifungal development. We screened a collection of 727 compounds that were previously approved for clinical use in humans for inhibition of pigmentation in Cryptococcus gattii, a lethal fungal pathogen that causes damage to both immunocompetent and immunocompromised hosts. The pyrimidine analogues flucytosine (5-fluorocytosine [5-FC]), 5-fluorouracil (5-FU) and carmofur were identified as efficient inhibitors of pigmentation in the C. gattii model. Since melanin synthesis is enzymatically catalyzed by laccase in Cryptococcus, we investigated whether inhibition of pigmentation by the pyrimidine analogues was laccase-mediated. Enzyme activity and expression of LAC genes were not involved in the effects of the pyrimidine analogues, suggesting alternative cellular targets for inhibition of pigmentation. To address this hypothesis, we screened a collection of approximately 8000 mutants of C. gattii that were produced by insertional mutation after incubation with Agrobacterium tumefaciens and identified a gene product required for the anti-pigmentation activity of 5-FC as a beta-DNA polymerase. Reduced expression of this gene affected capsule formation and urease activity, suggesting essential roles in the cryptococcal physiology. These results demonstrate a previously unknown antifungal activity of 5-FC and reveal a promising target for the development of novel antifungals.

Trichosporon asahii shares with Cryptococcus species the ability to produce glucuronoxylomannan (GXM), an immunomodulatory fungal polysaccharide. The ability of other opportunistic species of Trichosporon to produce GXM-like polysaccharides is unknown. In this study, we observed that T. mucoides was less pathogenic than T. asahii in an infection model of Galleria mellonella and asked whether this difference was related to the characteristics of GXM-like molecules. Compositional analysis of samples obtained from both pathogens indicated that the components of GXM (mannose, xylose and glucuronic acid) were, in fact, detected in T. mucoides and T. asahii glycans. The identification of the T. mucoides glycan as a GXM-like molecule was confirmed by its reactivity with a monoclonal antibody raised to cryptococcal GXM and incorporation of the glycan into the cell surface of an acapsular mutant of C. neoformans. T. mucoides and T. asahii glycans differed in molecular dimensions. The antibody to cryptococcal GXM recognized T. mucoides yeast forms less efficiently than T. asahii cells. Experiments with animal cells revealed that the T. mucoides glycan manifested antiphagocytic properties. Comparative phagocytosis assays revealed that T. mucoides and T. asahii were similarly recognized by macrophages. However, fungal association with the phagocytes did not depend on the typical receptors of cryptococcal GXM, as concluded from assays using macrophages obtained from Tlr2-/- and Cd14-/- knockout mice. These results add T. mucoides to the list of fungal pathogens producing GXM-like glycans, but also indicate a high functional diversity of this major fungal immunogen., (Copyright © 2018 Elsevier Inc. All rights reserved.)