Abstract
Once regarded as an AIDS-defining illness, Pneumocystis pneumonia (PcP) is nowadays prevailing in immunocompromised HIV-negative individuals such as patients receiving immunosuppressive therapies or affected by primary immunodeficiency. Moreover, Pneumocystis clinical spectrum is broadening to non-severely-immunocompromised subjects who could be colonized by the fungus while remaining asymptomatic for PcP, thus being able to transmit the infection by airborne route to susceptible hosts. Although the taxonomical position of the Pneumocystis genus has been clarified, several aspects of its life cycle remain elusive such as its mode of proliferation within the alveolus or its ploidy level. As no long-term culture model exists to grow Pneumocystis organisms in vitro, an option was to use a model of immunosuppressed rat infected with Pneumocystis carinii and sort life cycle stage fractions using a high-through-put cytometer. Subsequently, ploidy levels of the P. carinii trophic and cystic form fractions were measured by flow cytometry. In the cystic form, eight contents of DNA were measured thus strengthening the fact that each mature cyst contains eight haploid spores. Following release, each spore evolves into a trophic form. The majority of the trophic form fraction was haploid in our study. Some less abundant trophic forms displayed two contents of DNA indicating that they could undergo (i) mating/fusion leading to a diploid status or (ii) asexual mitotic division or (iii) both. Even less abundant trophic forms with four contents of DNA were suggestive of mitotic divisions occurring following mating in diploid trophic forms. Of interest, was the presence of trophic forms with three contents of DNA, an unusual finding that could be related to asymmetrical mitotic divisions occurring in other fungal species to create genetic diversity at lower energetic expenses than mating. Overall, ploidy data of P. carinii life cycle stages shed new light on the complexity of its modes of proliferation.
Highlights
The Pneumocystis genus comprises diverse species of micromycetes that proliferate in the alveolus of a wide variety of mammalian hosts
Secondary Alexa-647conjugated antibody was adequately reacted with corresponding primary antibody depending on the targeted P. carinii fraction that was to be incubated with SYTOXH Green
Authors interested in the ploidy level of Pneumocystis carinii have either (i) undertaken a population based approach looking at chromosomes of an entire P. carinii population [18,19,21,22] or (ii) analyzed cell by cell DNA content by using a low throughput quantitative fluorescence image analysis [16,20]
Summary
The Pneumocystis genus comprises diverse species of micromycetes that proliferate in the alveolus of a wide variety of mammalian hosts. Many patients are still at risk for PcP even if the introduction of highly active anti-retroviral therapy (HAART), the improvement of patient care in intensive care unit (ICU) and Pneumocystis chemotherapy have reduced the prevalence of PcP [2,3]. These patients include those who are unaware of their HIV-status, who have no access to HAART or who are intolerant or non-adherent to treatment. To clinically prominent PcP occurring in immunocompromised patients, the growing impact of more silent carriage of low burden of Pneumocystis organisms in the lungs of non-severelyimmunocompromised subjects is being recognized. The role of P. jirovecii as comorbidity factor in chronic pulmonary diseases such as chronic obstructive pulmonary disease has recently been reported [2,9]
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