Fitness Trade-Offs Associated with the Evolution of Resistance to Antifungal Drug Combinations

The evolution of drug resistance threatens human health worldwide. An emerging strategy to mitigate drug resistance is combination therapy. The fate of multidrug-resistant pathogens depends on their fitness relative to susceptible counterparts, yet the fitness consequences of multidrug resistance re...

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Main Authors: Jessica A. Hill, Teresa R. O’Meara, Leah E. Cowen
Format: Article
Language:English
Published: Elsevier 2015-02-01
Series:Cell Reports
Online Access:http://www.sciencedirect.com/science/article/pii/S2211124715000108
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author Jessica A. Hill
Teresa R. O’Meara
Leah E. Cowen
author_facet Jessica A. Hill
Teresa R. O’Meara
Leah E. Cowen
author_sort Jessica A. Hill
collection DOAJ
description The evolution of drug resistance threatens human health worldwide. An emerging strategy to mitigate drug resistance is combination therapy. The fate of multidrug-resistant pathogens depends on their fitness relative to susceptible counterparts, yet the fitness consequences of multidrug resistance remain enigmatic. Here, we dissect fitness consequences of the evolution of resistance to antifungal drug combinations in the leading human fungal pathogen, Candida albicans. We focus on the most widely deployed antifungals, the azoles, and inhibitors of the molecular chaperone Hsp90 and protein phosphatase calcineurin, which regulate cellular stress responses required for azole resistance. We find tradeoffs such that adaptation to drug combinations is associated with reduced fitness in distinct environments, including those relevant to the human host. We identify mutations associated with fitness tradeoffs in clinical isolates and that influence morphogenesis, a key virulence trait. Thus, we delineate evolutionary constraints that may minimize the evolution of resistance to antifungal combinations.
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spelling doaj.art-c39d40756b574811a59f18be5c03c16f2022-12-21T19:41:56ZengElsevierCell Reports2211-12472015-02-0110580981910.1016/j.celrep.2015.01.009Fitness Trade-Offs Associated with the Evolution of Resistance to Antifungal Drug CombinationsJessica A. Hill0Teresa R. O’Meara1Leah E. Cowen2Department of Molecular Genetics, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, CanadaDepartment of Molecular Genetics, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, CanadaDepartment of Molecular Genetics, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, CanadaThe evolution of drug resistance threatens human health worldwide. An emerging strategy to mitigate drug resistance is combination therapy. The fate of multidrug-resistant pathogens depends on their fitness relative to susceptible counterparts, yet the fitness consequences of multidrug resistance remain enigmatic. Here, we dissect fitness consequences of the evolution of resistance to antifungal drug combinations in the leading human fungal pathogen, Candida albicans. We focus on the most widely deployed antifungals, the azoles, and inhibitors of the molecular chaperone Hsp90 and protein phosphatase calcineurin, which regulate cellular stress responses required for azole resistance. We find tradeoffs such that adaptation to drug combinations is associated with reduced fitness in distinct environments, including those relevant to the human host. We identify mutations associated with fitness tradeoffs in clinical isolates and that influence morphogenesis, a key virulence trait. Thus, we delineate evolutionary constraints that may minimize the evolution of resistance to antifungal combinations.http://www.sciencedirect.com/science/article/pii/S2211124715000108
spellingShingle Jessica A. Hill
Teresa R. O’Meara
Leah E. Cowen
Fitness Trade-Offs Associated with the Evolution of Resistance to Antifungal Drug Combinations
Cell Reports
title Fitness Trade-Offs Associated with the Evolution of Resistance to Antifungal Drug Combinations
title_full Fitness Trade-Offs Associated with the Evolution of Resistance to Antifungal Drug Combinations
title_fullStr Fitness Trade-Offs Associated with the Evolution of Resistance to Antifungal Drug Combinations
title_full_unstemmed Fitness Trade-Offs Associated with the Evolution of Resistance to Antifungal Drug Combinations
title_short Fitness Trade-Offs Associated with the Evolution of Resistance to Antifungal Drug Combinations
title_sort fitness trade offs associated with the evolution of resistance to antifungal drug combinations
url http://www.sciencedirect.com/science/article/pii/S2211124715000108
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