Calcineurin regulates innate antifungal immunity in neutrophils

J Exp Med. 2010 May 10;207(5):923-31. doi: 10.1084/jem.20092531. Epub 2010 Apr 26.

Abstract

Patients taking immunosuppressive drugs, like cyclosporine A (CsA), that inhibit calcineurin are highly susceptible to disseminated fungal infections, although it is unclear how these drugs suppress resistance to these opportunistic pathogens. We show that in a mouse model of disseminated Candida albicans infection, CsA-induced susceptibility to fungal infection maps to the innate immune system. To further define the cell types targeted by CsA, we generated mice with a conditional deletion of calcineurin B (CnB) in neutrophils. These mice displayed markedly decreased resistance to infection with C. albicans, and both CnB-deficient and CsA-treated neutrophils showed a defect in the ex vivo killing of C. albicans. In response to the fungal-derived pathogen-associated molecular pattern zymosan, neutrophils lacking CnB displayed impaired up-regulation of genes (IL-10, Cox2, Egr1, and Egr2) regulated by nuclear factor of activated T cells, the best characterized CnB substrate. This activity was Myd88 independent and was reproduced by stimulation with the beta(1,3) glucan curdlan, indicating that dectin-1, rather than toll-like receptors, is the upstream activator of calcineurin. Our results suggest that disseminated fungal infections seen in CsA-treated patients are not just a general consequence of systemic suppression of adaptive immunity but are, rather, a result of the specific blockade of evolutionarily conserved innate pathways for fungal resistance.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antifungal Agents / immunology*
  • Calcineurin / deficiency
  • Calcineurin / drug effects
  • Calcineurin / genetics
  • Calcineurin / physiology*
  • Candida albicans
  • Candidiasis / epidemiology*
  • Candidiasis / immunology
  • Cyclosporine / adverse effects
  • Cyclosporine / therapeutic use
  • Disease Susceptibility
  • Homeostasis
  • Humans
  • Immunity, Innate / drug effects
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Mice
  • Mycoses / epidemiology*
  • Mycoses / immunology
  • Neutrophils / immunology*
  • Neutrophils / microbiology
  • Neutrophils / physiology
  • Polysaccharides, Bacterial / pharmacology
  • Zymosan / pharmacology
  • beta-Glucans / pharmacology

Substances

  • Antifungal Agents
  • Immunosuppressive Agents
  • Polysaccharides, Bacterial
  • beta-Glucans
  • curdlan
  • Cyclosporine
  • Zymosan
  • Calcineurin