Investigating antifungal tolerance

A refined single-cell sequencing technique provides insight into how pathogenic fungi respond to drugs.

Microscopy image of Candida albicans cells. Image credit: Vader1941 (CC BY-SA 4.0)

Many drugs currently used to treat fungal diseases are becoming less effective. This is partly due to the rise of antifungal resistance, where certain fungal cells acquire mutations that enable them to thrive and proliferate despite the medication. Antifungal tolerance also contributes to this problem, wherein certain cells can continue to grow and multiply, while other – genetically identical ones – cannot. This variability is partly due to differences in gene expression within the cells. The specific nature of these differences has remained elusive, mainly because their study requires the use of expensive and challenging single-cell technologies.

To address this challenge, Dumeaux et al. adapted an existing technique to perform single-cell transcriptomics in the pathogenic yeast Candida albicans. Their approach was cost effective and made it possible to examine the gene expression in thousands of individual cells within a population that had either been treated with antifungal drugs or were left untreated.

After two to three days following exposure to the antifungal treatment, C. albicans cells commonly exhibited one of two states: one subgroup, the ‘Ribo-dominant’ cells, predominantly expressed genes for ribosomal proteins, while the other group, the ‘Stress-dominant’ cells, upregulated their expression of stress-response genes. This suggests that drug tolerance may be related to different gene expression patterns in growing cell subpopulations compared with non-growing subpopulations.

The findings also indicate that the so-called ‘ribosome assembly stress response’ known to help baker’s yeast cells to survive, might also aid C. albicans in surviving exposure to antifungal treatments.

The innovative use of single-cell transcriptomics in this study could be applied to other species of fungi to study differences in cell communication under diverse growth conditions. Moreover, the unique gene expression patterns in C. albicans identified by Dumeaux et al. may help to design new antifungal treatments that target pathways linked to drug resistance.