Cited by 25Fungal and yeast genetics researchAntifungal resistance and susceptibilityBacterial Genetics and Biotechnology

Candida albicans exhibits heterogeneous and adaptive cytoprotective responses to antifungal compounds

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Dumeaux, Vanessa, Massahi, Samira, Bettauer, Van, Mottola, Austin, Dukovny, Anna, Khurdia, Sanny Singh, Costa, Anna Carolina Borges Pereira, Omran, Raha Parvizi +5 more·2023·eLife

Published version of a preprint

Abstract

Candida albicans, an opportunistic human pathogen, poses a significant threat to human health and is associated with significant socio-economic burden. Current antifungal treatments fail, at least in part, because C. albicans can initiate a strong drug tolerance response that allows some cells to grow at drug concentrations above their minimal inhibitory concentration. To better characterize this cytoprotective tolerance program at the molecular single-cell level, we used a nanoliter droplet-based transcriptomics platform to profile thousands of individual fungal cells and establish their subpopulation characteristics in the absence and presence of antifungal drugs. Profiles of untreated cells exhibit heterogeneous expression that correlates with cell cycle stage with distinct metabolic and stress responses. At 2 days post-fluconazole exposure (a time when tolerance is measurable), surviving cells bifurcate into two major subpopulations: one characterized by the upregulation of genes encoding ribosomal proteins, rRNA processing machinery, and mitochondrial cellular respiration capacity, termed the Ribo-dominant ( Rd ) state; and the other enriched for genes encoding stress responses and related processes, termed the Stress-dominant ( Sd ) state. This bifurcation persists at 3 and 6 days post-treatment. We provide evidence that the ribosome assembly stress response (RASTR) is activated in these subpopulations and may facilitate cell survival.

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  • Single-cell transcriptomics have shown that the ribosome assembly stress response supports survival under fluconazole exposure above the MIC.

    “Moreover, single-cell transcriptomics have shown that the ribosome assembly stress response supports survival under fluconazole exposure above the MIC, highlighting the importance of stress responses in antifungal tolerance [122].”

    From Insight into the Mechanisms and Clinical Relevance of Antifungal Heteroresistance (2025) · cites this paper as [122]

    The Abstract reports single-cell transcriptomic profiling of fluconazole-exposed Candida albicans cells and says the ribosome assembly stress response may facilitate survival. The Results likewise propose a possible role in drug tolerance. The claim omits that uncertainty by stating that the response supports survival as an established finding. (LLM, conf=0.87)

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Authors
Dumeaux, V., Massahi, S., Bettauer, V., Mottola, A., Dukovny, A., Khurdia, S. S., Costa, A. C. B. P., Omran, R. P., Simpson, S., Xie, J. L., Whiteway, M., Berman, J., & Hallett, M. T.
Affiliations
  • Western University (CA)
  • Concordia University (US)
  • Concordia University (CA)
  • Tel Aviv University (IL)
  • Stanford University (US)
Corresponding author
Hallett, Michael T
Venue
eLife
Published
2023-10-27
Volume
12
ISSN
2050-084X (ISSN-L)
OpenAlex
W4387966939
Cited by
25
References
129
Citations by year
2026: 6 · 2025: 9 · 2024: 7 · 2023: 3
FWCI
2.22
Type
journal article
Language
en
Open access
Locations
  • eLife (publishedVersion, cc-by)
  • bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Natural Sciences and Engineering Research Council of Canada (RGPIN-2018-05085)
  • Canada Foundation for Innovation (37083)
  • European Research Council (951475)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Bacterial Genetics and Biotechnology
Keywords
Candida albicans, antifungal drug tolerance, fluconazole, single-cell transcriptomics, cellular heterogeneity, ribosomal proteins, mitochondrial respiration, stress response genes, cell cycle phases, fungal drug resistance
MeSH terms
Antifungal Agents, Candida albicans, Humans, Microbial Sensitivity Tests, Mitochondria, Fluconazole, Drug Resistance, Fungal

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