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A gut-oral microbiome–driven axis controls oropharyngeal candidiasis through retinoic acid
Felix E.Y. Aggor, Martinna Bertolini, Chunsheng Zhou, Tiffany C. Taylor, Darryl A. Abbott, Javonn Musgrove, Vincent M. Bruno, Timothy W. Hand, Sarah L. Gaffen
Felix E.Y. Aggor, Martinna Bertolini, Chunsheng Zhou, Tiffany C. Taylor, Darryl A. Abbott, Javonn Musgrove, Vincent M. Bruno, Timothy W. Hand, Sarah L. Gaffen
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Research Article Immunology

A gut-oral microbiome–driven axis controls oropharyngeal candidiasis through retinoic acid

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Abstract

A side effect of antibiotics is outgrowth of the opportunistic fungus Candida albicans in the oropharynx (oropharyngeal candidiasis, OPC). IL-17 signaling is vital for immunity to OPC, but how the microbiome impacts antifungal immunity is not well understood. Mice in standard specific pathogen–free (SPF) conditions are resistant to OPC, whereas we show that germ-free (GF) or antibiotic-treated mice are susceptible. Oral type 17 cells and IL-17–dependent responses were impaired in antibiotic-treated and GF mice. Susceptibility could be rescued in GF mice by mono-colonization with segmented filamentous bacterium (SFB), an intestine-specific constituent of the microbiota. SFB protection was accompanied by restoration of oral IL-17+CD4+ T cells and gene signatures characteristic of IL-17 signaling. Additionally, RNA-Seq revealed induction of genes in the retinoic acid (RA) and RA receptor–α (RARα) pathway. Administration of RA rescued immunity to OPC in microbiome-depleted or GF mice, while RAR inhibition caused susceptibility in immunocompetent animals. Surprisingly, immunity to OPC was independent of serum amyloids. Moreover, RAR inhibition did not alter oral type 17 cytokine levels. Thus, mono-colonization with a component of the intestinal microflora confers protection against OPC by type 17 and RA/RARα, which act in parallel to promote antifungal immunity. In principle, manipulation of the microbiome could be harnessed to maintain antifungal immunity.

Authors

Felix E.Y. Aggor, Martinna Bertolini, Chunsheng Zhou, Tiffany C. Taylor, Darryl A. Abbott, Javonn Musgrove, Vincent M. Bruno, Timothy W. Hand, Sarah L. Gaffen

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Figure 4

SFB mono-colonization modulates oral transcriptional responses during OPC.

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SFB mono-colonization modulates oral transcriptional responses during OP...
Whole tongue mRNA from GF and SFB–mono-colonized mice infected orally with C. albicans was harvested at day 2 p.i. and subjected to RNA-Seq analysis. (A) Volcano plot of transcriptional changes in sham (uninfected) GF versus sham (uninfected) SFB–mono-colonized mice at baseline. (B) Gene expression was normalized between GF-OPC and GF-Sham mice and SFB-OPC and SFB-Sham mice, respectively. Venn diagram of differentially regulated genes in C. albicans–infected SFB–mono-colonized versus GF mice. LFC, log fold change. (C) g:Profiler analysis of the top 15 GO biological processes inferred from differentially regulated genes in groups 1 and 2 (from B). (D) Heatmap of type 17 pathway genes in SFB-OPC versus GF-OPC groups normalized against their respective sham controls. (E) Heatmap of genes in epithelial repair and keratinization pathways in SFB-OPC versus GF-OPC groups normalized against their respective sham controls.

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