When protoplasts of the opportunistic fungal pathogen Aspergillus fumigatus were treated with low but toxic levels of hydrogen peroxide (0?1 mM) or amphotericin B (0?5 mg ml "1 ), loss of cell viability and death were associated with a number of phenotypic changes characteristic of apoptosis. The percentage of protoplasts staining positive with annexin V-FITC, an indicator of the externalization of phosphatidylserine and an early marker of apoptosis, rose to~55 % within 1 h. This was followed by a similar increase in apoptotic DNA fragmentation detected by the TUNEL assay, and led to a loss of cell permeability and death in~90 % of protoplasts, as indicated by the uptake of propidium iodide. The development of an apoptotic phenotype was blocked when protoplasts were pre-treated with the protein synthesis inhibitor cycloheximide, indicating active participation of the cell in the process. However, no significant activity against synthetic caspase substrates was detected, and the inclusion of the cell-permeant broad-spectrum caspase inhibitor Z-VAD-fmk did not block the development of the apoptotic-like phenotype. Higher concentrations of H 2 O 2 (1?8 mM) and amphotericin B (1 mg ml "1 ) caused protoplasts to die without inducing an apoptotic phenotype. As predicted, the fungistatic antifungal agent itraconazole, which inhibits growth without causing immediate cell death, did not induce an apoptotic-like phenotype.
INTRODUCTIONThe incidence of life-threatening invasive aspergillosis in immunocompromised hosts has increased dramatically over the last two decades (Groll et al., 1996;Vogeser et al., 1997;Latgé, 1999;Denning et al., 2002). Aspergillus fumigatus is the most common aetiological agent of invasive aspergillosis, being responsible for approximately 90 % of human infections (Derouin, 1994). The incidence of invasive aspergillosis varies between 1 and 19 % for patients who have undergone solid organ transplantation (Patel & Paya, 1997;Verweij & Denning, 1997), and patients with leukaemia, AIDS and granulomatous disease are also at risk (Brown et al., 1998;Denning, 1998;Kaizer et al., 1998). In contrast, the disease is rarely found in immunocompetent hosts (Karim et al., 1997). A. fumigatus is a common, widespread saprophytic fungus, and environmental surveys indicate that humans inhale several hundred A. fumigatus conidia per day (Hospenthal et al., 1998). Ingestion and killing of spores by alveolar macrophages represent the first line of defence against infection, mainly by non-oxidative mechanisms, whilst neutrophils employ an oxidative respiratory burst to kill germinating conidia that have escaped macrophage engulfment (Schaffner et al., 1986;Levitz et al., 1986; Morgenstern et al., 1997;Roilides et al., 1998; Latgé, 2001). Invasive aspergillosis has a high mortality and morbidity rate, with only 34 % of patients showing a favourable response to antifungal therapy (Denning, 1996). The fungicidal agent amphotericin B is widely used to treat invasive aspergillosis, although it can have serious side-effect...