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. 2018 Mar 28;3(2):e00092-18.
doi: 10.1128/mSphere.00092-18. eCollection 2018 Mar-Apr.

Investigating Colonization of the Healthy Adult Gastrointestinal Tract by Fungi

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Investigating Colonization of the Healthy Adult Gastrointestinal Tract by Fungi

Thomas A Auchtung et al. mSphere. .

Abstract

A wide diversity of fungi have been detected in the human gastrointestinal (GI) tract with the potential to provide or influence important functions. However, many of the fungi most commonly detected in stool samples are also present in food or the oral cavity. Therefore, to recognize which gut fungi are likely to have a sustained influence on human health, there is a need to separate transient members of the GI tract from true colonizers. To identify colonizing fungi, the eukaryotic rRNA operon's second internal transcribed spacer (ITS2) was sequenced from the stool, saliva, and food of healthy adults following consumption of different controlled diets. Unlike most bacterial 16S rRNA genes, the only fungal ITS2 operational taxonomic units (OTUs) detected in stool DNA across multiple diets were also present in saliva and/or food. Additional analyses, including culture-based approaches and sequencing of the 18S rRNA gene, ITS2 cDNA, and DNA extracted using alternative methods, failed to detect additional fungi. Two abundant fungi, Saccharomyces cerevisiae and Candida albicans, were examined further in healthy volunteers. Saccharomyces became undetectable in stool when a S. cerevisiae-free diet was consumed, and the levels of C. albicans in stool were dramatically reduced by more frequent cleaning of teeth. Extremely low fungal abundance, the inability of fungi to grow under conditions mimicking the distal gut, and evidence from analysis of other public datasets further support the hypothesis that fungi do not routinely colonize the GI tracts of healthy adults. IMPORTANCE We sought to identify the fungi that colonize healthy GI tracts and that have a sustained influence on the diverse functions of the gut microbiome. Instead, we found that all fungi in the stool of healthy volunteers could be explained by their presence in oral and dietary sources and that our results, together with those from other analyses, support the model that there is little or no gastrointestinal colonization by fungi. This may be due to Westernization, primate evolution, fungal ecology, and/or the strong defenses of a healthy immune system. Importantly, fungal colonization of the GI tract may often be indicative of disease. As fungi can cause serious infections in immunocompromised individuals and are found at increased abundance in multiple disorders of the GI tract, understanding normal fungal colonization is essential for proper treatment and prevention of fungal pathogenesis.

Keywords: colonization; diet; fungi; gastrointestinal tract; mycobiome; saliva.

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Figures

FIG 1
FIG 1
Comparison of community fungal and bacterial/archaeal diversity levels. Numbers of unique ITS2 (blue circles) or 16S rRNA gene (orange diamonds) OTUs in 148 Human Microbiome Project samples (from 100 volunteers) that had been rarefied to 1,000 reads for both regions were determined. Plotted data represent the mean number of OTUs detected at the indicated number of samples when sample order was randomized over 1,000 iterations. The error bars represent the 95% confidence intervals. The ITS2 data most closely fit the power function y = 17.34x0.68 (R2 = 0.998), whereas the 16S rRNA gene data most closely fit the logarithmic equation y = 79.03ln(x) −17.84 (R2 = 0.988).
FIG 2
FIG 2
Relative abundances of fungal taxa detected by ITS2 DNA and cDNA analysis of stool samples from volunteers 1 to 4 following controlled diets A to D and the presence of those taxa in the saliva of the volunteers, components of the controlled diets, and known components of the volunteers’ regular diets. Stool DNA, stool cDNA, saliva, and controlled-diet samples had median read values of 24,655, 10,527, 18,540, and 18,500, respectively. For stool, the relative abundances for triplicate samples were averaged and sequences mapping to plants were removed. Samples with >1,000 reads remaining were rarefied to 1,000 reads. For saliva, there were 10 to 12 samples analyzed per volunteer that were collected across the diets. For controlled-diet components, two samples were analyzed (typically one whole sample and one sample rinse). A species was considered present if detected at ≥10 reads in any replicate of a sample. The species detected from stool samples of >1 diet of a volunteer are indicated with coloring. Regular diet components were those foods volunteers reported typically eating.
FIG 3
FIG 3
Relative abundances of microeukaryotic taxa detected by ITS2 analysis of DNA or cDNA from stool. Taxonomic differences between ITS2 DNA (blue) and cDNA (red) analyses following normalization to an equal number of microeukaryotic reads/sample were determined. Twenty-five samples from four volunteers on four controlled diets and one uncontrolled diet and from one volunteer on five uncontrolled diets were analyzed. Boxes contain the interquartile range, with the center line denoting the median relative abundance.
FIG 4
FIG 4
Relative ITS2 abundance of Saccharomyces in stool over time as a Saccharomyces cerevisiae-free diet was consumed. A logarithmically scaled chart showing the unrarefied relative abundances of Saccharomyces reads among ITS2 sequences amplified from stool DNA of a human volunteer is shown. Plant sequences were removed before analysis. The volunteer consumed a regular diet for 7 days and a Saccharomyces cerevisiae-free diet for 7 days and then resumed a regular diet. Day 8 data represent averages of results from two stool samples, and there was no sample on day 12.
FIG 5
FIG 5
Candida albicans levels were decreased in the mouth and stool of healthy human volunteer(s) when teeth were brushed more often. (A) Concentrations of C. albicans in saliva throughout days when an adult volunteer either did or did not perform tooth brushing after eating. The volunteer consumed the same diet on both tooth-brushing protocols, the experiment was performed for two different diets, and levels of C. albicans were measured in a sample of plaque at the end of each day. (B) The total number of C. albicans cells in the stool of a volunteer over time (plotted on a log axis). Following a period of brushing teeth just once per day, the volunteer performed tooth brushing after every meal for 8 consecutive days. The diet was not the same from day to day but contained similar levels of sugars throughout the time period. (C and D) Lastly, the total number of C. albicans cells was measured in the stool of (C) a volunteer who alternately followed different tooth-brushing protocols for 2 days over the course of 16 days or of (D) a second volunteer who twice conducted each tooth-brushing protocol on nonconsecutive days. For all experiments, saliva, plaque, or stool was plated on Sabouraud plates containing antibiotics. Possible C. albicans colonies were later spotted on chromogenic media to distinguish the C. albicans colonies from closely related species and to adjust C. albicans numbers.

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