pcr identification system for the genus aspergillus and three major pathogenic species: aspergillus...
TRANSCRIPT
PCR identification system for the genus Aspergillus and
three major pathogenic species: Aspergillus fumigatus,
Aspergillus flavus and Aspergillus niger
CHISE SUGITA*,$, KOICHI MAKIMURA$, KATSUHISA UCHIDA$, HIDEYO YAMAGUCHI$ & ATSUSHI NAGAI*
*First Department of Internal Medicine, Tokyo Woman’s Medical University, Shinjuku, Tokyo and $Teikyo University Instituteof Medical Mycology, Hachioji, Tokyo, Japan
A PCR system was developed that allowed recognition of three major pathogenic
Aspergillus species, namely A . fumigatus, A. niger and A. flavus, in isolates
obtained from clinical specimens. The primer pair for PCR was designed from
conserved sequences of internal transcribed spacer 1 (ITS1) ribosomal DNA and
its flanking regions. Products 521 bp in size were successfully amplified by PCR
from the seven Aspergillus species most frequently encountered as opportunistic
pathogens, and the three most commonly significant species were identified by
separate PCR reactions or nested PCR based on use of species-specific primers. To
our knowledge, this is first report of identification of the second and third most
frequent pathogenic Aspergillus species using specific PCR amplification. The PCR
based identification system reported here will be a powerful tool to control difficult
pulmonary fungal infections and to speed the application of effective treatment.
Keywords Aspergillus species, identification, internal transcribed spacer 1
ribosomal DNA, nested PCR
Introduction
Aspergillus species have recently caused increasing
numbers of life-threatening acute invasive infections
in immunocompromized patients [1]. The steadily
increasing incidence of invasive aspergillosis over the
last few decades is ascribable to the increasing number
of patients undergoing chemotherapy, bone marrow or
solid organ transplantation and intensive corticosteroid
therapy [2].
Conventional diagnosis of fungal infection relies on
the identification of pathogens by means of morpho-
logical characters specific to the genus and species. This
is sometimes unsuccessful, however, because of the
atypical features of some isolates. Molecular biological
identification systems for pathogenic aspergilli have
been suggested as a solution to this problem: for
example, a PCR based diagnostic method for detecting
the genus Aspergillus using 18S rDNA [3,4] has been
designed. Systems have also been described for specific
detection of Aspergillus fumigatus with primers based
on regions of the 28S rDNA [5] or of the internal
transcribed spacer (ITS) 1 and 2 regions of ribosomal
DNA (rDNA) [6�/9].
These PCR systems described to date are useful only
in identifying the genus Aspergillus as a whole or the
single species A. fumigatus. The ITS region contains
variable elements that allow for sequence-based identi-
fication of Aspergillus species [10]; therefore, the region
offers a possible template for design of species-specific
primers for identification of the major pathogenic
species.Because the number of species of pathogenic fungi
known to infect immunocompromized patients is
growing [9], it is essential that quick and reliable
methods of identification be found for the most
common pathogenic species of aspergilli. This means
that not just A. fumigatus, but also Aspergillus flavus
and A. niger, should be rapidly identified by a success-
ful system.
Correspondence: K. Makimura, Teikyo University Institute of
Medical Mycology, 359 Otsuka, Hachioji, Tokyo 192-0395, Japan.
Tel. :�/81 426 78 3256 Fax:�/81 426 74 9190 E-mail:
Received 10 January 2003; Accepted 10 November 2003
– 2004 ISHAM DOI: 10.1080/13693780310001656786
Medical Mycology October 2004, 42, 433�/437
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In the present study, we attempted to develop a rapid
and reliable identification system to identify the genus
Aspergillus in general and the three major pathogens
named. We developed an identification system based
on new primers, derived from the ITS1 region and its
flanking regions, for use in PCR and nested PCR.
Materials and methods
Organisms
Fungal strains used in this study are shown in Table 1.
Eighteen species were represented by 27 stock cultures.
Included were seven Aspergillus species represented by
16 strains, as well as two fresh clinical isolates. Clinical
strain 1 was isolated from a tumor of the lung; strain 2
was an isolate from sputum. In neither isolate could the
species be identified by its morphology because the
isolates had little or no ability to produce conidia.
DNA preparation
Strains were grown on Sabouraud dextrose agar (SDA;
peptone 1%, glucose 1%, agar 1%) at 278C for 1�/5 days
depending on strain growth rate. DNA was rapidly
prepared from strains of fungi by the method
previously described by authors of the present study
[3,11]. A small amount of fungal material grown on
SDA was placed in lysis buffer (200 mmol/l Tris-HCl
pH 8.0, 0.5% sodium dodecyl sulfate [SDS], 250 mmol/l
NaCl, 25 mmol/l ethylenediamine tetraacetic acid
[EDTA]) and, for molds, crushed with a conical
grinder. This material was then incubated at 1008Cfor 15 min and mixed with 150 ml 3.0 mol/l sodium
acetate, kept at �/208C for 10 min, then centrifuged at
10 000 g for 5 min. The supernatant was extracted once
with phenol-chloroform-isoamyl alcohol (25:24:1), and
subsequently extracted once with chloroform. DNA
was precipitated with an equal volume of isopropanol
at �/208C for 10 min, washed with 0.5 ml 70% ethanol,
dried, and suspended in 50 ml ultra pure water (Milli-Q
Table 1 Specificity of the primer sets tested in this study.
Species Strain Primer set codes
ASAP Fmi Fla Nig ITS
Aspergillus fumigatus TIMM3968 �/ �/ �/ �/ �/
2920 �/ �/ �/ �/ �/
0108 �/ �/ �/ �/ �/
A. flavus TIMM0057 �/ �/ �/ �/ �/
2935 �/ �/ �/ �/ �/
2912 �/ �/ �/ �/ �/
(A. oryzae ) 0117 �/ �/ �/ �/ �/
A. niger TIMM0113 �/ �/ �/ �/ �/
0114 �/ �/ �/ �/ �/
2915 �/ �/ �/ �/ �/
2930 �/ �/ �/ �/ �/
2932 �/ �/ �/ �/ �/
A. terreus TIMM2929 �/ �/ �/ �/ �/
A. versicolor TIMM1290 �/ �/ �/ �/ �/
A. japonicus TIMM2910 �/ �/ �/ �/ �/
A. clavatus TIMM0056 �/ �/ �/ �/ �/
Alternaria alternata TIMM3834 �/ �/ �/ �/ �/
Absidia corymbifera TIMM0002 �/ �/ �/ �/ �/
Penicillium chrysogenum TIMM0883 �/ �/ �/ �/ �/
P. expansum TIMM1293 �/ �/ �/ �/ �/
P. citreonigrum TIMM0882 �/ �/ �/ �/ �/
Pseudallescheria boydii TIMM0887 �/ �/ �/ �/ �/
Fusarium solani TIMM1304 �/ �/ �/ �/ �/
Mucor circinelloides TIMM3177 �/ �/ �/ �/ �/
Trichosporon asahii TIMM3966 �/ �/ �/ �/ �/
Cryptococcus neoformans TIMM3173 �/ �/ �/ �/ �/
Candida albicans TIMM1768 �/ �/ �/ �/ �/
ASAP, genus Aspergillus specific primer-pair; Fla, A. flavus -specific primer set; Fmi, A. fumigatus -specific primer set; ITS, general fungus
specific primer-pair; Nig, A. niger- specific primer set; TIMM, Teikyo University Institute of Medical Mycology.
– 2004 ISHAM, Medical Mycology, 42, 433�/437
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Synthesis A10; Millipore); 1 ml solution was used as the
template for PCR [11].
Oligonucleotide design
All oligonucleotides used in this study were designed
based on the relevant sequences of the ITS1 andflanking regions deposited in the DDBJ/EMBL/Gen-
Bank database (accession nos.: X78537, A. flavus ;
M55626, A. fumigatus ; X78538, A. niger ; X78540, A.
terreus ). The following two oligonucleotide primers
(termed ASAP) were designed for specific detection of
the genus Aspergillus, ASAP1:5?-CAGCGAGTACAT-
CACCTTGG-3? and ASAP2:5?-CCATTGTTGAAA-
GTTTTAACTGATT-3?. These oligonucleotides andthe others mentioned below were made by Amersham
Bioscience, Japan. The primers were expected to
amplify a fragment 521 bp in length including the
whole ITS1 region. Also, three oligonucleotide primer
sets based on specific regions within the ASAP1 and
ASAP2 amplicons were designed for use in identifying
A. fumigatus, A. niger and A. flavus. The A. fumigatus-
specific primer set (called Fmi) was made up of primersdesignated ASPU (5?-ACTACCGATTGAATGGCTC-
G-3?) and Af3r (5?-CATACTTTCAGAACAGCG-
TTCA-3?). The A. niger set (called Nig) was composed
of ASPU and Ni1r (5?-ACGCTTTCAGACAGT-
GTTCG-3?), while the A. flavus set (Fla) consisted of
ASPU and Fl2r (5?-TTCACTAGATCAGACAGAGT-
3?). Pan-fungal primers amplifying 18S rDNA regions
(B2F; 5?-ACTTTCGATGGTAGGATAG-3? and B4R;5?-TGATCGTCTTCGATCCCCTA-3? [11]) and ITS1
rDNA (18SF1; 5?-AGGTTTCCGTAGGTGAACCT-3?and 58SR1; 5?-TTCGCTGCGTTCTTCATCGA-3?[12]) were used as positive controls.
PCR
The genus specific ASAP PCR mixture contained 10 ml
10�/reaction buffer, 100 mM each of dATP, dCTP,
dGTP and dTTP, 2.5 U Taq polymerase (all Amer-
sham), 30 pmol of each primer, and 2 ml DNA template
solution. Ultra-pure water was added to increase thevolume to 100 ml. For ASAP PCR reaction, each
mixture was heated to 948C for 4 min and PCR was
performed with the following program for the thermal
cycler (GeneAmp PCR system 2400, Applied Biosys-
tems): 948C for 1 min; 558C for 2 min; and 728C for 90
s; all repeated for 30 cycles. Thermal cycling was
terminated by polymerization at 728C for 10 min.
For the species specific primer sets Fmi, Nig, andFla, PCR, 2 ml DNA solution from isolates or 1 ml of
the PCR products diluted 1/100 were used as a
template. Each mixture was heated to 948C for 4 min
and PCR was performed in cycles of 948C for 1 min;
608C for 15 s and 728C for 15 s. There were 25 cycles intotal. Thermal cycling was terminated by polymeriza-
tion at 728C for 10 min. The total cycling process
required 1.7 h.
Agarose gel electrophoresis
Between 5 and 10 ml PCR product was electrophoresed
in 1.2% agarose gel and visualized by ethidium bromide
staining and ultraviolet irradiation.
DNA sequence
PCR products were immediately sequenced by a DNA
sequencing kit (Applied Biosystems) with primers for
18S rDNA (B2F and B4R, detailed above) and an
automatic sequencer (Genetic Analyzer 310; Applied
Biosystems) used according to the manufacturer’sinstructions. The sequences were analyzed with Gene-
tyx-Mac10 software (Software Development, Tokyo,
Japan) and searched on the DDBJ/EMBL/GenBank
nucleotide database using BLAST programs.
Results
The genus-level specificity of the putative Aspergillus -specific primer system, or ASAP, was tested. A product
of 0.5 kbp was amplified by PCR from all tested
aspergilli, namely A. fumigatus, A. niger, A. flavus
(including its non-toxigenic domesticated form A.
oryzae), A. terreus, A. versicolor, A. japonicus and A.
clavatus, but not from other fungi, including Candida
albicans, Cryptococcus neoformans, Trichosporon asahii,
Mucor circinelloides, Fusarium solani, Pseudallescheria
boydii, Penicillium chrysogenum, P. citreonigrum (isolate
stored in TIMM under synonymous name P. ci-
treoviride ), P. expansum, Absidia corymbifera and
Alternaria alternata (Table 1).
The specificity of putatively species-specific primer-
sets for A. fumigatus, A. flavus and A. niger (Fmi, Fla
and Nig, respectively), was also tested. Each of these
primer-sets was successful in amplifying only the targetspecies (Table 1; Fig. 1).
Two nearly or completely nonsporulating clinical
isolates from respiratory materials, strains 1 and 2,
were subjected to the PCR identification. Strain 1 gave
a positive amplification with the 18S rDNA-based pan-
fungal primers, but it was negative by ASAP. This
means that it was not an Aspergillus species. Subse-
quent sequencing and mating analysis showed that thestrain was Schizophyllum commune (data not shown).
Strain 2 was positive by both pan-fungus PCR and
ASAP. Nested PCR showed that it was positive only
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with primer set Fla and was negative with Fmi and Nig
(Fig. 2); therefore, it was identified as A. flavus. This
result was also confirmed by DNA sequencing (data
not shown).
Discussion
Most previous publications on PCR-based detection or
identification systems for Aspergillus spp. were based
on using 18S or 28S rDNA as target DNA. However,
the sequences in these regions are conserved across a
wide range of fungi; it is therefore difficult to design
truly species-specific primers. As reported previously,
the more variable ITS regions have proven more useful
for identification of fungal species [13].
To our knowledge, the present study is the first using
specific PCR amplification to allow identification not
just of A. fumigatus but also A. flavus and A. niger, the
second and third most frequently significant Aspergil-
lus species in opportunistic infection, using specific
PCR amplification. The importance of these species
should not be underestimated. The number of infec-
tions they cause is increasing [9,14�/16].
Species identification of moulds using histopathol-
ogy or conventional morphology is not always success-
ful. For example, a fungus ball can be produced by a
number of filamentous fungi, such as S. commune [17]
or P. boydii [18], which are able to grow saprotrophi-
cally in the human body. If these fungi grow out as
nonsporulating or otherwise atypical mycelium, identi-
fication is problematical [17]. The infections cased by
these fungi are similar to aspergillosis clinically and
pathologically; however, these fungi have poor suscept-
ibility to amphotericin B and candins, so different
antifungal drugs must be used for their control. Drug
susceptibilities, treatment procedures and prognoses
vary widely among fungal species; therefore, reliable
techniques for species identification are essential for
effective management.
The genus Aspergillus consists of about 185 species
[19]. A. fumigatus, A. niger and A. flavus account for
more than 95% of isolates causing aspergillosis [20]. In
the diagnosis of aspergillosis, identification of the
species involved is extremely important. Contamination
caused by environmental fungi poses a serious problem
and Aspergillus species, including many nonpathogens,
are ubiquitous. To identify an Aspergillus from clinical
specimens as a causal agent often requires corrobora-
tion based on repeated isolation of the same fungal
species. This must be done reliably in order to exclude
confusion arising from successive isolations of various
contaminating aspergilli.
Numerous recent reports have advocated direct
sequencing of PCR products for rapid molecular
biological identification of fungal strains. The DNA
sequence is superably reliable and informative; how-
ever, the necessary equipment is expensive and the
process takes more than 2 days. The PCR based
identification system reported here is a powerful tool
that facilitates diagnosis of infection at an early stage,
and allows prompt control of difficult pulmonary
Fig. 1 Specificity of species-specific primer sets in nested PCR.
Lanes left to right depict specific primer set Fmi for Aspergillus
fumigatus ; Fla for A. flavus ; Nig for A. niger ; ITS1, ITS1-specific
panfungal primer set used as a positive control.
Fig. 2 Identification of morphologically unidentifiable clinical
isolates using the nested PCR system. Strain 1 is a filamentous
fungus isolated from a resected pulmonary tumour, and Strain 2 is a
mould cultured from sputum. Lanes: M, molecular marker; F,
panfungal primer pair (positive control); A, primer pair ASAP
specific for Aspergillus at genus level; Fmi, A. fumigatus specific
primers as in Fig. 1; Fla, A. flavus -specific primers; Nig, A. niger -
specific primers.
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fungal infections, in part by rapid application of
effective treatment.
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