Top: FK506-resistant strains isolated from the Mucor circinelloides complex. Phenotypic analysis of FK506-resistant isolates in Mucor janssenii CBS185.68 (PS1), Mucor bainieri CBS293.63 (PS3), and Mucor atramentarius CBS202.28 (PS6). WT, wild-type; M, mendelian mutant; E, epimutant. Bottom: Schematic overview of epigenetic silencing contributing to antifungal resistance in Mucor species. fkbA expression enables FKBP12 production and FK506 sensitivity (yeast-like morphology). Epigenetic silencing of fkbA via RNAi and/or heterochromatin leads to FK506 resistance and hyphal growth. Generated with BioRender.com.

#Antifungal resistance is a global threat, but epigenetic mechanisms drive rapid, reversible adaptation in fungi. This study shows that #RNAi or #heterochromatin driven #epimutations transiently silence the gene fkbA to confer FK506 #tacrolimus resistance in #Mucor @plosbiology.org 🧪 plos.io/4qdttWc

Top: FK506-resistant strains isolated from the Mucor circinelloides complex. Phenotypic analysis of FK506-resistant isolates in Mucor janssenii CBS185.68 (PS1), Mucor bainieri CBS293.63 (PS3), and Mucor atramentarius CBS202.28 (PS6). WT, wild-type; M, mendelian mutant; E, epimutant. Bottom: Schematic overview of epigenetic silencing contributing to antifungal resistance in Mucor species. fkbA expression enables FKBP12 production and FK506 sensitivity (yeast-like morphology). Epigenetic silencing of fkbA via RNAi and/or heterochromatin leads to FK506 resistance and hyphal growth. Generated with BioRender.com.

#Antifungal resistance is a global threat, but epigenetic mechanisms drive rapid, reversible adaptation in fungi. This study shows that #RNAi or #heterochromatin driven #epimutations transiently silence the gene fkbA to confer FK506 #tacrolimus resistance in #Mucor @plosbiology.org 🧪 plos.io/4qdttWc

Top: FK506-resistant strains isolated from the Mucor circinelloides complex. Phenotypic analysis of FK506-resistant isolates in Mucor janssenii CBS185.68 (PS1), Mucor bainieri CBS293.63 (PS3), and Mucor atramentarius CBS202.28 (PS6). WT, wild-type; M, mendelian mutant; E, epimutant. Bottom: Schematic overview of epigenetic silencing contributing to antifungal resistance in Mucor species. fkbA expression enables FKBP12 production and FK506 sensitivity (yeast-like morphology). Epigenetic silencing of fkbA via RNAi and/or heterochromatin leads to FK506 resistance and hyphal growth. Generated with BioRender.com.

#Antifungal resistance is a global threat, but epigenetic mechanisms drive rapid, reversible adaptation in fungi. This study shows that #RNAi or #heterochromatin driven #epimutations transiently silence the gene fkbA to confer FK506 #tacrolimus resistance in #Mucor @plosbiology.org 🧪 plos.io/4qdttWc

Tx cutaneous #mucor wide excision & systemic anti fungal amphoB initially (Posaconazole or isavuconazole can be used for step down therapy), some cases had success combining with hyperbaric oxygen

50% isolated cutaneous #mucor cases may not have underlying immunosuppressive. r.f. DM, hem CA, HSCT, SOT, deferoxamine, drug injections, renal failure, infant low birth weight, malnutrition, HIV, SLE, trauma, aplastic anemia & steroid use

Cutaneous #mucor in diabetics or immunosuppressed pts: usually acquired by direct inoculation via trauma. Can present as non healing ulcer or indurated plaque that evolves to eschar

Second, Alyssa showed that the TG11 antibody binds similarly to a wide range of important clinical isolates of #mucormycosis including #Rhizopus, #Lichtheimia, #Cunninghamella, and #Mucor species 10/