Magnetic Resonance Imaging Confirms Loss of Blood- Brain Barrier Integrity in a Mouse Model of Disseminated Candidiasis

Disseminated candidiasis primarily targets the kidneys and brain in mice and humans. Damage to these critical organs leads to the high mortality associated with such infections, and invasion across the blood- brain barrier can result in fungal meningoencephalitis. Candida albicans can penetrate a brain endothelial cell barrier in vitro through transcellular migration, but this mechanism has not been confirmed in vivo. MRI imaging using the extracellular vascular contrast agent Gd-DTPA demonstrated that integrity of the blood- brain barrier is lost during C. albicans invasion. Intravital two-photon laser scanning microscopy was used to provide the first real time demonstration of C. albicans colonizing the living brain, where both yeast and filamentous forms of the pathogen were found. Furthermore, we adapted a previously described method utilizing MRI to monitor inflammatory cell recruitment into infected tissues in mice. Macrophages and other phagocytes were visualized in kidney and brain by administering ultra-small iron oxide particles. In addition to obtaining new insights into the passage of C. albicans across brain microvasculature, these imaging methods provide useful tools to further study the pathogenesis of C. albicans infections, define the roles of Candida virulence genes in kidney versus brain infection, and assess new therapeutic measures for drug development.