Recombinant Trichophyton verrucosum High osmolarity signaling protein SHO1 (SHO1)

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Description

Introduction to Trichophyton verrucosum and SHO1 Protein

Trichophyton verrucosum belongs to the dermatophyte fungi, a group of closely related organisms that possess the ability to invade the stratum corneum of the epidermis and other keratinized tissues such as hair and nails . As a primary causative agent of ringworm in cattle and occasionally humans, T. verrucosum presents significant veterinary and medical challenges, particularly in rural communities where human-livestock interaction is common . The fungus typically manifests as alopecic patches covered with desquamations or thick crusts, primarily affecting the head region of infected animals .

The High Osmolarity Signaling protein SHO1 (SHO1) in T. verrucosum functions as an osmosensor, playing a crucial role in the organism's ability to adapt to environments with varying osmotic conditions . Also referred to as Osmosensor SHO1, this protein represents part of a signaling pathway that enables the fungus to survive and potentially thrive in diverse environmental conditions, including the challenging microenvironment of host tissues .

Physical and Chemical Properties

The recombinant T. verrucosum SHO1 protein demonstrates specific physicochemical properties that are essential for its biological function. As produced commercially, the protein is typically available in lyophilized powder form with greater than 90% purity as determined by SDS-PAGE analysis . The protein is stored in a Tris/PBS-based buffer containing 6% trehalose at pH 8.0, which maintains protein stability during storage .

Expression Systems and Production

Recombinant T. verrucosum SHO1 protein is typically expressed in Escherichia coli expression systems, which provide an efficient platform for producing eukaryotic proteins . The coding sequence for the full-length protein (amino acids 1-285) is inserted into an appropriate expression vector along with a sequence encoding an N-terminal histidine tag . This construct is then transformed into E. coli cells, which are cultured under controlled conditions to express the recombinant protein.

Purification and Quality Control

Following expression, the protein undergoes purification using affinity chromatography, taking advantage of the histidine tag's affinity for metal ions . Quality control measures include SDS-PAGE analysis to confirm purity (typically >90%) . The purified protein is then lyophilized and stored with appropriate buffer components to maintain stability.

Role in Osmotic Stress Response

The primary function of SHO1 protein in T. verrucosum, similar to its counterparts in other fungi, is to serve as a transmembrane osmosensor that detects changes in external osmolarity and initiates appropriate cellular responses . This function is particularly important for dermatophytes like T. verrucosum, which must adapt to varying osmotic conditions during colonization of different host tissues.

Potential Role in Pathogenicity

While not explicitly detailed in the available research for T. verrucosum, studies on related fungi suggest that stress response pathways, including those involving SHO1, can contribute to pathogenicity and virulence . Given that T. verrucosum is a significant dermatophyte pathogen affecting livestock and occasionally humans, understanding the role of SHO1 in its pathogenic mechanisms could provide valuable insights for developing targeted antifungal strategies .

Genomic Context

T. verrucosum possesses a genome with distinctive features compared to related dermatophytes. Comparative genomic analyses have revealed varying levels of transposable element content across dermatophyte species, with specific elements like the helitron family being most frequently found in T. verrucosum . This genomic context may influence the regulation and function of genes including SHO1, potentially contributing to the specific ecological niche and pathogenic capabilities of T. verrucosum.

Molecular Diagnostics and Species Identification

The SHO1 gene, along with other marker genes such as TUBB, SDHA, and EEF1A1, may have potential as identification targets in qRT-PCR techniques for dermatophyte detection and identification . Research has highlighted the importance of identifying stable reference genes for T. verrucosum, which can facilitate accurate gene expression analysis and molecular diagnostics .

Fundamental Research Applications

Recombinant T. verrucosum SHO1 protein represents a valuable tool for fundamental research into fungal osmotic stress responses and adaptation mechanisms. Applications include:

  1. Structure-function studies to understand signal transduction mechanisms

  2. Development of protein-protein interaction assays to identify pathway components

  3. Generation of antibodies for immunolocalization studies

  4. Screening potential antifungal compounds targeting osmotic stress pathways

Table: Comparative Features of T. verrucosum SHO1 and S. cerevisiae SHO1

FeatureT. verrucosum SHO1S. cerevisiae SHO1
Protein Length285 amino acids367 amino acids
UniProt IDD4DA58E7KMS3
SynonymsHigh osmolarity signaling protein SHO1; Osmosensor SHO1High osmolarity signaling protein SHO1; Osmosensor SHO1; Suppressor of SUA8-1 mutation; Synthetic high osmolarity-sensitive protein 1
Expression SystemE. coliE. coli
TagN-terminal His tagN-terminal His tag
Storage FormLyophilized powderLyophilized powder
Storage BufferTris/PBS-based buffer, 6% Trehalose, pH 8.0Tris/PBS-based buffer, 6% Trehalose, pH 8.0

Current Research Challenges and Limitations

Research on the specific functions and applications of T. verrucosum SHO1 protein faces several challenges. The cultivation of T. verrucosum requires specialized media and conditions, as highlighted in studies investigating gene expression under different growth conditions . Research has shown that different culture media, including Sabouraud, potato dextrose, and keratin-supplemented MM-Cove, significantly affect the growth and physiology of dermatophytes .

Additionally, molecular diagnostics for dermatophytes presents difficulties due to the close relatedness of species within the Trichophyton genus . The taxonomy of Trichophyton has evolved significantly with the integration of DNA sequence analysis, with sixteen species now recognized in the genus based on a combination of traditional morphological criteria and current phylogenetic species concepts .

Functional Genomics

RNA interference (RNAi) techniques could be employed for functional analysis of SHO1 in T. verrucosum, as the presence of Argonaut and dicer homologs in dermatophytes suggests that RNAi gene knockdowns could be feasible . Such approaches could clarify the role of SHO1 in pathogenicity and stress response.

Therapeutic Target Exploration

The potential role of SHO1 in pathogenicity suggests it could serve as a target for developing novel antifungal strategies. Screening compound libraries against recombinant SHO1 could identify inhibitors with potential therapeutic applications.

Product Specs

Form
Lyophilized powder
Note: We will prioritize shipping the format currently in stock. However, if you have a specific format preference, please indicate it in your order notes, and we will fulfill your request if possible.
Lead Time
Delivery time may vary depending on the purchasing method and location. Please consult your local distributors for specific delivery times.
Note: All of our proteins are shipped with standard blue ice packs by default. If you require dry ice shipping, please inform us in advance. Additional fees may apply.
Notes
Repeated freezing and thawing is not recommended. Store working aliquots at 4°C for up to one week.
Reconstitution
We recommend centrifuging the vial briefly before opening to ensure the contents settle at the bottom. Please reconstitute the protein in deionized sterile water to a concentration of 0.1-1.0 mg/mL. We recommend adding 5-50% glycerol (final concentration) and aliquoting for long-term storage at -20°C/-80°C. Our standard final glycerol concentration is 50%, which can be used as a reference.
Shelf Life
Shelf life is influenced by various factors, including storage conditions, buffer composition, temperature, and the inherent stability of the protein.
Generally, the shelf life of liquid form is 6 months at -20°C/-80°C. The shelf life of lyophilized form is 12 months at -20°C/-80°C.
Storage Condition
Upon receipt, store at -20°C/-80°C. Aliquoting is recommended for multiple uses. Avoid repeated freeze-thaw cycles.
Tag Info
Tag type will be determined during the manufacturing process.
The tag type is determined during production. If you have a specific tag type requirement, please inform us, and we will prioritize development of the specified tag.
Synonyms
SHO1; TRV_04002; High osmolarity signaling protein SHO1; Osmosensor SHO1
Buffer Before Lyophilization
Tris/PBS-based buffer, 6% Trehalose.
Datasheet
Please contact us to get it.
Expression Region
1-285
Protein Length
full length protein
Species
Trichophyton verrucosum (strain HKI 0517)
Target Names
SHO1
Target Protein Sequence
MARFQMSNLVGDPFALATVSIGMLAWIIGVVSCSIAHTKEVVPNFFWWSIAYQLCVLVGV AVVMGSNTSHIYGTAVVGYAAAGLVCTTFTLDSLVTSKQGARQSAGAGLILLAMTDIVWI FYFGSTSQSGPRAYIDSFAPHKEQPHSYRNSKPISHSYTPRPETTVSSAHPHMYSSAPLS GFETSSPMTGFNPAAASTTGLQPVLGSQTNASTVGGETGEVGQPTEYPYRAKAIYSYEAN PDDANEISFTKHEILEVSDVSGRWWQAKKSTGETGIAPSNYLILL
Uniprot No.

Target Background

Function
Plasma membrane osmosensor that activates the high osmolarity glycerol (HOG) MAPK signaling pathway in response to high osmolarity.
Database Links
Protein Families
SHO1 family
Subcellular Location
Cell membrane; Multi-pass membrane protein.

Q&A

What is the genetic organization of the SHO1 gene in T. verrucosum?

The SHO1 gene in T. verrucosum is identified as TRV_04002 in genomic annotations . The gene encodes a protein of 285 amino acids that functions as a high osmolarity signaling protein (osmosensor SHO1). For genetic analysis, researchers should employ PCR amplification using conditions similar to those utilized for dermatophyte gene analysis: initial denaturation at 98°C for 2 minutes, followed by 35 cycles of denaturation at 98°C for 10 seconds, annealing at 54°C for 15 seconds, and extension at 72°C for 1 minute . Sequence analysis should focus on identifying regulatory regions, promoter elements, and potential intron-exon boundaries to understand genetic regulation mechanisms.

What is the amino acid composition and predicted structure of T. verrucosum SHO1?

The full amino acid sequence of T. verrucosum SHO1 is: MARFQMSNLVGDPFALATVSIGMLAWIIGIVSCSIAHTKEVVPNFFWWSIAYQLCVLVGVAVVMGSNTSHIYGTAVVGYAAAGLVCTTFTLDSLVTSKQGARQSAGAGLILLAMTDIVWIFYFGSTSQSGPRAYIDSFAPHKEQPHSYRNSKPISHSYTPRPETTVSSAHPHMYSSAPLSGFETSSPMTGFNPAAASTTGLQPVLGSQTNASTVGGETGEVGQPTEYPYRAKAIYSYEANPDDANEISFTKHEILEVSDVSGRWWQAKKSTGETGIAPSNYLILL . Structural prediction suggests the presence of transmembrane domains consistent with membrane-localized signaling proteins. Bioinformatic analysis should include hydropathy profiling, secondary structure prediction, and homology modeling based on related fungal sensory proteins to identify functional domains critical for osmosensing and signal transduction.

What expression systems are optimal for producing functional recombinant T. verrucosum SHO1?

For successful expression of functional T. verrucosum SHO1, researchers should evaluate both prokaryotic and eukaryotic expression systems. E. coli-based expression using BL21(DE3) or Rosetta strains may be appropriate for initial production, with optimization of the following parameters:

ParameterRange to TestConsiderations
Temperature16-30°CLower temperatures often improve membrane protein solubility
Induction0.1-1.0 mM IPTGGradual induction may prevent aggregation
Expression time4-24 hoursMonitor optimal duration for functional protein
MediaLB, TB, 2XYTRich media may improve yield
Fusion tagsHis, GST, MBPMBP tag may enhance solubility

For membrane proteins like SHO1, consider eukaryotic expression systems such as Pichia pastoris or insect cells if E. coli expression yields insoluble protein. Verify expression through western blotting and test functionality through complementation assays in yeast SHO1-deficient strains.

What purification strategies are most effective for SHO1 protein?

Given the membrane-associated nature of SHO1 predicted from its sequence , a specialized purification approach is necessary:

  • Cell lysis: Use mild detergents (DDM, LDAO, or OG) to solubilize membrane proteins

  • Initial purification: Affinity chromatography using the fusion tag (e.g., Ni-NTA for His-tagged proteins)

  • Secondary purification: Size exclusion chromatography to ensure monodispersity

  • Quality control: Assess protein purity by SDS-PAGE and structural integrity by circular dichroism

For membrane proteins like SHO1, maintain detergent concentrations above critical micelle concentration throughout purification to prevent aggregation. Consider using fluorescence-based thermal shift assays to identify buffer conditions that maximize protein stability.

How can researchers assess the osmosensing function of T. verrucosum SHO1?

To characterize the osmosensing function of SHO1, implement the following methodological approaches:

  • Yeast complementation assays:

    • Transform SHO1-deficient S. cerevisiae strains with T. verrucosum SHO1

    • Evaluate growth restoration under high osmolarity conditions (1-2M NaCl or sorbitol)

    • Compare growth rates and morphological changes against positive and negative controls

  • MAPK pathway activation analysis:

    • Expose SHO1-expressing cells to osmotic shock

    • Measure phosphorylation of downstream MAPK components by western blotting

    • Quantify temporal activation patterns under varying osmotic conditions

  • Electrophysiological studies:

    • Reconstitute purified SHO1 in liposomes or planar lipid bilayers

    • Measure electrical properties in response to osmotic gradient changes

    • Correlate functional responses with structural predictions

These approaches provide complementary data on SHO1 function, connecting molecular activity to cellular responses under osmotic stress conditions.

What techniques are available for studying SHO1 protein interactions in T. verrucosum?

For comprehensive analysis of SHO1 protein interactions, employ both in vitro and in vivo approaches:

TechniqueMethodologyExpected Outcomes
Co-immunoprecipitationPull-down using SHO1-specific antibodies or epitope tagsIdentification of stable interacting partners
Proximity labelingBioID or APEX2 fusion proteinsDetection of transient or proximal interactions
Yeast two-hybridSHO1 as bait against T. verrucosum cDNA librarySystematic screening for interactors
Surface plasmon resonancePurified SHO1 and candidate interactorsQuantitative binding kinetics
Crosslinking mass spectrometryChemical crosslinking followed by MS/MS analysisStructural mapping of interaction interfaces

When analyzing results, focus on interactions that are conserved across related dermatophyte species to identify core signaling components versus species-specific adaptations.

How does T. verrucosum SHO1 compare to homologs in other dermatophyte species?

Comparative analysis of SHO1 across dermatophyte species provides insights into functional conservation and adaptation. Apply the following methodology:

  • Extract genomic DNA from multiple dermatophyte species using phenol-chloroform extraction

  • Amplify SHO1 genes using degenerate primers designed from conserved regions

  • Sequence amplicons and align with T. verrucosum SHO1

  • Calculate sequence identity and identify variable regions

Preliminary comparisons suggest:

SpeciesPredicted Relationship to T. verrucosum SHO1Notable Features
T. rubrumHigh similarity expected (≥80%)Most prevalent dermatophyte in human infections
T. interdigitaleHigh similarity expected (≥80%)Shows clonal population structure similar to T. rubrum
T. tonsuransModerate similarity expectedHost specialization may influence SHO1 sequence
T. benhamiaeModerate similarity expectedDivided into different races with variable genetics

Phylogenetic analysis should incorporate both sequence and functional data to understand how SHO1 evolution correlates with ecological niches and host adaptation patterns.

What evolutionary pressures have shaped SHO1 in the Trichophyton genus?

Evolutionary analysis of SHO1 should examine selection pressures across different functional domains. Methodology should include:

  • Calculate dN/dS ratios across the protein sequence to identify regions under purifying or positive selection

  • Map conserved regions to predicted functional domains

  • Compare evolutionary rates between dermatophytes with different host preferences (anthropophilic vs. zoophilic)

  • Correlate sequence evolution with environmental adaptation patterns

Based on T. rubrum population genetics data, dermatophytes tend toward clonal reproduction with limited genetic recombination . This pattern likely influences SHO1 evolution, with adaptive changes occurring primarily through mutation rather than recombination. Pay particular attention to transmembrane regions and sensing domains that directly interact with the external environment.

How might SHO1 contribute to T. verrucosum pathogenicity?

T. verrucosum causes inflammatory mycoses with variable clinical presentations depending on age and exposure patterns . SHO1, as an environmental sensing protein, potentially contributes to pathogenicity through several mechanisms:

  • Environmental adaptation:

    • Sensing humidity changes (relevant given the correlation between T. verrucosum infections and annual rainfall )

    • Temperature adaptation during host colonization

    • pH sensing during tissue invasion

  • Host factor recognition:

    • Detection of host antimicrobial peptides

    • Sensing of skin surface lipid composition

    • Adaptation to varying osmotic conditions across different body sites

  • Morphogenesis regulation:

    • Control of hyphal development during invasion

    • Regulation of virulence factor expression

    • Biofilm formation in chronic infections

The correlation between T. verrucosum infections and environmental humidity particularly suggests that osmosensing pathways play a key role in the infection cycle. Severe cases like hydronephrosis and joint contractures further highlight the importance of understanding virulence mechanisms.

What experimental models are appropriate for studying SHO1 function during infection?

To investigate SHO1's role during infection, implement the following models:

ModelMethodologyParameters to Measure
In vitro keratinocyte infectionCo-culture of T. verrucosum with human keratinocytesAdhesion, invasion, cytokine response
Reconstructed human epidermisGrowth of T. verrucosum on 3D skin modelsPenetration, tissue damage patterns
Ex vivo skin explantsInfection of skin samples from cattle or humansComparative invasion patterns
Guinea pig modelIn vivo infection of susceptible animalsDisease progression, fungal burden

When designing infection experiments, consider age-related differences in T. verrucosum clinical presentations observed in epidemiological studies , with children more frequently presenting with tinea capitis while adults develop skin infections. Include both wild-type and SHO1-deficient strains to assess the protein's specific contribution to pathogenicity.

What methods can be used to create SHO1 knockout strains in T. verrucosum?

Genetic manipulation of dermatophytes requires specialized approaches. Based on techniques used for related species , consider:

  • Homologous recombination-based gene targeting:

    • Design constructs with 1-2kb homology arms flanking a selection marker

    • Optimize transformation conditions for T. verrucosum (PEG-mediated or Agrobacterium-mediated)

    • Select transformants on appropriate media (typically containing hygromycin B)

    • Verify gene disruption by PCR and Southern blotting

  • CRISPR-Cas9 mediated gene editing:

    • Design guide RNAs targeting exons of the SHO1 gene

    • Optimize delivery methods (protoplast transformation or biolistic delivery)

    • Screen transformants for mutations using PCR and sequencing

    • Characterize mutants for osmotic stress responses

  • RNAi-based knockdown:

    • Create hairpin constructs targeting SHO1 mRNA

    • Transform into T. verrucosum

    • Verify reduced expression by qRT-PCR

For all genetic manipulations, careful phenotypic characterization is essential, comparing growth, morphology, and stress responses between mutant and wild-type strains.

What strategies can be employed for conditional expression of SHO1 in T. verrucosum?

For functional studies, conditional expression systems provide valuable tools. Implement the following methodological approaches:

  • Inducible promoter systems:

    • Adapt established fungal inducible promoters (e.g., GAL, MET, TET)

    • Create SHO1 fusions under inducible control

    • Optimize induction conditions for T. verrucosum

  • Destabilization domain technology:

    • Fuse SHO1 to a destabilization domain (DD)

    • Express in T. verrucosum

    • Control protein levels using stabilizing ligands

  • Temperature-sensitive alleles:

    • Generate temperature-sensitive SHO1 mutants

    • Characterize functionality at permissive and restrictive temperatures

When developing these systems, verification of conditional expression is critical using both protein detection methods (western blot) and functional assays (osmotic stress response) to confirm the system's reliability.

How can researchers map the complete SHO1 signaling pathway in T. verrucosum?

To elucidate the SHO1 signaling network, implement a multi-omics approach:

  • Phosphoproteomics:

    • Compare phosphorylation profiles between wild-type and SHO1 mutant strains

    • Identify differentially phosphorylated proteins following osmotic stress

    • Use SILAC or TMT labeling for quantitative comparisons

  • Transcriptomics:

    • Perform RNA-Seq analysis under varying osmotic conditions

    • Compare gene expression profiles between wild-type and SHO1 mutants

    • Identify transcription factors regulated by the SHO1 pathway

  • Genetic interaction mapping:

    • Create double mutants of SHO1 with other signaling components

    • Perform epistasis analysis to determine pathway hierarchy

    • Identify synthetic lethal interactions to reveal redundant pathways

  • Computational modeling:

    • Integrate multi-omics data to construct pathway models

    • Validate predictions through targeted experiments

    • Compare with known fungal osmoregulatory pathways

This comprehensive approach allows construction of a detailed signaling network, connecting SHO1 activation to downstream cellular responses.

What is the relationship between SHO1 and mating pathways in Trichophyton species?

The relationship between osmosensing and sexual development in dermatophytes remains largely unexplored. Based on T. rubrum population genetics data , methodological approaches should include:

  • Mating type determination:

    • Determine mating type of T. verrucosum isolates using PCR-based methods

    • Compare distribution with T. rubrum, which shows predominance of MAT1-1

    • Assess correlation between mating type and SHO1 sequence variants

  • Co-expression analysis:

    • Compare expression of SHO1 and mating-related genes under various conditions

    • Identify potential co-regulation patterns

    • Determine if osmotic stress influences mating pathway expression

  • Genetic interaction studies:

    • Create mutants in both SHO1 and mating pathway components

    • Assess phenotypic outcomes of combined mutations

    • Determine if osmotic stress affects mating efficiency

The predominantly clonal nature of T. rubrum populations suggests limited sexual reproduction in clinical isolates, raising questions about the potential interaction between environmental sensing and sexual development pathways in these fungi.

How does environmental adaptation through SHO1 influence T. verrucosum epidemiology?

Epidemiological studies of T. verrucosum show correlation between infection rates and annual rainfall , suggesting a significant role for environmental sensing in transmission and infection. Research methodologies should include:

  • Field sampling:

    • Collect environmental and clinical isolates from regions with varying humidity

    • Sequence SHO1 genes to identify potential adaptive variants

    • Correlate SHO1 sequence with geographical and climatic data

  • Experimental evolution:

    • Subject T. verrucosum isolates to cycling osmotic conditions

    • Monitor SHO1 sequence changes over generations

    • Assess changes in virulence following adaptation

  • Comparative analysis:

    • Compare SHO1 sequences between isolates from different host species

    • Assess correlation between SHO1 variants and host preference

    • Determine if SHO1 polymorphisms correlate with severity of infection

This integrated approach connects molecular mechanisms to population-level patterns, potentially explaining the observed correlation between T. verrucosum infections and humidity levels .

What role might SHO1 play in rare severe manifestations of T. verrucosum infection?

While T. verrucosum typically causes superficial infections, rare severe cases like hydronephrosis and joint contractures have been reported . To investigate SHO1's potential role in these manifestations:

  • Isolate characterization:

    • Sequence SHO1 from isolates causing severe disease

    • Compare against isolates from typical superficial infections

    • Identify potential mutations associated with enhanced virulence

  • Host-pathogen interaction studies:

    • Assess SHO1-dependent invasiveness in tissue models

    • Determine if SHO1 variants affect inflammatory responses

    • Evaluate ability to survive in deep tissues

  • Immune evasion assessment:

    • Compare host immune responses to wild-type and SHO1 mutant strains

    • Determine if SHO1 signaling affects expression of immune evasion factors

    • Assess adaptation to varying osmotic environments in different tissues

Understanding SHO1's role in severe infections could provide insights into predicting and preventing such manifestations, particularly in vulnerable populations.

How can SHO1 research contribute to improved diagnosis of T. verrucosum infections?

Current diagnosis of T. verrucosum involves culture and molecular methods . SHO1 research could enhance diagnostic approaches through:

  • Development of SHO1-specific molecular diagnostics:

    • Design PCR primers targeting species-specific regions of SHO1

    • Develop rapid molecular tests for clinical laboratories

    • Create multiplexed assays distinguishing T. verrucosum from other dermatophytes

  • Antigen detection systems:

    • Develop antibodies against SHO1 protein

    • Create immunochromatographic tests for rapid diagnosis

    • Implement in point-of-care settings

  • Metabolomic signatures:

    • Identify metabolites regulated by SHO1 pathways

    • Develop detection methods for these biomarkers

    • Correlate metabolite profiles with clinical outcomes

These approaches could accelerate diagnosis, particularly beneficial given the slow growth of T. verrucosum in culture (up to 4 weeks) .

What potential does SHO1 hold as a therapeutic target for dermatophyte infections?

As a key regulator of environmental adaptation, SHO1 represents a potential target for antifungal development:

  • Structure-based drug design:

    • Use the predicted structure of SHO1 to identify potential binding pockets

    • Screen compound libraries for molecules targeting these sites

    • Validate candidates through functional assays

  • Pathway-based inhibition:

    • Target downstream components of the SHO1 signaling pathway

    • Develop combination therapies affecting multiple pathway components

    • Assess synergy with existing antifungals

  • Immunomodulatory approaches:

    • Determine if SHO1 signaling affects host immune recognition

    • Develop adjuvant therapies enhancing immune clearance

    • Target host-pathogen interface identified through SHO1 studies

Given the severe manifestations that can occur in some cases , developing targeted therapeutics could significantly improve outcomes, particularly for recalcitrant or invasive infections.

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