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Journal of Clinical Microbiology, July 2003, p. 3022-3027, Vol. 41, No. 7
0095-1137/03/$08.00+0 DOI: 10.1128/JCM.41.7.3022-3027.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Sequence Diversity of the Intergenic Spacer Region of the rRNA Gene of Malassezia globosa Colonizing the Skin of Patients with Atopic Dermatitis and Healthy Individuals
Takashi Sugita,1* Minako Kodama,2 Masuyoshi Saito,3 Tomonobu Ito,3 Yukihiko Kato,3 Ryoji Tsuboi,3 and Akemi Nishikawa2
Department of Microbiology,1
Department of Immunobiology, Meiji Pharmaceutical University, Kiyose,2
Department of Dermatology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan3
Received 17 January 2003/
Returned for modification 30 March 2003/
Accepted 28 April 2003

ABSTRACT
The lipophilic yeast
Malassezia globosa is one of the major
constituents of the mycoflora of the skin of patients with atopic
dermatitis (AD). We compared the genotypes of
M. globosa colonizing
the skin surface of 32 AD patients and 20 healthy individuals
for polymorphism of the intergenic spacer (IGS) 1 region of
the rRNA gene. Sequence analysis demonstrated that
M. globosa was divided into four major groups, which corresponded to the
sources of the samples, on the phylogenetic tree. Of the four
groups, two were from AD patients and one was from healthy subjects.
The remaining group included samples from both AD patients and
healthy subjects. In addition, the IGS 1 region of
M. globosa contained short sequence repeats: (CT)
n, and (GT)
n. The number
of sequence repeats also differed between the IGS 1 of
M. globosa from AD patients and that from healthy subjects. These findings
suggest that a specific genotype of
M. globosa may play a significant
role in AD, although
M. globosa commonly colonizes both AD patients
and healthy subjects.

INTRODUCTION
Malassezia species are lipophilic yeasts that are part of the
normal human cutaneous commensal flora; they are isolated from
sebaceous gland-rich areas of the skin, particularly on the
chest, back, and head. They are also associated with several
cutaneous diseases, including atopic dermatitis (AD), folliculitis,
pityriasis versicolor, and seborrheic dermatitis (
1,
7). In
a taxonomic revision in 1996, the genus
Malassezia was classified
into seven different species:
M. furfur,
M. globosa,
M. restricta,
M. obtusa,
M. pachydermatis,
M. slooffiae, and
M. sympodialis (
9). Recently, we described an eighth species,
M. dermatis,
which was isolated from Japanese patients with AD (
27). Since
the taxonomic revision of the genus
Malassezia, several studies
have examined the distribution of the newly defined species
of
Malassezia on healthy human skin and lesions of skin diseases
(
2,
10,
21). However, culture media or sampling techniques often
affect analyses of the
Malassezia microflora. In a previous
study, we used a nonculture method as an alternative to fungal
culture to analyze the distribution of cutaneous
Malassezia species (
25).
M. globosa and
M. restricta were detected in approximately
90% of AD patients, and
M. furfur and
M. sympodialis were detected
in approximately 40% of the subjects. In healthy subjects,
M. globosa,
M. restricta, and
M. sympodialis were detected in approximately
40 to 60% of the subjects;
M. furfur was found in only 4% of
the subjects; and no other
Malassezia species were detected.
Therefore, these four species are common inhabitants of the
skin of both AD patients and healthy individuals. In addition,
while anti-
Malassezia immunoglobulin E (IgE) antibody was detected
in more than 90% of AD patients, no antibody was found in healthy
subjects. Based on these results,
M. globosa and
M. restricta are thought to play a significant mycological role in AD.
M. globosa is also part of the major microflora on the skin of
healthy individuals. We used the intergenic spacer (IGS) region
of the rRNA gene to investigate the genotypes of
M. globosa colonizing the skin of AD patients and healthy subjects. The
fungal rRNA gene consists of 5S, 5.8S, 18S (small subunit),
and 26S (large subunit) subunits (Fig.
1). Two other regions
are positioned between the subunits: the internal transcribed
spacer (ITS) and the IGS. These two regions are further divided
into two subregions. The 18S and 26S ribosomal DNAs (rDNAs)
and ITS regions have been widely utilized in studies of molecular
systematics and to identify microorganisms (
17,
23). The IGS
regions have higher rates of divergence than other subunits
or regions. Some authors (
5,
20,
24,
26) have demonstrated that
the sequence of the IGS region shows remarkable intraspecies
diversity.
In this study, we compared the levels of DNA sequence divergence
among the IGS regions of
M. globosa, which is the key candidate
allergen in AD, obtained from the skin of AD patients and from
healthy subjects.

MATERIALS AND METHODS
Sequencing the IGS region of M. globosa stock strains.
Two stock strains, CBS 7996 (type strain of
M. globosa) and
CBS 8745, were purchased from Centraalbureau voor Schimmelcultures
(Utrecht, The Netherlands). They were maintained on modified
Leeming and Notman agar (LNA; 20 g of glucose, 50 g of malt
extract, 1 g of polypeptone, 20 g of bile salts) (OXOID, Hampshire,
United Kingdom), 1% Tween 40, 0.2% glycerol, and 50 µg
of chloramphenicol per ml (Sankyo, Tokyo, Japan) at 32°C.
Genomic DNA was extracted by the method of Makimura et al. (
18).
The IGS region containing 5S rDNA was amplified from each strain
by using primers 26S-F and P1R, shown in Table
1. The reactions
were performed in a final reaction mixture (50 µl) containing
10 pmol of each primer; 200 µM each dATP, dTTP, dGTP,
and dCTP; 2.5 mM MgCl
2; 0.5 U of Takara Ex
Taq polymerase (Takara,
Shiga, Japan); and 10
x reaction buffer (Takara). Amplification
reactions were performed in a GeneAmp PCR system 9700 (PE Applied
Biosystems, Foster, Calif.) using the following cycling parameters:
94°C for 1 min; followed by 30 cycles of 94°C for 30
s, 54°C for 30 s, and 72°C for 2 min; followed by a
final extension at 72°C for 10 min. The PCR product was
sequenced with an ABI PRISM cycle sequencing kit (PE Applied
Biosystems) using the primers shown in Table
1 in accordance
with the manufacturer's instructions.
Subjects.
Thirty-six AD outpatients (24 males and 12 females; 20 to 64
years of age; mean age, 33.3 ± 10.5 years) at Tokyo Medical
University Hospital and 30 healthy students (10 males and 20
females; 19 to 25 years of age; mean age, 20.9 ± 1.4
years) at Meiji Pharmaceutical University were involved in this
study. AD was diagnosed according to the criteria of Hanifin
and Rajka (
11), and samples were collected from erythematous
lesions on the face and neck. Routine skin care, including intermittent
applications of mild steroid ointment or petrolatum, was administered
before sampling. Written informed consent was obtained from
each subject.
Sequencing the IGS 1 region from patient samples.
Malassezia samples were collected by applying a 3- by 3-cm transparent OpSite dressing (Smith and Nephew Medical Ltd., Hull, United Kingdom), and the fungal DNA was extracted from the OpSite dressing as described previously (25). Briefly, the collected dressing was placed in 1 ml of lysing solution (100 mM Tris-HCl [pH 8.0], 30 mM EDTA [pH 8.0], 0.5% sodium dodecyl sulfate) and incubated at 100°C for 15 min. After deproteinization, DNA was precipitated with 2-propanol and Ethatimate (Nippon Gen, Toyama, Japan). The DNA pellet was resuspended in 30 µl of TE (10 mM Tris-HCl [pH 8.0], 1 mM EDTA [pH 8.0]). The DNA extracted (10 µl) from each sample was added to 40 µl of PCR master mixture, which consisted of 5 µl of 10x PCR buffer (Takara), 4 µl of 200 µM deoxynucleoside triphosphates, 10 pmol of each primer, and 0.5 U of Takara Ex Taq DNA polymerase (Takara). PCR was performed with an initial denaturation at 94°C for 1 min; followed by 30 cycles of 30 s at 94°C, 1 min at 54°C, and 30 s at 72°C; followed by a final extension at 72°C for 10 min with primers gb-F (GCTTTCGAGTGCATACCACAC) and gb-R (GGAAATAGGATGAGAGAAAC). The PCR products were cloned with a TA cloning kit (Invitrogen Corp., Carlsbad, Calif.), and three positive clones were sequenced with an ABI PRISM cycle sequencing kit (PE Applied Biosystems) and Sequence Rx Enhancer solution A (GIBCO BRL, Life Technologies, Rockville, Md.) in accordance with the manufacturers' instructions.
Molecular phylogenetic analysis.
The sequences of the IGS 1 region were aligned using Clustal W (28). For neighbor-joining analysis (22), the distances between sequences were calculated with Kimura's two-parameter model (13). A bootstrap analysis was conducted with 100 replicates (8).
Formation of chimeric molecules.
To confirm whether chimeric molecules formed under the PCR conditions used in this study, mixed genomic DNA from the eight known Malassezia species was used for PCR coamplification of the IGS region. Then, the IGS amplified from the mixed genomes was cloned, 30 clones were selected at random, and their sequences were determined.
Nucleotide sequence accession number.
The nucleotide sequences determined in this study have been deposited with the DNA Data Bank of Japan (DDBJ) under accession no. AB099877, AB099878 (CBS 7966), AB099879, and AB099880 (CBS 8745).

RESULTS
IGS 1 sequences of M. globosa. (i) Stock strains.
Complete sequences of the IGS region, including 5S rDNA, were
determined for two CBS stock strains of
M. globosa. Their sequences
ranged from 2288 to 2300 bp long. The
M. globosa IGS 1 regions
were 444 to 454 bp long, while the IGS 2 regions were 1,716
to 1,738 bp long. The IGS 1 and 2 regions of this microorganism
showed 12.6, and 6.1% dissimilarity, respectively. Therefore,
IGS 1 is more suitable than IGS 2 for differentiating closely
related strains.
M. globosa IGS 1 had four short sequence repeats
(SSRs) of (CT)
n, (CT)
n, (CT)
n, and (GT)
n at positions 29 to
49, 278 to 291, 380 to 485, and 242 to 267 in the IGS sequence
of strain CBS 7996 (type strain of
M. globosa), respectively.
Alignments of IGS 1 of two strains of
M. globosa are shown in
Fig.
2. Because
M. globosa had three (CT)
ns in its IGS 1 region,
these are referred to as (CT1)
n, (CT2)
n, and (CT3)
n in this
article.
(ii) Samples from the subjects.
M. globosa DNA was found in 32 of 36 AD patients and 20 of 30
healthy subjects. Under the PCR conditions described above,
420- to 467-bp fragments were amplified and analyzed.
(iii) SSRs.
The number of sequence repeats of (GT)n and (CT)n in the IGS 1 region is shown in Fig. 3. The number of SSRs in the IGS 1 region of samples from healthy subjects was more variable than in samples from AD patients for (CT)n. The number of sequence repeats in the IGS 1 region ranged from 4 to 11 for (CT1)n, 3 to 10 for (CT2)n, and 3 to 11 for (CT3)n, and there were 4 in 50%, 8 in 60%, and 9 to 11 in 80% of the samples from AD patients. For (GT)n, the respective numbers of repeats in 70 to 80% of the SSRs in the IGS 1 region derived from AD patients and healthy subjects were 9 to 11 and 15 to 19, respectively.
(iv) Phylogenetic analysis.
In each patient or healthy subject, three clone sequences were
determined, and they were identical without exception. A phylogenetic
tree constructed from 52 IGS 1 sequences is shown in Fig.
4.
The tree consists of four major groups, which correspond to
the sources of the samples (AD patients or healthy subjects).
Two groups were from AD patients, and one was from healthy subjects.
The remaining group included samples from both AD patients and
healthy subjects. The IGS 1 sequences derived from the healthy
subjects were more diverse than those from AD patients. The
levels of IGS 1 sequence similarity within samples collected
from AD patients and from healthy subjects were 94.5% ±
3.5% and 89.9% ± 3.5%, respectively.
Formation of chimeric molecules.
Thirty clones were chosen at random and sequenced. No clone
was identified as a chimeric molecule.

DISCUSSION
One member of the genus
Malassezia,
M. globosa, commonly colonizes
the skin of both AD patients and healthy subjects. The major
antigen for IgE antibodies in AD patients is a glycoprotein
(Malg46b) from
M. globosa (
14,
15). This paper describes differences
between the IGS 1 genotypes of
M. globosa colonizing the skin
surface of both populations. The rRNA gene is a marker that
reflects the phylogenetic evolution of microorganisms and has
been widely used for taxonomy and identification (
17,
23). While
the taxonomic significance of the 18S and 26S rDNA and ITS regions
is known, that of the IGS region is unclear. Previously, we
demonstrated that the DNA sequence of the IGS region showed
remarkable intraspecies diversity in the pathogenic yeasts
Cryptococcus neoformans and
Trichosporon asahii (
24,
26). While analyzing
the IGS sequences of several yeasts from humans, we found SSRs
in the
M. globosa IGS sequence. Due to their high variability,
SSRs are widely used to study the molecular epidemiology of
pathogenic microorganisms (
3,
4,
19,
29). As far as we know,
M. globosa is the only yeast from humans that has these SSRs.
The IGS 1 sequences of
M. globosa isolates obtained from AD
patients and healthy individuals were almost identical in the
two groups, with the exception of the four SSRs, which could
be used to distinguish between microorganisms from AD patients
and those from healthy individuals. When a phylogenetic tree
was constructed from IGS sequences excluding the SSRs, the
M. globosa sequences obtained from AD patients and healthy subjects
intermingled.
We used a PCR-based nonculture method to analyze the genotypes of M. globosa colonizing the skin surface of patients with AD, since M. globosa is difficult to isolate by culture methods. When using PCR-based approaches, the generation of chimeric sequences must also be considered, because pseudosequences may generate nonexistent genotypes of this microorganism. Wang and Wang (30) found that chimeric sequences occurred at a rate of 32% after 30 cycles of PCR amplification targeting the consensus sequence of the bacterial 16S rRNA gene by using mixed genomic DNA from eight bacterial species. We used M. globosa species-specific oligonucleotide primers targeting the IGS sequence, which is the most variable region in the rRNA gene. The primers used in this study did not amplify the DNA of other Malassezia species (data not shown). Although chimera molecules should not be generated theoretically, we also confirmed that no chimera molecules formed under our experimental conditions with genomic DNA from the eight known Malassezia species.
The M. globosa organisms originating from AD patients were phylogenetically different from the M. globosa organisms obtained from healthy subjects with respect to their IGS sequences, although M. globosa colonized both AD patients and healthy individuals at high frequency. Why do the genotypes in each population differ? The reason is unclear, but the genotypes might correspond to the physiological characteristics of this microorganism. First, we considered the possible influence of skin surface lipids, a mixture of secretions from the sebaceous glands and epidermal cells, consisting mainly of triglycerides, squalene, wax esters, cholesterol, ceramides, and free fatty acids (6). Although the lipid composition in AD patients is generally no different from that of healthy subjects, a significant decrease in ceramide 1 and differences in the concentrations of the related molecules linoleate and oleate have been reported (12, 31). Such differences in composition may affect the colonization of strains with different lipid requirements. Moreover, therapeutic agents used to treat AD may affect the selective colonization of the microorganism. The base ingredients in these ointments affect the growth of Malassezia species (16). While M. furfur can utilize white petrolatum, hydrophilic ointment, and heparinoid in hydrophilic ointment, M. globosa cannot utilize these ingredients. Therefore, active ingredients such as steroids and tacrolimus might affect the selective colonization of M. globosa. The antifungal drug susceptibility of this microorganism should also be considered. Since no patient in this study received antifungal therapy, this possibility can be excluded. Since the analysis of M. globosa genotypes in this study is based on a nonculture method, the significance of genotype differences will be elucidated by investigating their phenotypic and physiological characteristics with viable cells.
In conclusion, our IGS sequence analysis revealed differences in the genotypes of M. globosa colonizing the skin surface of AD patients and healthy subjects, suggesting that genotype should be taken into consideration when studying the relationship between M. globosa and AD.

ACKNOWLEDGMENTS
This study was supported in part by a Grant for the Promotion
of the Advancement of Education and Research in Graduate Schools
from the Ministry of Education, Culture, Sports, Science, and
Technology, Japan, and in part by IATRON Laboratories, Inc.
(A.N.).

FOOTNOTES
* Corresponding author. Mailing address: Department of Microbiology, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Tokyo 204-8588, Japan. Phone: 81-424-95-8762. Fax: 81-424-95-8762. E-mail:
sugita{at}my-pharm.ac.jp.


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Journal of Clinical Microbiology, July 2003, p. 3022-3027, Vol. 41, No. 7
0095-1137/03/$08.00+0 DOI: 10.1128/JCM.41.7.3022-3027.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
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