{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:14:13Z","timestamp":1788311653226,"version":"build-2803163510"},"reference-count":37,"publisher":"European Respiratory Society (ERS)","issue":"4","license":[{"start":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T00:00:00Z","timestamp":1600905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2020,9,15]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p><jats:italic>Aspergillus fumigatus<\/jats:italic>is a saprobic fungus that causes a range of pulmonary diseases, some of which are characterised by fungal persistence such as is observed in cystic fibrosis (CF) patients. Creation of genetic variation is critical for<jats:italic>A. fumigatus<\/jats:italic>to adapt to the lung environment, but biofilm formation, especially in CF patients, may preclude mutational supply in<jats:italic>A. fumigatus<\/jats:italic>due to its confinement to the hyphal morphotype. We tested our hypothesis that genetic variation is created through parasexual recombination in chronic biofilms by phenotypic and genetic analysis of<jats:italic>A. fumigatus<\/jats:italic>isolates cultured from different origins.<\/jats:p><jats:p>As diploids are the hallmark of parasex, we screened 799<jats:italic>A. fumigatus<\/jats:italic>isolates obtained from patients with CF, chronic pulmonary lung disease and acute invasive aspergillosis, and from the environment for spore size. Benomyl sensitivity, nuclear content measurements through fluorescence-activated cell sorting and scanning electron microscopy were used to confirm the diploid state of large size spores. Whole genome sequencing was used to characterise diploid-associated genetic variation.<\/jats:p><jats:p>We identified 11 diploids in isolates recovered from six of 11 (55%) CF patients and from one of 24 (4%) chronic aspergillosis patients, but not in 368 isolates from patients with acute<jats:italic>Aspergillus<\/jats:italic>infection and the environment. Diploid formation was associated with accumulation of mutations and variable haploid offspring including a voriconazole-resistant isolate.<\/jats:p><jats:p>Parasexual recombination allows<jats:italic>A. fumigatus<\/jats:italic>to adapt and persist in CF patients, and plays a role in azole resistance development. Our findings are highly significant for understanding the genetics and biology of<jats:italic>A. fumigatus<\/jats:italic>in the human lung.<\/jats:p>","DOI":"10.1183\/23120541.00020-2020","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T21:00:24Z","timestamp":1600981224000},"page":"00020-2020","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":28,"title":["Parasexual recombination enables<i>Aspergillus fumigatus<\/i>to persist in cystic fibrosis"],"prefix":"10.1183","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3105-4867","authenticated-orcid":false,"given":"Tobias","family":"Engel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8600-9860","authenticated-orcid":false,"given":"Paul 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