Récente Révision Des Espèces De Dermatophytes Et De Leur Nomenclature

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Récente Révision Des Espèces De Dermatophytes Et De Leur Nomenclature DERMATOLOGIE Récente révision des espèces de dermatophytes et de leur nomenclature Dr MICHEL MONOD a Rev Med Suisse 2017 ; 13 : 703-8 L’identification des dermatophytes est souvent compliquée par morphologiques qui existent au sein d’une même espèce. De la variabilité de leurs caractères en culture et des problèmes de surcroît, des isolats d’espèces différentes peuvent présenter nomenclature. L’analyse d’un ensemble de séquences d’ADN a le même aspect. A cela s’ajoutent des problèmes de nomen­ permis de redéfinir les genres et les espèces de ces champignons clature avec plusieurs noms pour la même espèce (synonymes), spécialisés. Les noms d’espèces ont été révisés en accord avec la et avec une pléthore d’espèces décrites.3 nouvelle convention adoptée pour la nomenclature des champi- gnons, et avec le soin de ne pas chambouler tous les usages. Les La taxonomie des dermatophytes au niveau des genres et des conclusions de cette étude et les noms d’espèces à utiliser ont espèces a été récemment revisitée sur la base d’analyse de sé­ été approuvés par un ensemble d’experts praticiens ou fonda- quences d’ADN.3 La nomenclature a été révisée en accord mentalistes travaillant avec ce groupe de champignons. Les avec la nouvelle convention adoptée pour celle des espèces de points importants concernant la définition d’espèces et quelques champignons4 et le soin de préserver au maximum les noms changements de nomenclature ont été résumés dans cet article. utilisés en pratique. L’objectif de cet article est de présenter les aboutissements de cette révision et de donner les noms d’espèces qui devraient être dorénavant adoptés par les labo­ Revision of the dermatophyte species and the ratoires, par les médecins et dans la littérature. nomenclature of these fungi Dermatophyte species identification often remains difficult because variation of isolates in the same species, overlapping characters in DES PREMIÈRES DESCRIPTIONS CLINIQUES cultures and problems of nomenclature. DNA sequencing recently allowed the genus and species of these fungi to be reexamined. Spe- À L’IDENTIFICATION DES ESPÈCES PAR PCR cies names were revised according to the new nomenclature Les premières espèces de dermatophytes ont été décrites convention adopted for fungi. The conclusions of this taxonomic seulement par l’aspect clinique de lésions et d’observations study were approved by expert practitioners and searchers working microscopiques attestant de la nature fongique de l’infection. with dermatophytes. Important points about species definition and C’est en 1839 que Schönlein, professeur de médecine à Zurich nomenclature changes were summarized in the present communi- de 1833 à 1839, rapporta la nature mycologique d’une teigne.5 cation. Ce champignon a été appelé Achorion schoenleinii par Remak en 1845,6 puis Trichophyton schoenleinii par Langeron et Milo­ chevitch en 1930.7 Entre 1841 et 1844, plusieurs espèces ont été INTRODUCTION décrites dont Trichophyton mentagrophytes par Gruby en fran­ çais sous le nom de « mentagre », avec une étymologie grecque Les dermatophytes sont des champignons filamenteux spé­ et latine signifiant « plante attrapée au menton » (mentum : cialisés capables de dégrader la kératine. Ils sont la cause de la menton ; αγρα : attraper ; φυτον : plante).8 Gruby décrivit éga­ plupart des mycoses de la peau, des cheveux et des ongles. On lement des teignes de la barbe et du scalp et en nomma l’agent distingue trois groupes écologiques de dermatophytes : 1) les étiologique sous le nom de Microsporum audouinii en référence espèces anthropophiles dont l’habitat naturel est l’homme ; 2) aux petites spores localisées le long de la tige pilaire.9 Enfin, les espèces zoophiles dont l’habitat naturel est un animal, et cet auteur fit une description détaillée de la teigne tondante qui sont responsables des zoonoses les plus fréquentes et 3) les par Herpes tonsurans, 10 qui devint Trichophyton tonsurans par espèces géophiles dont l’habitat naturel est le sol. Les espèces Malmsten en 1845 et 1848.11 Trichophyton tonsurans est l’espèce anthropophiles ne sont généralement pas inflammatoires. Au type du genre Trichophyton. contraire, les espèces zoophiles et géophiles provoquent des mycoses inflammatoires chez l’homme. On doit la première étude systématique des dermatophytes au Français Sabouraud en 1910 dans son ouvrage intitulé « les L’efficacité et le succès d’une thérapie envers une dermato­ teignes ».12 Sur la base des aspects cliniques des lésions, d’exa­ phytose (ou teigne) varient en fonction de l’espèce du cham­ mens mycologiques directs au microscope et de cultures, pignon.1,2 Il est donc primordial d’identifier l’espèce de derma­ Sabouraud classifia les dermatophytes en quatre genres : tophyte dans le cas d’une teigne. Cependant, leur identification Achorion, Trichophyton, Microsporum et Epidermophyton. En en culture reste souvent incertaine en raison des variations 1934, Emmons modernisa la taxonomie proposée par Sabou­ raud et d’autres auteurs.13 Il classifia les dermatophytes en a a Service de dermatologie et vénéréologie, Laboratoire de mycologie, CHUV, 3 genres (Trichophyton, Microsporum et Epidermophyton) sur la 1011 Lausanne base de la morphologie des spores produites par les champi­ [email protected] gnons en culture, et élimina le genre Achorion. WWW.revmed.CH 29 mars 2017 703 REVUE MÉDICALE SUISSE FIG 1 Interfertilité de souches + et – de Trichophyton benhamiae A : Confrontation de souches de sexe opposé (+ et –) ; B : Cléistothèces observés à la loupe (barre = 100 µm) ; C : Asques et ascospores d’un cléistothèce écrasé (barre = 10 µm). Les dermatophytes isolés à partir des lésions se reproduisent déposé dans une collection et sélectionné comme référence en culture uniquement de manière asexuée, c’est­à­dire avec lorsque le matériel original de l’espèce n’existe plus, ayant été des spores générées suite à une mitose. Cependant, dès 1959, perdu ou détruit). plusieurs auteurs ont montré que des souches de sexe opposé (+ et –) au sein de certaines espèces pouvaient générer de pe­ Le genre Trichophyton a été réduit à une quinzaine d’espèces tites fructifications contenant des asques et des ascospores pathogènes anthropophiles ou zoophiles. Epidermophyton après confrontation dans des conditions particulières de con tient une seule espèce, Epidermophyton floccosum, qui est cultures (figure 1).14 Les espèces de dermatophytes pour anthropophile. Le genre Microsporum ne contient plus que lesquelles la reproduction sexuée avait été obtenue au labora­ 3 espèces : M. canis (zoophile), M. audouinii et M. ferrugineum toire ont été classées dans les genres d’ascomycètes Arthro- (anthropophiles). Les espèces géophiles (ainsi que quelques derma et Nanizzia au sein des champignons. espèces zoophiles qui n’infectent que très rarement l’homme) sont dans d’autres genres (Nannizia et Arthroderma) bien dis­ Jusqu’à la fin des années 90, les différentes espèces de derma­ tincts de Trichophyton, Epidermophyton et Microsporum. Les tophytes étaient toujours identifiées d’après leurs caractères espèces formant des macrospores en forme de navettes avec macroscopiques et microscopiques. De nombreuses espèces des cloisons transversales se trouvent dans les genres Micros- ayant été décrites seulement par l’aspect clinique de lésions porum (par exemple, M. canis) et Nannizia. ou les caractères des champignons en culture, il existait une profusion d’espèces et de variétés pour lesquelles il n’y avait Les points importants pour le praticien concernant la défini­ pas d’holotype (holotype = spécimen (culture, souche) dépo­ tion des espèces ou des changements de nomenclature sont sé dans une collection et désigné par un auteur comme maté­ les suivants (tableau 1) : riel de référence pour la nomenclature d’un taxon décrit lors 1. Arthroderma benhamiae devient Trichophyton benhamiae. de sa publication originale). Dès les années 90, les espèces 2. Trichophyton interdigitale (anthropophile) est considéré ont été identifiées par des séquences d’ADN. En particulier, le comme une espèce distincte de T. mentagrophytes (zoo­ polymorphisme des ITS1 et ITS2 (internal transcribed spacers) phile). de l’ADN codant pour les ribosomes (rDNA) s’est révélé très 3. Arthroderma vanbreuseghemii est abandonné au profit de discriminant pour distinguer les espèces.15,16 T. mentagrophytes. 4. Trichophyton soudanense est considéré comme espèce dis­ tincte de Trichophyton violaceum. RÉVISION DES ESPÈCES ET DE LEUR 5. Microsporum gypseum est abandonné au profit de Nannizia gypsea. Nanizzia fulva et Nanizzia incurvata sont des espèces NOMENCLATURE EN 2016 très proches qui ont été souvent appelées M. gypseum par La taxonomie des dermatophytes a été revisitée d’après l’ana­ les praticiens. Ce dernier nom correspondait alors à un lyse des séquences d’ADN de 5 gènes.3 Sur la base de ces complexe d’espèces.20 Les trois espèces ont été clairement séquences, un arbre phylogénétique a permis de bien définir distinguées sur la base de l’interfertilité des souches d’une les genres auxquels appartiennent les espèces anthropophiles même espèce, 17 les souches de deux espèces différentes et zoophiles, et les espèces exclusivement géophiles dont n’étant pas interfertiles. beaucoup ne sont pas pathogènes pour l’homme.3 Les espèces 6. Microsporum persicolor est abandonné au profit de Nannizia de dermatophytes ont été définies en se basant à la fois sur les persicolor. séquences d’ADN, sur les caractères phénotypiques observés en culture, sur l’interfertilité entre souches17-19 et aussi sur leur caractère anthropophile,
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