ATP-binding cassette (
ABC) transporters help export various substrates across the cell membrane and significantly contribute to drug resistance. However, a recent study reported an unusual case in which the loss of an
ABC transporter in Candida albicans, orf19.4531 (previously named ROA1), increases resistance against antifungal
azoles, which was attributed to an altered membrane potential in the mutant strain. To obtain further mechanistic insights into this phenomenon, here we confirmed that the plasma membrane-localized transporter (renamed CDR6/ROA1 for consistency with C. albicans nomenclature) could efflux
xenobiotics such as
berberine,
rhodamine 123, and
paraquat. Moreover, a CDR6/ROA1 null mutant, NKKY101, displayed increased susceptibility to these
xenobiotics. Interestingly, fluorescence recovery after photobleaching (FRAP) results indicated that NKKY101 mutant cells exhibited increased plasma membrane rigidity, resulting in reduced
azole accumulation and contributing to
azole resistance. Transcriptional profiling revealed that ribosome biogenesis genes were significantly up-regulated in the NKKY101 mutant. As ribosome biogenesis is a well-known downstream phenomenon of target of
rapamycin (TOR1) signaling, we suspected a link between ribosome biogenesis and TOR1 signaling in NKKY101. Therefore, we grew NKKY101 cells on
rapamycin and observed TOR1 hyperactivation, which leads to Hsp90-dependent
calcineurin stabilization and thereby increased
azole resistance. This in vitro finding was supported by in vivo data from a mouse model of systemic
infection in which NKKY101 cells led to higher fungal load after
fluconazole challenge than wild-type cells. Taken together, our study uncovers a mechanism of
azole resistance in C. albicans, involving increased membrane rigidity and TOR signaling.