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A method employing labeling of cell-surface proteins with Sulfo-NHS-SS-biotin and subsequent affinity enrichment with NeutrAvidin has been optimized in order to make cell-surface proteins from Gram-positive bacteria reliably accessible to quantitative mass spectrometric analyses. The optimized biotinylation approach was applied for analysis of the lipoproteome from S. aureus and S. pneumoniae on a global scale and the influence of mutations in the lipoprotein maturation pathway on the cell-surface and exoproteomes of both species was investigated. The biotinylation approach was integrated into a proteomic workflow that employs metabolic labeling with heavy nitrogen for relative protein quantification to investigate proteomic differences between S. aureus in a biofilm model and its free-floating, planktonic counterparts.
During infections, innate immune cells are crucial for initiating a pro-inflammatory immune response and clearing the invading pathogen. Delay in pathogen clearance or initiation of an immune response due to impaired functionality of immune cells can result in devastating consequences. The cellular compartment of the innate immune system comprises an array of specialized cell types: Macrophages are tissue-resident professional phagocytes that clear cellular debris, pathogens, and foreign objects. Dendritic cells (DCs) are immune sentinels specialized in antigen uptake and subsequent T cell priming. They are primary sources of cytokines in response to infection. Neutrophils are efficient effector cells that respond rapidly to infection and clear bacteria by different mechanisms. If effector mechanisms of these cells are affected by either bacterial or other factors, infections might not be resolved and can spread throughout the host. Cobalt-chromium-molybdenum biomaterial is widely used in arthroplasty. Implant-derived wear particles and ions lead to macrophage-driven adverse local tissue reactions: Such reactions have been linked to an increased risk of periprosthetic joint infection after revision arthroplasty. While metal-induced cytotoxicity is well characterized in human macrophages, direct effects on their functionality remain elusive. In Paper I, we show that local peri-implant tissue is exposed to Co and Cr in situ. Influx of macrophages is also evident. Exposure of isolated human monocytes/macrophages to Cr3+ in vitro had only minor effects. However, exposure of monocytes/macrophages to pathologic concentrations of Co2+ significantly impaired both phenotype and functionality. High concentrations of Co2+ induced loss of surface markers, including CD14 and CD16. Both Co2+ and Cr3+ impaired macrophage responses to Staphylococcus aureus infection. Co2+ -exposed macrophages, in particular, showed decreased phagocytic activity. These findings demonstrate the immunosuppressive effects of locally elevated metal ions on the innate immune response. Streptococcus pyogenes (group A streptococcus, GAS) causes a variety of diseases ranging from mild to severe necrotizing soft tissue infections (NSTIs). In the host environment hypervirulent GAS variants carrying mutations within the genes encoding for control of virulence (Cov)R/S two component system are enriched. This adaptation is associated with loss of SpeB secretion. In Paper II, we show that in vitro infections with hyper-virulent GAS variants harboring dysfunctional CovR/S suppress secretion of IL-8 and IL-18 by human monocytic cells. This phenotype was mediated by a caspase-8 dependent mechanism. Knockout of streptococcal SLO in a GAS strain carrying functional CovR/S even increased secretion of IL1β and IL-18 by moDCs. Of 67 fully sequenced GAS NSTI isolates, 28 contained covS or covR mutations that rendered the TCS dysfunctional. However, no differences in systemic IL-8 and IL-18 were detected in these patients. GAS isolates recovered from patients often display a mixed phenotype, consisting of SpeB positive (SpeB+ ) and SpeB negative (SpeB- ) clones. Irreversible loss of SpeB expression is often caused by loss of function mutations in regulatory components (CovR/S, RopB). Loss of SpeB is often associated with hyper-virulence. In Paper III, we show that the host environment induces transiently abrogated secretion of SpeB by GAS. Tissue inflammation, neutrophil influx, and degranulation correlated with increased frequencies of SpeB- GAS clones. Isolates recovered from tissue expressed but did not secrete SpeB, which was reversible. Neutrophilderived ROS were identified as the main factor responsible for abrogated SpeB secretion. Hyper-virulent SpeB- clones also exhibit better survival within and induce excessive degranulation of neutrophils.
Our modern understanding of the hygiene hypothesis is that bacteria are not only the cause of disease but also essential for a healthy immune response and regulation. Varied microbial exposure prenatally and in early childhood protects us from pathological immune reactions such as autoimmune diseases and allergies. Against this background, the hypothesis that bacteria can act as allergens appears paradoxical. Nevertheless, there is growing evidence that Staphylococcus aureus (S. aureus) is associated with allergic reactions and serine protease-like proteins (Spls) produced by S. aureus have been identified as pacemakers of allergic reactions. To open prospects for treatment or causal therapy in patients at risk, the underlying mechanism of allergy induction by Spls was studied, focusing on the IL-33 pathway in airway inflammation. In a murine asthma model C57BL/6 J wild-type mice were repeatedly exposed to SplD via intratracheal application. After two weeks a Th2-biased inflammatory response was observed in the airways: IL-33 and eotaxin production, eosinophilia, bronchial hyperreactivity, and goblet cell hyperplasia. Blocking IL-33 activity with its soluble receptor ST2 counteracted these effects: significantly decreased numbers of eosinophils, IL-13+ type 2 ILCs, IL-13+CD4+ T cells as well as reduced IL-5 and IL-13 production by lymph node cells were observed. This study indicates that SplD induces allergic airway inflammation via the IL-33/ST2 axis. IL-33 upregulation was not accompanied by cell death, which indicates that IL-33 may not be passively released by dying cells but actively secreted by the airway epithelium. Future identification of the physiological substrates of the Spls may help to shed light on the source of IL-33 in SplD-induced airway inflammation.
While the causes of allergy induction by S. aureus Spls were addressed by investigating the underlying mechanism, the consequences of this were also of interest: Does the pro-allergenic response to S. aureus affect patients exposed to S. aureus in their airways? Therefore, the humoral and cellular immune response against Spls was studied in cystic fibrosis (CF) patients who are more frequently colonized with S. aureus than the healthy population and suffer from frequent recurrent airway infections. In this patient cohort a Th2 shift of the Spl-specific immune response became evident, including high Spl-specific serum IgE levels, strong induction of Th2 cell differentiation and production of type 2 cytokines following ex vivo stimulation with recombinant Spls. The observed response seems to be specific for Spls rather than being a general feature of S. aureus proteases since other putative allergens of S. aureus (ScpA, SspB) did not show increased IgE binding in CF sera. The Th2-driven immune response might impede antibacterial clearance and worsen the clinical picture. Larger clinical studies are needed to validate this notion by correlating the anti-S. aureus immune response with clinical parameters and testing new therapy options.
These results and findings shed light on a novel, possibly underestimated facet of the immune response against S. aureus and give impetus for further research on bacterial allergens in general, reaching beyond the species S. aureus.
The metabolomic approach is one part of the "-omics" cascade further comprising genomic, transcriptomic, and proteomic investigations. Since information about the metabolome of the important human pathogenic bacterium Staphylococcus aureus is scarce, the aim of this thesis is the characterization of the exo- and endometabolome of this bacterium on a most global scale. For this, the metabolomic platform consisting of the analytical instruments used for 1H-NMR spectroscopy, HPLC-MS, and GC-MS analysis was applied. First, the requirements for an accurate sampling procedure for the analysis of intracellular metabolites are presented, explaining important pitfalls during the sampling and the subsequent metabolome analysis via HPLC-MS and GC-MS (book chapter I). The challenging task of the metabolite identification is demonstrated, as well as the requirements for absolute quantification of intracellular metabolites. In order to enhance the knowledge about the staphylococcal physiology and the biochemical network, the impact of different stresses and varying cultivation media on the bacterial metabolite pool was investigated in several studies. In article I, a first description of the primary metabolism of growing S. aureus COL cells cultivated aerobically in CDM is provided. This study also monitored the adaptation to glucose starvation on the level of metabolites and proteins. The uptake of all amino acids and the secretion and reuse of overflow metabolites were analyzed in a time-dependent manner. During the switch to a non-growing state, a drastic rearrangement of the amino acid pool in the bacterial cells was detected, and intracellular amounts of glycolytic intermediates were found to decrease in parallel to extracellular glucose exhaustion. During infection processes, S. aureus has to cope with varying levels of oxygen supply, including anaerobic conditions. A global metabolomic approach investigated the adaptation of S. aureus COL to strict anaerobic conditions using CDM as the culture medium. Thereby only linear growth was possible despite the higher uptake rate of glucose compared to aerobically, logarithmically growing cells. In an anoxic environment, S. aureus mainly switched on the less reliable lactic acid fermentation. Only serine and threonine but no alanine were significantly taken up. Subsequent glucose limitation led to energy starvation indicated by a drop in the adenylate energy charge. This was accompanied with an arrest of the fermentative metabolism and declining numbers of colony-forming units without taking advantage of the energy supplying arginine deiminase pathway. Compared to the established CDM, the eukaryotic cell culture medium RPMI 1640 provides more in vivo-like growth conditions. In article II, the growth behavior and the metabolic footprint of the S. aureus strains COL and HG001 were investigated during the aerobic cultivation in RPMI 1640 medium. Both strains are commonly used in laboratory research. The observed uptake and secretion pattern of extracellular metabolites provides important information for infection studies in which this medium is used for the precultivation of S. aureus. The extracellular accumulation of the noncanonical D-amino acid D-isoleucine was an interesting outcome. The strain specific metabolic footprint points to noteworthy differences in the biochemical system of both strains. Moreover, this study demonstrates the impact of the cultivation medium on the metabolic status of bacterial cells. Due to increasing resistance against a large number of antibiotics, community- and hospital- acquired infections with S. aureus are of major concern in medical therapy. Thus, greater knowledge about adaptive mechanisms after antibiotic treatment is required. In article III, the response of S. aureus HG001 to antibiotics with varying target sides, such as ciprofloxacin, erythromycin, fosfomycin, vancomycin, and ampicillin, was investigated on the metabolite level. Thereby, the abundances of 176 intracellular metabolites were observed in a time-dependent manner, thus providing the most comprehensive experimental metabolite dataset so far available for S. aureus. None of the antibiotic compounds led to alterations of single metabolite amounts, but mostly entire metabolic pathways were affected. The intermediates of the cell wall biosynthesis were affected by each antibiotic, confirming this pathway as the most potential target for new antibacterial compounds. The metabolite composition of human nasal secretions and human sweat was analyzed, since such secretions present natural habitats of S. aureus during the colonization of typical host sides. The results confirm that the bacteria has to cope with low concentrations of most of the amino acids but large amounts of urea and lactate during host colonization. Considering the supply of amino acids, the results support the usage of the RPMI 1640 medium as a step to more in vivo-like cultivation experiments. Moreover, essential information for future studies about the adaptation of S. aureus to more in vivo growth conditions is provided. Altogether, the metabolomic approach was proven to be an important tool for helping unravel the complex bacterial metabolism and the environmental factors that also play a role in the virulence of Staphylococcus aureus.
Staphylococcus aureus (S. aureus) is among the most common infectious agents, burdening the
global health care system and challenging physicians. Thus, the demand for vaccination is
increasing, and despite many attempts, no vaccine is currently available. The iron-regulated
surface determinant protein B (IsdB) is a highly conserved surface protein of S. aureus. It has
an essential role in bacterial iron acquisition and cell attachment, functioning as a fitness factor.
It has been shown that IsdB is critical for S. aureus virulence and growth in iron-restricted
conditions, such as the human host. Therefore, IsdB was studied as a vaccine candidate. A nonadjuvant vaccine (V710) was developed based on IsdB, which showed promising results in the
preclinical, phase I, and phase IIa trials. Unexpectedly, in a phase IIb/III, in cardiothoracic
surgery patients that were infected by S. aureus, mortality was significantly higher in the
vaccinated group than the placebo. Despite increased antibody levels against IsdB in the
vaccinated patients, V710 failed to prevent S. aureus infection. Therefore, a better
understanding of the interaction between S. aureus and the immune system is required.
We have discovered that IsdB has an important role in host-pathogen interaction. This bacterial
protein activated human monocytes and murine bone marrow-derived dendritic cells
(mBMDCs) to produce proinflammatory cytokines, such as IL-6, TNF-α, IL-12, IL-23, IL-33,
and IL-1β. In silico molecular docking and DimPlot analysis predicted that IsdB binds to -TLR4
via non-covalent interactions. Microscale thermophoresis confirmed that IsdB has a high
affinity to recombinant human TLR4 in the nanomolar range. Inhibition of TLR4 completely
abolished the production of all the cytokines mentioned above in both cell types. Furthermore,
we characterized the TLR4 signaling pathway triggered by IsdB. In human monocytes, blocking
the myeloid differentiation factor 88 (MyD88) adaptor protein and NF-κβ transcription factor
caused complete abrogation of proinflammatory cytokines in response to IsdB, revealing that
IsdB induces cytokine release via the TLR4-MyD88-NF-κβ dependent pathway.
The consistent release of IL-1β suggested that IsdB induced activation of the inflammasome, a
multi-molecular complex known to play a crucial role in innate immunity. We corroborated our
observations in human monocytes and mBMDCs by inhibiting essential components of the
NLRP3 inflammasome. Blocking NLRP3, caspases in general and caspase-1 completely
inhibited the release of IL-1β. In monocytes, IsdB alone was sufficient to induce NLRPdependent IL-1β release, suggesting an alternative pathway of inflammasome activation. In
contrast, mBMDCs required an additional stimulus, such as ATP or MSU (known stress
signals) besides IsdB, to release IL-1β, indicating a classical inflammasome activation. These
results demonstrate that IsdB induces the release of IL-1β via the TLR4-NLRP3-Caspase-1
axis. Next, we addressed the molecular mechanisms involved in IsdB-induced IL-1β in monocytes.
A low concentration of intracellular potassium (K+) resulting from K+ efflux is known to trigger the NLRP3 inflammasome-mediated IL-1β release. We demonstrated that blocking potassium efflux by inhibition of ion channels, such as pannexin channels (P2X)7, and addition of extracellular KCl significantly reduced IsdB-induced IL-1β. Other common inflammasome activators, such as phagolysosome rupture and reactive oxygen species (ROS), did not contribute to the release of IL-1β in response to IsdB. In summary, we revealed yet another role of IsdB beyond iron acquisition from Hb and attachment to the host cells via vitronectin and integrins. It is conceivable that IsdB’s interaction with innate immune cells modulates the quality of the adaptive immune response, showing a new facet in the pathogen-host relationship of S. aureus that should be considered in future
vaccine development.
Staphylococcus aureus (S. aureus) endocarditis is still one of the most fatal heart diseases, with a mortality rate of 20-45%. In recent years, the importance of endothelial cells (ECs) in the context of endocarditis has become more evident. The vascular endothelium forms a selective barrier between blood and the adjacent tissue by maintaining an anti-inflammatory and anti-thrombogenic phenotype. However, in case of insertion of cardiac implants, an injury of the endothelium can occur which promotes platelet aggregation followed by S. aureus adherence to the platelets, especially in areas with low hemodynamic shear stress. This process is considered as a key event in the development of infective endocarditis (IE) and allows bacteria to colonize the heart valves. Despite extensive research, the pathogenesis of IE is still not completely understood. Therefore, further investigations are needed to enable an effective prevention of this life-threatening disease.
In order to study the infection process of S. aureus, internalization experiments with two different S. aureus strains, one control strain (HG001) and one strain isolated from an endocarditis patient (T-72949) were performed in human coronary artery endothelial cells (HCAEC). Subsequently, an extensive proteome analysis of the host cells was carried out. More specific analyses were performed using peptidoglycan (PGN), a cell wall component of Gram-positive bacteria, which causes a pro-inflammatory response in ECs. In this context, the focus remained on the analysis of cellular changes in terms of cell stiffness, wound healing, and additionally platelet aggregation.
The analysis of the HCAEC host proteome revealed a time-related difference depending on the infecting bacterial strain. Several proteins involved in host cell signaling pathways exhibited a higher abundance at earlier time points in host cells infected with endocarditis strain T-72949 compared to those infected with HG001. Further proteome analysis uncovered several adaptations on the cellular side that enable internalization and replication of both S. aureus strains as well as the activation of pathways that promote cellular recovery. Furthermore, it could be shown that PGN reduced cellular stiffness which could lead to an increased bacterial uptake and would thereby promote the development of a chronic S. aureus infection. Additionally, PGN prevented effective wound healing which promotes a pro-thrombotic and pro-inflammatory condition. This status could facilitate the bacterial infection of further cells. Apart from that, PGN induced platelet aggregation which could ease bacterial adhesion to thrombotic surfaces (e.g., dysfunctional endothelium). The following formation of a mature vegetation might protect the bacteria from the immune system and antibiotics.
The results of the present work emphasize the central role of ECs in the context of IE. It could be demonstrated that a healthy monolayer of ECs enables a beneficial cell response and may prevent the development of vascular diseases. Moreover, the comprehensive proteome dataset which was generated in this project provides a valuable source of information for future studies to unravel further molecular mechanisms of endocarditis and possible therapeutic approaches.
In vitro and in vivo analyses of mono- and mixed-species biofilms formed by microbial pathogens
(2022)
Microbial biofilms can be defined as multicellular clusters of microorganisms embedded in a self-produced extracellular matrix (ECM), which is primarily composed of polymeric biomolecules. Biofilms represent one of the most severe burdens in both industry and healthcare worldwide, causing billions of dollars of treatment costs annually because biofilms are inherently difficult to prevent, treat, and eradicate. In health care settings, patients suffering from cystic fibrosis, or patients with medical implants are highly susceptible to biofilm infections. Once a biofilm is formed, it is almost impossible to quantitatively eradicate it by mechanical, enzymatical, chemical, or antimicrobial treatment. Often the only remaining option to fully eradicate the biofilm is removing of the infected implant or body part. The primary reasons for the inherent resistance of biofilms against all forms of antimicrobial treatment are (I) a reduced metabolic activity of biofilm-embedded cells climaxing in the presence of metabolic inactive persister cells, as well as (II) the protective nature of the biofilm matrix acting as a (diffusion) barrier against antimicrobials and the host immune system. Consequently, there is an urgent need to better understand microbial biofilms from a structural and (patho-) physiological point of view in order to be able to develop new treatment strategies.
Therefore, the aims of this study were to investigate fundamental physiological properties of different clinically relevant single and multi-species biofilms, both in vitro and in vivo. Furthermore, the effectiveness of a novel treatment strategy using cold atmospheric pressure plasma was evaluated in vitro to treat biofilms of the pathogenic fungus C. albicans.
In article I, the intracellular and ECM protein inventory of Staphylococcus aureus during in vitro biofilm growth in a flow reactor was analyzed by liquid-chromatography coupled to tandem mass-spectrometry (LC-MS/MS) analysis combined with metabolic footprint analysis. This analysis showed that anaerobiosis within biofilms releases organic acids lowering the ECM pH. This, in turn, leads to protonation of alkaline proteins – mostly ribosomal proteins originating from cell lysis as well as actively secreted virulence factors – resulting in a positive net charge of these proteins. As a consequence, these proteins accumulate within the ECM and form an electrostatic network with negatively charged cell surfaces, eDNA, and metabolites contributing to the overall biofilm stability.
In article II, the in vivo metaproteome of the multi-species biofilm community in cystic fibrosis sputum was investigated. To this end, an innovative protocol was developed allowing the enrichment of microbial cells, the extraction of proteins from a small amount of cystic fibrosis sputum, and subsequent metaproteome analysis. This protocol also allows 16S sequencing, metabolic footprint analysis, and microscopy of the same sample to complement the metaproteome data. Applying this protocol, we were able to significantly enhance microbial protein coverage providing first insights into important physiological pathways during CF lung infection. A key finding was that the arginine deaminase pathway as well as microbial proteases play a so far underappreciated role in CF pathophysiology.
In articles III and IV, a novel treatment strategy for biofilms formed by the important fungal pathogen Candida albicans was evaluated in vitro. Biofilms were treated with two different sources of nonthermal plasma (with the Nonthermal Plasma Jet “kINPen09” as well as with the Microwave-induced plasma torch “MiniMIP”) and the effect on growth, survival, and viability was assessed by counting colony-forming units (CFU), by cell proliferation assays, as well as by live/dead staining combined with fluorescence microscopy, confocal laser scanning microscopy, (CLSM) and atomic force microscopy (AFM). These tests revealed that biofilms were effectively inactivated mostly on the bottom side of biofilms, indicating a great potential of these two plasma sources to fight biofilms.
SUMMARY To date, Staphylococcus aureus is the most common cause of nosocomial infections and the species is becoming increasingly resistant to antibiotics. Beyond this, S. aureus colonises the nasal mucosa of circa 35% of the healthy population, so-called carriers. Importantly, S. aureus nasal carriage is a major risk factor for the development of S. aureus infections, which are commonly caused by the colonising strain. This underlines the importance of host factors for the outcome of S. aureus-host interactions. Despite the clinical importance of nasal carriage, little is known about humoral immune responses triggered by colonisation. Therefore, this thesis was focussed on the anti-staphylococcal antibody responses of S. aureus carriers and noncarriers. Staphylococcal superantigens (SAgs) served as indicator antigens for our studies. SAgs are virulence factors with extraordinary variability in the species S aureus and act as extremely potent T cell mitogens. To date, 19 different SAg gene loci are known in the species S. aureus, but molecular-epidemiological studies on the distribution of these genes are limited. Therefore, we established five multiplex PCRs for the detection of all known SAgs. With this robust and high-throughput technique we analysed the SAg gene patterns of more than 300 isolates, including 107 nasal isolates of S. aureus carriers and 88 blood culture isolates of hospital patients from Western Pomerania. The SAg gene patterns were highly heterogeneous, which can be explained by their localisation on mobile genetic elements (MGE), such as genomic islands, pathogenicity islands, phages and plasmids. Most isolates (~80%) harboured SAg genes, on average five to six, and SAgs of the enterotoxin gene cluster (egc) were by far the most prevalent. Additionally, we observed a strict correlation between the presence of SAg genes and the T cell mitogenic potency of clinical isolates. SAg-encoding MGEs can be distributed by two distinct mechanisms: horizontal transfer by bacteriophages and vertical transmission to daughter cells. To investigate the distribution of SAg genes within the S. aureus population, we determined the clonal relationship of our isolates by spa genotyping. Interestingly, SAg-gene encoding MGEs were not randomly distributed, but rather closely linked to clonal lineages. Each clonal lineage was characterised by defined combinations of SAg genes. These data suggest that the simultaneous assessment of virulence gene profiles and the genetic background strongly enhances the discriminatory power of genetic investigations into the mechanisms of S. aureus virulence. Indeed, the comparison of virulence genes within each clonal complex indicated a role in invasiveness for some MGEs, e.g. the exfoliative toxin D-encoding pathogenicity island, while rendering it unlikely for SAgs. It is known that neutralising serum antibodies against the SAgs SEA, SEB, SEC, SED and TSST-1 are frequently present in healthy individuals. However, the neutralising antibody profiles against more recently described SAgs or complex SAg cocktails as secreted by clinical isolates had not been determined so far. Therefore, we screened more than 100 sera for their SAg neutralising capacity with a neutralisation assay. We observed a marked heterogeneity and surprisingly large “gaps” in the neutralising capacity. Interestingly, the egc SAgs were inhibited only rarely (5-10%), whereas between 32 and 86% of the tested sera neutralised “classical” SAgs. This “egc gap” in the SAg-neutralising antibody profiles of healthy individuals was unexpected, since egc SAgs are by far the most prevalent SAgs. We could demonstrate that the “egc gap” is probably not due to different T cell activating properties of egc SAgs compared to classical SAgs, but rather to a differential regulation of SAg gene expression. S. aureus carriers have an increased risk of developing an S. aureus bacteraemia, which is in most cases caused by the colonising strain. Intriguingly, a large prospective clinical trial revealed a considerably higher mortality in noncarriers with invasive S. aureus strains compared to carriers with invasive disease. To explain these paradoxical findings, we hypothesised that in carriers partial immunity against the colonising strain may contribute to their improved outcome. We used SAgs as strain-specific indicator antigens. Importantly, sera from persistent carriers neutralised SAgs of their colonising strain with significantly higher efficiency than sera from noncarriers. This antibody response was strain-specific, since the antibody response of carriers against other SAgs did not differ from that of noncarriers. Thus, colonisation with S. aureus confers a strong and strain-specific antibody response against staphylococcal SAgs. We suggest that in carriers neutralising antibodies directed against SAgs and other staphylococcal virulence factors confer partial protection during systemic infections. This could explain the better prognosis of carriers with S. aureus bacteraemia compared to noncarriers. Moreover, our data imply that the key to understanding the pathogenesis of S. aureus disease may lie in the identification of host factors rather than bacterial factors. Such host factors could be the immune status and gene polymorphisms that contribute to colonisation, susceptibility to infection and outcome of infection. Finally, while the treatment of S. aureus bacteraemia with pooled immunoglobulins was performed in the past without significant success, our findings on strain-specific antibody profiles suggest that therapies with customised cocktails of monoclonal antibodies could have a higher efficacy.
Staphylococcus aureus is present in around a third of the human population as a constant commensal in the anterior nares, in a third as an intermittent commensal, and a third are non-carriers. However, S. aureus is also a dangerous pathogen, responsible for many types of infections. Recently, the emerging of methicillin-resistant S. aureus strains has aggravated the health problem. Treating infections caused by the invasive strains has become ineffective with conventional antibiotics. Noticeably, transmission of S. aureus has occurred not only in healthcare settings but also in the community; furthermore, transmission between humans and domestic animals has been reported. Although studies about host-pathogen interactions of S. aureus have advanced our knowledge in the last decades, we still have not fully understood mechanisms of the immune system in responses to S. aureus. The aim of this study is to unravel interactions of the human adaptive immune system to selected S. aureus virulence factors. In particular, the study focuses on two aspects: the reaction of human antibodies to the bacterial extracellular proteins in S. aureus-induced furunculosis with an emphasis on Panton-Valentine Leukocidin and responses of the adaptive immune system to membrane-bound lipoproteins of S. aureus. Furunculosis is a variety of hair follicle infection in which S. aureus is one of the chief causal pathogens involved. The corresponding bacterial strains are generally capable of producing of a pore-forming toxin, known as Panton-Valentine Leukocidin (PVL). Recently, the emerging of pvl-positive methicillin-resistant S. aureus has become a problem for treating the bacterially caused furuncles. Colonization with the bacteria is a risk factor for development of chronic or recurrent boils. It is not yet known why furunculosis patients are largely infants or young adults. In this context, we untangled the responses of antibody IgG antibodies to S. aureus extra-cellular factors, notably the PVL toxin, in families in which the patients were children. Multiplex PCR demonstrated that S. aureus clones, isolated from the patients’ wounds but also from the nares of family members, harbored genes coding for PVL toxin. Spa-typing highlighted that bacterial genotypes were very similar in each family. This suggests that transmission of pvl-positive S. aureus took place between family members. The finding also raises the question why only the young patients but not family members who were colonized by the same S. aureus clones suffered from furunculosis. 2D immune proteomics procedures showed a tendency of higher IgG titers against bacterial virulence factors in family healthy members than in patients. PVL-specific antibodies were measured using ELISA, in which patients’ PVL-specific IgG titers were low. This supports the idea that antibodies, probably in conjunction with T cells, might contribute to clinical protection in furunculosis. This research will serve as a foundation for future studies, in which our results should be validated in a larger cohort. Among S. aureus’ virulence factors are lipoproteins, which are anchored in the bacterial cell membrane. Lipoproteins perform various functions in colonization, immune evasion, and immunomodulation. These proteins are potent activators of the complex of innate immune receptors termed Toll-like receptors (TLR) 2 and 6. This study addressed the specific B-cell and T-cell responses to lipoproteins in human S. aureus carriers and non-carriers. 2D immune proteomics and ELISA approaches revealed that titers of serum antibody (IgG) binding to the S. aureus lipoproteins were very low or even unmeasurable in healthy individuals except for the lipoprotein SaeP. Only patients with cystic fibrosis or epidermolysis bullosa who were heavily exposed to the bacteria, generated an antibody response also to lipoproteins. Proliferation assays and cytokine profiling data showed only subtle responses of T cells in healthy individuals; three out of eight tested lipoproteins did not elicit proliferation. Hence, the robust activation of the innate immune system by S. aureus lipoproteins does not translate into a strong adaptive immune response. Reasons for this may be inaccessibility of lipoproteins for B cells as well as ineffective processing and presentation of the antigens to T cells. The main findings implicate that family members can serve as S. aureus reservoirs causing recurrent furunculosis in young patients and that antibodies may provide partial protection from such infections by S. aureus. We have found that, different from proteins that are secreted by S. aureus, lipoproteins which anchored in the bacterial cell membrane, do not trigger strong responses from the human adaptive immune system. This suggests that these proteins remain mostly hidden in the bacterial cell-wall.
This thesis contains results from transcriptome studies on different aspects of host-pathogen interactions. First, liver gene expression profiles from a murine chronic stress model served to elucidate aspects of the influence of stress on metabolism and immune response state. Chronic stress in female BALB/c mice was shown to lead to a hypermetabolic syndrome including induction of gluconeogenesis, hypercholesteremia, and loss of essential amino acids, to the induction of the acute phase response, but also of immune suppressive pathways and to the repression of hepatic antigen presentation. Increased leukocyte trafficking, increased oxidative stress together with counter-regulatory gene expression changes, and an induction of apoptosis were detected. The influence of intra-venous infection on the host kidney gene expression was analyzed in another murine model using the wild type strain Staphylococcus aureus RN1HG and its isogenic sigB mutant. Gene expression profiling indicated a highly reproducible host kidney response to infection. The comparison of infected with non-infected samples revealed a strong inflammatory reaction of kidney tissue, e. g. Toll-like receptor signaling, complement system, antigen presentation, interferon and IL-6 signaling. However, the results of this study did not provide any hints for differences in the pathomechanism of the S. aureus strains RN1HG and ΔsigB, since the host response did not differ between infections with the two strains analyzed. Effects of SigB might be transient, only apparent at earlier time points, or might also be compensated for in the in vivo infection by the interlaced pattern of other regulators. SigB might possess only to a lesser extent characteristics attributed to virulence factors and might act in vivo more like a virulence modulator and fine tune bacterial reactions. In addition to the analysis of tissue samples, different in vitro models were furthermore studied. The third part of this thesis focuses on bone-marrow derived macrophages (BMM) of the two mouse strains BALB/c and C57BL/6, which are described in literature to exhibit genetically determined differences in their reaction to infection. Expression profiling was performed on control and IFN-γ treated samples from a serum-free cultivation system and revealed mainly induction of gene expression after treatment of BMM with IFN-γ. Gene expression changes confirmed known IFN-γ effects like induction of immunoproteasome, antigen presentation, interferon signaling related genes, GTPase/GBPs, and inducible NO synthase. IFN-γ dependent gene expression changes were highly similar in BALB/c and C57BL/6 BMM. Considering gene expression differences between BMM of both strains, a similar expression trend was visible on the level of untreated controls as well as after IFN-γ treatment. Differentially expressed genes between BMM of both strains included immune-relevant genes as well as genes linked to cell death, but the coverage of functional groups was limited. The bronchial epithelial cell line S9 was used as an in vitro model system for the infection with S. aureus RN1HG. The fourth chapter in this thesis includes S9 cell gene expression signatures 2.5 h and 6.5 h after start of infection. At the early time point, only 40 genes were differentially expressed, which nevertheless indicated a beginning pro-inflammatory response, e. g. induction of cytokines (IL-6, IFN-β, LIF) or prostaglandin-endoperoxide synthase 2 (PTGS2), but also counter-regulatory processes, e. g. induction of CD274. The host cell response was dramatically aggravated at the later 6.5 h time point. Differential expression was detected for 1196 genes. These included induced cytokines, pattern recognition receptor signaling, antigen presentation, and genes involved in immune defense (e. g. GBPs, MX, APOL). Negative effects on growth and proliferation were even more enhanced in comparison to the early time point, and signs for apoptotic processes were revealed. Finally, the last chapter addresses amongst others the pathogen’s expression profile in the S9 cell in vitro infection model at the two time points 2.5 h and 6.5 h after start of infection by tiling array gene expression analysis. The pathogen expression profiling revealed the activity of the SaeRS two-component system in internalized staphylococci. Partly dependent on SaeRS, the induction of adhesins (e. g. fnbAB, clfAB), toxins (hlgBC, lukDE, hla), and immune evasion genes (e. g. chp, eap) was observed. Furthermore, expression changes of metabolic genes were recorded (gene induction of amino acid biosynthesis, TCA cycle, gluconeogenesis; gene repression of glycolysis, purine biosynthesis, tRNA synthetases). Expression analysis recorded a distinct bacterial expression program, which supported literature results of a specific, bacterial strain and host cell line dependent transcriptional adaptation of the pathogen.