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The human antibody response to experimental colonization with Staphylococcus aureus NCTC8325-4
(2008)
The four main work packages and their most important results are briefly described as following. 1. Characterization of the extracellular proteome of S. aureus NCTC8325-4 Reference maps of the extracellular proteins of S. aureus NCTC8325-4 were produced at pH ranges 6-11 and 4-7. In total, 119 (pH 6-11) and 177 (pH 4-7) protein spots were identified, corresponding to 48 and 114 proteins, respectively. Among them were many well-known virulence factors such as alpha-hemolysin (Hla), beta-hemolysin Hlb, gamma-hemolysin subunits (HlgA-C), hyaluronate lyase (HysA) and staphylococcal superantigen-like protein 11 (Ssl11). We also detected various extracellular enzymes, which can cause tissue degradation and are involved in nutrient acquisition, for example, autolysin (Atl), glycerol ester hydrolase (Geh), lipase (Lip), thermonuclease (Nuc), several serine proteases SplA-F (SplA-F), V8 protease (SspA), cysteine protease (SspB), staphopain thiol proteinase (88195808, SspP). Many of these proteins probably also contribute to the virulence of S. aureus. 2. Optimization of a 2-D immunoblot (IB) method for the comprehensive investigation of IgG binding to S. aureus extracellular proteins (strain NCTC8325-4) The immune proteome of S. aureus NCTC8325-4 was revealed by probing 2-D blots of S. aureus extracellular proteins at the two pH ranges 6-11 and 4-7 with a pool of sera from 16 volunteers. IgG binding was detected with high sensitivity using a peroxidase-coupled secondary Ab in combination with an ECL-substrate. With application of the software package Delta2D, we could clearly define 66 immune reactive spots on the immunoblots (IBs) of pH range 6-11 and 38 spots on IBs of pH range 4-7. 72 of these 104 immune reactive spots could be identified by matching the IBs with the protein reference maps. These spots represented 36 identified proteins, many of which are known virulence factors, or they are involved in bacterial cell wall biosynthesis and degradation. Generally, the most abundant proteins were also highly immune reactive, but there was no strict correlation between protein abundance and immune reactivity. Some low abundance proteins, especially basic proteins, showed high immune reactivity on 2-D IBs, for example, Atl, 88195808 (SspP) and iron-regulated surface determinant protein A (IsdA). On the other hand, we observed proteins, which were present in large amounts but did not bind IgG such as peptidoglycan hydrolase (LytM) and a hypothetical protein 88193909 (SAOUHSC_00094). 3. Determination of the anti-staphylococcal Ab profiles of S. aureus carriers and noncarriers Comparing the serum IgG binding patterns of sera from the 16 individual volunteers, we observed pronounced heterogeneity in total IgG binding, spot patterns and spot intensities. Five spots were stronger in carriers than in noncarriers (P< 0.05, Mann-Whitney U test). These spots represent IgG binding to SspA, SspB, IsaA, and two hypothetical proteins. A principal component analysis based on differential IgG binding to these spots showed that the carriers were more closely related to each other than the noncarriers, but that they could not be clearly separated from the noncarriers. 4. Does experimental colonization induce changes of the anti-staphylococcal Ab profiles? Finally, we tested whether symptom-free experimental colonization of the 16 volunteers with S. aureus NCTC8325-4 elicited an IgG response. When we compared sera obtained before colonization with those taken 4 weeks after the inoculation with the laboratory S. aureus strain, we did not observe major changes in the Ab patterns. We conclude that short- term colonization with a strain of low virulence does not suffice to induce an Ab production, which is comparable to that present already before the colonization. Thus, either long term high density colonization is required, or as we consider most likely, the adaptive immune response is primarily triggered by (minor) S. aureus infections. Taken together, in this work we have separated the soluble proteins from complex extracellular S. aureus protein extracts with good reproducibility, large coverage (pH 6-11 and 4-7) and high resolution. With application of an ECL substrate, our 2-D immunoblotting procedure resulted in the highly sensitive detection of IgG binding over a wide range of signal intensities. The most important finding with this technique was the pronounced variability of anti-staphylococcal Ab profiles in healthy adults. This could well explain differences in susceptibility to S. aureus infection and its complications. The Ab responses are presumably triggered by long-term colonization or, more likely, by minor infections with S. aureus, since experimental nasal colonization of healthy volunteers with a bacterial strain of low virulence did not induce impressive changes in the Ab profiles.
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.
Influenza A Virus (IAV), Staphylococcus aureus (staphylococci), and Streptococcus pneumoniae (pneumococci) are leading viral and bacterial causes of pneumonia. Dendritic cells (DCs) are present in the lower respiratory tract. They are characterized by low expression of co-stimulatory molecules, including CD80 and CD86 and high capacity of antigen uptake. Subsequently, DCs upregulate co-stimulatory signals and cytokine secretion to effectively induce T-cell priming. Here, we investigated these processes in response to bacterial and viral single as well as coinfections using human monocyte-derived (mo)DCs. Irrespective of single or coinfections, moDCs matured in response to IAV and/or staphylococcal infections, secreted a wide range of cytokines, and activated CD4+, CD8+ as well as double-negative T cells. In contrast, pneumococcal single and coinfections impaired moDC maturation, which was characterized by low expression of CD80 and CD86, downregulated expression of CD40, and a mild cytokine release resulting in abrogated CD4+ T-cell activation. These actions were attributed to the cholesterol-dependent cytotoxin pneumolysin (Ply). Infections with a ply-deficient mutant resulted in restored moDC maturation and exclusive CD4+ T-cell activation. These findings show that Ply has important immunomodulatory functions, supporting further investigations in specific modalities of Ply-DC interplay.
Staphylococcus aureus can be a harmless colonizer of the human body, which colonizes about 20-30% of the population. If S. aureus overcomes the outer physical barrier of the body, comprised of the skin and mucous surfaces, it can also cause severe diseases such as endocarditis, pneumonia, or sepsis. S. aureus possesses a variety of secreted and surface bound virulence factors to mediate attachment and invasion into the host, to disseminate an infection and to modulate and evade the immune system. But not only the huge amount of virulence factors turn S. aureus into a dangerous human pathogen, also its resistances to a broad spectrum of commonly used antibiotics make infections hard to treat. During the last years it became apparent that S. aureus can be internalized by as well as replicate and persist in professional and non-professional phagocytic cells. It is suggested that the intracellular compartment protects S. aureus from antibiotic treatment and the immune system. To accomplish the adaptation to the intracellular compartment, S. aureus needs to regulate its gene expression by regulatory systems. One of these regulators is the alternative sigma factor SigB, which directly and indirectly regulates the expression of about 200 genes in vitro. However, the stimuli leading to the activation of SigB in S. aureus are barely known and also its role during an infection varies, depending on the S. aureus strain and infection model used. Therefore, the importance of SigB during the early adaption of S. aureus to the intracellular environment should be elucidated using a cell culture infection model. First, the existing cell culture infection workflow had to be modified to improve the data analysis and to increase the yield of identified proteins to comparatively monitor the adaption reaction of S. aureus HG001 and its isogenic ΔsigB mutant to the intracellular milieu of S9 human bronchial epithelial cells. The proteome analysis in conjunction with RT-qPCR analysis of the wild type and the ΔsigB mutant revealed a fast and transient activation of SigB directly after internalization. Quantitative analysis of the intracellular bacterial titer demonstrated a requirement of SigB for intracellular replication. Differences in the proteome composition of the ΔsigB mutant in comparison to the wild type after internalization reflected the different growth rates, resistance to antibiotics and toxic compounds, adaptation to oxidative stress, and protein quality control mechanisms. The accessory gene regulator (Agr) is like SigB also a global regulator of gene expression in S. aureus. To elucidate possible benefits in the intracellular survival of the co-occurrence of S. aureus wild type and Δagr mutant cells, like it can be found in sites of an infection, a co-infection assay was established. With the co-infection assay the simultaneous and competitive intracellular survival in comparison to the individual intracellular survival was followed for three days post-infection (p.i.). The single and the co-infection revealed that the wild type was able to replicate more efficiently during the first hours p.i. than the Δagr mutant, but the mutant was able to survive more efficiently. The extracellular proteome of S. aureus represents the key compartment for virulence factors. Virulence factors are secreted or bound to the surface of the S. aureus cell. With the infection workflow applied in this study, secreted proteins are lost during the enrichment of the intracellular bacteria for proteome analysis. Therefore, no information about the levels or the regulation of virulence factor expression can be acquired in the cell culture infection model using cell sorting approaches. Hence, the extracellular proteome of S. aureus was analyzed in vitro from shake flask experiments. To get a comprehensive overview of the regulatory impact of different global regulators onto the secretome, S. aureus LS1 mutants lacking the global regulators Agr, SarA and SigB were compared to the respective wild type. Additionally the protein level of the secretome of the well characterized and frequently used S. aureus strains 6850, CowanI, HG001, LS1, SH1000, and USA300 was comparatively analyzed. This project was performed in collaboration with the group of Prof. Löffler from the Institute of Medical Microbiology in Jena. The data of the extracellular proteome generated in this thesis were combined with phenotypic and toxicity data to explain strain differences in invasiveness, cytotoxicity, phagosomal escape, and intracellular persistence in infection experiments.
Thiol or sulfhydryl groups are highly reactive functional groups in cellular systems. Molecules carrying thiol groups are mostly derivatives of the amino acid cysteine and are grouped as low molecular weight (LMW)-thiols: coenzyme A (CoA), glutathione (GSH) or bacillithiol (BSH). LMW-thiols can help in the maintenance of the reduced cellular environment as so called redox-buffers. Additionally, they act as co-factors in enzyme reactions or help in the detoxification of reactive oxygen or nitrogen species, electrophilic compounds or thiophilic metalloids (arsenite, tellurite). In proteins from different organisms cysteine is underrepresented compared to other amino acids, but still overtakes diverse roles. It is an important determinant in the tertiary and quaternary structure of proteins. The nucleophilic character of the thiol or thiolate group, respectively, makes cysteine the catalytically active amino acids of different enzymes. As a precursor cysteine participates in the formation of Fe-S clusters and coordinates different co-factors like heme, iron or zinc. The main goal of this study was the investigation of the different cellular thiol pools, now defined as the thiolome. The thiolome is the entity of the cellular thiol pools, i.e. LMW-thiols and protein thiols, and the dynamics between these pools. In Bacillus subtilis and Staphylococcus aureus mixed disulfides between protein thiols and free LMW-thiols, so called S-thiolations, were identified in different proteins in response to the thiol specific reagent diamide. Some of these S-thiolations were located at catalytically active cysteine residues. Subsequent analysis of metabolites supports this: the S-thiolation of the cobalamine-independent methionine-synthase MetE led to a decrease of the cellular methionine content. Additionally, the conversion of threonine to different branched-chain amino acids (BCAAs) was disrupted by the S-thiolation of the branched-chain amino acid aminotransferase YwaA, thereby probably inducing the synthesis of ppGpp, the alarmon of the stringent response. In addition to the identification of S-thiolations a technique was established which allowed the discrimination between intra- and intermolecular disulfides. The non-reducing/ reducing diagonal gel electrophoresis was applied to B. subtilis and S. aureus and confirmed known existing disulfide bonds, e.g. in alkyl hydroperoxide reductase AhpC or the thiol peroxidase Tpx. In response to diamide an increase of specific disulfide bonds in different proteins was observed. The analysis of the LMW-thiol content by an HPLC-approach allowed the observation of the dynamics of the thiolome. In response to diamide the reduced LMW-thiol content decreased by 75%, reduced protein thiols by 60%. Collaborations with other working groups allowed the identification of BSH in this approach. Additionally, an unknown thiol was found that is likely a derivative of BSH. Screening of the LMW-thiol content of different S. aureus-strains under various growth conditions revealed that strains 8325-4 and SH1000 lack BSH. The lack of BSH was attributed to an 8 bp-duplication in the bshC-gene that encodes the last enzyme of the BSH-synthesis. BSH-production was restored by transducing plasmid-borne functional BshC from strain Newman into strains 8325-4 and SH1000. The reconstitution of the BSH-synthesis aided in the resistance to the antibiotic fosfomycin but did not increase the resistance to different oxidants (diamide, sodium hypochlorite, hydrogen peroxide). The production of BSH had also positive effects on the survival of S. aureus inside human bronchial epithelial cells and murine macrophages in phagocytosis assays. Additionally, a GSH-uptake was observed into S. aureus which has before been known as a GSH-free bacterium. Taken together, this thesis provides the first insights into both, the LMW-thiol- and protein thiol pool of low GC, Gram-positive bacteria under different conditions. A plethora of different methodologies was used to describe the thiolome. The bacterial thiolome is a sophisticated system which is tightly regulated, but also flexible enough to not rely on determined molecules like BSH. The influences of the thiolome are not restricted to its own system and regulation, but also affect different branches of cellular physiology like the metabolism of BCAAs.
Bacterial infections represent an increasing threat in human health and hospital- acquired infections meanwhile account for 99,000 deaths every year in the United States (Ventola, 2015). Live-threating bacterial infections will certainly emerge to an even more serious concern in future, essentially by accelerated development of antibiotic resistance. Only recently, the discovery of plasmid-encoded mcr-1, that confers resistance against colistin, marks the point where this highly transmissible resistance mechanism is now reported for every so far developed antibiotic (Liu et al., 2016). Staphylococcus aureus is a Gram-positive bacterium and well-known for its ability to quickly acquire resistance toward antibiotics either by chromosomal mutations and/or horizontal gene transfer (Pantosti et al., 2007). Although approximately 30% of the population is colonized with S. aureus (Kluytmans et al., 1997), it can transform to an invasive pathogen that causes a wide range of severe infections including pneumonia. The success of S. aureus as opportunistic pathogen can be attributed to combinations of several beneficial properties and capabilities including the expression of an arsenal of virulence factors (Archer, 1998), intracellular persistence (Garzoni & Kelley, 2009) and subversion of host cell defense mechanisms (Schnaith et al., 2007). The airway epithelium is the first line of defense against bacterial pathogens by forming a relative impermeable physical barrier composed of epithelial cells that are linked by tight junctions, desmosomes and adherence junctions (Davies & Garrod, 1997). Additionally, the airway epithelium mediates the detection of bacterial pathogens via toll-like receptors (TLRs) that recognize a variety of bacterial molecular patterns such as lipopolysaccharide (LPS), peptidoglycan and flaggelin (Sha et al., 2012). This interaction is transduced via protein phosphorylations into the cell in order to promote adaptation to the infection by initiation of the adaptive and innate immune defense. Although few insights where obtained of the signaling host responses towards staphylococcal infections (Agerer et al., 2003; 2005; Ellington et al., 2001), a comprehensive description of the host signaling network is largely missing. Thus, this dissertation thesis focuses on the decipherment of phosphorylation-mediated signaling responses towards S. aureus infections in non- professional and professional phagocytes by mass spectrometry-based phosphoproteomic techniques. The results of this thesis are summarized in the four chapters. Chapter I introduces to recent advances in the development of methodologies applied in the field of phosphoproteomics, including quantification strategies, peptide fractionation techniques and phosphopeptide enrichment methods applied for the system-wide characterization of protein phosphorylations by mass spectrometry. Additionally, publications reporting phosphorylation-based host signaling responses towards bacterial pathogens or their molecular patterns that applied mass spectrometry-based phosphoproteomics are discussed. In chapter II, the responses of the human bronchial epithelial cell lines 16HBE14o- and S9 following challenge with staphylococcal alpha- toxin at the level of proteome and phosphoproteome are summarized. General and cell type-specific signaling events are highlighted and evidences linking the activity of the epidermal growth factor receptor (EGFR) with differences in tolerance toward alpha-toxin are provided. Chapter III describes the modulation of the host signaling network of 16HBE14o- airway epithelial cells triggered by infection with S. aureus including temporal dissection of signaling events. Several protein kinases were identified as important signaling hubs mediating the host response. Targeted pharmaceutical inhibition of these kinases was probed and resulted in reduction of intracellular bacterial load. Chapter IV describes the rearrangement of the kinome by the differentiation of THP-1 monocytes to macrophage-like cells by application of quantitative kinomics. This approach identified the kinase MAP3K7 (TAK1) as key mediator of bacterial clearance, chemokine secretion and the differentiation process itself.
Die Atemwege sind mögliche Eintrittspforten für Staphylococcus aureus in den menschlichen Organismus. Inhalierte Bakterien oder Bakteriencluster kommen initial vermutlich nicht direkt mit den Epithelzellen der Atemwege in Kontakt, sondern nur mit der aufgelagerten Mukusschicht. Die Mikroorganismen nehmen in dieser Situation möglicherweise über sekretorische lösliche Virulenzfaktoren auf die Funktion der Epithelzellen Einfluss und können dadurch das Infektionsgeschehen für sich günstig beeinflussen. Die Behandlung einer Infektion ist oft schwierig, da viele S. aureus-Stämme resistent gegenüber Antibiotika sind. Es ist daher von großem Interesse, mehr über die vielfältigen Interaktionen dieser Bakterien mit ihren eukaryotischen Wirtszellen in Erfahrung zu bringen. Bisher ist nur wenig über die Reaktionen humaner Atemwegsepithelzellen auf Kontakt mit S. aureus-Sekretionsprodukten bekannt, deswegen wurden in dieser Arbeit die Effekte der löslichen Virulenzfaktoren, Hämolysin A und B, auf die Zellmorphologie, Zytokinsezernierung und Ca2+-Signaltransduktion in verschiedenen humanen Atemwegsepithelzellen (16HBE14o-, S9, A549) genauer charakterisiert. Unter rHla-Einwirkung konnte in konfluenten Zellrasen die Bildung parazellulärer Lücken beobachtet werden, wobei die Stärke der Reaktion zelltypspezifisch war. Für die in vivo-Situation könnte der Verlust des stabilen Zellverbands bedeuten, dass das Bakterium dadurch die Möglichkeit erhielte, in den Wirtsorganismus einzudringen. Die Untersuchungen an primären Nasenepithelzellen unterstützen diese Schlussfolgerung. Hingegen zeigten Hämolysin B und die bakteriellen Zellwandbestandteile Lipoteichonsäure und Peptidoglykan kaum Effekte auf die Morphologie der Zellen. Durch fluorometrische Messung mit Indo1-beladenen Zellen wurde deutlich, dass die rHla-Behandlung und der daraus resultierende Einbau von Hla-Poren in die Membran der Atemwegsepithelzellen zu einem Ca2+-Einstrom in die Zellen führen. Wurden die A549-Zellen mit höheren Hla-Konzentrationen behandelt, war der Ca2+-Einstrom sehr stark und konnte nicht durch den zelleigenen Ca2+-Auswärtstransport kompensiert werden, so dass die intrazelluläre Ca2+-Konzentration [Ca2+]i stetig anstieg. Diese Ca2+-Überladung könnte zur Schädigung der Zellen oder gar zum Absterben einiger Zellen beigetragen haben, was in den Experimenten mit dem Time lapse-Mikroskop beobachtet wurde. Auch die Behandlung der A549-Zellen mit rHlb, durch dessen Sphingomyelinase-Aktivität Spaltprodukte entstehen können, die selbst als Signalmoleküle fungieren, führte zu einer leicht veränderten [Ca2+]i in den A549-Zellen. Ob dieses durch Sphingosin-1-Phosphat erfolgt, das in A549-Zellen tatsächlich ein deutliches Ca2+-Signal erzeugt, oder durch andere Hlb-bedingte Effekte auf die Zellen, wurde nicht abschließend geklärt. Auch der direkte Einfluss der beiden Hämolysine auf die Freisetzung von pro-inflammatorischen Zyto- und Chemokinen aus den Atemwegsepithelzellen unter rHla und rHlb wurde quantitativ bestimmt. Mit Hilfe von FlowCytomix-Kits konnte ebenfalls gezeigt werden, dass beide Hämolysine die Sekretion von IL-6 und IL-8 aus den Zellen bewirken. Um die physiologischen Vorgänge im respiratorischen Gewebe nach Kontakt mit S. aureus bzw. dessen Virulenzfaktoren zu ergründen, wurden in dieser Arbeit verschiedene endogene Proteinkinasen und Signalmoleküle der Atemwegsepithelzellen pharmakologisch inhibiert und untersucht, wie sich die selektive Hemmung der Signaltransduktion auf die Lückenbildung im Zellrasen unter der Stimulation mit rHla auswirkt. Da die intrazelluläre Konzentration von Ca2+-Ionen für die Steuerung der Salz- und Wassersekretion im respiratorischen Gewebe und somit für die Abwehr potentieller Pathogene wichtig ist, wurden für diese Arbeit einige Schlüsselelemente dieses Systems analysiert. Die Resultate weisen auf eine komplexe Verbindung der Signalwege hin, wobei die Zellantworten häufig Zelltyp-spezifisch waren. Es konnte durch Time lapse-Beobachtungen gezeigt werden, dass Calmodulin, c-Src, Calpaine, die Proteinkinasen A, G, B und C sowie NF-κB den Zellen tendenziell helfen, ihre Zellform unter rHla-Einwirkung zu bewahren. Für Calmodulin, die Ca2+/CaM abhängige Kinase II, ERK1/2, p38 und NF-κB wurde eine Beteiligung an der Erhöhung der Sekretionsraten von IL-8 und IL-6 durch rHla sowie rHlb festgestellt. Die Ergebnisse deuten darauf hin, dass die untersuchten Signalwege, je nach Intensität der Einwirkung der bakteriellen Faktoren auf die Atemwegsepithelzellen, sowohl zellprotektive als auch Epithel-beeinträchtigende Prozesse beeinflussen, jedenfalls aber in die Produktion von Signalen (Freisetzung von Zyto- und Chemokinen) eingebunden sind, die solcherart Epithelzellen in vivo an das Immunsystem eines Wirts senden.
Staphylococcus aureus is a commensal colonizing 20-30% of the population as well as a pathogen causing diverse diseases ranging from skin infections via toxin mediated diseases to life threatening conditions. In its interplay with the human host, this microorganism resorts to an extensive repertoire of both membrane-bound and secreted virulence factors facilitating adhesion to, invasion of, and spreading into various host tissues. Among the numerous virulence factors produced by S. aureus are the staphylococcal superantigens (SAgs). They directly cross-link conserved regions of the T cell-receptor with MHC class II molecules (outside the peptide-binding cleft) on antigen presenting cells. This results in a strong stimulation of up to 20% of all T cells which respond with proliferation and massive cytokine release. Recently, the enterotoxin gene cluster (egc) located on a pathogenicity island was described. The egc-genes are the most prevalent SAg genes in commensal and invasive S. aureus isolates. However, they appear to cause toxic shock only very rarely and their presence is negatively correlated with severity of S. aureus sepsis. Therefore it was suggested that SAgs might differ in their pro-inflammatory potential. In addition to their superantigenicity, SAgs also act as conventional antigens and induce a specific antibody response. In contrast to non-egc SAgs, despite the high prevalence of egc SAgs, neutralizing antibodies against egc SAgs are very rare, even among carriers of egc-positive S. aureus strains. In order to find an explanation for this “egc-gap”, we have tested two non-exclusive hypotheses: (i) egc and non-egc SAgs have unique intrinsic properties and drive the immune response into different directions and (ii) egc and non-egc SAgs are released by S. aureus under different conditions, which shape the immune response to them. To test these hypotheses, we compared the effects of egc and non-egc SAgs on human blood cells. Their T cell-mitogenic potencies, the elicited cytokine profiles as well as their impact on gene expression were highly similar. Both egc and non-egc SAgs induced a very strong pro-inflammatory response. In contrast, the regulation of SAg release by S. aureus differed markedly between egc and non-egc SAgs. Egc-encoded proteins were secreted by S. aureus during exponential growth, while non-egc SAgs were released in the stationary phase. We conclude that the distinct biological behavior of egc and non-egc SAgs is not due to their intrinsic properties, which are very similar, but is caused by their differential release by S. aureus. Traditionally, S. aureus has not been considered as an intracellular pathogen but strong evidence emerged indicating that staphylococci can invade and persist in various cell types. Internalization might constitute a bacterial strategy to evade the host’s defense reactions and the action of antibiotics. The intracellular niche might thus constitute a reservoir for chronic or relapsing infections. Contrary to their potential importance, genome-wide functional genomics analyses of the adaptation reactions of S. aureus to the host cell environment are rare and so far confined to gene expression profiling. Investigations addressing the proteome of internalized S. aureus are still lacking due to the challenge of obtaining a sufficient number of infecting bacteria. The proteome of other pathogens such as Francisella tularensis has been characterized by classical 2-DE approaches. However, the number of bacteria required for such a 2-DE based approach is often exceeding the numbers available from in vivo infection models. Furthermore, this approach does not allow monitoring of time-dependent quantitative changes in protein levels. Here, a workflow allowing time-resolved analysis of internalized S. aureus by combining pulse-chase stable isotope labeling by amino acids in cell culture with high capacity cell sorting, on-membrane digestion, and high-sensitivity mass spectrometry is presented. This workflow permits detection and quantitative monitoring of several hundred staphylococcal proteins from as little as a few million internalized S. aureus cells. This approach has been used to reveal time-resolved changes in levels of proteins in S. aureus RN1HG upon internalization by human bronchial epithelial cells. Proteins involved in stress adaptation as well as protein folding and some components of the phosphotransferase system were upregulated in internalized staphylococci, whereas proteins of the purine biosynthesis pathway and tRNA aminoacylation were downregulated. Furthermore, regulatory adaptive responses of internalized S. aureus to the intracellular milieu were shown as global regulators displayed increased protein abundance levels compared to non-internalized bacteria. Taken together, we observed changes in levels of proteins with functions in protection against oxidative damage and adaptation of cell wall synthesis in internalized S. aureus.
Im Rahmen dieser Dissertation wurden die antimikrobiellen Effekte der Phytopharmaka
BNO 101 und Myrtol stand. auf Staphylococcus aureus direkt miteinander verglichen. Für
BNO 101 umfassten die Untersuchungen Wachstumsexperimente mit Messungen der
Optischen Dichte und Experimente zur CFU-Bestimmung. In keinem dieser Experimente
konnten antimikrobielle Effekte auf S. aureus unter Behandlung gezeigt werden. Für Myrtol
stand. wurden Wachstumsexperimente analog durchgeführt. Hierbei konnte ein deutlicher
bakteriostatischer Effekt auf S. aureus und verglichen mit BNO 101 eine höhere Wirksamkeit
nachgewiesen werden.
Unter der Gesamtkonzentration von 0,25% Myrtol stand. liegen die Überlebensraten der
Bakterien 4 h bis 24 h nach Behandlung bei unter 40% im Vergleich zu der Kontrolle. Um
Ursachen für die antibakteriellen Effekte zu finden, wurden die Zellen mittels
Rasterelektronenmikroskopie morphologisch zu verschiedenen Zeitpunkten nach Behandlung
untersucht und eine Myrtol stand.-spezifische Volumenzunahme von bis zu 69% ermittelt.
Zusätzlich wurden Proteinproben der Zellen mittels 2D-DIGE aufgetrennt. Hierbei wurden
separat intrazellulär 1223 sowie extrazellulär 610 Proteinspots detektiert und miteinander
verglichen. Durch Behandlung mit 0,25% Myrtol stand. wurde das S. aureus Proteom über den
gesamten Messzeitraum von 24 h nach Behandlung massiv verändert. Mittels
anschließendem tryptischen Verdau und Massenspektrometrie (LC-MS) signifikant
veränderter Spots, konnte eine Vielzahl von Proteinen identifiziert und davon 54 verschiedene
Proteine einzelnen Stoffwechselwegen durch Datenbankabgleich und Literaturrecherche
zugeordnet werden. Bemerkenswert ist die deutliche Reduktion der Virulenzfaktoren des
Bakteriums durch Myrtol stand. Behandlung. Unter anderem konnten für Superantigen Enterotoxine, Leukotoxine, Hämolysine und Serine-Proteasen und den Genregulator Agr
deutlich verminderte Proteinmengen nach Behandlung gemessen werden. Die veränderten
Proteinmengen sind hierbei sowohl auf eine Umverteilung der Proteine zwischen den
Zellkompartimenten, als auch auf deutliche Regulation in der Proteinbiosynthese
zurückzuführen. Neben den Virulenzfaktoren ließen sich bspw. auch zahlreiche Enzyme der
Zellwand- und Zellmembransynthese sowie des Energiemetabolismus mit deutlich
veränderten Proteinmengen nachweisen, die für das Überleben der Bakterienzellen kritisch
sind. Mittels Direktverdau und nachfolgender LC-MS der Proteinproben wurden die
Ergebnisse bestätigt und weitere regulierte Proteine identifiziert.
Im Rahmen dieser Dissertation konnten antimikrobielle Effekte von Myrtol stand. auf
Staphylococcus aureus nachgewiesen und deren Ursachen aufgezeigt werden. Die
ausführlichen Proteinanalysen nach Behandlung mit Myrtol stand. lassen auf eine starke
verminderte Virulenz des Bakteriums schließen. Angesichts des Bedarfs an zielgerichteten
Therapieverfahren entsprechend der Phänotypen von CRS und ABRS, bietet die systemische
Gabe von Myrtol stand. hier eine kausale Therapieoption. Die zusätzliche Möglichkeit einer
topischen Anwendungsform kann angesichts der hier gezeigten Wirkungen eine
vielversprechende Behandlungsmaßnahme sein und sollte Ziel klinischer Untersuchungen
werden
Das Auftreten einer postoperativen Wundinfektion bedeutet für den Patienten die Verwirklichung eines gefürchteten persönlichen Risikos, stellt den behandelnden Ärzten oft vor schwer zu lösende Aufgaben und belastet die Solidargemeinschaft durch einen erheblichen Kostenanstieg. Obwohl Staphylococcus aureus weltweit als der häufigste und gefährlichste Erreger von SSI gilt, muss jede Klinik die lokalen Gegebenheiten (Erreger-Prävalenz, Resistenzlage etc.) kennen und sich ihnen stellen.
Ziel der vorliegenden Arbeit war es, die Bedeutung von Staphyloccocus aureus für die Klinik und Poliklinik für Unfall-, Wiederherstellungschirurgie und Rehabilitative Medizin der Universitätsmedizin Greifswald zu untersuchen. Dazu wurden drei klinische Studien durchgeführt: zur Erfassung der Prävalenz von MRSA und MSSA, zur Untersuchung der Effektivität präoperativer Hautantiseptik bei unfallchirurgischen Patienten sowie zur Frage, ob Staphylococcus aureus als verursachendes Pathogen einer Implantat-assoziierten Infektion einen Risikofaktor für ein Wiederauftreten der Infektion nach erfolgter Therapie darstellt.
Es konnte gezeigt werden, dass etwa ein Fünftel der Patienten der Unfallchirurgie Greifswald bereits bei Ankunft im Krankenhaus Träger von MRSA oder MSSA war. Während operativer Eingriffe gelang trotz einer leitliniengerecht durchgeführten Hautantisepsis nur bei 65% der Patienten eine vollständige Keimreduktion. In einem Fall konnte die Verschleppung eines MSSA-Klons von der präantiseptischen Hautflora in die postantiseptische Wundflora bewiesen werden. Nicht zuletzt hatten Patienten mit durch MSSA infiziertem Osteosynthesematerial ein deutlich erhöhtes Risiko einer Re-Infektion nach zunächst erfolgreicher Beruhigung der Infektion.
Die Ergebnisse der drei durchgeführten Studien zeigen, dass Staphylococcus aureus auch in Greifswald bei der Behandlung unfallchirurgischer Patienten die antizipierte, bestimmende Rolle spielt. Prävalenz des Pathogen, Persistenz trotz etabliertem perioperativen Hygieneregime und Auswirkung einer tatsächlich eingetretenen Infektion auf die Heilungschancen wurden dargelegt.
Den Fokus perioperativer Hygiene-Maßnahmen zur Vermeidung von SSI weiterhin auf Gram-positive Erreger, namentlich Staphylokokken, zu richten, ist aktuell in der Klinik für Unfallchirurgie in Greifswald gerechtfertigt.