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Life-threatening toxic shock syndrome is often caused by the superantigen toxic shock syndrome toxin-1 (TSST-1) produced by Staphylococcus aureus. A well-known risk factor is the lack of neutralizing antibodies. To identify determinants of the anti-TSST-1 antibody response, we examined 976 participants of the German population-based epidemiological Study of Health in Pomerania (SHIP-TREND-0). We measured anti-TSST-1 antibody levels, analyzed the colonization with TSST-1-encoding S. aureus strains, and performed a genome-wide association analysis of genetic risk factors. TSST-1-specific serum IgG levels varied over a range of 4.2 logs and were elevated by a factor of 12.3 upon nasal colonization with TSST-1-encoding S. aureus. Moreover, the anti-TSST-1 antibody levels were strongly associated with HLA class II gene loci. HLA-DRB1*03:01 and HLA-DQB1*02:01 were positively, and HLA-DRB1*01:01 as well as HLA-DQB1*05:01 negatively associated with the anti-TSST-1 antibody levels. Thus, both toxin exposure and HLA alleles affect the human antibody response to TSST-1.
The iron-regulated surface determinant protein B (IsdB) of Staphylococcus aureus is involved in the acquisition of iron from hemoglobin. Moreover, IsdB elicits an adaptive immune response in mice and humans. Here, we show that IsdB also has impact on innate immunity. IsdB induces the release of proinflammatory cytokines, including IL-6 and IL-1β, in innate immune cells of humans and mice. In silico analysis and thermophoresis show that IsdB directly binds to TLR4 with high affinity. TLR4 sensing was essential for the IsdB-mediated production of IL-6, IL-1β, and other cytokines as it was abolished by blocking of TLR4-MyD88-IRAK1/4-NF-κB signaling. The release of IL-1β additionally required activation of the NLRP3 inflammasome. In human monocytes infected with live S. aureus, IsdB was necessary for maximal IL-1β release. Our studies identify S. aureus IsdB as a novel pathogen-associated molecular pattern that triggers innate immune defense mechanisms.
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.
Staphylococcus aureus(S. aureus) is a pathobiont of humans as well as a multitude of animalspecies. The high prevalence of multi-resistant and more virulent strains ofS. aureusnecessitatesthe development of new prevention and treatment strategies forS. aureusinfection. Major advancestowards understanding the pathogenesis ofS. aureusdiseases have been made using conventionalmouse models, i.e., by infecting naïve laboratory mice with human-adaptedS. aureusstrains. However,the failure to transfer certain results obtained in these murine systems to humans highlights thelimitations of such models. Indeed, numerousS. aureusvaccine candidates showed promising resultsin conventional mouse models but failed to offer protection in human clinical trials. These limitationsarise not only from the widely discussed physiological differences between mice and humans, but alsofrom the lack of attention that is paid to the specific interactions ofS. aureuswith its respectivehost. For instance, animal-derivedS. aureuslineages show a high degree of host tropism and carry arepertoire of host-specific virulence and immune evasion factors. Mouse-adaptedS. aureusstrains,humanized mice, and microbiome-optimized mice are promising approaches to overcome theselimitations and could improve transferability of animal experiments to human trials in the future.
Staphylococcus aureus can cause life-threatening diseases, and hospital- as well as community-associated antibiotic-resistant strains are an emerging global public health problem. Therefore, prophylactic vaccines or immune-based therapies are considered as alternative treatment opportunities. To develop such novel treatment approaches, a better understanding of the bacterial virulence and immune evasion mechanisms and their potential effects on immune-based therapies is essential. One important staphylococcal virulence factor is alpha-toxin, which is able to disrupt the epithelial barrier in order to establish infection. In addition, alpha-toxin has been reported to modulate other cell types including immune cells. Since CD4+ T cell-mediated immunity is required for protection against S. aureus infection, we were interested in the ability of alpha-toxin to directly modulate CD4+ T cells. To address this, murine naïve CD4+ T cells were differentiated in vitro into effector T cell subsets in the presence of alpha-toxin. Interestingly, alpha-toxin induced death of Th1-polarized cells, while cells polarized under Th17 conditions showed a high resistance toward increasing concentrations of this toxin. These effects could neither be explained by differential expression of the cellular alpha-toxin receptor ADAM10 nor by differential activation of caspases, but might result from an increased susceptibility of Th1 cells toward Ca2+-mediated activation-induced cell death. In accordance with the in vitro findings, an alpha-toxin-dependent decrease of Th1 and concomitant increase of Th17 cells was observed in vivo during S. aureus bacteremia. Interestingly, corresponding subsets of innate lymphoid cells and γδ T cells were similarly affected, suggesting a more general effect of alpha-toxin on the modulation of type 1 and type 3 immune responses. In conclusion, we have identified a novel alpha-toxin-dependent immunomodulatory strategy of S. aureus, which can directly act on CD4+ T cells and might be exploited for the development of novel immune-based therapeutic approaches to treat infections with antibiotic-resistant S. aureus strains.
: Platelets are components of the blood that are highly reactive, and they quickly respond
to multiple physiological and pathophysiological processes. In the last decade, it became clear that
platelets are the key components of circulation, linking hemostasis, innate, and acquired immunity.
Protein composition, localization, and activity are crucial for platelet function and regulation. The
current state of mass spectrometry-based proteomics has tremendous potential to identify and quantify thousands of proteins from a minimal amount of material, unravel multiple post-translational
modifications, and monitor platelet activity during drug treatments. This review focuses on the role
of proteomics in understanding the molecular basics of the classical and newly emerging functions
of platelets. including the recently described role of platelets in immunology and the development
of COVID-19.The state-of-the-art proteomic technologies and their application in studying platelet
biogenesis, signaling, and storage are described, and the potential of newly appeared trapped ion
mobility spectrometry (TIMS) is highlighted. Additionally, implementing proteomic methods in
platelet transfusion medicine, and as a diagnostic and prognostic tool, is discussed.
Pretransplant Tolerance Induction Reduces the Islet Mass Required to Reverse Diabetes in NOD Mice
(2007)
Islet transplantation can restore normoglycemia in diabetic patients. However, its application is limited by the high number of islets required to reverse diabetes. As the mass and potency of most human islet preparations are marginal, a large impact on the applicability of islet transplantation is expected from the implementation of strategies that improve engraftment of these islet preparations. The roles of adaptive immunity and immunosuppression on islet engraftment are not well studied. Therefore, the effects of currently used immunosuppression with antilymphocyte serum, tacrolimus and sirolimus on islet engraftment were separated from their impact on immunity and diabetes reversal rates were compared after islet allotransplantation in immunosuppressed and chimeric, non-immunosuppressed NOD mice. Both strategies prevented rejection of islet allografts and reduced the frequency of donor-specific, IFN-gamma-secreting T cells. However, in order to achieve stable diabetes reversal with a probability of about 80% after islet allotransplantation in diabetic NOD mice, a fourfold higher islet mass (400 islets) was required in immunosuppressed recipients, compared with non-immunosuppressed recipients made tolerant pretransplant by induction of mixed hematopoietic chimerism (100 islets). The failure of immunosuppressed mice to become normoglycemic after low-dose islet transplantation primarily resulted from the inhibitory effects of tacrolimus combined with sirolimus on islet engraftment and not from the inhibitory effects of this combination on islet graft function. These data suggest that immunotherapeutic strategies that control adaptive immunity without interfering with islet neovascularization or other processes critical to islet engraftment are likely to improve the success rate of marginal mass human islet allografts.
Postoperative Immune Suppression in Visceral Surgery: Characterisation of an Intestinal Mouse Model
(2011)
Background: Postoperatively acquired immune dysfunction is associated with a higher mortality rate in case of septic complications. As details of this severe clinical problem are still unknown, animal models are essential to characterise the mechanisms involved. Methods: Mice were laparotomised and the small intestine was pressed smoothly in antegrade direction. For extension of trauma, the intestine was manipulated three times consecutively. Following this, the ex vivo cytokine release of splenocytes was determined. The degree of surgical trauma was analysed by detection of HMGB1 and IL-6 in serum and by neutrophil staining in the muscularis mucosae. Results: We adapted the previously described animal model of intestinal manipulation to provide a model of surgically induced immune dysfunction. Following intestinal manipulation, the mice showed elevated serum levels of HMGB1 and IL-6 and increased infiltration of granulocytes into the muscularis mucosae. Ex vivo cytokine release by splenocytes was suppressed in the postoperative period. The degree of suppression correlated with the extent of surgical trauma. Conclusions: In this study, we describe a surgically induced immune dysfunction animal model, in which a significant surgical trauma is followed by an immune dysfunction. This model may be ideal for the characterisation of the postoperative immune dysfunction syndrome.
Infective endocarditis (IE) is a potentially life-threatening infection of the endocardial surfaces of the heart, most frequently the valves. It is typically caused by bacteria, less commonly by fungi. Over the past years, the morbidity and mortality of IE have gradually increased, and it is now the fourth most common life-threatening infection after sepsis, pneumonia, and intra-abdominal abscess. Despite advances in cardiac imaging and diagnostic techniques, the diagnosis of IE remains challenging. The lack of fast and reliable diagnosis of IE can lead to serious complications. Therefore, new diagnostic and therapeutic tools are urgently needed.
This study had two main aims: (i) to investigate whether a pathogen-specific antibody response in IE patients is mounted against different IE pathogens and whether analysis of such a response might be useful for complementing the classical blood culture diagnosis, and (ii) generate and characterize neutralizing monoclonal antibodies (mAbs) against three virulence factors of Staphylococcus aureus (S. aureus), which is the most common etiological agent in IE.
Our research group has recently established an xMAP® (Luminex®) technology-based serological assay that simultaneously quantifies the antibody response against 30 different pathogens. Within the research consortium Card-ii-Omics, we conducted a prospective, observational clinical discovery study involving 17 IE patients and 20 controls (i.e., patients with non-infectious heart-related conditions). Plasma samples were obtained on the day of IE diagnosis from all patients, while samples at later dates over the course of infection were available for only some patients. Invasive pathogens were identified by blood culture.
The infection array revealed antibodies against a broad range of pathogens in both controls and IE patients, suggesting a broad immune memory. Overall, antibody levels did not significantly differ between both groups, but we observed high antibody titers against those pathogens that were detected by blood culture. Whenever available (in the case of 13/17 IE patients), back-up and follow-up plasma samples (obtained before or after diagnosis, respectively) were included in the analyses that provided valuable information about the kinetics of antibody response during the course of infection. Notably, infection array data confirmed (and extended) the blood culture data in only 2/13 cases. In three cases, serology contradicted the microbiological diagnosis, and in three cases, the infection array was able to identify pathogens, while the microbiological diagnosis failed. In three cases, serology was negative while microbiological diagnosis was positive, and in two cases, both serology and microbiological diagnosis were negative. In 6 out of 8 cases with increases in antibody levels, this response was directed against gut microbes. This supports the leaky gut hypothesis, which assumes that breaching of the gut barrier causes translocation of gut microbes into the bloodstream, which then infect the heart valves. Moreover, we observed an increase in antibody titers in 4 patients against the yeast C. albicans, suggesting a secondary fungal infection. Finally, this study emphasized that the timing of plasma collection is crucial for studying antibody kinetics in IE.
After demonstrating that pathogen-specific antibodies are generated during IE, we aimed to generate mAbs against the prime IE pathogen S. aureus and study their functions on a molecular level. Using the hybridoma technology, our research group has recently generated mAbs against two S. aureus surface proteins/adhesion factors (clumping factor A (ClfA) and fibronectin-binding protein A (FnBPA)), both involved in biofilm formation, as well as an extracellular enzyme, the staphylococcal serine protease–like protein B (SplB), a virulence factor. In this work, the sequences of the mAbs were determined from hybridoma RNA. Then those mAbs were produced at a larger scale in order to determine their binding and neutralizing capacities using in vitro assays such as ELISA, Western blot, Dot blot, microscale thermophoresis, and in a mouse model.
The anti-SplB mAb specifically targeted SplB, with no cross-reactivity to other Spls or extracellular proteins (ECP) of S. aureus. Though anti-SplB mAb showed moderate binding to SplB with a Kd value of 2.54 μM and high sequence homology to the germline sequence, it neutralized the enzymatic activity of SplB up to 99% in 5-fold molar excess as showed in an in vitro substrate cleavage assay. Previous work showed that SplB facilitates the release of proinflammatory cytokines in endothelial cells and induces endothelial damage in mice. Here, we demonstrated that the anti-SplB mAb efficiently blocked the function of SplB in vivo, thus markedly reducing the damage to the endothelial barrier. In conclusion, we identified the strong neutralizing potential of a mAb against SplB, which merits further investigation as a candidate for the immunotherapy of SplB-induced S. aureus pathologies, including IE.
High antibody titers against S. aureus adhesins, including ClfA and FnBPA, have been reported in IE patients. Besides, ClfA is involved in serious S. aureus bloodstream and biofilm-related infections. Similarly, FnBPA facilitates biofilm formation and inhibits macrophage invasion. These important properties make the two bacterial adhesins ideal candidates for a passive vaccination strategy. We generated two murine ClfA-mAbs, ClfA-002 and ClfA-004, which showed strong specificity to ClfA. However, ClfA-004 showed reduced binding strength compared to ClfA-002 due to a single non-synonymous nucleotide change (Phe Tyr) at the CDR3 region. While the ClfA-002 mAb reduced the binding of ClfA to fibrinogen by around 60%, the ClfA-004 had no inhibitory capacity. We also generated two murine and twelve humanized anti-FnBPA mAbs, which showed similar and moderate binding to FnBPA. One murine mAb (anti-FnBPA D4) partially inhibited the binding of FnBPA to fibronectin. FnBPA contains 11 tandem repeats that can all bind to fibronectin. This redundancy could be the reason for the lack of complete inhibition. Hence, in this work, we characterized the properties of neutralizing mAbs against two adhesins of S. aureus. These mAbs should be tested in the future, alone and in combination with other mAbs and antibiotics, for their ability to reduce staphylococcal biofilm formation.
In conclusion, we showed that antibody profiling of IE patients can provide valuable insights into the causative agent(s), and can help in guiding the antibiotic therapy. However, sampling is crucial in IE, which often dwells for many weeks before being clinically diagnosed. Because of the severity of IE, which can be life-threatening, I suggest to establish biobanks to store patient samples upon hospital admission that will provide a baseline in case of a later microbial infection. Moreover, our results suggest that C. albicans plays an important and so far underestimated role in IE. In the second part of the thesis, we characterized several mAbs against an S. aureus protease and two adhesins. Of high interest is a neutralizing mAb against SplB, which shows promising results in vitro and in vivo. Further in vitro and in vivo tests need to be conducted to study the anti-biofilm activity of the anti-FnBPA- and anti-ClfA-mAbs and explore their utility as therapeutic agents.