Refine
Year of publication
Document Type
- Doctoral Thesis (42)
- Article (31)
Is part of the Bibliography
- no (73)
Keywords
- - (27)
- Staphylococcus aureus (14)
- Sepsis (9)
- <i>Staphylococcus aureus</i> (4)
- Antikörper (4)
- IgE (4)
- Immunreaktion (4)
- Immunsuppression (4)
- Immunsystem (4)
- allergy (4)
- vaccine (4)
- BALB/c Maus (3)
- Impfstoff (3)
- JSNZ (3)
- Maus (3)
- Regulatorischer T-Lymphozyt (3)
- T-Lymphozyt (3)
- sepsis (3)
- Allergie (2)
- Antibody response (2)
- Apoptose (2)
- Bakteriämie (2)
- COVID-19 (2)
- DEREG (2)
- Foxp3 (2)
- Genotypisierung (2)
- Granulozyt (2)
- Immunoglobulin G (2)
- Immunoglobulin M (2)
- Methylene blue (2)
- Monozyt (2)
- Pathogen inactivation (2)
- S. aureus (2)
- SplB (2)
- Stress (2)
- Superantigen (2)
- Surgery (2)
- T cell (2)
- T-Zellen (2)
- Th2 (2)
- Tumor (2)
- Zelltod (2)
- colonization (2)
- host adaptation (2)
- infection (2)
- mouse models (2)
- neutrophils (2)
- platelets (2)
- 3-dioxygenase (1)
- <i>S. aureus</i> (1)
- <i>Streptococcus mutans</i> (1)
- <i>Streptococcus oralis</i> (1)
- A20 (1)
- ATA (1)
- Airway inflammation (1)
- Allergen (1)
- Allergic diseases (1)
- Allergy (1)
- Antigenpräsentation (1)
- Antikörperantworten (1)
- B cell response (1)
- B-Zelle (1)
- BALB/c mouse (1)
- Bacteria (1)
- Bacterial allergens (1)
- Bakteriologie (1)
- Bauchfellentzündung (1)
- Bauchspeicheldrüsenkrebs (1)
- Blood compatibility test (1)
- Blood supply (1)
- C57 BL/6 mice (1)
- C57BL/6 Maus (1)
- CASP (1)
- CD38 antibody (1)
- CD4 (1)
- CTLA-4 (1)
- Card-ii-Omics (1)
- Carrier (1)
- Chlamydia (1)
- ClfA (1)
- Coombs test (1)
- Corticosteron (1)
- Cystic Fibrosis (1)
- Cystic fibrosis (1)
- Cytokine (1)
- Cytokines (1)
- Daratumumab (1)
- Demographic change (1)
- Dendritische Zelle (1)
- Diabetes mellitus (1)
- Donor research (1)
- Effects of blood donation (1)
- Enterotoxin Gene Cluster (1)
- Entzündung (1)
- Erkundungsverhalten (1)
- FcγRIIa (1)
- FnBPA (1)
- Fragebogen (1)
- Furunkulose (1)
- GATA1 (1)
- Gel card (1)
- GlpQ (1)
- Glucocorticosteroide (1)
- HDI (1)
- HEK cells (1)
- HLA-DR (1)
- Histondeacetylase-Inhibitor (1)
- Host Pathogen Interactions (1)
- Human (1)
- Humanbiologie (1)
- IDO1 (1)
- IL-10 (1)
- IL-33 (1)
- IgG (1)
- IgG4 (1)
- IgM (1)
- Immobilisation (1)
- Immunantwort (1)
- Immune modulation (1)
- Immune response (1)
- Immunglobulin G (1)
- Immunglobuline (1)
- Immunisierung (1)
- Immunmodulation (1)
- Immunologie (1)
- Immunregulation (1)
- Immunstimulation (1)
- Immuntherapie (1)
- Indirect antiglobulin test (1)
- Indolamin-2 (1)
- Infektionen (1)
- Infektionsmodelle (1)
- Inflammation (1)
- Inselzelltransplantation (1)
- IsdB (1)
- Kaltes Plasma (1)
- Kolonisierung (1)
- Kynurenin (1)
- Körperbild (1)
- LC-MS/MS (1)
- LPS (1)
- Leukozyten (1)
- Lipoprotein (1)
- Lymphozyt (1)
- MRI (1)
- MS-275 (1)
- MSCRAMM (1)
- Macrophage (1)
- Magen (1)
- Makrophage (1)
- Massenspektrometrie (1)
- Mausmodell (1)
- Mausstammvergleich (1)
- Mood regulation (1)
- Mouse model (1)
- Mukoviszidose (1)
- NETose (1)
- NETosis (1)
- NETs (1)
- NF-kappaB Signalweg (1)
- NF-kappaB pathway (1)
- NK-Cells (1)
- NK-Zellen (1)
- NOD Maus (1)
- NOD mouse (1)
- NaB (1)
- Natürliche Killerzelle (1)
- Neuroendokrines System (1)
- Neutrophile (1)
- Newcastle disease Virus (1)
- Niereninsuffizienz (1)
- Noradrenalin (1)
- Onkolyse (1)
- Operation (1)
- PBMC (1)
- PF4 (1)
- PTMs (1)
- Panton-Valentin-Leukozidin (1)
- Panton-Valentine Leukocidin (1)
- Peritonitis (1)
- Plasmamedizin (1)
- Polymerase-Kettenreaktion (1)
- Polytrauma (1)
- Postoperative immune suppression (1)
- Psychischer Stress (1)
- RBC antibody screening (1)
- Red blood cell concentrates (1)
- Reserpin (1)
- SAHA (1)
- Schlaganfall (1)
- Serine protease-like proteins (1)
- Solid phase (1)
- Sozialverhalten (1)
- SplD (1)
- Staphylococci (1)
- Surgically induced immune dysfunction (1)
- Sympathikus (1)
- Systemic infection (1)
- T cell superallergen (1)
- T cells (1)
- T-cells (1)
- TNFAIP3 (1)
- Th2 cells (1)
- Therapeutic antibody interference (1)
- Tierversuch (1)
- Toll-like-Rezeptor (1)
- Transkriptomanalyse (1)
- Translokation (1)
- Transportstress (1)
- Trauma (1)
- Tryptophan (1)
- Tryptophanstoffwechsel (1)
- Virotherapie (1)
- Western Blot Verfahren (1)
- Wirtsadaptation (1)
- Wundheilung (1)
- Zystische Fibrose (1)
- aPF4/H antibodies (1)
- activation status (1)
- acute stress (1)
- adaptive Immunantwort (1)
- adaptive Immunität (1)
- adaptive immunity (1)
- adaptives Immunsystem (1)
- adhesion inhibitor (1)
- adjuvants (1)
- akuter Stress (1)
- alpha-toxin (1)
- anti- (1)
- antibody repertoire (1)
- antibody response (1)
- antibody-secreting cells (1)
- anti‐PF4/heparin antibodies (1)
- apoptosis (1)
- asthma (1)
- atomic force microscopy (1)
- aurintricarboxylic acid (1)
- autoimmune (1)
- bakterielle Infektion (1)
- bakterielle Translokation (1)
- bleeding (1)
- bleeding tendency (1)
- blood platelets (1)
- blood smear (1)
- body image (1)
- bone marrow transplantation (1)
- case report (1)
- cell elasticity (1)
- cerebral thrombosis (1)
- chemotherapy (1)
- chirurgisch (1)
- clonal complex (1)
- coagulation (1)
- cold physical plasma (1)
- complication (1)
- cystic fibrosis (1)
- dendritic cells (1)
- depressionsähnliches Verhalten (1)
- dirty mouse (1)
- egc superantigens (1)
- egc-Superantigene (1)
- enterotoxin gene cluster (1)
- eosinophils (1)
- epidemiology (1)
- expression (1)
- factor analysis (1)
- foxp3 (1)
- furunculosis (1)
- genotyping (1)
- gut epithelial (1)
- habitat (1)
- haemorrhage (1)
- hereditary thrombocytopenias (1)
- host-pathogen-interaction (1)
- immune evasion (1)
- immune evasion cluster (1)
- immune polarization (1)
- immunoediting (1)
- immunofluorescence (1)
- immunoglobulin g (1)
- immunoproteomics (1)
- immunosuppression (1)
- immunosupression (1)
- indoleamine 2,3-dioxygenase (1)
- infective endocarditis (1)
- infective endocarditis, antibody response, monoclonal antibodies, S. aureus, SplB, ClfA, FnBPA, Card-ii-Omics (1)
- inherited platelet defects (1)
- inherited platelet disorders (1)
- innate immunity (1)
- innate lymphoid cells (1)
- interaction (1)
- islet transplantation (1)
- jep Gene (1)
- kynurenine pathway (1)
- laboratory (1)
- length (1)
- leucocytes (1)
- livestock (1)
- major surgery (1)
- mass spectrometry (1)
- methyltryptophan (1)
- mixed chimerism (1)
- monoclonal antibodies (1)
- monocyte (1)
- mouse (1)
- multi-species biofilm (1)
- multiple myeloma (1)
- mupirocin (1)
- nanoindentation (1)
- nasale Besiedlung (1)
- neutralisierende Antikörper (1)
- neutralizing antibodies (1)
- nose (1)
- oxidation-specific epitopes (1)
- pathogen-specific IgG (1)
- peritonitis (1)
- phagocyte oxidase (1)
- phagocytes (1)
- phosphoproteomics (1)
- pig (1)
- plasma medicine (1)
- platelet factor 4 (1)
- platelet pathophysiology (1)
- platelet transfusion proteomics (1)
- pneumonia (1)
- polymicrobial sepsis (1)
- polyreactive antibodies (1)
- precision medicine (1)
- proteomic analysis (1)
- questionnaire (1)
- rat (1)
- re-establishment of macrophages (1)
- reactive oxygen species (1)
- regulatory T cells (1)
- regulatory t cells (1)
- reserpine (1)
- restraint stress (1)
- sensitization (1)
- serology (1)
- shame boundary (1)
- signaling (1)
- sodium (1)
- solid tumor models (1)
- splenectomy (1)
- stiffness (1)
- superantigens (1)
- sympathetic nervous system (1)
- sympathische Denervierung (1)
- synthetic heparins (1)
- targeted proteomics (1)
- targeted therapy (1)
- therapeutics (1)
- thrombocytopenia (1)
- transcriptome (1)
- transportation stress (1)
- tryptophan metabolites (1)
- tumor surveillance (1)
- type 2 immune response (1)
- type 2 immunity (1)
- virulence (1)
- weight loss (1)
- wildling (1)
- wound healing (1)
- zweidimensionale Westernblots (1)
- γδ T cells (1)
Institute
- Institut für Immunologie u. Transfusionsmedizin - Abteilung Immunologie (73) (remove)
Publisher
- MDPI (12)
- Frontiers Media S.A. (9)
- S. Karger AG (3)
- Wiley (3)
- Karger (2)
- AO Research Institute Davos (1)
- BMJ Publishing Group Ltd (1)
Introduction: In the light of the ongoing SARS-CoV-2 pandemic, convalescent plasma is a treatment option for COVID-19. In contrast to usual therapeutic plasma, the therapeutic agents of convalescent plasma do not represent clotting factor activities, but immunoglobulins. Quarantine storage of convalescent plasma as a measure to reduce the risk of pathogen transmission is not feasible. Therefore, pathogen inactivation (e.g., Theraflex®-MB, Macopharma, Mouvaux, France) is an attractive option. Data on the impact of pathogen inactivation by methylene blue (MB) treatment on antibody integrity are sparse. Methods: Antigen-specific binding capacity was tested before and after MB treatment of plasma (n = 10). IgG and IgM isoagglutinin titers were tested by agglutination in increasing dilutions. Furthermore, the binding of anti-EBV and anti-tetanus toxin IgG to their specific antigens was assessed by ELISA, and IgG binding to Fc receptors was assessed by flow cytometry using THP-1 cells expressing FcRI and FcRII. Results: There was no significant difference in the isoagglutinin titers, the antigen binding capacity of anti-EBV and anti-tetanus toxin IgG, as well as the Fc receptor binding capacity before and after MB treatment of plasma. Conclusion: MB treatment of plasma does not inhibit the binding capacity of IgM and IgG to their epitopes, or the Fc receptor interaction of IgG. Based on these results, MB treatment of convalescent plasma is appropriate to reduce the risk of pathogen transmission if quarantine storage is omitted.
: An enhanced indoleamine 2,3-dioxygenase 1 (IDO1) activity is associated with an increased
mortality risk in sepsis patients. Thus, the preventive inhibition of IDO1 activity may be
a promising strategy to attenuate the severity of septic shock. 1-methyltryptophan (1-MT)
is currently in the interest of research due to its potential inhibitory effects on IDO1 and
immunomodulatory properties. The present study aims to investigate the protective and
immunomodulatory effects of 1-methyltryptophan against endotoxin-induced shock in a porcine
in vivo model. Effects of 1-MT were determined on lipopolysaccharide (LPS)-induced tryptophan
(TRP) degradation, immune response and sickness behaviour. 1-MT increased TRP and its metabolite
kynurenic acid (KYNA) in plasma and tissues, suppressed the LPS-induced maturation of neutrophils
and increased inactivity of the animals. 1-MT did not inhibit the LPS-induced degradation of TRP
to kynurenine (KYN)—a marker for IDO1 activity—although the increase in KYNA indicates that
degradation to one branch of the KYN pathway is facilitated. In conclusion, our findings provide
no evidence for IDO1 inhibition but reveal the side effects of 1-MT that may result from the proven
interference of KYNA and 1-MT with aryl hydrocarbon receptor signalling. These effects should be
considered for therapeutic applications of 1-MT.
: 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.
The GATA1 transcription factor is essential for normal erythropoiesis and megakaryocytic differentiation. Germline GATA1 pathogenic variants in the N-terminal zinc finger (N-ZF) are typically associated with X-linked thrombocytopenia, platelet dysfunction, and dyserythropoietic anemia. A few variants in the C-terminal ZF (C-ZF) domain are described with normal platelet count but altered platelet function as the main characteristic. Independently performed molecular genetic analysis identified a novel hemizygous variant (c.865C>T, p.H289Y) in the C-ZF region of GATA1 in a German patient and in a Spanish patient. We characterized the bleeding and platelet phenotype of these patients and compared these findings with the parameters of two German siblings carrying the likely pathogenic variant p.D218N in the GATA1 N-ZF domain. The main difference was profound thrombocytopenia in the brothers carrying the p.D218N variant compared to a normal platelet count in patients carrying the p.H289Y variant; only the Spanish patient occasionally developed mild thrombocytopenia. A functional platelet defect affecting αIIbβ3 integrin activation and α-granule secretion was present in all patients. Additionally, mild anemia, anisocytosis, and poikilocytosis were observed in the patients with the C-ZF variant. Our data support the concept that GATA1 variants located in the different ZF regions can lead to clinically diverse manifestations.
Vaccine-induced immune thrombotic thrombocytopenia (VITT) and cerebral venous sinus thrombosis (CVST) have been recently described as rare complications following vaccination against SARS-CoV-2 with vector vaccines. We report a case of a young woman who presented with VITT and cerebral CVST 7 days following vaccination with ChAdOx1 nCov-19 (AstraZeneca). While the initial MRI was considered void of pathological findings, MRI 3 days later revealed extensive CVST of the transversal and sigmoidal sinus with intracerebral haemorrhage. Diagnostic tests including a platelet-factor-4-induced platelet activation assay confirmed the diagnosis of VITT. Treatment with intravenous immunoglobulins and argatroban resulted in a normalisation of platelet counts and remission of CVST.
The study of host-pathogen interactions is central to a better understanding of the human microbiome, infections and the inner workings of immune cells. One focal point of this research is how the human immune system recognises both harmful and harmless antigens, integrates the resulting signals and forms a response, and how, conversely, microbes can manipulate this reaction.
In this thesis, Pseudomonas aeruginosa (P. aeruginosa), a critical pathogen in chronic and nosocomial infections, was in the focus. The aim was to search for bacterial proteins that favour a type 2 immune response, as it is orchestrated by CD4+ type 2 T helper cells (Th2 cells). The humoral arm of a type 2 response is dominated by IgG4 and IgE. Such immune responses are typically directed against multicellular pathogens like helminths and other parasites. However, type 2 immune responses are suboptimal for the defence against extracellular bacteria like P. aeruginosa. Previous research suggests that some bacterial proteins may promote a switch to such an insufficient immune response as a mechanism of immune evasion.
To optimise the sensitivity of the search for type 2 response inducing proteins of P. aeruginosa, cystic fibrosis (CF) patients were studied, as many are exposed to the pathogen in their airways over prolonged time periods. As such, the humoral immune response of 9 CF patients to their own P. aeruginosa strain was examined. For this, the secretomes of 9 clinical P. aeruginosa isolates from CF patients and the P. aeruginosa reference strain PAO-1 were studied by 2D-immunoblotting for their ability to be bound by IgG4 and IgG1 from respective patient sera. IgG4 served as a proxy for IgE, as assays analysing IgE binding suffer from low sensitivity because of low serum concentrations of IgE. Antibody reactive P. aeruginosa proteins were then identified by liquid chromatography tandem mass spectrometry and the results were compared with proteomics data from literature.
In total, 308 distinct protein spots were analysed. These belonged to 17 bacterial proteins, which comprise the entire known P. aeruginosa secretome. Of these spots, 232 were bound by IgG4, and 24 by IgG1 only. Notably proteases like serralysin and P. aeruginosa elastase presented with an IgG4 bias. This is concordant with previous research linking proteases to a type 2 immune response. Moreover, structural proteins like
agellins were also immunodominant. Flagellins are known as common targets of immune detection in bacteria. These proteins also demonstrated a clear IgG4 bias.
Thus, the search for secreted P. aeruginosa proteins that elicit an IgG4-dominated antibody response was successful. It remains to be shown whether these bacterial proteins are also recognized by IgE and Th2 cells, meaning whether they are truly driving a type 2 immune response in CF patients. It is also an open question whether the observed IgG4 bias in the antibody response to the exoproteome of P. aeruginosa is specific to CF or a general feature of the human immune response to the pathogen.
Therapeutische Antikörper können unerwartete Wirkungen verursachen, wenn das Zielantigen nicht nur auf den Zielzellen exprimiert wird. Ein gegen das CD38-Antigen gerichteter Antikörper, Daratumumab (DARA), wurde für die Behandlung des multiplen Myeloms entwickelt. Allerdings beeinträchtigt dieser Antikörper erheblich die Verträglichkeitsuntersuchungen zwischen Blutkonserve und Patientenplasma vor der Transfusion von Erythrozytenkonzentraten.
CD38 wird auch auf Erythrozyten (RBCs) exprimiert. Durch die Bindung von DARA an die Spendererythrozyten wird im indirekten Antihumanglobulintest (IAT) eine in vitro Unverträglichkeit mit allen Testerythrozyten angezeigt. Dies wird dadurch verursacht, dass das erforderliche Antihumanglubulin (AHG) humanes IgG bindet, unabhängig davon, welches Zielantigen dieser Antikörper hat. Infolgedessen können Agglutinationen durch transfusionsrelevante Antikörper im Patientenplasma von DARA-induzieretn Agglutinationen nicht unterschieden werden, wodurch das Risiko für akute hämolytische Transfusionsreaktionen steigt.
Daraus ergab sich die Fragestellung für meine Arbeit – eine Modifikation für den IAT zu finden, der diese Interferenz auflöst. Ich habe zwei neue Strategien verfolgt: i) die Adsorption von DARA aus dem Patientenplasma mit CD38-exprimierenden peripheren Blutzellen, ii) die Blockung der DARA-Bindungsstelle auf Erythrozyten, ohne dass die Bindung von transfusionsrelevanten erythrozytären Antikörpern behindert wird.
Für den ersten Ansatz konnte ich PBMCs als die Zellen identifizieren, die die höchste CD38 Expression zeigten. Leider konnte die Inkubation von DARA-gespiktem Plasma selbst nach mehreren Adsorptionsschritten die Interferenz im IAT nicht vollständig beseitigen. Auch die Durchführung der Methode erwies sich als nicht praktikabel für ein Routine-Diagnostiklabor. Für den zweiten Ansatz habe ich mit Hilfe von Pepsin F(ab‘)2 Fragmente von DARA hergestellt um damit die DARA-Bindungsstelle auf den Erythrozyten zu blockieren, damit das AHG nur an gebundene transfusionsrelevante Antikörper bindet. Die Zugabe von DARA F(ab´)2 Fragmenten zu den Testerythrozyten konnte die DARA-induzierten Agglutinationen im IAT verhindern und im Plasma vorhandene erythrozytäre Alloantikörper sichtbar und differenzierbar machen. Weiterhin konnte ich nachweisen, dass die Zugabe von DARA (Fab´)2 Fragmenten nicht die Sensitivität der Teste im Gelzentrifugationstest und im Capture® beeinträchtigt. Experimente mit Plasma von Myelom-Patienten vor und nach der DARA-Infusion bestätigten die Ergebnisse. Die Verwendung von F(ab‘)2 Fragmenten ist ein vielversprechendes Verfahren, um Interferenzen von therapeutischen Antikörpern im IAT der prätransfusionellen Diagnostik aufzulösen - nicht nur für Daratumumab.
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.
Background and Objectives: Vaccine induced thrombotic thrombocytopenia (VITT) may occur after COVID-19 vaccination with recombinant adenoviral vector-based vaccines. VITT can present as cerebral sinus and venous thrombosis (CSVT), often complicated by intracranial hemorrhage. Today it is unclear, how long symptomatic VITT can persist. Here, we report the complicated long-term course of a VITT patient with extremely high titers of pathogenic anti-platelet factor 4 (PF4)-IgG antibodies. Methods: Clinical and laboratory findings are presented, including the course of platelet counts, D-Dimer levels, clinical presentation, imaging, SARS-CoV-2-serological and immunological, platelet activating anti-PF4-IgG, as well as autopsy findings. Results: The patient presented with extended superior sagittal sinus thrombosis with accompanying bifrontal intracerebral hemorrhage. Repeated treatment with intravenous immune globuline (IVIG) resolved recurrent episodes of thrombocytopenia. Moreover, the patient’s serum remained strongly positive for platelet-activating anti-PF4-IgG over three months. After a period of clinical stabilization, the patient suffered a recurrent and fatal intracranial hemorrhage. Conclusions: Complicated VITT with extremely high anti-PF4-IgG titers over three months can induce recurrent thrombocytopenia despite treatment with IVIG and anticoagulation. Plasma exchange, immunoadsorption, and /or immunosuppressive treatment may be considered in complicated VITT to reduce extraordinarily high levels of anti-PF4-IgG. Long-term therapy in such cases must take the individual bleeding risk and CSVT risk into account.
Background: Previous studies suggest that blood donation impacts blood donors’ psychological state, with either positive or negative effects, such as feeling more energetic or more exhausted. It has not yet been described how long these effects last. Materials and Methods: This prospective cohort study consisted of a qualitative and a quantitative part: (1) Psychological characteristics which changed after blood donation were identified by structured interviews of regular whole blood donors (n = 42). Based on this, a questionnaire addressing 7 psychological dimensions was established. (2) The psychological state of 100 blood donors was assessed after blood donation by applying the questionnaire 15–30 min before and during donation, as well as 15–30 min, 6 h, 24 h, 72 h, 1 week, and 8 weeks after donation. The resulting changes were summarized to a score. Furthermore, potential correlations of the score with pre-donation blood pressure, hemoglobin, or body mass index were calculated. Results: Seven items were identified which changed in at least 25% of blood donors (mood, concentration, satisfaction, resilience, spirit of initiative, physical well-being, energy level). In the 100 blood donors, the well-being score increased (positive effects, n = 23), showed minor changes (n = 53), or decreased (negative effects, n = 24). The positive effects lasted for about 1 week and the negative effects for 3 days. Conclusion: While the frequency of psychological effects following blood donation identified by our study was comparable to others, the changes of the psychological state in our donors were traceable for a longer period than previously acknowledged.
ntroduction: In the light of the ongoing SARS-CoV-2 pandemic, convalescent plasma is a treatment option for COVID-19. In contrast to usual therapeutic plasma, the therapeutic agents of convalescent plasma do not represent clotting factor activities, but immunoglobulins. Quarantine storage of convalescent plasma as a measure to reduce the risk of pathogen transmission is not feasible. Therefore, pathogen inactivation (e.g., Theraflex®-MB, Macopharma, Mouvaux, France) is an attractive option. Data on the impact of pathogen inactivation by methylene blue (MB) treatment on antibody integrity are sparse. Methods: Antigen-specific binding capacity was tested before and after MB treatment of plasma (n = 10). IgG and IgM isoagglutinin titers were tested by agglutination in increasing dilutions. Furthermore, the binding of anti-EBV and anti-tetanus toxin IgG to their specific antigens was assessed by ELISA, and IgG binding to Fc receptors was assessed by flow cytometry using THP-1 cells expressing FcRI and FcRII. Results: There was no significant difference in the isoagglutinin titers, the antigen binding capacity of anti-EBV and anti-tetanus toxin IgG, as well as the Fc receptor binding capacity before and after MB treatment of plasma. Conclusion: MB treatment of plasma does not inhibit the binding capacity of IgM and IgG to their epitopes, or the Fc receptor interaction of IgG. Based on these results, MB treatment of convalescent plasma is appropriate to reduce the risk of pathogen transmission if quarantine storage is omitted.
Das Gram-positive Bakterium S. aureus besiedelt rund 20 % der Menschen persistent und asymptomatisch, während sich bei den anderen Phasen der Kolonisation und Nicht-Kolonisation abwechseln. Als opportunistisches Pathogen kann S. aureus seinen Wirt auch infizieren und eine Vielzahl von Krankheitsbildern hervorrufen. Diese reichen von oberflächlichen Haut- und Weichteilinfektionen bis hin zu komplexen Infektionsgeschehen wie der Sepsis und können den Tod der betroffenen Person zur Folge haben. Antibiotika-resistente Varianten wie Methicillin-resistente S. aureus (MRSA) verkomplizieren die Therapie und sind als „Krankenhauskeime“ gefürchtet. Die Kolonisierung und Infektion mit MRSA beschränkt sich allerdings nicht nur auf Gesundheitseinrichtungen, sondern etablierte sich auch in der Allgemeinbevölkerung sowie in Landwirtschaftsbetrieben. Da S. aureus neben dem Menschen ebenfalls eine Vielzahl von Wild- und Nutztieren kolonisieren und infizieren kann, welche als Reservoir, Überträger sowie als Brutstätten neuer Varianten fungieren, ist ein holistischer Ansatz wie das „One Health“-Konzept gefordert, um Ausbreitung und Infektionen unter Kontrolle zu halten.
Dies erfordert geeignete Tiermodelle, um die komplexen Interaktionen von S. aureus mit seinem Wirt zu analysieren und therapeutisch zu beeinflussen. Am häufigsten werden dafür etablierte Labormaus-Stämme (z.B. C57BL/6, BALB/c) eingesetzt und mit S. aureus-Stämmen des Menschen kolonisiert oder infiziert. Weil S. aureus jedoch einen Wirtstropismus ausbildet, ist die Aussagekraft solcher Mausmodelle durch die Inkompatibilität zwischen Erreger und Wirt limitiert. Manche Aspekte der Wirt-Pathogen-Interaktion lassen sich in diesen Modellen gar nicht untersuchen. Hier könnten murin-adaptierte S. aureus-Stämme eine bessere Option sein, zumal Vorarbeiten unserer Arbeitsgruppe zeigten, dass Mäuse natürliche Wirte von S. aureus sind.
In dieser Arbeit sollte daher untersucht werden, ob Befunde aus dem Menschen in der Maus repliziert werden können, wo die Limitationen von Mausmodellen liegen und wie mögliche Optimierungsansätze aussehen könnten. Weitere Schwerpunkte lagen auf Analysen der Populationsstruktur von S. aureus in murinen Spezies unterschiedlicher Habitate und der Adaptation muriner S. aureus-Isolate an ihren Wirt. Außerdem wurden Maus-adaptierte Stämme in Infektions- und Kolonisationsmodellen eingesetzt, um ihre Eignung im Mausmodell zu testen.
In einer Originalarbeit (Mrochen et al.; Front. Immunol.; 2021) haben wir anhand der Immunantwort auf die beiden S. aureus-Virulenzfaktoren SplB und GlpQ beschrieben, dass Daten aus klinischen Studien in der Maus rekapituliert werden können. S. aureus-naive Mäuse zeigten nach Vakzinierung mit SplB eine sehr ähnliche Polarität der Immunantwort wie Menschen nach natürlicher Besiedlung/Infektion mit S. aureus. Mäuse reagierten mit einer Th2-Antwort auf das nicht-adjuvantierte Protein SplB, zudem war die Anzahl an Eosinophilen in der Milz signifikant erhöht. Im Serum der Mäuse ließ sich SplB-spezifisches IgE messen. Damit spiegelte das Mausmodell den beim Menschen bekannten Typ2-Bias der Immunreaktion auf Spls von S. aureus wider. GlpQ löste hingegen ohne Adjuvans keine messbare Immunreaktion aus, hatte also eine geringe Immunogenität. Dies zeigt, dass S. aureus-naive Mäuse sich dazu eignen könnten, die intrinsische Immunogenität und das Immunpolarisationspotential von S. aureus-Proteinen zu untersuchen, was für die Entwicklung von S. aureus-Vakzinen von Bedeutung ist.
In einem Übersichtsartikel (Mrochen et al.; Int. J. Mol. Sci.; 2020) haben wir die Limitationen von konventionellen S. aureus-Infektionsmodellen, bei denen Mäuse mit human-adaptierten S. aureus-Isolaten infiziert werden, veranschaulicht und Alternativen aufgezeigt. Zunächst stellten wir den Wirtstropismus von S. aureus und Mechanismen der Wirtsanpassung dar. Darauf aufbauend diskutierten wir einige Limitationen konventioneller Mausmodelle. Wir betrachteten Aspekte der genetischen Variation der verwendeten Maus- und S. aureus-Stämme, wirtsspezifische Virulenzfaktoren, Unterschiede des humanen und murinen Immunsystems, den Einfluss des murinen Mikrobioms und der verwendeten Infektionsdosen. Zusammenfassend kann dazu gesagt werden, dass durch die Inkompatibilitäten zwischen humanen S. aureus-Isolaten und der Maus die bakterielle Fitness und Virulenz eingeschränkt ist. Dies kann die Aussagekraft von Experimenten massiv einschränken. Beispielsweise können in ihrer Affinität verminderte Rezeptor-Ligand-Interaktionen die Akquisition von Nährstoffen erschweren und die Wirkungslosigkeit bestimmter Virulenzfaktoren (wie z.B. Superantigenen) die Immunevasion behindern. Wir haben daraufhin alternative Modell-Ansätze vorgestellt und diskutiert, welche unterschiedliche Aspekte der Wirt-S. aureus-Interaktion verbessern sollen (humanisierte Mäuse, dirty mice, Wildlinge). Die ebenfalls mögliche Verwendung murin-adaptierter S. aureus-Stämme beseitigt Inkompatibilitäten zwischen Maus und S. aureus komplett, kann aber manche humanspezifischen Vorgänge nicht modellieren.
In zwei weiteren Originalarbeiten (Mrochen et al.; Int. J. Med. Microbiol.; 2018 und Raafat et al.; Toxins; 2020) haben wir die Populationsstruktur von S. aureus in Labormäusen bzw. Ratten unterschiedlicher Habitate (Labor, Wildnis) beschrieben und die Adaptation der Bakterien an diese Wirte dargestellt. Rund um den Globus sind Labormäuse mit S. aureus besiedelt. Einige murine Isolate gehörten zu klonalen Komplexen wie CC1, CC5, CC8 und CC15, die sich auch beim Menschen finden, sodass hier eine Übertragung vom Menschen auf die Maus wahrscheinlich ist. Dennoch zeigten viele der Isolate eindeutige Zeichen einer Wirtsadaptation. So waren humanspezifische Virulenzfaktoren seltener als bei humanen Referenzisolaten gleicher Linien vorhanden. 47 % der Isolate gehörten jedoch zum klonalen Komplex CC88, der selten beim Menschen ist. Diese Linie war in Vorarbeiten unserer Arbeitsgruppe bereits als murin-adaptiert identifiziert worden, was sich hier bestätigte.
Bei Laborratten zeigte sich ein ähnliches Bild. Auch hier wurden viele Stämme isoliert, die zu typisch humanen Linien (z.B. CC1, CC8, CC15) gehören, außerdem CC88-Isolate. Sie zeigten Zeichen einer Adaptation an Ratten. S. aureus-Isolate aus Wildratten und aus von Wildratten abstammenden Ratten in Gefangenschaft besaßen eine vollkommen andere Populationsstruktur. Hier fanden sich u.a. Linien (CC49, CC130, ST890), die wir in einer anderen Studie aus Wildmäusen isoliert haben. Auch sie wiesen die Zeichen einer Wirtsadaptation auf.
Diese Studien zeigen, dass die Besiedlung von Labormäusen und -ratten durch S. aureus weit verbreitet ist und vermutlich meist vom Menschen ausgeht. Dennoch weisen die Laborstämme Anzeichen einer Adaptation an die Nager auf, was eine längere Kontaktzeit voraussetzt, die diese evolutionären Vorgänge ermöglicht. Die Besiedlung der Labortiere hat zudem Folgen für die Konstitution des Immunsystems, da es auf dieses Bakterium geprimt wird. Weiterhin kann eine Besiedlung zu opportunistischen Infektionen führen. Folglich sollte bei Experimenten stets der S. aureus-Besiedlungsstatus erfasst werden, um einen etwaigen Einfluss auf die erzielten Ergebnisse ausschließen bzw. nachweisen zu können. Bei Wildnagern und ihren Verwandten weist S. aureus eine andere Populationsstruktur auf, welche über einen gewissen Zeitraum auch in Gefangenschaft stabil zu sein scheint. Wildtiere sind damit ein bedeutendes Reservoir und potentielle Überträger von S. aureus, aber ebenfalls eine Quelle neuer Stämme, die zu Forschungszwecken eingesetzt werden könnten.
In zwei weiteren Originalarbeiten (Trübe et al.; Int. J. Med. Microbiol.; 2019 und Fernandes et al.; Microorganisms; 2021) haben wir die Eignung verschiedener murin-adaptierter Stämme in Infektions- und Kolonisationsmodellen diskutiert. S. aureus-Isolate aus Wild- und Labormäusen wurden in BALB/c-Mäusen mit dem humanen Stamm Newman verglichen. Ein CC49-Isolat (S. aureus DIP), das aus Rötel- und Gelbhalsmäusen stammte, erwies sich als besonders virulent und provozierte selbst in einer im Vergleich mit dem Stamm Newman zehnfach geringeren Infektionsdosis vergleichbare Symptome und Immunreaktionen. Die geringere Infektionsdosis ist wahrscheinlich klinisch relevanter, da pathophysiologische Eigenschaften von S. aureus auch dichteabhängig reguliert werden (quorum sensing).
In einem Kolonisationsmodell mit dem murin-adaptierten Laborstamm JSNZ wurde die dekolonisierende Wirkung von Aurintricarbonsäure (ATA) evaluiert. ATA war zuvor in breit angelegten in vitro-Screenings als potenter Adhäsionsinhibitor identifiziert worden. C57BL/6-Mäuse wurden mit JSNZ kolonisiert und anschließend mit ATA behandelt. Leider war ATA im Mausmodell wirkungslos, während mit der in der Klinik eingesetzten Kontrollsubstanz Mupirocin eine vollständige Dekolonisation erreicht werden konnte. JSNZ bestätigte sich jedoch als persistierender Besiedler der Maus. Dieses Besiedlungsmodell ist daher sehr gut geeignet, um neue Agenzien für eine S. aureus-Dekolonisierung zu testen oder die Wirt-Pathogen-Interaktion bei der Kolonisation im Detail zu analysieren.
Die Ergebnisse dieser Arbeit zeigen, dass sich Mausmodelle besser für die Forschung an S. aureus eignen als bisher angenommen. Trotzdem muss die Übertragbarkeit der Ergebnisse auf den Menschen stets kritisch überprüft werden. Die Maus-adaptierten S. aureus-Stämme sind ein neues und potentes Werkzeug, die S. aureus-Forschung zu optimieren. Von besonderem Interesse ist die Möglichkeit, Mäuse persistent zu kolonisieren, wie dies typisch für die Interaktion von S. aureus mit seinem menschlichen Wirt ist. Diese wichtige Facette im Zusammenspiel zwischen dem Erreger und seinem Wirt wird nun erstmals der experimentellen Forschung zugänglich.
Sepsis wird als eine lebensbedrohliche Organdysfunktion aufgrund einer fehlregulierten Reaktion des Organismus auf eine Infektion definiert (Sepsis-3) (23). Trotz der Fortschritte in der modernen Medizintechnik und der Entwicklung neuer Medikamente bleibt die Sepsis weiterhin eine der häufigsten Todesursachen auf Intensivstationen weltweit. Hinzu kommt, dass zukünftig von einer steigenden Letalität auszugehen ist. Gründe hierfür sind neben dem zunehmenden Anteil älterer und chronisch kranker Patienten die zunehmende Invasivität vieler diagnostischer und operativer Eingriffe und die steigende Antibiotikaresistenz der Erreger (35). Der rasante Anstieg resistenter Krankheitserreger weltweit stellt die Sepsisbehandlung vor neue Herausforderungen. Entscheidend für die Senkung der Letalität ist eine schnelle Diagnostik und eine zielgerichtete Therapie. Die auf kulturellen Verfahren basierte vorherrschende mikrobiologische Standarddiagnostik ist zu zeitintensiv, daher werden aktuell molekular-basierte Verfahren entwickelt die eine schnelle Diagnostik ermöglichen.
Ziel dieser Arbeit war herauszufinden, ob sich der Organismus in einer Sepsis mit dem invasivem Krankheitserreger auseinandersetzt und eine humorale Immunantwort generiert und ob diese Immunantwort erregerspezifisch ist.
Zur Beantwortung dieser Fragen wurde in dieser Arbeit ein Verfahren entwickelt, um die Antikörper-Bindung an verschiedene bakterielle Proteine zu quantifizieren.
Dafür wurden humane Plasmen von Sepsispatienten aus einer prospektiven klinischen Studie (VYOO-Studie, Greifswald) mittels automatisiertem 1D-Western Blot Verfahren (Simple WesternTM assay) auf ihren erregerspezifischen Antikörper-Gehalt untersucht. Das Erregerspektrum wurde durch die extrazellulären Proteine häufiger Sepsiserreger
(Enterococcus faecium, Enterococcus faecalis, Staphylococcus haemolyticus, Staphylococcus aureus, Pseudomonas aeruginosa, Serratia marcescens und Escherichia coli) bereitgestellt. Alle Bakterienisolate, mit Ausnahme von S. aureus (USA300 Δspa), stammen aus Wundabstrichen, Trachealsekreten und Blutkulturen der Sepsispatienten und wurden in der Medizinischen Mikrobiologie des Greifswalder Universitätsklinikums aufbewahrt und für die Kultivierung zur Verfügung gestellt. Mit Hilfe des automatisierten, eindimensionalen Western Blot (1D-WB) wurde die Bindung der extrahierten extrazellulären Proteine (ec-stat) verschiedener Sepsiserreger an humanen Serumantikörpern untersucht.
Die Ergebnisse dieser Arbeit stellen heraus, dass immunkompetente Patienten während einer systemischen Infektion eine adaptive Immunantwort generieren. Um herauszufinden ob diese Immunantwort erregerspezifisch ist, wurden die Patientenplasmen nicht nur gegen extrazelluläre Proteine (ec-stat) des jeweiligen invasiven Erregers getestet, sondern auch gegen ec-stat anderer Bakterienspezies. Bei jedem der untersuchten Erreger konnten Patienten mit einem Antikörperanstieg identifiziert werden. Bei keinem Patienten stiegen Antikörper gegen alle untersuchten Erreger an. Schlussfolgernd beruht der Antikörperanstieg auf einer spezifischen Reaktion des Immunsystems auf bakterielle Invasion und ist demzufolge erregerspezifisch.
Es zeigte sich, dass v.a. bei Patienten mit einer abdominellen Sepsis die Antikörpertiter gegen mehrere Darmbakterienspezies ansteigen. Diese Befunde deuten darauf hin, dass sich das Immunsystem mit multiplen Erregern auseinandergesetzt hat, selbst wenn mikrobiologisch nur ein Erreger nachgewiesen wurde. Dies könnte relevant für die Antibiotikatherapie sein.
Des Weiteren konnte beobachtet werden, dass trotz mikrobiologisch nachgewiesenem Erreger bei einigen Patienten keine Immunantwort gegen den Keim generiert wurde.
Insgesamt zeigen die Daten, dass viele Patienten bereits vor einer Infektion spezifische Antikörper gebildet haben. Schlussfolgernd hat sich das adaptive Immunsystem schon seit längerer Zeit (vor Infektion) mit dem Krankheitserreger auseinander gesetzt.
Mit Hilfe einer immunologischen Sepsisserologie, wie der Verwendung des in dieser Arbeit genutzten Simple WesternTM Assays, lassen sich wichtige Informationen über die Pathogenese der Sepsis und die Reaktion des Immunsystems gewinnen. Diese ergänzen die konventionelle mikrobiologische Diagnostik. Ein besseres Verständnis der Immunantwort bei Sepsis ist eine Voraussetzung für die Entwicklung neuer therapeutische Ansätze. In wie weit der Simple WesternTM Assay - jedoch das diagnostische Portfolio bei Sepsis erweitern kann, müssen weitere Untersuchungen zur Sensitivität und Reproduzierbarkeit adressieren.
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.
Background: Annual transfusion rates in many European countries range between 25 and 35 red blood cell concentrates (RBCs)/1,000 population.It is unclear why transfusion rates in Germany are considerably higher (approx. 50–55 RBCs/1,000 population). Methods: We assessed the characteristics of transfusion recipients at all hospitals of the German federal state Mecklenburg-Western Pomerania during a 10-year longitudinal study. Results: Although 75% of patients received ≤4 RBCs/patient in 2015 (1 RBC: 11.3%; 2 RBCs: 42.6%; 3 RBCs: 6.3%; 4 RBCs: 15.0%), the mean transfusion index was 4.6 RBCs due to a minority of patients with a high transfusion demand. Two thirds of all RBCs were transfused to only 25% of RBC recipients. Consistently, male patients received a higher number of RBCs (2005: 54.2%; 2015: 56.8%) and had a higher mean transfusion index than female patients (mean 5.1 ± 7.2; median 2; inter-quartile range [IQR] 2–4 vs. mean 4.0 ± 5.8; median 2; IQR 2–4). The absolute transfusion demand decreased between 2005 and 2015 by 13.5% due to a composite of active reduction (clinical practice change) and population decline in the 65- to 75-year age group (lower birth rate cohort 1940–1950); however, with major differences between hospitals (range from –61.0 to +41.4%). Conclusion: Transfusion demand in a population could largely be driven by patients with high transfusion demand. Different treatment practices in this group of patients probably add to the major differences in transfusion demand per 1,000 individuals between countries. The available data cannot prove this hypothesis. Implementation of a diagnosis-related group-based monitoring system is urgently needed to allow informative monitoring on the population level and meaningful comparisons between transfusion practices.
High Na+ Environments Impair Phagocyte Oxidase-Dependent Antibacterial Activity of Neutrophils
(2021)
Infection and inflammation can augment local Na+ abundance. These increases in local Na+ levels boost proinflammatory and antimicrobial macrophage activity and can favor polarization of T cells towards a proinflammatory Th17 phenotype. Although neutrophils play an important role in fighting intruding invaders, the impact of increased Na+ on the antimicrobial activity of neutrophils remains elusive. Here we show that, in neutrophils, increases in Na+ (high salt, HS) impair the ability of human and murine neutrophils to eliminate Escherichia coli and Staphylococcus aureus. High salt caused reduced spontaneous movement, degranulation and impaired production of reactive oxygen species (ROS) while leaving neutrophil viability unchanged. High salt enhanced the activity of the p38 mitogen-activated protein kinase (p38/MAPK) and increased the interleukin (IL)-8 release in a p38/MAPK-dependent manner. Whereas inhibition of p38/MAPK did not result in improved neutrophil defense, pharmacological blockade of the phagocyte oxidase (PHOX) or its genetic ablation mimicked the impaired antimicrobial activity detected under high salt conditions. Stimulation of neutrophils with phorbol-12-myristate-13-acetate (PMA) overcame high salt-induced impairment in ROS production and restored antimicrobial activity of neutrophils. Hence, we conclude that high salt-impaired PHOX activity results in diminished antimicrobial activity. Our findings suggest that increases in local Na+ represent an ionic checkpoint that prevents excessive ROS production of neutrophils, which decreases their antimicrobial potential and could potentially curtail ROS-mediated tissue damage.
Humans are exposed to a plethora of microorganisms that reside on outer and inner body surfaces. These are collectively referred to as the human microbiome. The evolutionary relationship between humans and their microbiome is very complex. It is now widely accepted that these microorganisms are not just passive spectators but play an important role in health. The presence or absence of certain microbes is also linked to various diseases, including inflammatory bowel disease, cardiovascular disease, obesity, cancer, and allergies.
Allergies are several conditions caused by a misguided immune response to foreign antigens that are typically harmless. Common allergic diseases include atopic dermatitis (AD), allergic asthma, hay fever, and anaphylaxis. The incidences of allergic diseases are continuously rising, with up to 40% of the human population thought to be sensitised to environmental antigens. This increased incidence is not simply the result of societies becoming more aware and better at diagnosing these diseases. It is believed that the increases in allergies and sensitisation have environmental causes and are related to Western lifestyles. It is known that the rate of allergies is less frequent in developing countries. They are also more likely to occur in urban than rural areas. The prevailing view of the involvement of bacteria in allergies is described by the hygiene hypothesis. The hypothesis claims that decreased exposure to diverse microbial communities early in life increases the risk of developing allergic diseases. There are numerous examples to support this claim. For example, children born and raised in close contact to farm animals or in the presence of pets, and who are thus in direct and constant contact with a complex microbial environment, are protected from allergic diseases. On the other hand, colonisation or infection with certain bacteria increases allergic disease risks. This seems to contradict the hygiene hypothesis.
It appears that the members of the microbiome have different effects on allergy, and the hygiene hypothesis may not apply to every player in the complex microbial diversity that humans are in contact with. Therefore, a better understanding of the host bacterial interaction is required on the level of bacterial species.
This work studies the interplay between bacteria and the immune system to identify and characterise bacterial components with allergenic properties. In this quest, Staphylococcus aureus (S. aureus) and Staphylococcus epidermidis (S. epidermidis) were investigated for their allergenic properties and involvement in different allergic diseases. In the case of S. aureus, evidence is presented on allergic implications for two different components; serine protease-like proteins (Spls) and superantigens (SAg). Furthermore, experimental support is provided on the allergenic properties of the extracellular serine protease (Esp) from S. epidermidis. We argue that stimulating allergic reactions by staphylococci is an immune evasion mechanism that increases the survival chances of the bacteria within the host.
In chapter 1, an introduction is given to both S. aureus and S. epidermidis and their interactions with the immune system. Also, the bacterial components with allergenic properties and allergic diseases with known bacterial involvement are presented. Finally, the question of why bacteria cause allergy is discussed.
Chapter 2 describes allergic reactions to the Spls of S. aureus in a cohort of cystic fibrosis patients. Chapter 3 focuses on the SAgs of S. aureus. SAgs were discovered more than 30 years ago, but their physiological function is still under discussion. In this chapter, the allergenic properties of SAgs and their possible immunological mechanisms are reviewed, and a possible link between SAgs and allergic diseases is discussed. In chapter 4, the focus shifts to S. epidermidis and its involvement in AD. The human immune response to the Esp from S. epidermidis is characterised in healthy and AD individuals. The allergenic properties of Esp imply a detrimental role of S. epidermidis in AD. Finally, chapter 5 summarises and discusses the results of this thesis. In this section, the pieces are put together, and attention is brought back to the question of why bacteria cause allergies.
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.
Protection against Staphylococcus aureus is determined by the polarization of the anti-bacterial immune effector mechanisms. Virulence factors of S. aureus can modulate these and induce differently polarized immune responses in a single individual. We proposed that this may be due to intrinsic properties of the bacterial proteins. To test this idea, we selected two virulence factors, the serine protease-like protein B (SplB) and the glycerophosphoryl diester phosphodiesterase (GlpQ). In humans naturally exposed to S. aureus, SplB induces a type 2-biased adaptive immune response, whereas GlpQ elicits type 1/type 3 immunity. We injected the recombinant bacterial antigens into the peritoneum of S. aureus-naïve C57BL/6N mice and analyzed the immune response. This was skewed by SplB toward a Th2 profile including specific IgE, whereas GlpQ was weakly immunogenic. To elucidate the influence of adjuvants on the proteins’ polarization potential, we studied Montanide ISA 71 VG and Imject™Alum, which promote a Th1 and Th2 response, respectively. Alum strongly increased antibody production to the Th2-polarizing protein SplB, but did not affect the response to GlpQ. Montanide enhanced the antibody production to both S. aureus virulence factors. Montanide also augmented the inflammation in general, whereas Alum had little effect on the cellular immune response. The adjuvants did not override the polarization potential of the S. aureus proteins on the adaptive immune response.
In cystic fibrosis (CF) infectious and allergic airway inflammation cause pulmonary exacerbations that destroy the lungs. Staphylococcus aureus is a common long-term colonizer and cause of recurrent airway infections in CF. The pathogen is also associated with respiratory allergy; especially the staphylococcal serine protease-like proteins (Spls) can induce type 2 immune responses in humans and mice. We measured the serum IgE levels specific to 7 proteases of S. aureus by ELISA, targeting 5 Spls (76 CF patients and 46 controls) and the staphopains A and B (16 CF patients and 46 controls). Then we compared cytokine release and phenotype of T cells that had been stimulated with Spls between 5 CF patients and 5 controls. CF patients had strongly increased serum IgE binding to all Spls but not to the staphopains. Compared to healthy controls, their Spl-stimulated T cells released more type 2 cytokines (IL-4, IL-5, IL-13) and more IL-6 with no difference in the secretion of type 1- or type 3 cytokines (IFNγ, IL-17A, IL-17F). IL-10 production was low in CF T cells. The phenotype of the Spl-exposed T cells shifted towards a Th2 or Th17 profile in CF but to a Th1 profile in controls. Sensitization to S. aureus Spls is common in CF. This discovery could explain episodes of allergic inflammation of hitherto unknown causation in CF and extend the diagnostic and therapeutic portfolio.
Our goal was to provide a comprehensive overview of the antibody response to Staphylococcus aureus antigens in the general population as a basis for defining disease-specific profiles and diagnostic signatures. We tested the specific IgG and IgA responses to 79 staphylococcal antigens in 996 individuals from the population-based Study of Health in Pomerania. Using a dilution-based multiplex suspension array, we extended the dynamic range of specific antibody detection to seven orders of magnitude, allowing the precise quantification of high and low abundant antibody specificities in the same sample. The observed IgG and IgA antibody responses were highly heterogeneous with differences between individuals as well as between bacterial antigens that spanned several orders of magnitude. Some antigens elicited significantly more IgG than IgA and vice versa. We confirmed a strong influence of colonization on the antibody response and quantified the influence of sex, smoking, age, body mass index, and serum glucose on anti-staphylococcal IgG and IgA. However, all host parameters tested explain only a small part of the extensive variability in individual response to the different antigens of S. aureus.
Infections are often caused by pathobionts, endogenous bacteria that belong to the microbiota. Trauma and surgical intervention can allow bacteria to overcome host defences, ultimately leading to sepsis if left untreated. One of the main defence strategies of the immune system is the production of highly specific antibodies. In the present proof-of-concept study, plasma antibodies against 9 major pathogens were measured in sepsis patients, as an example of severe systemic infections. The binding of plasma antibodies to bacterial extracellular proteins was quantified using a semi-automated immunoblot assay. Comparison of the pathogen-specific antibody levels before and after infection showed an increase in plasma IgG in 20 out of 37 tested patients. This host-directed approach extended the results of pathogen-oriented microbiological and PCR diagnostics: a specific antibody response to additional bacteria was frequently observed, indicating unrecognised poly-microbial invasion. This might explain some cases of failed, seemingly targeted antibiotic treatment.
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.
Sepsis ist die dritthäufigste Todesursache in Deutschland und verursacht jährliche Krankenhauskosten von mehr als 8 Mrd. €. Über die Pathophysiologie ist noch immer vieles unbekannt. Bei der Bekämpfung von extrazellulären Infektionserregern spielt vor allem das humorale Immunsystem eine wichtige Rolle, da die von B-Zellen/ Plasmazellen gebildeten Antikörper wichtige antiinfektive Agenzien darstellen. Dennoch ist die Rolle der B-Zellen bei einer Sepsis nicht gut verstanden. Ergebnisse aus Mausmodellen, aber auch aus klinischen Studien mit Sepsispatienten zeigen einerseits die vermehrte Apoptose von B-Zellen, anderseits wurde auch eine polyklonale B-Zellaktivierung beschrieben, die mit einem unspezifischen Anstieg der Antikörperkonzentrationen im Blut einhergeht.
In dieser Arbeit sollte untersucht werden, ob während einer systemischen bakteriellen Infektion, wie der Sepsis, auch eine Erreger-spezifische Antikörperantwort ausgebildet wird. Mit Hilfe von zwei serologischen Assays wurde die Antikörperantwort von Sepsispatienten gegen extrazelluläre Proteine von 16 typischen Sepsiserregern bestimmt. Anhand von Plasmaproben aus zwei prospektiven Studien konnte die Antikörperkinetik von einem Zeitpunkt vor der klinischen Diagnose bis maximal 16 Tage nach Diagnose ermittelt werden.
Mittels eines Simple Western Assays - einem semi-quantitativen Immunoblot-Assay - wurde zunächst die Erreger-spezifische Antikörperantwort von Patienten mit einer vorliegenden mikrobiologischen Erregerdiagnose untersucht. 54 % der Patienten zeigten eine spezifische humorale Immunantwort gegen den mikrobiologisch diagnostizierten Erreger, wohingegen die Antikörperspiegel für das Kontrollantigen TT unverändert blieben.
Zur Untersuchung der zweiten Patientenkohorte wurde ein Bead-basierter Suspensions-Array auf Grundlage der xMAP-Technologie (Luminex®) entwickelt. Der Infection Array ermöglichte die gleichzeitige Quantifizierung der spezifischen Antikörperantwort gegen 16 verschiedene Erreger. Bei 64 der 76 untersuchten Patienten wurden Anstiege der IgG-Antikörper gegen einen oder mehrere dieser Erreger beobachtet. In 62,5 % der Fälle stimmten diese Anstiege mit der mikrobiologischen Diagnose überein. Bei 20/64 Patienten wurden signifikante Anstiege der IgG-Spiegel spezifisch für einen oder zwei Erreger nachgewiesen, in 44/64 Fällen wurden Anstiege gegen mehr als zwei Erreger beobachtet. Bei Letzteren richtete sich die Antikörperantwort hauptsächlich gegen Enterokokken und Enterobacteriaceae, was primär auf zwei Ursachen zurückgeführt werden kann: (i) Ein Großteil dieser Patienten hatte einen intraabdominellen Infektionsfokus. Polymikrobielle Infektionen durch endogene Darmbakterien, typischerweise verursacht durch eine Darmruptur oder die Insuffizienz einer chirurgischen Darmnaht, sind hierbei ein plausibler Befund, der der mikrobiologischen Diagnostik offenbar häufig entgeht. (ii) Außerdem können Sepsis-bedingte Organstörungen zu einer gesteigerten Darmpermeabilität führen, die wiederum die Translokation intestinaler Bakterien erleichtert.
Die Ergebnisse dieser Arbeit lassen den Schluss zu, dass die beobachteten Antikörperreaktionen auf eine Antigen-spezifische Memoryantwort zurückzuführen sind. In etwa 2/3 der Fälle wird eine Sepsis endogen durch Bakterien des eigenen Mikrobioms verursacht. Entsprechend war es nicht überraschend, dass gegen alle untersuchten Erreger bereits vor der Infektion und auch bei gesunden Kontrollpersonen basale antibakterielle IgG-Spiegel gemessen wurden. Zudem waren die IgG-Anstiege oft bereits zwischen Tag 0 und Tag 8 zu beobachten. Bei einer Primärantwort mit dem Erreger würde die Aktivierung der Zellen und der Klassenwechsel der Antikörper deutlich mehr Zeit erfordern.
Die Untersuchung der Erreger-spezifischen Antikörperantwort hat gezeigt, dass ein serologischer Assay Rückschlüsse auf den Infektionserreger zulässt. Außerdem zeigen die Daten, dass auch Kommensale wie Darmbakterien das Immunsystem prägen, was wiederum Einfluss auf die humorale Immunantwort während einer Infektion haben kann. Dieser Aspekt wird bei Mausmodellen oft vernachlässigt, kann aber entscheidend für die Translation der Ergebnisse aus Tierversuchen auf den Menschen sein. Aber auch diagnostisch bietet der Infection Array Einsatzmöglichkeiten. Im Gegensatz zur konventionellen Erregerdiagnostik ist die Serologie robust gegenüber einer bereits begonnenen Antibiotikagabe, und sie könnte dabei helfen, zwischen einer Kontamination und dem Infektionserreger zu unterscheiden, z. B. im Fall von KNS wie S. epidermidis. Ebenso wäre der Einsatz bei Biofilm-assoziierten Infektionen wie z. B. Protheseninfektionen oder Endokarditis denkbar. Hier besteht die Infektion oft bereits lange asymptomatisch, bevor sie klinisch diagnostiziert wird. Bei Diagnose bestehen meist bereits erhöhte Antikörperspiegel, die sich von denen gesunder Individuen unterscheiden. Ein serologischer Test könnte hier invasive Eingriffe, um an Material für die mikrobiologische Diagnose heranzukommen, reduzieren und die Sensitivität der Erregerdiagnostik erhöhen. Durch den Einsatz rekombinanter Proteine kann die Spezifität des Assays in der Zukunft erhöht werden. Zu diesem Zweck wurden in dieser Arbeit bereits erste immunogene Proteine identifiziert. Durch die Verwendung rekombinanter Proteine wäre zudem zukünftig die Erweiterung des Erregerpanels um typische, aber womöglich schwerkultivierbare Erreger möglich. Damit könnte die Sepsisforschung Neuland betreten.
Exploring Virulence Factors and Alternative Therapies against Staphylococcus aureus Pneumonia
(2020)
Direct monitoring of drug‐induced mechanical response of individual cells by atomic force microscopy
(2020)
Abstract
Mechanical characteristics of individual cells play a vital role in many biological processes and are considered as indicators of the cells’ states. Disturbances including methyl‐β‐cyclodextrin (MβCD) and cytochalasin D (cytoD) are known to significantly affect the state of cells, but little is known about the real‐time response of single cells to these drugs in their physiological condition. Here, nanoindentation‐based atomic force microscopy (AFM) was used to measure the elasticity of human embryonic kidney cells in the presence and absence of these pharmaceuticals. The results showed that depletion of cholesterol in the plasma membrane with MβCD resulted in cell stiffening whereas depolymerization of the actin cytoskeleton by cytoD resulted in cell softening. Using AFM for real‐time measurements, we observed that cells mechanically responded right after these drugs were added. In more detail, the cell´s elasticity suddenly increased with increasing instability upon cholesterol extraction while it is rapidly decreased without changing cellular stability upon depolymerizing actin cytoskeleton. These results demonstrated that actin cytoskeleton and cholesterol contributed differently to the cell mechanical characteristics.
Abstract
Background
Heparin induced thrombocytopenia (HIT) is likely a misdirected bacterial host defense mechanism. Platelet factor 4 (PF4) binds to polyanions on bacterial surfaces exposing neo‐epitopes to which HIT antibodies bind. Platelets are activated by the resulting immune complexes via FcγRIIA, release bactericidal substances, and kill Gram‐negative Escherichia coli.
Objectives
To assess the role of PF4, anti‐PF4/H antibodies and FcγRIIa in killing of Gram‐positive bacteria by platelets.
Methods
Binding of PF4 to protein‐A deficient Staphylococcus aureus (SA113Δspa) and non‐encapsulated Streptococcus pneumoniae (D39Δcps) and its conformational change were assessed by flow cytometry using monoclonal (KKO,5B9) and patient derived anti‐PF4/H antibodies. Killing of bacteria was quantified by counting colony forming units (cfu) after incubation with platelets or platelet releasate. Using flow cytometry, platelet activation (CD62P‐expression, PAC‐1 binding) and phosphatidylserine (PS)‐exposure were analyzed.
Results
Monoclonal and patient‐derived anti‐PF4/H antibodies bound in the presence of PF4 to both S. aureus and S. pneumoniae (1.6‐fold increased fluorescence signal for human anti‐PF4/H antibodies to 24.0‐fold increase for KKO). Staphylococcus aureus (5.5 × 104cfu/mL) was efficiently killed by platelets (2.7 × 104cfu/mL) or their releasate (2.9 × 104cfu/mL). Killing was not further enhanced by PF4 or anti‐PF4/H antibodies. Blocking FcγRIIa had no impact on killing of S. aureus by platelets. In contrast, S. pneumoniae was not killed by platelets or releasate. Instead, after incubation with pneumococci platelets were unresponsive to TRAP‐6 stimulation and exposed high levels of PS.
Conclusions
Anti‐PF4/H antibodies seem to have only a minor role for direct killing of Gram‐positive bacteria by platelets. Staphylococcus aureus is killed by platelets or platelet releasate. In contrast, S. pneumoniae affects platelet viability.
Abstract
Background
Heparins are usually produced from animal tissues. It is now possible to synthesize heparins. This provides the abilities to overcome shortages of heparin, to optimize biological effects, and to reduce adverse drug effects. Heparins interact with platelet factor 4 (PF4), which can induce an immune response causing thrombocytopenia. This side effect is called heparin‐induced thrombocytopenia (HIT). We characterized the interaction of PF4 and HIT antibodies with oligosaccharides of 6‐, 8‐, 10‐, and 12‐mer size and a hypersulfated 12‐mer (S12‐mer).
Methods
We utilized multiple methodologies including isothermal calorimetry, circular dichroism spectroscopy, single molecule force spectroscopy (SMFS), enzyme immunosorbent assay (EIA), and platelet aggregation test to characterize the interaction of synthetic heparin analogs with PF4 and anti‐PF4/heparin antibodies.
Results
The synthetic heparin‐like compounds display stronger binding characteristics to PF4 than animal‐derived heparins of corresponding lengths. Upon complexation with PF4, 6‐mer and S12‐mer heparins showed much lower enthalpy, induced less conformational changes in PF4, and interacted with weaker forces than 8‐, 10‐, and 12‐mer heparins. Anti‐PF4/heparin antibodies bind more weakly to complexes formed between PF4 and heparins ≤ 8‐mer than with complexes formed between PF4 and heparins ≥ 10‐mer. Addition of one sulfate group to the 12‐mer resulted in a S12‐mer, which showed substantial changes in its binding characteristics to PF4.
Conclusions
We provide a template for characterizing interactions of newly developed heparin‐based anticoagulant drugs with proteins, especially PF4 and the resulting potential antigenicity.
Staphylococcus aureus (S. aureus) can secrete a broad range of virulence factors, among which staphylococcal serine protease-like proteins (Spls) have been identified as bacterial allergens. The S. aureus allergen serine protease-like protein D (SplD) induces allergic asthma in C57BL/6J mice through the IL-33/ST2 signaling axis. Analysis of C57BL/6J, C57BL/6N, CBA, DBA/2, and BALB/c mice treated with intratracheal applications of SplD allowed us to identify a frameshift mutation in the serine (or cysteine) peptidase inhibitor, clade A, and member 3I (Serpina3i) causing a truncated form of SERPINA3I in BALB/c, CBA, and DBA/2 mice. IL-33 is a key mediator of SplD-induced immunity and can be processed by proteases leading to its activation or degradation. Full-length SERPINA3I inhibits IL-33 degradation in vivo in the lungs of SplD-treated BALB/c mice and in vitro by direct inhibition of mMCP-4. Collectively, our results establish SERPINA3I as a regulator of IL-33 in the lungs following exposure to the bacterial allergen SplD, and that the asthma phenotypes of mouse strains may be strongly influenced by the observed frameshift mutation in Serpina3i. The analysis of this protease-serpin interaction network might help to identify predictive biomarkers for type-2 biased airway disease in individuals colonized by S. aureus.
Neue Antibiotika und Präventionsmaßnahmen gegen S. aureus sind aufgrund der starken Ausbreitung multiresistenter S. aureus-Stämme dringend erforderlich. Zur Entwicklung von Therapie- und Präventionsmaßnahmen werden geeignete Infektionsmodellen benötigt, die die klinische Situation möglichst exakt widerspiegeln. Da die Spezies S. aureus stark wirtsspezifisch ist, könnten wirtsadaptierte S. aureus-Stämme hierbei äußerst hilfreich sein. In der Infektionsforschung werden vor allem Mausmodelle verwendet. Da bisher jedoch angenommen wurde, dass Mäuse keine natürlichen Wirte von S. aureus sind, sind S. aureus-Forscher davon ausgegangen, dass Mäuse kein geeignetes Modell darstellen. Das wurde durch unsere und andere Arbeitsgruppen allerdings in den letzten Jahren widerlegt. Wir konnten zeigen, dass Labor- und Wildmäuse mit S. aureus besiedelt sind.
Im Rahmen dieser Arbeit sollte geklärt werden, ob murine Infektionsmodelle durch die Verwendung von mausadaptierten S. aureus-Stämmen optimiert werden können. Aus über 250 S. aureus-Stämmen, die aus Labor und Wildmäusen isoliert wurden, wurden vier mausadaptierte S. aureus-Isolate ausgewählt und mit dem humanen S. aureus-Isolat Newman in einem Pneumonie- und Bakteriämiemodell vergleichen. Diese Stämme wiesen einen repräsentativen spa-Typ sowie typischen Phagenmuster und Virulenzgene auf. Zudem waren sie in der Lage, murines Plasma zu koagulieren und in murinem Vollblut zu replizieren.
Es zeigte sich, dass das murine Isolat S. aureus DIP sowohl im Pneumonie- als auch im Bakteriämiemodell deutlich virulenter war als das humane Isolat Newman und die anderen getesteten mausadaptierten Stämme. Nach kürzester Zeit starben alle Tiere, die mit S. aureus DIP infiziert wurden. Wurde die Infektionsdosis im Vergleich zu Newman um 90 % reduziert, waren die bakterielle Last, der Belastungsscore, sowie die Zytokin- und Chemokinkonzentrationen nach Infektion mit S. aureus DIP bzw. S. aureus Newman vergleichbar. Im Besiedlungsmodell konnte gezeigt werden, dass die mausadaptierten Stämme S. aureus JSNZ sowie S. aureus DIP in der Lage sind, Mäuse über einen Zeitraum von 7 Tagen stabil zu besiedeln. Mäuse, die mit S. aureus Newman besiedelt waren, konnten den Stamm innerhalb dieses Zeitraums eliminieren. Die Genomsequenzierung der in vivo verwendeten S. aureus Stämme zeigte, dass lediglich S. aureus DIP für das Leukozidin LukMF‘ kodiert. Das lässt vermuten, dass die Präsenz des Virulenzfaktors für die gesteigerte Virulenz von S. aureus DIP verantwortlich sein könnte.
Des Weiteren sollten in dieser Arbeit ein Besiedlungsmodell mit murinen S. aureus-Isolaten etabliert und die beteiligten Immunzellen quantifiziert werden. Es zeigte sich, dass Mäuse mit murinen S. aureus-Isolaten bis zu 7 Tage besiedelt werden können wohingegen S. aureus Newman zu diesem Zeitpunkt nur noch in 20 % der Tiere nachweisbar war. Zudem konnte bei der intranasalen Besiedlung mit einer hohen Dosis S. aureus DIP [1 × 10^8 CFU] gezeigt werden, dass sowohl Th17-Zellen als auch γδ-T-Zellen nach 7 Tagen IL-17A, IL-17F und IL-22 produzieren. Jedoch konnte die Zytokinproduktion nur in Tieren nachgewiesen werden, die einen hohen Belastungsscore aufwiesen. Da nach 24 Stunden bei Tieren mit hohem Belastungsscore auch Bakterien in der Lunge detektiert wurde, ist anzunehmen, dass S. aureus diese Tiere nicht nur besiedelt, sondern bei ihnen auch eine Atemwegsinfektion verursacht hatte. Durch den geringen prozentualen Anteil an ILCs in den zervikalen Lymphknoten war es nicht möglich Rückschlüsse auf deren Zytokinproduktion zu ziehen. Somit gelang es zwar ein murines S. aureus-Besiedlungsmodell zu etablieren, jedoch kann keine Aussage zu den beteiligten Zellen des Immunsystems getroffen werden.
Zusammenfassend konnte gezeigt werden, dass Labormäuse mit mausadaptierten S. aureus-Stämmen länger besiedelt werden können als mit dem humanen Referenzstamm Newman. Zudem konnte mit Hilfe des mausadaptierten Stammes S. aureus DIP die Infektionsdosis im Pneumonie- und Bakteriämiemodell erheblich reduziert werden. Somit gelang es Mausmodelle durch die Verwendung von mausadaptierten S. aureus-Stämmen zu optimieren, auch wenn das nicht auf alle getesteten Isolate zutrifft. Durch die Anpassung an den murinen Wirt stellen mausadaptierte S. aureus-Stämme wie DIP und JSNZ ein physiologischeres Modell der Pathogen-Wirts-Interaktion dar. Die Verwendung eines solchen Stammes ermöglicht es ein besseres Verständnis für Infektionsprozesse und die Pathogen-Wirt-Interaktionen zu erlangen und dadurch eventuell neue Therapiemöglichkeiten zu entwickeln.
Es ist zu berücksichtigen, dass auch die Verwendung mausadaptierter S. aureus-Stämme in murinen Besiedlungs- und Infektionsmodellen lediglich ein Modell darstellt, welches Vor- und Nachteile hat. Daher ist es essenziell, dass Wissenschaftler die Grenzen jedes Modellsystems kennen und das richtige Infektionsmodell (oder eine Kombination davon) auswählen, um ihre Forschungsfragen zu beantworten.
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.
Oxidation-Specific Epitopes (OSEs) Dominate the B Cell Response in Murine Polymicrobial Sepsis
(2020)
In murine abdominal sepsis by colon ascendens stent peritonitis (CASP), a strong increase in serum IgM and IgG antibodies was observed, which reached maximum values 14 days following sepsis induction. The specificity of this antibody response was studied in serum and at the single cell level using a broad panel of bacterial, sepsis-unrelated as well as self-antigens. Whereas an antibacterial IgM/IgG response was rarely observed, studies at the single-cell level revealed that IgM antibodies, in particular, were largely polyreactive. Interestingly, at least 16% of the IgM mAbs and 20% of the IgG mAbs derived from post-septic mice showed specificity for oxidation-specific epitopes (OSEs), which are known targets of the innate/adaptive immune response. This identifies those self-antigens as the main target of B cell responses in sepsis.
Although antigen-specific priming of antibody responses is impaired during sepsis, there is nevertheless a strong increase in IgM and IgG serum concentrations. Using colon ascendens stent peritonitis (CASP), a mouse model of polymicrobial abdominal sepsis, we observed substantial increases in IgM as well as IgG of all subclasses, starting at day 3 and peaking 2 weeks after sepsis induction. The dominant source of antibody-secreting cells was by far the spleen, with a minor contribution of the mesenteric lymph nodes. Remarkably, sepsis induction in splenectomized mice did not change the dynamics of the serum IgM/IgG reaction, indicating that the marginal zone B cells, which almost exclusively reside in the spleen, are dispensable in such a setting. Hence, in systemic bacterial infection, the function of the spleen as dominant niche of antibody-producing cells can be compensated by extra-splenic B cell populations as well as other lymphoid organs. Depletion of CD4+ T cells did not affect the IgM response, while it impaired IgG generation of all subclasses with the exception of IgG3. Taken together, our data demonstrate that the robust class-switched antibody response in sepsis encompasses both T cell-dependent and -independent components.
Staphylococcus aureussuperantigens (SAgs) are among the most potent T cell mitogensknown.They stimulate large fractions of T cells by cross-linking their T cell receptor withmajor histocompatibility complex class-II molecules on antigen presenting cells, resulting in Tcell proliferation and massive cytokine release. To date, 26 different SAgs have been described in thespeciesS. aureus; they comprise the toxic shock syndrome toxin (TSST-1), as well as 25 staphylococcalenterotoxins (SEs) or enterotoxin-like proteins (SEls). SAgs can cause staphylococcal food poisoningand toxic shock syndrome and contribute to the clinical symptoms of staphylococcal infection. Inaddition, there is growing evidence that SAgs are involved in allergic diseases. This review providesan overview on recent epidemiological data on the involvement ofS. aureusSAgs and anti-SAg-IgEin allergy, demonstrating that being sensitized to SEs—in contrast to inhalant allergens—is associatedwith a severe disease course in patients with chronic airway inflammation. The mechanisms by whichSAgs trigger or amplify allergic immune responses, however, are not yet fully understood. Here, wediscuss known and hypothetical pathways by which SAgs can drive an atopic disease
Indoleamine 2,3-dioxygenase (IDO) and tryptophan 2,3-dioxygenase (TDO2) are the key enzymes of tryptophan (TRP) metabolism in the kynurenine pathway (KP). Both enzymes function as indicators of immunosuppression and poor survival in cancer patients. Direct or indirect targeting of either of these substances seems thus reasonable to improve therapy options for patients. In this study, glioblastoma multiforme (GBM) as well as head and neck squamous cell carcinomas (HNSCC) were examined because of their different mechanisms of spontaneous and treatment-induced immune escape. Effects on gene expression and protein levels were examined. Accompanying assessment of TRP metabolites from treated GBM cell culture supernatants was conducted. Our results show a heterogeneous and inversely correlated expression profile of TRP-metabolizing genes among GBM and HNSCC cells, with low, but inducible IDO1 expression upon IFNγ treatment. TDO2 expression was higher in GBM cells, while genes encoding kynurenine aminotransferases were mainly confined to HNSCC cells. These data indicate that the KP is active in both entities, with however different enzymes involved in TRP catabolism. Upon treatment with Temozolomide, the standard of care for GBM patients, IDO1 was upregulated. Comparable, although less pronounced effects were seen in HNSCC upon Cetuximab and conventional drugs (i.e., 5-fluorouracil, Gemcitabine). Here, IDO1 and additional genes of the KP (KYAT1, KYAT2, and KMO) were induced. Vice versa, the novel yet experimental cyclin-dependent kinase inhibitor Dinaciclib suppressed KP in both entities. Our comprehensive data imply inhibition of the TRP catabolism by Dinaciclib, while conventional chemotherapeutics tend to activate this pathway. These data point to limitations of conventional therapy and highlight the potential of targeted therapies to interfere with the cells' metabolism more than anticipated.
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.
Functional characterization of a novel protease isolated from a mouse-adapted S. aureus strain
(2018)
Background: The high incidence of methicillin-resistant Staphylococcus aureus
(MRSA) strengthens the need for new effective antibiotics and a protective vaccine. Up till now, mainly human-adapted Staphylococcus aureus strains were used to study S. aureus pathogenicity in mouse models. However, it is known that S. aureus is highly host-specific. Recently, a mouse-adapted S. aureus strain, JSNZ, was identified. This strain could be a promising tool in developing more appropriate infection models. JSNZ produces high amounts of a putative extracellular protease, named JSNZ extracellular protease (Jep). Since the jep gene was only detected in S. aureus isolates from laboratory mice and wild small rodents and shrews, we hypothesize that Jep is important for colonization and infection in mice. The jep deletion mutant previously created by our collaborators from the University of Auckland, New Zealand, intriguingly showed a reduced survival and growth fitness in murine serum and whole blood as compared to the JSNZ wild type (WT) strain.
Objective: To elucidate the role of Jep in the interaction between S. aureus and its
host by comparing the impact of JSNZ WT with a mutant and a complement strain on the murine immune system. In addition, the elucidation of possible genetic factors behind host-adaptation of S. aureus strains isolated from wild rodents and shrews.
Methods: A jep complemented strain was generated by chromosomal replacement.
JSNZ WT, the jep mutant and the complement strain were subjected to functional
assays (whole blood survival assay, coagulation assay). In addition, the genetic
background that might confer host specificity was tested by staph array genotyping.
Results: The mutant strain JSNZDjep was successfully complemented with the jep
gene using a chromosomal integration approach. The WT strain and the
complemented strain produced the Jep protein in comparable amounts.
Unexpectedly, the complemented strains did not behave like the WT strain but rather like the mutant in a series of in vitro assays. Firstly, the growth of both the deletion mutant and the complemented strains was slightly reduced in TSB as compared to the WT strain. Secondly, the jep knockout strain showed a strongly reduced survival in murine whole blood compared to its wild type counterpart, but so did the complemented strain. Finally, the coagulation of murine plasma was less pronounced for the jep deletion mutant and the complemented strain as compared to the JSNZ WT. To exclude a defect in jep gene expression, we compared the amount of Jep expressed during growth in TSB medium for the three strains. The complemented strain produced Jep in a manner similar to the WT strain in a growth-phase dependent manner, suggesting that Jep expression was not affected during the creation of the complemented strain.
The array data showed some differences in the genetic makeup between animal
isolated strains and matched human strains. For example, while all animal isolates of the CC88 lacked the resistance mecA gene it was found in some human isolates of the same strain.
Conclusion: In conclusion, our unidentified mutation created during the generation
of the jep knock-out strain rather than the jep gene itself manipulated the murine
immune response. The responsible gene and the underlying mechanisms remain to
be clarified. Genetic profiling of S. aureus strains allowed us to obtain some valuable information including data about CC49, the most frequently isolated lineage in wild rodents and shrews where compared to the human isolates the murine strains showed clear signs of host adaptation. However, the analysis had several limitations including the small sample size.
Ischemic stroke is the second leading cause of death worldwide and a disease with a variety of risk factors including hypotension, nutrition/obesity, and smoking but also increased age. In an ageing society stroke is a great challenge and leaves the survivors with disabilities. The aim of this dissertation was to investigate the immunologic changes post ischemic stroke, in order to use a better understanding for new therapeutic approaches as well as for improvement of translation of results from bench to bedside. Ischemic stroke leads to a local and peripheral immune activation. On the other side an immune dysfunction/suppression occurs, that leads to a higher risk of stroke-associated infections. In this dissertation, a long-lasting elevation of HMGB1 after stroke and a correlation with blood leukocyte numbers could be shown. HMGB1 seems to be an important mediator of an endogenous inflammation and an interesting target for post-stroke immunomodulation. In a further study we showed that the quality of the immune response of infiltrating T cells has an impact on the neurologic outcome and functional recovery after experimental stroke. Importantly, a mechanism of how infections, mimicked by LPS injections, could worsen the outcome of stroke patients was revealed. In the context of stroke-induced immunosuppression regulatory T cells as an immunosuppressive T cells subset seem to not play a role as their suppressive capacity is reduced after stroke. Interestingly, the CD39 expression on Tregs is similarly increasing with age in humans and mice. This shows the importance of an age equivalent in experimental studies. In search of predictors for the outcome after stroke as well as the risk of infections, we performed single nucleotide polymorphism genotyping in the IL-1RN and TLR4 gene of stroke patients. Functional significant variants in the IL-1RN and TLR4 genes may have an impact on outcome and systemic markers of inflammation post stroke but these findings need to be replicated in studies with much larger cohorts.
Das Pankreaskarzinom gehört zu den wenigen malignen Erkrankungen mit einer Fünf-Jahres-Überlebensrate im nur einstelligen Bereich, die sich seit mehr als dreißig Jahren nicht wesentlich verändert hat. Trotz intensiver Forschung sind die Therapieerfolge bei Patienten mit Pankreaskarzinom noch immer unzureichend. Die in den letzten Jahren in den Fokus gerückten Immuntherapien zeigen erste vielversprechende Ergebnisse, die immunologische Charakterisierung von Virotherapien im Pankreaskarzinom, steht noch am Anfang. Die onkolytische Wirkung des NDV Feldisolates R75/98 wurde bisher nicht untersucht. Daher wurden in dieser Arbeit zunächst das direkte onkolytische Potential sowie die NDV-induzierte Expressionsänderung immunmodulatorischer Moleküle in sechs humanen und vier murinen Tumorzelllinien pankreatischen Ursprungs evaluiert. Mit Ausnahme der murinen Panc02 Zelllinie waren alle Zelllinien zu unterschiedlichem Ausmaß durch NDV infiziert. In humanen Zellen war neben einer Proliferationsinhibition ebenfalls Apoptose zu verzeichnen. Diese Effekte waren in murinen Zelllinien weniger stark ausgeprägt, diese Zelllinien reagierten mit deutlich gesteigerter Expression von MHC I und Rae-1δ sowie verminderter TGF-β Sekretion. Die Ergebnisse der in vitro Untersuchungen stellen eine Verbindung zwischen den für die Tumorentstehung verantwortlichen Mutationen und dem dadurch bedingten Phänotyp mit der Anfälligkeit für eine NDV-Infektion dar. Zur Charakterisierung der Immunantwort nach NDV-Infektion hinsichtlich der Induktion einer sekundären anti-Tumor Immunantwort wurde ein murines, orthotopes Pankreastumormodell genutzt, in welchem zwei verschiedene syngene Zelllinien in das Pankreas implantiert wurden. Die Infektion von Mäusen mit NDV R75/98, denen spontan entstandene DT6606PDA Zellen implantiert wurden, führte bereits zwei Tage nach Infektion zu einer Verkleinerung des Tumors durch direkte Onkolyse und die zeitgleiche Induktion der NK-Zell-Antwort. Außerdem wurde das durch TGF-β vermittelte inhibitorische Milieu durch die NDV-Infektion aufgehoben. Die NK-Zellen wurden durch das Fehlen von MHC I und die Expression viraler Proteine und Rae-1δ auf den DT6606PDA Zellen zur Zell-vermittelten Lyse aktiviert. Im weiteren Verlauf kam es zur Aktivierung des adaptiven Arms des Immunsystems und die Infiltration von CD8+ und CD4+ T-Zellen in das Tumorgewebe und zur Zell-vermittelte Tumorlyse. Die Bildung von NDV-spezifischen Antikörpern ermöglichte zudem die Opsonierung der Tumorzellen durch infiltrierte Makrophagen. Unter Verwendung von UV-inaktiviertem Virus konnte diese Induktion der humoralen Immunantwort ebenfalls beobachtet werden, die Tumorabstoßung blieb allerdings aus. Der adoptive Transfer NDV-aktivierter Splenozyten zeigte, dass die Erhöhung der Immunogenität durch NDV zwar förderlich ist, jedoch keine Voraussetzung für eine erfolgreiche Tumorabstoßung darstellt. So ist in diesem Modell die Aktivierung der Immunsystems durch NDV und damit die Aufhebung der Tumor-assoziierten Immuninhibition der Schlüssel zu einer erfolgreichen Tumorabstoßungsreaktion. Die adaptive, spezifische anti-Tumor Immunantwort verhindert weiterhin das Rezidiv im murinen Modell des Pankreaskarzinoms. Diese Erkenntnisse wurden durch die Verwendung von Panc02 Zellen im Pankreastumormodell bestätigt. So führte die NDV-vermittelte Rekrutierung und Aktivierung von NK-Zellen zwar zu einer starken Reduktion der Tumormasse innerhalb der ersten Woche nach Infektion, jedoch blieb die Induktion der spezifischen adaptiven Immunantwort aus. Zurückzuführen war dies auf die Implantation dieser Zellen, die zu einer zu einer generellen Immunsuppression durch TGF-β führte. Die NK-Zell-vermittelte Tumorzelllyse begünstigte das immunoediting und führte so zur Bildung eines nicht-immunogenen, immunsuppressiv wirkenden Tumors. Dadurch wurde nicht nur die Induktion der adaptiven Immunantwort verhindert, sondern auch eine anhaltende NK-Zell-vermittelte Lyse unterbunden und führte zum Rezidiv im Panc02 Modell. Insgesamt zeigen die Ergebnisse dieser Arbeit, dass NDV R75/98 in der Lage ist, sowohl direkte Onkolyse auszulösen als auch die Immunogenität der Tumorzellen zu erhöhen. Diese wiederum steigert die Zell-vermittelte Tumorzelllyse und fördert ein pro-inflammatorisches Milieu. Die NDV-vermittelte Induktion der adaptiven Immunantwort und damit die Aufhebung der Tumor-assoziierten Immunsuppression stellen jedoch die Grundvoraussetzung der erfolgreichen Ausbildung einer anti-Tumor Immunantwort dar und gewährleisten gleichzeitig die Verhinderung eines Rezidivs. In Anbetracht der unzureichenden Therapieerfolge mit klassischen Chemotherapien und der ersten Erfolge immunmodulatorischer Therapien sollte die NDV-vermittelte Tumorabstoßung weiter aufgeklärt und als mögliche Alternative in klinischen Studien zur Therapie von Bauchspeicheldrüsenkrebs in Betracht gezogen werden.
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.
Cancer is one of the leading causes of death in industrialized nations. Nowadays, cancer therapy mainly consists of surgery, radiation and chemotherapy. Thanks to intensive research alternative treatment strategies like gene therapy and especially immunotherapies are on the rise. Immunotherapies base on the idea of stimulating and supporting the patients immune system to generate an effective anti-tumor immune response. Dendritic Cells are perfect targets for this purpose, since these potent antigen-presenting immune cells influence the balance of the immune system by defining the route of action. Stimulation of these cells by activation of cellular signaling pathways results in maturation, upregulation of surface molecules and secretion of cytokines. A20 has been identified as a regulator of dendritic cell maturation and attenuator of their immune stimulating properties. Hence, the blockade of that natural inhibitor reveals an elegant way to activate cellular pathways of DCs. A siRNA against A20 obtains a functional blockade via RNA interference if it can be delivered into the cytoplasm of the target cells. CpG oligodeoxynucleotides can be used for this intracellular transport. CpGs contain DNA motifs similar to those found in bacteria. Innate immune cells can detect this DNA via the toll-like receptor 9 getting activated and stimulated. CpG oligodeoxynucleotides are already in clinical use as adjuvants in vaccines and in cancer therapy approaches. Linking A20-specific siRNA to CpG enables A20 regulation and cell stimulation selectively in toll-like receptor 9 expressing cells, like dendritic cells. Aim of this study was to investigate if these constructs trigger immune cell activation and if they are able to break immune-suppression in the tumor environment to enhance anti-tumor immunity. A long-term growth factor dependent bone marrow-derived dendritic cell culture has been established in order to analyze the CpG-siRNA A20 effects on murine dendritic cells. The constructs were internalized shortly after administration (1 hour) and led to cell stimulation/activation. The intraperitoneal treatment with the constructs induced local cellular activation and systemic IL-6, TNF-α cytokine production in healthy mice. Subcutaneous growing B16 melanoma tumors were treated peritumorally to analyse whether the observed immune-stimulation has effects on established tumors. The silencing of A20 enhances CpG-induced activation of NF-κB followed by elevated expression of IL-6, TNF-α and IL-12 in this tumor model. These changes led to enhanced anti-tumor immune responses manifested by increased numbers of tumor-specific cytotoxic T cells, high levels of tumor cell apoptosis and delayed tumor growth. New constructs were designed and tested on dendritic cells isolated from healthy donors in order to test whether the obtained results for the murine system are applicable to the human system. CpG-siRNA A20 constructs induced cell activation and cytokine expression (IL-6, TNF-α) significantly more than CpG alone. Even though responds of the donor DCs were variable, there are promising similarities to the results of the mouse experiments. The significant role of A20 in controlling the immune-stimulatory activity of DCs has been confirmed in this study. The novel CpG-siRNA A20 constructs provide a strategy for simultaneous A20 silencing and CpG-mediated cell stimulation directly in vivo. This therapeutic approach induces potent adaptive and innate immune responses against established tumors in mouse melanoma model leading to prolongation of survival. CpG-targeted A20 blockade is a new immune-stimulatory approach, which could be suitable for supplementation or optimization of clinical tumor treatments.
Staphylococcus (S.) aureus kann viele unterschiedliche Infektionstypen verursachen. Infektionen mit S. aureus können sowohl lokal, als auch systemisch auftreten, und dann zu Bakteriämien oder sogar Sepsis führen. S. aureus ist ein prominentes Beispiel für die aktuelle Antibiotika-Krise. Resistenzen gegenüber zahlreichen Antibiotika erfordern neue Präventions- und Therapieansätze gegen S. aureus-Infektionen. Ideal wäre eine Antikörper-induzierende anti-S. aureus-Vakzine. Bisher sind jedoch alle Vakzinekandidaten in der klinischen Prüfung gescheitert. Aktuell wird daher von einigen Experten bezweifelt, dass S. aureus-spezifische Antikörper überhaupt protektiv wirken können. Dagegen werden nun Th17-Zellen als entscheidende Komponente des Immunsystems bei der Abwehr von S. aureus angesehen. Um die Rolle von Antikörpern bei S. aureus-Infektionen zu untersuchen, wurde in dieser Arbeit ein Verfahren entwickelt, um die IgG-Bindung an S. aureus-Proteine zu quantifizieren. Eigens für diesen Zweck wurde eine Protein A-negative Mutante des S. aureus-Stamms USA300 hergestellt. Die Bakterien wurden unter Eisenlimitation kultiviert, da sich herausgestellt hat, dass sich dadurch mehr Informationen über die IgG-Bindung an S. aureus-Proteine erhalten ließen. Es wurden Seren von gesunden Probanden und von verschiedenen Patientenkohorten getestet. Die Daten zeigen, dass Erreger-spezifische Antikörper bei S. aureus-Bakteriämie und Zystischer Fibrose zumindest als Marker für die Protektion vor einem schweren Verlauf angesehen werden können. Die Information über die IgG-Bindung an acht S. aureus-Proteine erlaubte die Stratifizierung von Patienten, die während der Bakteriämie eine Sepsis entwickelten von solchen, die keine Sepsis entwickelten. Hinweise, dass die spezifischen Antikörper sogar protektiv wirken, zeigten Untersuchungen der Seren von Hyper-IgE-Syndrom-Patienten. Diese Patienten leiden häufig unter schweren S. aureus-Infektionen. Neben ihrem angeborenen Th17-Zelldefekt mangelte es ihnen auch an S. aureus-spezifischen IgG-Antikörpern. Es konnte gezeigt werden, dass die Substitution spezifischer IgG-Antikörper bei diesen immunkompromittierten Patienten vor neuen S. aureus-Infektionen schützt. Das heißt, dass diese Patienten trotz ihres Th17-Zelldefekts S. aureus besser abwehren können. Diese Daten verdeutlichen das mögliche Potenzial von IgG bei der Protektion vor S. aureus-Infektionen. Neben den beiden Rollen als Kommensale und als Pathogen, wird über eine dritte Rolle von S. aureus diskutiert: S. aureus als Allergen. Die Empfänglichkeit für eine S. aureus-Besiedlung ist bei Th2-dominierten Erkrankungen erhöht. Jedoch ist unbekannt, ob S. aureus aufgrund von Überlebensvorteilen so häufig bei diesen Erkrankungen vorkommt, oder ob das Bakterium sogar selbst diese Th2-dominierte Ausrichtung der Immunantwort durch Allergene induzieren kann. Deshalb sollte in dieser Arbeit nach S. aureus-Allergenen gesucht werden, die diese Qualität der Immunantwort induzieren können. IgG4 diente dabei als Surrogatmarker für eine Th2-Immunantwort. Die IgG4-Bindung aus Seren gesunder Spender an S. aureus-Proteine wurde untersucht. S. aureus-Serinproteasen (SplA bis SplF) stellten sich dabei als die dominanten IgG4-bindenden Proteine heraus. Deshalb wurde die adaptive Immunantwort auf die Spls genauer untersucht. Die IgG-Antwort auf Spls ist in Richtung IgG4 verschoben und Spl-spezifische T-Zellen sezernierten Zytokine, die typisch für eine Th2-Immunantwort sind. Insgesamt zeigen die Daten, dass bereits bei gesunden Probanden die Immunantwort gegenüber Spls in Richtung einer Typ 2 Inflammation verschoben ist. Spls scheinen in der Lage zu sein, durch die Induktion eines entsprechenden Zytokinprofils die Qualität der Immunantwort auf S. aureus zu modulieren. Bei entsprechend prädisponierten Menschen könnte die Immunantwort durch Spls in Richtung Th2 entgleisen. Dann würde allergenspezifisches IgE synthetisiert und eine Allergie ausgelöst werden. Patienten, deren Lunge mit S. aureus besiedelt/infiziert war, besaßen besonders viel Spl-spezifisches IgE. Eine adäquate Immunreaktion gegen S. aureus ist essentiell für die Abwehr des Mikroorganismus. Die Ergebnisse dieser Arbeit stellen heraus, dass S. aureus-spezifische Antikörper – entgegen der Meinung einiger Experten – einen positiven Beitrag leisten können, indem sie vor schweren Infektionsverläufen schützen. Es werden Vorschläge für die Zusammensetzung einer auf Antikörpern basierenden anti-S. aureus-Vakzine aufgezeigt. Aber die Immunreaktion gegen S. aureus kann auch pathologische Folgen haben. Die Ergebnisse dieser Arbeit stützen die Hypothese, dass S. aureus Allergien verursachen kann. Sie liefern außerdem starke Hinweise darauf, dass Spls dabei als Allergene eine Schlüsselrolle einnehmen. Diese Erkenntnis ist neu und unerwartet. Angesichts der weltweiten Bedeutung von Allergien, besonders von Asthma, muss die mögliche Rolle der Spls bei deren Pathogenese mit hoher Priorität weiter aufgeklärt werden.
Die Sepsis ist trotz zahlreicher Fortschritte in der intensivmedizinischen Versorgung auch heute noch schwer zu beherrschen und mit einer hohen Letalität verbunden. Infolge einer immer schneller einsetzenden Antibiotikatherapie und supportiven Maßnahmen verstirbt nur ein kleiner Teil der Patienten in der Phase der Hyperinflammation. Im weiteren Verlauf kommt es jedoch zur Ausprägung einer Immunsuppression. Ein Großteil der Patienten verstirbt hier aufgrund nicht eradizierter primärer oder zusätzlicher sekundärer Infektionen. In dieser Arbeit wurde ein murines in vivo-Modell zur Untersuchung der Sepsis-bedingten Immunsuppression etabliert und diese umfassend charakterisiert. Überraschend war, dass das adaptive Immunsystem zu Beginn einer Sepsis voll kompetent auf Antigen reagiert. Eine Suppression des adaptiven Immunsystems entwickelte sich dann innerhalb einiger Tage. Neben Immundefekten durch Apoptose und/oder Funktionsverlust der T- und B-Zellen spielte die aktive Suppression durch regulatorische T-Zellen dabei eine große Rolle. Sie könnte Angriffsmöglichkeiten für die Behandlung in der Klinik bieten. In einem Immunisierungsmodell wurde darüber hinaus untersucht, ob die Immunsuppression bei Sepsis vom operativen Trauma abgetrennt werden kann. Die Ergebnisse zeigen, dass es auch infolge einer „einfachen“ Impfung zur transienten Suppression des adaptiven Immunsystems kommt. Die untersuchten Aspekte der „Sepsis-induzierten“ Immunsuppression lassen sich somit vom operativen Trauma und von der systemischen bakteriellen Infektion – d. h. von der Sepsis – trennen.
Non-healing wounds pose a major burden to patients and health care systems alike. These wounds are chronically stuck in the inflammatory phase of the healing process without transitioning to the proliferative phase. They are also characterized by the excessive presence of leukocytes which are assumed to provoke the persistent inflammation observed in pathological wound healing. Recent studies suggested a beneficial role of cold physical plasma in the treatment of chronic wounds. Hence, it was the central question, whether exposure to cold physical plasma would affect the viability and/or function of human leukocytes. Cold plasma displays various properties of which the generation of reactive molecules, such as reactive oxygen and nitrogen species (ROS/RNS), where found to be central in mediating redox changes in leukocytes. Oxidative stress was present especially in lymphocytes that readily underwent apoptosis after exposure to plasma. This was largely a direct consequence of plasma-generated hydrogen peroxide but not superoxide or RNS. Amount of apoptosis was comparable among several lymphocyte subpopulations, with the wound healing-relevant γδ T cells being least affected. Lymphocyte apoptosis was accompanied by mitochondrial membrane depolarization, caspase 3 activation, DNA fragmentation, and phosphatidylserine exposure. These results are in line with previous characterizations of the intrinsic apoptotic pathway in redox biology, and suggest that plasma-induced apoptosis was not mediated by alternative molecular mechanisms. An important immune response mechanism, the proliferation of lymphocytes, was not interrupted in plasma-treated but non-apoptotic cells. In wounds, a central role of leukocytes is to orchestrate the healing response via the release of small communication molecules called cytokines. Non-healing wounds are associated with elevated amounts of pro-inflammatory IL-1β, IL-6, and TNFα, and plasma-treatment of leukocytes strongly decreased their concentrations. At the same time, the expression of anti inflammatory cytokines (IL-10, TGFβ) was markedly increased. The pro inflammatory chemokine IL-8 was the only molecule to be significantly increased in supernatants of plasma-treated cells. IL-8 is the major chemo-attractant for neutrophil granulocytes. Neutrophils are frequently associated with non-healing wounds. These professional phagocytes are the first to migrate to the site of injury where they inactivate invading pathogens by various mechanisms. Importantly, highly relevant effector functions remained mostly unaffected by plasma treatment: the phagocytosis of bacteria, the oxidative burst, and the intracellular killing of microbes. Of note, plasma induced a strong induction of neutrophil extracellular traps (NETs). Decorated with antimicrobial proteins, NETs are web-like chromatin extrusions that entrap pathogens. These results have several implications for wound healing. Plasma-treated neutrophils were still capable of eradicating bacteria, which are frequently associated with non-healing wounds. In addition, plasma-induced NETs could aid in wound healing by providing an antibacterial scaffold to safeguard against further dissemination of microorganisms. Chronic wounds display a state of sustained inflammation and plasma induced apoptosis but not necrosis in lymphocytes. This was an important finding as necrosis, the involuntary cell death, is associated with the release of intracellular content, enhancing inflammation. By contrast, apoptosis dampens it as dead cells are cleared by macrophages inducing anti inflammatory responses. Further, the cytokine signature of plasma-treated leukocytes was largely non inflammatory, which could further decrease inflammation in wounds. Altogether, this work provided first insight with regard to effects and mechanisms of cold physical plasma treatment of wound-relevant leukocytes. Generally, these cells were affected by a plasma mediated modulation of their redox state. Future studies should include the possibility of redox modulation into their experimental approach to further elucidate the role of ROS/RNS in inflammation and possibly to improve existing wound healing therapies.
Bei der Bekämpfung chlamydialer Infektionen spielen CD8+ T-Zellen eine wichtige Rolle. Für diese ist die Aktivierung durch MHCI-präsentierte Peptidantigene auf der Oberfläche Chlamydien-infizierter DCs von entscheidender Bedeutung. Die intrazellulären Mechanismen, die zu einer effektiven MHCI-Präsentation führen sind jedoch weitestgehend unbekannt. In dieser Arbeit wurde die Antigenprozessierung und -präsentation chlamydialer Peptidantigene anhand von in vitro-Infektionsstudien und funktionaler Antigenpräsentations-Assays untersucht. Dafür wurde die immortalisierte murine DC-Zelllinie JAWSII und CD8+ T-Zellen aus der Milz Chlamydien-infizierter C57BL/6-Mäuse verwendet. Es konnte gezeigt werden, dass Chlamydien nach der PDI-abhängigen Aufnahme durch Clathrin- beziehungsweise Caveolin-vermittelte Endozytose eine PV ausbilden, die durch ein Gerüst aus Vimentin stabilisiert wird. Durch die Infektion kommt es zur Reifung der DCs einhergehend mit einer erhöhten Oberflächenexpression von MHCI-Molekülen. Für die Neusynthese dieser ist die TLR-2-abhängige Aktivierung des NF-kB-Signalweges verantwortlich. Für die erhöhte Oberflächenexpression scheint jedoch der p38- und ERK1/2- abhängige Transport vorgefertigter MHCI-Moleküle vom GA zur Plasmamembran der zeitbestimmende Schritt zu sein. Neben dem Oberflächentransport sind p38 und ERK1/2 auch entscheidend für die Aktivierung der cPLA2. Diese produziert nach Hspb-1- vermittelter Translokation an das Vimentin-Gerüst der PV, Arachidonsäure, die sich in die Membran der PV einlagert und somit zur Destabilisierung derselben führt. Dadurch gelangen akkumulierte CPAF-Moleküle ins Zytosol der DCs, wo sie beginnen das Vimentin- Gerüst abzubauen. Dies wiederum führt zur Freisetzung der Chlamydien ins Zytosol. Mit Hilfe verschiedener mikroskopischer Bildgebungsverfahren konnte gezeigt werden, dass die freigesetzten zytosolischen Chlamydien zunächst ubiquitiniert und durch den Adaptorkomplex p62/SQSTM-1 erkannt werden. Dieser führt die Chlamydien anschließend LC-3- positiven Autophagosomen zu, in denen die chlamydialen Antigene durch Cathepsine prozessiert werden. Dabei werden ausschließlich chlamydiale Proteine prozessiert, die im bakteriellen Zytoplasma oder der Membran lokalisiert sind. Die prozessierten Peptidantigene werden im Zytosol weiterprozessiert und gelangen entweder über den klassischen MHCI-Präsentationsweg oder den vakuolaren Kreuzpräsentations-Weg auf die Zelloberfläche. Da Epithelzellen die primären Zielzellen einer Chlamydien-Infektion sind, ist die Erkennung und Eliminierung dieser durch CD8+ T-Zellen essentiell für die anti-chlamydiale Immunantwort. In dieser Arbeit konnte erstmals gezeigt werden, dass Chlamydien-infizierte Epithelzellen in der Lage sind Peptidantigene auf MHCI-Molekülen zu präsentieren und dass die postulierte CPAF-vermittelte Reduzierung der MHCI-Oberflächenexpression nicht stattfindet. Zudem konnte gezeigt werden, dass IFN-gamma-stimulierte Epithelzellen einen DC-Infektionsphänotyp, charakterisiert durch erhöhte cPLA2-Aktivität und Lokalisation der Chlamydien in Autophagosomen, zeigen. Dies deutet daraufhin, dass Epithelzellen, die durch IFN-gamma von aktivierten Effektor-T-Zellen stimuliert wurden, in der Lage sind, chlamydiale Antigene autophagosomal zu prozessieren und zu präsentieren. Die Ergebnisse dieser Arbeit erlauben erstmals ein erweitertes Verständnis der MHCI- vermittelten Antigenpräsentation in Chlamydien-infizierten DCs und liefern entscheidende Hinweise für zukünftige immunologische Therapieansätze und Impfstrategien.