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Applied and Environmental Microbiology, October 2003, p. 5907-5913, Vol. 69, No. 10
0099-2240/03/$08.00+0 DOI: 10.1128/AEM.69.10.5907-5913.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.
Faculdade de Ciências Médicas,1 Instituto de Biologia Prof. Roberto AlcÂntara Gomes, Universidade do Estado do Rio de Janeiro,3 Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil2
Received 2 December 2002/ Accepted 18 July 2003
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Epidemic or invasive clones, as well as the atypical sucrose-fermenting biotype, of diphtheria bacilli seem to possess some selective advantage, such as increased virulence or an enhanced ability to colonize and spread (14). Attachment of bacteria is a critical step in the pathogenesis of many infections, particularly in cases where the pathogen is confined to mucosal surfaces. Investigations carried out with Brazilian diphtheria bacillus isolates demonstrated that non-sucrose-fermenting strains preferentially colonize skin lesions and show higher cell surface hydrophobicity than throat-colonizing sucrose-fermenting strains (12, 13). C. diphtheriae strains adhere to human erythrocytes and solid surfaces at various intensities. The hemagglutinating activity of nonfimbrial adhesion protein combination 67-72p is influenced by the concentrations of sugar residues expressed on bacterial surface (5). Sialic acid terminal moieties are expressed mainly on the surface of the nonhemagglutinating and highly glass-adherent sucrose-fermenting strain 241 (11). C. diphtheriae, which is generally considered to be an extracellular colonizer, also exhibits the ability to survive within cultured epithelial cells (9). The molecular differences observed in bacterial adherence to host cells might correlate with maintenance and dissemination of specific C. diphtheriae clones.
The expression of adherence factors by several species is influenced by the iron supply in the environment. Iron restriction in the growth medium promotes slime production by Staphylococcus aureus (1, 17) and Staphylococcus epidermidis (7), production of mucin-binding adhesins by Pseudomonas aeruginosa (19), and hydrophobicity of and adherence to HEp-2 cells by Vibrio parahaemolyticus (6).
Although studies have reported regulatory roles of iron in the pathogenesis of C. diphtheriae infection, little is known about the actual connection between iron availability and the adhesive properties of diphtheria bacilli. The present study investigated the influence of low iron availability on the expression of proteins and surface sugar residues of two toxigenic strains of C. diphtheriae and evaluated their adherence to human erythrocytes and HEp-2 cells.
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Microorganisms were grown in three different media at 37°C for 24 h without shaking: Trypticase soy broth (TSB) (Difco) (iron content [measured by atomic absorption spectrophotometry] of 0.74 µg ml-1), TSB deprived of iron by addition of the chelating agent 2,2'-dipyridyl (Sigma Chemical Co., St. Louis, Mo.) at a final concentration of 0.5 mM (TSB - Fe) (19) and TSB enriched with 4.0 mM to 1.0 M FeCl3 (TSB + FeCl3) (21). Experiments were also done with microorganisms initially cultured in iron-limited TSB and subcultured in TSB [(TSB - Fe)TSB]. Bacterial cells were harvested by centrifugation at 10,000 x g, washed with 0.01 M Na-phosphate-buffered saline (PBS) (pH 7.2) to deplete the chelated-iron residues, and subjected to further studies. Bacterial growth was monitored by counting CFU on solid media (6).
Determination of adherence to HEp-2 cells.
Bacterial adherence to a cell line derived from a human epidermoid larynx carcinoma (ATCC CCL23 HEp-2; American Type Culture Collection, Manassas, Va.) was assayed as previously described (9). Briefly, HEp-2 cells were grown in Dulbecco's modified Eagle medium (Sigma) supplemented with 5% fetal calf serum (Gibco BRL, Grand Island, N.Y.), 50 µg of gentamicin ml-1, 2.5 µg of amphotericin B ml-1, and 0.5% L-glutamine at 37°C in 5% CO2 atmosphere. Microorganisms were washed twice with Dulbecco's mineral salt solution (PBS-D; Sigma) and resuspended in Dulbecco's modified Eagle medium without antibiotics to a final concentration of 1.0 x 106 bacteria ml-1. Monolayers grown to about 95% confluence in 24-well tissue culture plates were infected with 250 µl of bacterial suspension per well. Infected monolayers were washed six times and lysed with PBS-D plus 0.1% Triton X-100 after incubation in 5% CO2 at 37°C for periods of 30 and 120 min. Bacterial viable counts (CFU) of supernatant and HEp-2 monolayer lysates for each incubation period were determined and expressed as the mean ± standard deviation from three independent experiments performed in triplicate. The adherence index for each incubation period represented the percentage of adherence, calculated as lysate CFU x (lysate CFU + supernatant CFU)-1 x 100.
Hemagglutination and hemagglutination inhibition assays.
Hemagglutination and hemagglutination inhibition assays were performed with a 0.5% suspension of human group B erythrocytes as previously described (5, 12). The nonfimbrial adhesion protein combination 67-72p were obtained from C. diphtheriae strain CDC-E8392 grown in TSB by mechanical blending and precipitation by ammonium sulfate (25 and 45% saturation) (5). Hemagglutination inhibition assays were performed in the presence of dilutions of a solution of these protein adhesins (300 µg/ml) at 37°C for 1 h.
Bacterial autoaggregation assays.
Briefly, microorganisms that remained clumped in TSB medium were considered to be spontaneously autoaggregating bacteria. Aliquots (50 µl) of bacterial suspensions prepared in PBS (pH 6.8) were dropped on a glass slide and observed for aggregation. Nonaggregating bacteria produced turbid suspensions. Spontaneously autoaggregating strains were considered to be highly hydrophobic, and aggregating strains were considered to be moderately hydrophobic (13).
Assays for adherence to glass.
Briefly, microorganisms were inoculated in glass tubes (13 by 100 mm) containing 4 ml of TSB and incubated for 48 h at 37°C without shaking. The tubes were gently shaken for 5 s, and the supernatants containing bacterial cells that were nonadherent to the surfaces of the glass tubes were discarded. TSB (4 ml) was then added, and the tubes were reincubated for 48 h. This procedure was repeated twice. The glass-adherent bacteria created a confluent coat of cells on sides of the tube (12).
SDS-PAGE analysis of crude cells lysates.
Bacterial cells were lysed by treatment with 5 mg of lysozyme (grade III; Sigma) ml-1 in PBS for 2 h at 37°C (16). Protein samples were solubilized in cracking buffer (0.5 mM Tris-HCl [pH 6.8], 4% sodium dodecyl sulfate [SDS], 20% glycerol, 10% ß-mercaptoethanol, and 0.001% bromophenol blue) by heating at 100°C for 15 min. After cell debris and unbroken cells were cleared by centrifugation at 14,000 x g for 5 min, supernatants were collected and used as crude cell lysates. The protein profiles were observed by SDS-10% polyacrylamide gel electrophoresis (SDS-10% PAGE) (Bio-Rad, Richmond, Calif.) with the Laemmli buffer system (10), and the gels were stained with Coomassie brilliant blue R-250 (Bio-Rad).
Western blot analysis of bacterial surface proteins.
Bacterial cell surface proteins were labeled with biotin (Sigma) at 37°C for 1 h by previously described methods (8) and washed with PBS (pH 9.0) before preparation of crude cell lysates as described above. Proteins bands obtained in SDS-PAGE were transferred to a nitrocellulose membrane at 100 V and 400 mA for 90 min with a Mini Trans-Blot cell (Bio-Rad). Protein blots were blocked in PBS containing 0.5% Tween 20 with 5% skim milk for 2 h at room temperature, washed three times with PBS-D (pH 7.3), and incubated with streptavidin-peroxidase conjugate (Sigma) diluted 1:5,000 in PBS-0.5% Tween 20 for 30 min at room temperature. The nitrocellulose membrane was washed three times and then reacted with 0.3% hydrogen peroxide, 1 mg of 3,3'-diaminobenzidine ml-1, and 1 mg of imidazole ml-1 for color development (25).
Lectin binding studies.
Briefly, a bacterial suspension (15 µl) containing 3 x 107 bacteria ml-1 was placed on glass slides, air dried, and fixed in methanol at 22°C for 10 min. The slides were washed in PBS-5% bovine serum albumin (BSA) for 5 min and then incubated with 15 µl of increasing dilutions of fluorescein isothiocyanate-labeled lectins (FITC-lectin) (Sigma) in PBS-5% BSA at 22°C for 30 min. The slides were then washed three times in PBS-5% BSA for 5 min each time, mounted in PBS-glycerol (50%), and observed under a fluorescence microscope (Universal Photomicroscope; Zeiss, Oberkochen, Germany). FITC-lectin binding to bacterial cells was inhibited by preincubation with the specific sugar hapten (0.1 M) (11).
Lectin radioiodination and binding studies.
The lectins from Sambucus nigra (SNA) and Canavalia ensiformis (ConA) were conjugated with 125I-labeled acylating agent in the presence of 0.1 M specific inhibitory sugars (2). Specific activities ranged from 1 x 104 to 3 x 104 cpm of lectin µg-1. For the lectin binding studies, 106 bacterial cells were incubated with a range of concentrations of iodinated lectin in 150 µl of PBS-0.5% BSA. The amount of iodinated lectin bound to the cells was determined with a gamma counter (Beckman Instruments, Inc., Palo Alto, Calif.). The specificity of binding was ascertained by performing parallel binding determinations in the presence of a 0.1 M concentration of the specific sugar inhibitor for each concentration of lectin used (11).
Transmission electron microscopy (TEM).
Bacterial cells (strain 241) were fixed with 0.2% glutaraldehyde at 4°C for 15 min, placed on Formvar-coated grids (200 mesh; Sigma), negatively stained with 1% potassium phosphotungstate, and viewed in an EM 906 Zeiss transmission electron microscope (5).
Statistical analysis.
Results were statistically analyzed with Student's t test.
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TABLE 1. Number of viable bacterial cells in supernatant and HEp-2 cell monolayer lysates and adherence index for C. diphtheriae strains grown under standard and iron-limited conditions
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Adherence to glass and hydrophobic properties.
The results in Table 2 demonstrate that strain 241 grown in iron-limited medium (TSB - Fe) did not exhibit binding to glass surfaces. Strain 241 cultured in TSB - Fe became adherent to glass after its subsequent growth in standard TSB. Conversely, iron limitation led to spontaneous autoaggregating of both strains 241 and CDC-E8392.
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TABLE 2. Adherence to glass and autoaggregating activity of C. diphtheriae strains grown under different iron conditionsa
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FIG. 1. Protein profiles of strains CDC-E8392 (A) and 241 (B) of C. diphtheriae grown under standard and iron-limited conditions. Total protein was analyzed by SDS-10% PAGE. Lane 1, molecular mass markers; lanes 2 and 4, strains CDC-E8392 and 241, respectively, from standard cultures; lanes 3 and 5, strains CDC-E8392 and 241, respectively, from iron-limited cultures. Arrows indicate proteins bands expressed at high levels, and dots indicate proteins bands that were absent or expressed at low levels in iron-limited cultures.
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TABLE 3. Activities of lectins of various specificities for C. diphtheriae strains grown under standard and iron-limited conditionsa
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FIG. 2. (A) Binding of iodinated lectins SNA (, ) and ConA ( , ) to C. diphtheriae strain 241 grown under standard (, ) and iron-limited ( , ) conditions. (B) For each lectin, the binding data for high-affinity receptors (filled symbols from panel A have been plotted by the method of Steck and Wallach) (23) according to the equation C/[lectin] bound = 1/Kn x 1/[lectin] free + 1/n, where C is the concentration of bacteria, n is the number of lectin molecules bound per cell, K is the lectin association constant, and [lectin] is the concentration of lectin in molar. All points represent means from triplicate experiments; the standard deviations is less than 10%.
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FIG. 3. Electron micrographs showing structural differences on the surface of the sucrose-fermenting C. diphtheriae strain 241 grown under standard (A) and iron-limited (B) conditions. Magnifications, x40,000 and x70,500, respectively.
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Analysis of whole-cell protein profiles showed that iron limitation is able to both inhibit and stimulate protein expression, as previously observed with S. epidermidis (26) and S. aureus (17, 24), respectively. The roles of most iron-regulated proteins, other than toxin, in the pathogenicity of C. diphtheriae remain unknown. Previous transmission electron microscopy studies with immunolabeled colloidal gold-protein A revealed a diffuse distribution of 67-72p on the surfaces of both the hemagglutinating CDC-E8392 and nonhemagglutinating 241 C. diphtheriae strains grown in iron-containing medium (5). Here, the results of inhibition assays suggest that the 67-72p protein combination also act as hemagglutinins of C. diphtheriae, including strain 241. Western blot analysis demonstrated the binding of 67-72p to membranes of HEp-2 cells, as previously observed with erythrocytes by immunoblotting (5).
Prior investigations demonstrated that differences in degrees of hemagglutination and adherence to glass were related to differences in the expression of surface carbohydrates of C. diphtheriae. For strains 241 and CDC-E8392, lectin receptors containing terminal D-GlcNAc, D-GalNAc, D-Gal, D-Man, and sialic acid were identified on surfaces of cells grown in iron-containing medium. Sialic acid residues were expressed mainly on the surface of the nonhemagglutinating and highly glass-adherent strain 241. It is known that sugar residues, particularly sialic acid residues, contribute to the expression of hydrophilic characteristics and adherence to glass by C. diphtheriae (11). Here we have demonstrated that iron has a regulatory role in the expression of surface carbohydrate moieties of C. diphtheriae strains. We have observed an absolute reduction in the sialic acid residues and a significant increase in the amounts of D-GlcNAc, D-GalNAc, D-Gal, and D-Man residues in both strains. Sialic acid terminal constituents of cell moieties seemed to raise difficulties in C. diphtheriae adherence to HEp-2 cells, as previously observed with erythrocytes (11).
Hydrophobic interaction is expected to provide the driving force for host-parasite interaction through the displacement of water and formation of adhesive bonds (6). In the present study, for strain CDC-E8392, iron limitation enhanced bacterial hydrophobicity (autoaggregation) but did not influence the adhesion to human cells. For strain 241, low-iron conditions enhanced bacterial autoaggregation and adherence to erythrocytes and HEp-2 cells but inhibited adherence to glass surfaces. In the same way, previous studies demonstrated that the hydrophobicity and HEp-2 cell adherence of the gram-negative species V. parahaemolyticus in iron-limited culture were significantly increased. Those authors suggested that the enhancement of cell adherence of V. parahaemolyticus was probably due to the formation of lateral flagella, a cytotoxic factor, or other, unknown factors (6). However, for C. diphtheriae, iron limitation intensified autoaggregation and adherence to erythrocytes and HEp-2 cells, possibly by reduction of electrostatic repulsion and/or by increased exposure of 67-72p due to the removal of the sialic acid. Similar observations during bacterial treatment with neuraminidase were previously made (5, 11, 13).
Iron limitation inhibited slime production by strain 241, as suggested by TEM and corroborated by glass and lectin binding assays. Among the structures involved in virulence, bacteria have developed the production of slime, a higher-molecular-mass polymer of carbohydrate that encourages biofilm formation. In the gram-positive species S. epidermidis, iron limitation promotes slime production (7). S. aureus slime-producing strains preferentially accumulate on surfaces and are responsible for chronic colonization, whereas non-slime-producing strains are responsible for acute infection (24). C. diphtheriae slime-producing strains preferentially accumulate on glass surfaces and are responsible for acute respiratory infection, whereas non-slime-producing strains show higher cell surface hydrophobicity and are responsible for colonization of skin lesions (12, 13).
Similar to the case for other human pathogens, under iron-restrictive circumstances C. diphtheriae develops alternative metabolic strategies to overcome the environmental conditions. Low iron availability modulates the adhesive properties and expression of surface carbohydrate moieties of strains and consequently may influence the course of C. diphtheriae infection.
We are grateful to Gabriel Oliver from LAQAM, Instituto de Química, Universidade do Estado do Rio de Janeiro, for technical assistance with iron measurement by atomic absorption spectrophotometry.
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