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Infection and Immunity, July 1999, p. 3207-3214, Vol. 67, No. 7
Departments of
Medicine,1
Anatomy,2
Biochemistry3 and Microbiology
and Immunology5 and Cardiovascular
Research Institute,4 University of California,
San Francisco, San Francisco, California 94143
Received 16 March 1999/Returned for modification 5 April
1999/Accepted 15 April 1999
The interaction of Pseudomonas aeruginosa type IV pili
and the glycosphingolipid asialo-GM1 (aGM1) can mediate bacterial
adherence to epithelial cells, but the steps subsequent to this
adherence have not been elucidated. To investigate the result of the
interaction of pili and aGM1, we used polarized epithelial monolayers
of Madin-Darby canine kidney (MDCK) cells in culture, which contained
little detectable aGM1 on their apical surface but were able to
incorporate exogenous aGM1. Compared to an untreated monolayer,
P. aeruginosa PA103 displayed an eightfold increase in
association with and fivefold more cytotoxicity toward MDCK cells
pretreated with aGM1. Cytotoxicity of either carrier-treated or
aGM1-treated monolayers required the type III secreted protein ExoU.
Asialo-GM1 pretreatment of MDCK monolayers likewise augmented bacterial
internalization of an isogenic invasive strain approximately fourfold.
These increases were not seen in monolayers treated with GM1, the
sialyated form of the glycolipid, and were inhibited by treatment with
an antibody to aGM1. Also, the aGM1-mediated adhesion, cytotoxicity,
and internalization required intact type IV pili since nonpiliated
PA103 mutants were unaffected by aGM1 pretreatment of MDCK cells. These
results demonstrate that epithelial cell injury and bacterial
internalization can proceed from the same adhesin-receptor interaction,
and they indicate that P. aeruginosa exoproducts solely
determine the steps subsequent to adhesion.
Adherence to host cells is a crucial
step in the initiation and establishment of infections caused by
bacterial pathogens (14). Pseudomonas aeruginosa,
an opportunistic pathogen of humans and the major cause of death in
patients with cystic fibrosis (CF), utilizes type IV pili as an adhesin
for binding to host cells. Early in the course of infection, P. aeruginosa encounters epithelial tissues where cells are organized
in polarized monolayers with distinct apical and basolateral surfaces
that differ in their protein and lipid compositions by nature of
differential trafficking of membrane components (36). Pili
have been demonstrated to mediate adherence to polarized and
nonpolarized epithelial cell types in culture, including human buccal
cells (11, 51), lung pneumocytes (7, 15),
exfoliating trachael cells (52), immortalized human airway
cells (16), and HeLa and Madin-Darby canine kidney (MDCK)
cells (6). As a further indication of the role for pili in
infection, nonpiliated mutants have been shown to have decreased virulence relative to their parental strains in animal models of
pulmonary (16, 46), intraperitoneal (15), and
burned skin (42) infections. Also, defects in pilus
production have been shown to block entry of adherent P. aeruginosa into epithelial and endothelial cell lines (7,
39). Thus, type IV pili are considered to be factors significant
in the early stages of P. aeruginosa chronic and acute
infections (reviewed in reference 24).
P. aeruginosa pili are polar, flexible organelles that are
composed of a single protein subunit, PilA. In vitro studies have shown
that P. aeruginosa pili bind to glycolipids contained within epithelial cell membranes (3, 33) and show a specificity toward those with the Gal With this in mind, we sought to determine whether the adherence of
P. aeruginosa to epithelial cells through the interaction of
pili and aGM1 could contribute to the disease process by causing cytotoxicity and/or bacterial internalization. MDCK cells, which differentiate into a well-polarized epithelial monolayer in culture, are susceptible to P. aeruginosa-induced cell damage when
the bacteria are added to the apical surface (2). The
bacteria appear to associate with a subset of apically exposed cells
and then preferentially accumulate on the basolateral surface
(2), which appears to be more susceptible to injury
(19). The observed cytotoxicity correlated to virulence in a
respiratory model of acute pneumonia for a variety of strains (2,
43) and for transposon-generated isogenic mutants
(25). We have found that glycosphingolipid added to these
cells will incorporate into their apical surface; using this system, we
demonstrate that adherence of P. aeruginosa to MDCK cells
mediated by the specific interaction between type IV pili and aGM1 can
contribute to both the killing of epithelial cells by an ExoU-dependent
mechanism as well as to internalization of invasion-proficient P. aeruginosa into epithelial cells.
Bacterial growth conditions.
P. aeruginosa PA103 was
propagated on Vogel-Bonner medium (VBM) agar (48) containing
100 µg of gentamicin or tetracycline ml
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Pili Binding to Asialo-GM1 on Epithelial Cells Can
Mediate Cytotoxicity or Bacterial Internalization by
Pseudomonas aeruginosa


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ABSTRACT
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
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INTRODUCTION
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
1-4GlcNAc disaccharide available such as
asialo-GM1(aGM1) and aGM2 (23, 40, 45). This
disaccharide moiety is specifically recognized by the
C-terminal domain of the PilA subunit (29, 34), the amino
acid sequence of which can differ between P. aeruginosa
strains (30). Several studies have indicated a direct
correlation between the presence of aGM1 on host cells and P. aeruginosa adherence, thus demonstrating the role of this
glycosphingolipid as a bacterial receptor. Specifically, increased
bacterial binding to scarified corneal epithelium was shown to be
coincident with the presence of greater quantities of aGM1 on these
cells, and this adherence was attenuated by addition of an anti-aGM1
monoclonal antibody (27). It has also been determined that
pilus-dependent P. aeruginosa association with immortalized nasal polyp epithelial monolayers was able to be competed specifically with aGM1 and that this glycolipid was found to be more prevalent on
the surface of primary CF cells than on wild-type airway cells (41). Imundo et al. (28) further demonstrated
that the aGM1-specific binding of P. aeruginosa was greater
to a CF bronchial cell line than to an isogenic cell line expressing
the wild-type CF transmembrane receptor. Finally, P. aeruginosa binding to regenerating respiratory epithelial cells
isolated from either CF or non-CF patients was inhibited by treatment
with anti-aGM1 antisera (9, 10). These previous results have
led some investigators to propose that an increase in aGM1 on the
epithelial surfaces of CF patients may contribute to chronic bacterial
infection (28, 41). Also implied is a role for aGM1 in
P. aeruginosa infection of epithelial surfaces that have
been injured and are regenerating due to increased exposure of the glycosphingolipid.
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MATERIALS AND METHODS
Top
Abstract
Introduction
Materials and Methods
Results
Discussion
References
1 when
appropriate. Escherichia coli XL1-Blue (for cloning) and S17-1 (for conjugation) were grown in LB broth or on LB agar containing ampicillin (50 µg ml
1), gentamicin (15 µg
ml
1), or tetracycline (20 µg ml
1) when
necessary. Strains used and constructed are listed in Table 1.
TABLE 1.
Strains, phage, and plasmids used in this study
Allelic replacement of the PA103 pilA gene.
The
plasmids used are listed in Table 1. For allelic replacement of the
pilA gene of PA103, a 1.24-kb HindIII
fragment of the vector pP103 containing the PA103 pilA gene
(30) was blunted with T4 polymerase and cloned into the
SmaI site of pEX100T, a suicide vector containing the
Bacillus subtilis sacB gene (44). A 458-bp
StuI/Bsu36I fragment comprising the majority of
the pilA open reading frame was then replaced with the
2.4-kb xylE/aacC1 cassette of pX1918GT (44). The
resulting plasmid (pLW01) was transformed into E. coli S17-1
for conjugal transfer to PA103. Matings were performed on LB agar
overnight at 37°C, and exoconjugants were selected on VBM agar plus
100 µg of gentamicin ml
1 and 5% sucrose (to eliminate
single recombinants by nature of the sacB gene contained on
pEX100T). Allelic replacement of the pilA gene (to generate
PA103
pilA) was confirmed by assay of the Gmr
strains for carbenicillin sensitivity, loss of twitching motility on
VBM agar, resistance to the bacteriophage PO4, and absence of PilA by
anti-PilA Western blotting and for cassette insertion by Southern
blotting (data not shown). pilA is the terminal
pilin-related gene in its operon, so the insertion of the
xylE/aacC1 cassette is not expected to affect expression of
downstream genes involved in pilin biogenesis or function.
1 and 5%
sucrose and then screened as described. The resulting strain was
designated PA103
pilApscJ::Tn5.
Mammalian cell culture and glycosphingolipid addition. Approximately 5 × 106 MDCK type II cells cultured in minimal essential medium Eagle (MEM) plus Earle's balanced salt solution (Sigma Chemical Co.) and 5% fetal calf serum (GIBCO) were seeded onto 12-mm-diameter, 0.4-µm-pore-size polycarbonate Transwell filters (Corning Costar Corporation). Cells were grown for 3 days at 37°C in 5% CO2 to allow for the formation of highly polarized monolayers. For their use in adherence, internalization, or cytotoxicity assays, the monolayers were placed in MEM supplemented with 20 mM HEPES buffer pH 7.4 (MEM-lite) and maintained in room air.
Monosialoganglioside (GM1) or gangliotetraosyl ceramide (aGM1) (Matreya Inc.) was suspended at 10 mg ml
1 in dimethyl sulfoxide
(DMSO); 5 µl of this stock solution, the appropriate dilution in
DMSO, or DMSO only was added to 195 µl of fresh MEM-lite on the
apical surface of a 3-day-old MDCK monolayer, followed by incubation at
37°C for 1 h with gentle rocking. After this treatment and
before addition of bacteria, the monolayers were washed twice with
MEM-lite.
Immunofluorescence microscopy.
MDCK cells were cultured as
indicated, and immunofluorescence was performed as previously described
(47), with the following modifications. A 1:1,000 dilution
of rabbit polyclonal anti-GM1 or anti-aGM1 antiserum (Wako Bioproducts)
diluted in 200 µl of phosphate-buffered saline (PBS) containing 0.7%
fish skin gelatin (PBS-FSG) was added to the apical surface of MDCK
monolayers for 60 min at 37°C. The monolayers were then washed three
times with PBS, fixed with 4% paraformaldehyde in PBS for 1 h at
37°C, quenched with 75 mM NH4Cl and 20 mM glycine in PBS
for 15 min at room temperature, washed with PBS, then permeabilized for
30 min at room temperature with PBS-FSG containing 0.005% saponin and
100 µg of RNase ml
1. The filters were cut from their
plastic supports, and monolayers were treated with fluorescein
isothiocyanate (FITC)-conjugated goat anti-rabbit antibody (Jackson
Immunoresearch Laboratories Inc.) diluted 1:100 in PBS-FSG-saponin plus
2 µg of propidium iodide (a fluorescent nucleic acid stain)
ml
1 for 1 h at 37°C, washed in PBS, fixed with 4%
paraformaldehyde in 100 mM sodium cacodylate for 15 min at room
temperature, rinsed again in PBS, and then mounted under coverslips for
visualization by immunofluorescence microscopy using a fluorescein or
rhodamine filter set.
Antibody treatment for blocking experiments. Rabbit anti-aGM1 polyclonal antisera (Wako Bioproducts) was added to glycosphingolipid- or DMSO-treated monolayers prior to the addition of bacteria. To do so, the monolayers were washed with PBS and treated by apical addition of a 1:5 or 1:10 dilution of antibody in 100 µl of PBS for 2 h at 37°C. The cells were then washed twice with MEM-lite and placed in fresh medium prior to the addition of bacteria for association or cytotoxicity assays.
Association, internalization, and cytotoxicity assays. P. aeruginosa strains were grown overnight at 37°C in LB broth without shaking, pelleted at room temperature, resuspended in MEM-lite, and then diluted to an A600 of 0.1; 150 µl of this suspension (containing approximately 1.5 × 107 CFU as measured by dilution plating) was added to the apical surface of MDCK monolayers in MEM-lite (multiplicity of infection [MOI] of 10).
Bacterial association with 3-day-old MDCK monolayers was measured after 2 h of cocultivation at 37°C by washing the monolayers three times with MEM-lite, cutting each filter from its support, rinsing the filter again in MEM-lite, and then placing the filter in 1 ml of MEM-lite containing 0.25% Triton X-100 to lyse the MDCK cells. After 15 min at 25°C, this mixture was vortexed with glass beads for 15 s, the lysis procedure was repeated, and the lysate was serially diluted onto LB agar for bacterial quantitation. Internalization was assessed by an aminoglycoside exclusion assay after incubation of the bacteria with 3-day-old MDCK monolayers for 3 h at 37°C (MOI of 10). At this time, the cells were washed three times with MEM-lite and incubated with amikacin (400 mg ml
1) in
MEM-lite. After 2 h at 37°C, the MDCK cells were washed again in
MEM-lite and lysed by the procedure described for the association assay, and internalized bacteria were quantitated by dilution plating.
Each association or internalization assay was performed in triplicate,
and the number of bacteria recovered in each sample was standardized to
the number of bacteria in the inoculum (quantitated by dilution plating
onto LB agar).
For cytotoxicity assays, approximately 1.5 × 107
bacteria were added to the apical medium of a treated MDCK monolayer
(MOI of 10). After incubation for 3 to 3.5 h at 37°C in room
air, cytotoxicity was quantitated by the release of lactate
dehydrogenase (LDH) into the medium. Aliquots of the apical and basal
medium were removed and assayed for LDH activity by measuring pyruvate
reduction as instructed by the manufacturer (Sigma). LDH activity
represents the total apical and basal pyruvate reduced per milliliter
after subtraction of LDH released by exposure of cells to medium only (MEM-lite). Each assay was performed on three individual monolayers, and the error bars represent standard deviation from the mean.
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RESULTS |
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Exogenous glycolipids can be incorporated into the apical membrane of MDCK cells. P. aeruginosa can adhere to and subsequently cause damage to, or become internalized in, filter-grown MDCK cells (2, 19, 26). To determine the contribution of aGM1 receptor to these processes, the apical surface of uninfected cells grown on permeable supports was stained with an anti-aGM1 antibody and visualized by immunofluorescence microscopy. The majority of the cells in a monolayer showed no significant staining, but isolated clumps of cells were heavily stained with anti-aGM1 (Fig. 1A). These regions consisted of approximately 5 to 20 adjacent cells and comprised less than 5% of the total cells in an MDCK monolayer. Examination of the anti-aGM1-stained cells at a higher magnification (×1,000) revealed a punctate distribution of the aGM1 signal on their apical surface. These stained cells did not appear different from other MDCK cells in the monolayer when stained with the nucleic acid dye propidium iodide (Fig. 1B). Although the opaque nature of the permeable filters prevented analysis by phase microscopy, the propidium iodide staining pattern was indicative of a uniform and intact monolayer. Furthermore, the cells that stained with anti-aGM1 were viable since they excluded a membrane-impermeable fluorescent dye (ethidium homodimer-1; Molecular Probes) when it was added to cells prior to permeabilization (data not shown). A similar staining pattern to that obtained with the anti-aGM1 antibody was seen when MDCK monolayers were treated with the fluorescein-labeled lectin peanut agglutinin, which recognizes the carbohydrate available in aGM1 (data not shown).
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1) was added to the apical medium of MDCK cells, and
its incorporation into the apical surface of the monolayer was
monitored by immunofluorescence microscopy. As displayed in Fig. 1,
anti-GM1 or anti-aGM1 staining on the apical surface of an MDCK
monolayer treated with glycosphingolipid was much greater than that of
a DMSO-treated monolayer (compare Fig. 1E and G to Fig. 1A and C), a
clear indication that the added glycolipid was associated with the
apical membrane of the epithelial cells. At a magnification of ×400,
the antiglycosphingolipid staining with either antibody was punctate
and dispersed inequally throughout the apical surface of the monolayer.
At higher magnification (×1,000), the staining of exogenous aGM1 still
appeared punctate and not concentrated on particular cells (data not
shown). This staining was obviously distinct from that of the clusters
of aGM1-stained cells that were evident in the monolayer before
addition of glycosphingolipid. Again, propidium iodide staining was
indicative of an undamaged MDCK monolayer (Fig. 1D and H). Also, the
addition of aGM1 or GM1 did not increase the permeability of the
monolayer to the small molecule FITC-inulin (data not shown), nor did
it cause measurable cell damage as assayed by LDH release into the
medium (see Fig. 3).
These experiments demonstrate that the amount of glycosphingolipid
present on the apical surface of MDCK monolayer can be increased by
experimental manipulation. Although the mechanism by which the
exogenous glycolipid becomes incorporated into the MDCK apical surface
is not clear, this system enables measurement of the biological
consequences of P. aeruginosa binding to the receptor aGM1
in the context of host epithelial cells.
Treatment of MDCK monolayers with aGM1 can increase the adherence
of P. aeruginosa in a pilus-dependent manner.
Isolated
P. aeruginosa pili have been demonstrated to bind to aGM1 in
vitro, and adherence of whole bacteria has been correlated to the
presence of aGM1 on several mammalian cell types (10, 27, 28,
41). To determine if aGM1 in the context of an MDCK monolayer
could increase P. aeruginosa binding, an MDCK monolayer treated with DMSO carrier or with 250 µg of GM1 or aGM1
ml
1 was apically infected with the P. aeruginosa PA103, and the number of adherent bacteria was
quantitated. After 2 h of incubation, approximately 1% of the
added inoculum adhered to the apical surface of MDCK cells treated with
DMSO carrier, while eightfold more, or 8% of the inoculum, bound to
monolayers pretreated with aGM1 (see Fig. 3A). This effect was specific
to aGM1, since association with a monolayer receiving GM1 was
approximately equal to that of a monolayer treated with the DMSO
carrier (see Fig. 3A). The ganglioside GM1 is identical to aGM1 except
that it contains a sialic acid residue protecting the Gal
1-4GlcNAc
carbohydrate which is recognized by P. aeruginosa pili. To
determine if the bacterial interaction with aGM1 was dependent on the
presence of pili, we produced a PA103 mutant devoid of pili
(PA103
pilA) by insertional inactivation of the
pilA gene and assayed its adherence. Association of this
nonpiliated mutant to DMSO-treated MDCK monolayers was reduced 10-fold
relative to the wild-type strain, as only 0.09% of the inoculum bound
(Fig. 2A). Also, the number of adherent nonpiliated bacteria was not
significantly changed by prior treatment of the MDCK cells with aGM1 or
GM1 (Fig. 2A). Thus, the increased bacterial association to MDCK cells treated with exogenous aGM1 required P. aeruginosa pili.
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The interaction of pili and aGM1 can mediate cytotoxicity through
an ExoU-dependent process.
To determine if P. aeruginosa binding to host cells through the interaction of pili
and aGM1 could contribute to bacterium-mediated cytotoxicity, we added
PA103 or PA103
pilA to MDCK monolayers pretreated with
aGM1, GM1, or DMSO carrier and quantitated cell damage by LDH release.
Consistent with previously published data (31), the addition
of PA103 to control MDCK cells caused significant damage compared to
monolayers that were not exposed to bacteria (7.9 versus 0.7 U of LDH
ml
1 released [Fig. 3A]).
A further fivefold increase in LDH release, to 46 U ml
1,
was observed upon addition of PA103 to monolayers pretreated with 250 µg of aGM1 ml
1 (Fig. 3A). In contrast, incubation of
PA103 with MDCK cells pretreated with 250 µg of GM1 ml
1
caused no more cytotoxicity than with DMSO treatment, as 6.9 U of LDH
ml
1 was released. The increase in cytotoxicity due to
aGM1 addition was concentration dependent, and the amount of LDH
released from MDCK cells correlated to the quantity of aGM1 (0 to 250 µg ml
1) that was present in the pretreatment (Fig. 3A,
inset).
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pilA caused no significant damage to MDCK monolayers (0.5 U of LDH ml
1 released),
and no increase in cytotoxicity was observed when the monolayers were
pretreated with aGM1 or GM1 (Fig. 3A). This result also indicates that
aGM1 treatment or incorporation itself caused no damage to MDCK cells.
As an additional measure of the specificity of the PA103 pili-aGM1
interaction, anti-aGM1 antibody was used in an attempt to block MDCK
cell damage. Antibody treatment of MDCK monolayers that had received
aGM1 caused a threefold reduction in the ability of PA103 to cause
cytotoxicity (Fig. 3B). However, without glycosphingolipid addition,
the cytotoxicity of PA103 was unaltered by an identical anti-aGM1
treatment. While this finding is indicative of the specificity for
aGM1, it also suggests that this receptor may not significantly contribute to cell damage in untreated MDCK monolayers. Similar results
were obtained in the bacterial adherence assay, where there was also
minimal effect of anti-aGM1 treatment on DMSO-treated MDCK monolayers
(Fig. 2B).
Damage to MDCK cells was previously shown to require the putative
cytotoxin ExoU, which is exported by type III secretion (17,
25). This was also the case with aGM1-treated MDCK cells. A PA103
mutant unable to produce ExoU due to a transposon insertion into the
structural gene
(PA103exoU::Tn5; mutant 8 in
reference 25) had minimal cytotoxicity toward MDCK
cells treated with DMSO carrier. Cytotoxicity was not increased when
the MDCK monolayer was pretreated with aGM1 or GM1 (Fig. 3C). As in the
previous experiment, the cytotoxicity of the wild-type strain was
increased approximately fivefold in aGM1-treated MDCK cells, but the
total amount of LDH released in this experiment was reduced due to the shorter incubation time of the bacteria with the MDCK cells (3 h versus
3.5 h). Since ExoU is required for MDCK cell damage with or
without aGM1 supplementation, the same mechanism of cytotoxicity appears to be utilized in each case.
The interaction of pili and aGM1 can mediate the internalization of PA103 into epithelial cells. P. aeruginosa has been demonstrated to be internalized into epithelial cells (7, 20, 21, 37-39), though this process is not a prerequisite for cytotoxicity (13). We sought to determine if the adherence of P. aeruginosa to MDCK cells via pili binding to aGM1 could also act as an initial step in the internalization process. Since strain PA103 is not internalized into epithelial cells as efficiently as many other P. aeruginosa strains, an invasion-competent isogenic mutant defective in type III secretion, PA103pscJ::Tn5 (mutant N in reference 31), was used to quantify internalization into MDCK cells by an aminoglycoside exclusion assay. The inactivation of the type III secretion system in this mutant has been shown to augment PA103 internalization presumably by preventing translocation of an anti-internalization factor (22, 26). While 1.4% of the added PA103pscJ::Tn5 was detected inside MDCK cells treated with DMSO carrier, this was increased approximately fourfold to 5.9% by pretreatment of the monolayer with aGM1 (Fig. 4). Pretreatment of a monolayer with GM1 did not have a substantial effect on internalization, and 2.1% of the inoculum was taken into the epithelial cells (Fig. 4).
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pilApscJ::Tn5, was internalized into DMSO-treated MDCK cells approximately sixfold less
effectively than PA103pscJ::Tn5 (0.23%
of the inoculum), and treatment of MDCK monolayers with GM1 or aGM1 did
not alter the internalization of this nonpiliated strain (Fig. 4).
Thus, as with cytotoxicity, internalization of P. aeruginosa
into epithelial cells was mediated by the specific interaction of type
IV pili and aGM1.
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DISCUSSION |
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The type IV pili of P. aeruginosa are thought to assist
in establishing an interaction between the pathogen and epithelial cells during the early stages of infection. This work indicates that
the association of P. aeruginosa pili and the aGM1 present on epithelial cells can contribute to the pathogenic process by leading
to host cell damage or to bacterial internalization. To demonstrate
this, we used filter-grown MDCK cell monolayers which incorporate
exogenous aGM1 or GM1 into their apical surfaces, as indicated by an
increase in immunostaining with an antiglycosphingolipid antibody in
comparison to a monolayer not receiving glycosphingolipid (Fig. 1).
Monolayers pretreated with aGM1 were susceptible to eightfold more
P. aeruginosa adherence, fivefold more cytotoxicity, and
fourfold greater bacterial internalization than monolayers pretreated
with DMSO carrier (Fig. 2A, 3A, and 4). Several criteria indicate that
these effects were due to the specific interaction between type IV pili
and aGM1. First, pretreatment of MDCK monolayers with the ganglioside
GM1, which differs from aGM1 in that it has a sialylic acid protecting
the Gal
1-4GlcNAc disaccharide to which P. aeruginosa pili
bind (42, 48), did not increase bacterial adherence,
cytotoxicity, or internalization (Fig. 2A, 3A, and 4). Second, the
elimination of pili by disruption of the PA103 pilA
structural gene abolished the increases in adherence, cytotoxicity, and
internalization due to aGM1 pretreatment (Fig. 2A, 3A, and 4). Finally,
the effect of aGM1 pretreatment on adherence and cytotoxicity was
attenuated by a polyclonal antibody directed against anti-aGM1 (Fig. 2B
and 3B). Thus, we have demonstrated that P. aeruginosa
adherence to aGM1 on epithelial cells via their type IV pili can act as
an initial step leading to cell damage or to internalization.
This observation that cytotoxicity or internalization can occur subsequent to the same adherence step (pili binding to aGM1) is significant since it indicates that the attributes of the bacterial strain determine the pathway taken. It has been postulated that these events utilize entirely separate pathways, based on the demonstration that cytotoxicity does not require internalization (13, 18). Our data suggest, however, that each of these can proceed from an identical adhesin-receptor interaction and the outcome depends on factors produced by the bacterium. Given that P. aeruginosa isolates differ in the types and amounts of exoproteins produced and that some of these factors act as cytotoxins (17, 25) whereas others influence internalization (13, 26), it is reasonable that the properties of a particular strain, and not the type of host cell interaction, define the progression of an infection.
Though we demonstrate the relevance of P. aeruginosa binding to aGM1, the participation of other host cell receptors in cytotoxicity or internalization is not excluded. In fact, our finding that antibodies to aGM1 do not abrogate adherence or cytotoxicity in DMSO-treated MDCK cells (Fig. 2B and 3B) suggests that receptors other than aGM1 are largely responsible for P. aeruginosa-mediated cytotoxicity or internalization in this particular cell type. These may be other glycolipids or glycoproteins since mutant MDCK cell monolayers that had altered apical surface glycosylation (concanavalin A-resistant or ricin-resistant cells) were previously shown to be less susceptible to PA103-induced cell damage than wild-type MDCK monolayers (2). Whether these other receptors colocalize with the aGM1-staining cells is under investigation. Regardless, our results indicate that type IV pili appear to be the dominant adhesin toward MDCK monolayers since nonpiliated strains were noncytotoxic and approximately 10-fold less adherent and invasive than wild-type bacteria. In other cell types this may not be the case, as it has been shown that the lipopolysaccharide-CF transmembrane regulator interaction may also play an important role in bacterial uptake (41, 42).
In addition to their roles as adhesins, P. aeruginosa pili may also contribute to the pathogenic process in other ways. Type IV pili are responsible for twitching motility, a type of surface locomotion that is thought to depend on the dynamic extension and retraction of pili (35). Interestingly, mutant strains with pili that appear nonretractile not only lost twitching motility (5, 50) but also had reduced adherence to and cytotoxicity toward epithelial cells as well as decreased virulence in a mouse pneumonia model (8). This finding suggests that additional functions of pili, presumably dependent on their extension and retraction, are necessary in host cell interactions. This is further supported by our observation that adhesion of non-piliated PA103 mutants due to centrifugation of the bacteria onto MDCK monolayers was not sufficient to rescue the noncytotoxic phenotype (48a). One possibility is that the dynamic nature of pili assists in type III effector translocation. Our work demonstrates that secretion of the putative cytotoxin ExoU by a type III mechanism (17, 25) was required for the PA103-mediated damage to MDCK cells due to the binding of pili to added aGM1 (and without added aGM1) (Fig. 3). Precedence for a requirement for type IV pili function in type III effector translocation has been noted in the interaction of enteropathogenic E. coli and epithelial cells. In this case, bundle-forming pili have been postulated to initiate host cell contact prior to the establishment of more intimate association via the bacterial adhesin intimin and the bacterium-produced receptor Tir (1, 4, 32). This intimate adherence ultimately results in the formation of the attaching and effacing lesions, which require type III-secreted effector molecules (12). For P. aeruginosa adherence, pili binding to aGM1 could lead to closer contact and promote secretion of factors such as ExoU.
Our observations suggest a model for the establishment of a P. aeruginosa infection. The polarized sorting of molecules in highly differentiated epithelial layers results in the paucity of aGM1 or other receptor on their apical surfaces, and thus these cells are relatively resistant to infection by P. aeruginosa. Consistent with this, it has previously been shown that epithelial cell polarity affects susceptibility to P. aeruginosa injury and invasion; in polarized MDCK cells, the basolateral surface is more sensitive to damage (19). The present studies, which demonstrate only a small amount of anti-aGM1 immunofluorescence staining of untreated MDCK monolayers and a lack of an effect of anti-aGM1 treatment on adherence to and cytotoxicity toward DMSO-treated monolayers, support this hypothesis. However, apical aGM1 could become available by epithelial monolayer injury and regeneration (10) or in the context of CF (41). The increased amount of aGM1 receptor could be recognized by P. aeruginosa expressing type IV pili, and that adherence could result in either cell injury or bacterial internalization, depending on the factors produced by the particular strain. Cytotoxicity would subsequently allow the bacteria to gain access to the basolateral surface of epithelial cells, where they would be able to more rapidly spread and eventually disseminate to distant sites of infection. Alternatively, as suggested by others (37, 38), increased P. aeruginosa internalization may assist in the establishment of other forms of infection. Experiments to test this model are in progress.
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ACKNOWLEDGMENTS |
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We thank members of the Engel laboratory for critical reading of the manuscript and for scientific advice.
J.C.C. was supported by the Bank of America-Gianinni Foundation. J.N.E. was supported by grants from the University Wide AIDS Research Program, the NIH (R01 AI42806), and the American Lung Association. K.E.M. was supported by NIH grant R01 HL55980. J.N.E. is a Career Investigator of the American Lung Association.
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FOOTNOTES |
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* Corresponding author. Mailing address: Division of Infectious Disease, Box 0654, University of California, San Francisco, CA 94143-0654. Phone: (415) 476-7355. Fax: (415) 476-9364. E-mail: Jengel{at}medicine.ucsf.edu.
Present address: Department of Bacteriology, University of
Wisconsin, Madison, Madison, WI 53706.
Present address: Department of Obstetrics and Gynecology,
University of California, San Francisco, San Francisco, CA 04143.
Editor: D. L. Burns
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