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Infection and Immunity, September 1999, p. 4945-4949, Vol. 67, No. 9
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Identification of a Third Metalloprotease Toxin
Gene in Extraintestinal Isolates of Bacteroides
fragilis
Gyung-Tae
Chung,1
Augusto A.
Franco,2
Shaoguang
Wu,2
Gi-Eun
Rhie,1
Rodney
Cheng,2
Hee-Bok
Oh,1 and
Cynthia L.
Sears2,*
Laboratory of Bacterial Toxins, Department of
Microbiology, National Institute of Health, Seoul,
Korea,1 and Divisions of Infectious
Diseases and Gastroenterology, Department of Medicine, Johns Hopkins
University School of Medicine, Baltimore, Maryland2
Received 5 April 1999/Returned for modification 4 June
1999/Accepted 18 June 1999
 |
ABSTRACT |
To further understand the epidemiology of enterotoxigenic
Bacteroides fragilis (ETBF), 89 extraintestinal B. fragilis strains from Seoul, Korea, were examined for secretion
of B. fragilis toxin (BFT) by the HT29/C1 biologic assay
and for the B. fragilis toxin gene (bft) by
colony blot hybridization and PCR. Complete agreement between the three
techniques was found. Overall, 34 B. fragilis strains
(38%) were identified as ETBF. Eleven of the 34 ETBF strains (32%)
expressed a new isoform of BFT (Korea-BFT). This new isoform is more
related to BFT-2 than to BFT-1. Like BFT-1 and BFT-2, Korea-BFT cleaves
E-cadherin, the zonula adherens protein.
 |
TEXT |
Strains of enterotoxigenic
Bacteroides fragilis (ETBF) have been associated with
diarrheal diseases of animals, young children, and adults (15, 16,
18-20, 23, 24, 30). The secretory response to ETBF is attributed
to the expression of a ca. 20-kDa protein (termed B. fragilis toxin or BFT), which stimulates fluid accumulation in
lamb ligated ileal loops and alters the morphology of human intestinal
cells in vitro, especially HT29/C1 cells (2, 4, 11, 14, 17, 21,
22, 24, 27).
Sequencing of the bft gene and substrate analysis in vitro
indicates that BFT is a zinc-dependent metalloprotease and that there
are two isoforms of bft, bft-1 and
bft-2. The two bft isoforms have 92% amino acid
sequence identity (6, 10, 12). ETBF strains produce one, but
not both, of these BFTs (6). Studies performed to date
indicate that (i) purified BFT-2 has modest but consistently greater
biological activity than purified BFT-1 when tested on HT29/C1 cells
and (ii) BFT-1 and BFT-2 elute with different concentrations of NaCl
from a high-resolution anion-exchange column (MonoQ) and exhibit
different electrophoretic mobilities on sodium dodecyl
sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) (28).
Both BFTs act in a reversible manner to alter the morphology and
physiology of polarized epithelial cells (HT29/C1, MDCK, and T84)
(2, 17). Recently, it was determined that both BFTs cleave
the zonula adherens protein, E-cadherin (29).
The bft gene is contained in a pathogenicity island of 6 kb,
which contains another metalloprotease gene, termed mpII
(5, 13). The protein encoded by mpII exhibits a
zinc-binding metalloprotease motif similar to BFT-1 and BFT-2; however,
recombinant MPII neither has biologic activity on HT29/C1 cells nor
cleaves the E-cadherin protein (4a). It has been proposed
that putative B. fragilis toxins fall into two categories
(25). The first category (class I toxins) includes BFT-1 and
BFT-2, which act by cleavage of the E-cadherin protein. The second
category (class II toxins) at present contains only the MPII protein.
As yet, no biological activity has been identified for MPII.
In this study, we identified a third isoform of bft class I
(Korea-bft) in ETBF strains isolated from extraintestinal
samples in Seoul, Korea. Eleven of 34 ETBF strains (32%) isolated in
Korea contained Korea-bft. However, this third isoform of
bft was not identified in a collection of ETBF strains
isolated in the United States.
Detection of ETBF strains.
A total of 89 extraintestinal
B. fragilis strains isolated between 1995 and 1997 from
Severance Hospital, Seoul, Korea, were tested for BFT production by a
tissue culture assay and for the presence of the bft gene by
colony blot hybridization and PCR. For the tissue culture assay,
HT29/C1 cells were used as previously described (14, 27).
For colony blot hybridization, a 32P-labeled 1.2-kb
SmaI-DraIII bft fragment containing
bft-2 was used as a probe. For PCR, primers were designed
from the published bft-2 sequence from ETBF 86-5443-2-2 (6). The sequence of the forward primer (primer 1)
corresponded to bp 54 to 72 of bft with the addition of a
sequence for an EcoRI restriction site at the 5' end
(5'-CGCGGAATTCATGTTCTAATGAAGCTGAT-3'), and the sequence of
the reverse primer (primer 2) corresponded to the inverse complement of
bp 10 to 38, downstream of the bft stop codon
(5'-TTCCATTAATCGAACTTCGATTCTCACTC-3'). Complete agreement in
detection of either BFT activity or bft sequence was found
between the three assays. Overall, 34 B. fragilis strains
(38%) identified by cell culture as producing BFT were also
bft positive by colony blot hybridization and PCR. None of the 55 nontoxigenic B. fragilis (NTBF) strains, as
determined by cell culture, were positive by colony blot or PCR.
However, when primers 1 and 2 were used for PCR, 11 of the 34 ETBF
strains identified by cell culture and colony blot produced a weak
predicted product (ca. 1.2 kb) and also yielded a nonspecific 0.6-kb
fragment (Fig. 1), suggesting that some
differences might exist between the bft gene of these
strains and the bft-2 sequence. The other 23 ETBF strains
produced only the predicted 1.2-kb fragment. When primer 2 was replaced
by primer 5, whose sequence was derived from the inverse complement of
the last 19 nucleotides of bft (5'-TGGTCTCGAGATCGCCATCTGCTATTTCC-3'), all 34 ETBF strains
yielded only the predicted 1.2-kb fragment (data not shown). ETBF
strains were identified more often from blood (12 of 22 strains
[54%]) than from the other extraintestinal sources (22 of 67 strains [33%]; P < 0.07 [by chi-square analysis]) (Table
1).

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FIG. 1.
Representative results of PCR with primers 1 and 2 (sequences in text) for detection of ETBF from extraintestinal samples.
All B. fragilis strains tested in this gel were identified
as ETBF by cell culture assay and colony blot hybridization. Lanes: 1, DNA molecular weight marker (1-kb DNA ladder [Gibco BRL]); 2, ETBF
86-5443-2-2 (bft-2 positive control); 3, B. fragilis 419 (blood isolate); 4, B. fragilis 536 (pus
isolate); 5, B. fragilis 723 (pleural fluid isolate); 6, B. fragilis 713 (right foot isolate); 7, B. fragilis 529 (blood isolate); 8, B. fragilis 586 (blood
isolate); 9, B. fragilis 502 (blood isolate); 10, ETBF VPI
13784 (bft-1 positive control); 11, NTBF 077225-2 (negative
control). The arrows show the predicted 1.2-kb product and the
nonspecific 0.6-kb product found in strains 419 and 586.
|
|
Identification of the Korea-BFT subtype.
To determine the
bft gene sequence of the ETBF strains that produced a weak
predicted PCR product and an additional 0.6-kb band when primers 1 and
2 were used, the bft gene of one strain with this pattern
(strain 419 [blood isolate]) was cloned and sequenced from a Lambda
ZAP library by using the ZAP Express Vector Kit (Stratagene, La Jolla,
Calif.). The B. fragilis 419 Lambda ZAP library was screened
with a 519-bp PCR fragment yielded by primers BG1
(5'-ACGGTGTATGTGATTTGTCTGAG-3') and BG2
(5'-CAACCGAGATTTTTAGCGATTA-3'). The sequences of the BG1 and
BG2 primers were derived from bp 10 to 32 and from bp 506 to 527 of the
published partial bft-1 sequence (12). Positive
clones were isolated and excised as described by the manufacturer
(Stratagene). The bft gene of one excised plasmid (pBFT-6)
containing bft in a 4-kb BglII fragment (similar
to bft-1 and bft-2 in strains VPI 13784 and
86-5443-2-2 [46]) was sequenced by the fluorescent
dideoxy terminator method. The DNA sequence was analyzed with programs
developed by the Genetics Computer Group of the University of Wisconsin
(3) and the NCBI BLAST server (1). Like
bft-1 and bft-2, the bft gene from
strain 419 was predicted to encode a 397-residue holotoxin with a
calculated molecular mass of ca. 44.5 kDa. However, alignment of the
predicted amino acid sequence of the 419 bft gene with those
of strains VPI 13784 (containing bft-1) and 86-5443-2-2 (containing bft-2) revealed that 419 BFT (termed Korea-BFT)
has 93 and 96% identity with BFT-1 and BFT-2, respectively (Fig.
2). Alignment of Korea-BFT with the BFT-1
and BFT-2 proteins suggested that Korea-BFT is also synthesized as a
preproprotein, where the initial 18 amino acids comprise a signal
peptide followed by a 193-residue "pro" region and an active mature
region of 186 residues containing the zinc-binding signature motif.
Like BFT-1 and BFT-2 (6), the preproprotein domain of
Korea-BFT was more conserved than the mature domain. Only 5 and 6 amino
acid differences in the 211-amino-acid preproprotein region were
detected between Korea-BFT and BFT-1 or BFT-2, respectively. In
contrast, 21 and 11 amino acid changes were detected when the
186-amino-acid mature protein region of Korea-BFT was compared with
those of BFT-1 and BFT-2, respectively. Sequence analysis indicated
that Korea-BFT is more related to BFT-2 than to BFT-1; however, the
amphipathic domain identified in the carboxy-terminal region of BFT-2
is not present in Korea-BFT (Fig. 2).

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FIG. 2.
Alignment of BFT-1, Korea-BFT (BFT-K), and BFT-2
sequences from ETBF VPI 13784, 419, and 86-5443-2, respectively. The
signal peptide sequences are underlined, the arrowhead shows the start
of the mature protein, residues forming the zinc-binding signature
motif are in boldface type and marked with asterisks, and the
carboxy-terminal 20 residues which are predicted to form an amphipathic
region in BFT-2 are enclosed in a box. Modeling of this region in
Korea-BFT did not yield an amphipathic domain.
|
|
Frequency of Korea-BFT.
Our previous study showed that ETBF
strains containing each subtype of BFT could be distinguished by
hybridization with oligonucleotide probes specific for bft-1
or bft-2 (6). However, we found that the specific
oligonucleotide probe used to detect ETBF strains containing
bft-2 could not discriminate between this bft
subtype and Korea-bft. To test the possibility that the
restriction patterns of bft-1, bft-2, and
Korea-bft might permit discrimination between the three
subtypes, the nucleotide sequences of the three alleles were
restriction mapped with a program developed by the Genetics Computer
Group of the University of Wisconsin (3). We found that
enzymatic digestion of the three bft subtypes with
Sau3AI predicted different patterns. When primers 1 and 5 were used to generate the bft gene followed by
Sau3AI, the fragments predicted by the program were 848 and
294 bp for bft-1; 571, 461, and 110 bp for bft-2;
and 848, 184, and 110 bp for Korea-bft. These predicted fragments were obtained when the PCR-generated (primers 1 and 5) VPI
13784, 86-5443-2-2, and 419 bft genes were digested with the
restriction enzyme Sau3AI (Fig.
3).

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FIG. 3.
Agarose gel electrophoresis of fragments produced by
Sau3AI digestion of the bft gene amplified by PCR
with primers 1 and 5 (sequences in text). Lanes: 1, DNA molecular
weight marker ( X174 RF DNA/HaeIII fragments [Gibco
BRL]); 2, bft-1 from ETBF VPI 13784; 3, bft-2
from ETBF 86-5443-2-2; 4, Korea-bft from ETBF 419.
|
|
To determine the
bft subtype of the 34 Korean ETBF strains
identified by the HT29/C1 cell assay, colony blot, and PCR, the
bft gene amplified by PCR with primers 1 and 5 was digested
with
the restriction enzyme
Sau3AI. These data revealed that
the 11
ETBF strains (32%) that yielded a weak PCR product when primers
1 and 2 were initially used exhibited the Korea-
bft pattern
after
Sau3AI digestion of the PCR product of primers 1 and 5. Of the
remaining 23 ETBF strains, 14 (41%), and 9 (22%)
exhibited
bft-1 and
bft-2 patterns, respectively.
These results were confirmed
by colony blot hybridization with
oligonucleotide probes specific
for
bft-1 (probe
MTVPI, 5'-GGCGCTGAGCATACGGATAATT-3') and
bft-2/Korea-
bft (probe MT086,
5'-GGTGCTAGGCATGCGGATGATC-3'). Probe MTVPI hybridized
only with
the 14 ETBF strains with the
bft-1 pattern, and probe
MT086
hybridized with the 20 ETBF strains with the
bft-2 or
Korea-
bft pattern.
To further analyze the frequency of Korea-
bft, we determined
if this subtype of
bft was present in
bft-2-positive ETBF strains
isolated in the United States.
Seventeen ETBF strains containing
bft-2 isolated from
extraintestinal and intestinal samples in
the United States (
4b,
6) were characterized by enzymatic
digestion with
Sau3AI. We found that all 17 ETBF strains yielded
the
typical restriction pattern of
bft-2 (data not
shown).
Korea-BFT purification and biologic activity.
The Korea-BFT
protein from strain 419 was purified as previously described to
determine its biological activity and properties (26, 29).
During purification steps with Q-Sepharose and phenyl-agarose chromatography, Korea-BFT did not differ significantly from BFT-1 and
BFT-2 purified from strains VPI 13784 and 86-5443-2-2, respectively (28). In the final purification step with a high-resolution anion-exchange column (MonoQ), the Korea-BFT protein eluted at the same
concentration of NaCl (ca. 0.18 M) as did BFT-2 purified from strain
86-5443-2-2 (28).
In Western blot analysis using anti-BFT-2 serum as the primary
antibody, we found that purified Korea-BFT had the same electrophoretic
mobility on SDS-PAGE as did BFT-2 purified from ETBF 86-5443-2-2
(data
not shown); in contrast, BFT-1 purified from VPI 13784 had
a different
electrophoretic mobility (Fig.
4A).

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FIG. 4.
(A) Electrophoretic mobility of purified BFT-1 from ETBF
VPI 13784 (lane 1) and purified Korea-BFT from ETBF 419 (lane 2) on
SDS-PAGE, analyzed by a Western blot probed with polyclonal anti-BFT-2
serum. (B) Cleavage of E-cadherin by BFT. HT29/C1 cells were treated
with BFT (100 ng/ml) for 3 h, lysed in 1× SDS gel loading buffer,
and examined by Western blotting with E2 antibodies against the
cytoplasmic domain of E-cadherin. Lane 1, untreated HT29/C1 cells; lane
2, HT29/C1 cells treated with BFT-2 purified from ETBF 86-5443-2; lane
3, HT29/C1 cells treated with Korea-BFT purified from ETBF 419. Loss of
staining intensity of intact E-cadherin (120 kDa) is observed in
HT29/C1 cells treated with BFT-2 and Korea-BFT.
|
|
Purified Korea-BFT was active on HT29/C1 cells assay at a concentration
similar to that observed with purified BFT-1 or BFT-2
(reference
28 and data not shown). Cleavage of E-cadherin on
HT29/C1 cells by purified Korea-BFT (100 to 200 ng/ml) was determined
by Western blotting with antibodies to the cytoplasmic domain
of
E-cadherin, as described previously (
29). Like purified
BFT-1
and BFT-2, Korea-BFT cleaved HT29/C1 E-cadherin after 3 h of
incubation
(Fig.
4B and data not
shown).
This report extends our understanding of the molecular epidemiology of
ETBF strains and indicates that the toxins secreted
by these strains
are more complex than previously identified.
Intriguingly, Kato
(
9) recently reported data identifying a
unique isoform of
bft in 14% of intestinal
B. fragilis strains
isolated from children and adults in Japan. Subsequent data indicate
that this
bft isoform identified in Japan and the
Korea-
bft isoform
reported herein are identical
(
9a). The absence of this newly
identified
bft
isoform in ETBF strains isolated in the United
States raises
interesting questions regarding the molecular evolution
of ETBF strains
and indicates that further studies to clarify
the global distribution
of ETBF strains and their toxin subtypes
are warranted. In addition,
our data confirm prior reports of
Kato et al. (
7,
8) in
which a high percentage of extraintestinal
B. fragilis
strains, particularly bloodstream isolates (ca. 30%),
in Japan were
identified as ETBF strains. In contrast, ETBF strains
isolated from
extraintestinal sites were rare (6%) in a collection
of strains
isolated at the Johns Hopkins Hospital (
14). One
hypothesis
to potentially explain this difference is that the
Asian ETBF strains
are more virulent, by as-yet-unidentified mechanisms,
than are ETBF
strains examined to date in the United States. Alternatively,
the
prevalence of intestinal ETBF strains may be higher in Japan
and Korea
due to either gut ecologic factors (e.g., dietary influence
on
intestinal flora) or earlier evolution of ETBF strains in these
countries. These data, combined with the association of ETBF with
diarrheal illnesses in children greater than 1 year old and, more
recently, in adults (
30), indicate that further studies of
the
epidemiology and clinical impact of ETBF are
necessary.
Nucleotide sequence accession number.
The Korea-bft
gene sequence has been submitted to the GenBank database and assigned
accession no. AF081785.
 |
ACKNOWLEDGMENTS |
We thank Dwight Derr for tissue culture assistance, and we
acknowledge the gifts of B. fragilis strains by Tracy
Wilkins of the Virginia Polytechnic Institute (strain VPI 13784) and
Lyle Myers (strain 86-5443-2-2) and the anti-E-cadherin E2 antibody by
James Nelson, Stanford University.
This work was supported by National Research Award AI09863-01 (A.A.F.)
and National Institutes of Health Award DK45496 (C.L.S.).
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Divisions of
Infectious Diseases and Gastroenterology, Johns Hopkins University
School of Medicine, Ross Bldg., Rm. 933, 720 Rutland Ave., Baltimore, MD 21205. Phone: (410) 955-9680. Fax: (410) 955-9677. E-mail: csears{at}welchlink.welch.jhu.edu.
Editor:
J. T. Barbieri
 |
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