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Infection and Immunity, November 2001, p. 7152-7158, Vol. 69, No. 11
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.11.7152-7158.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Inhibition of Attaching and Effacing Lesion
Formation following Enteropathogenic Escherichia coli
and Shiga Toxin-Producing E. coli Infection
Kathene
Johnson-Henry,1
John L.
Wallace,2
Naveen S.
Basappa,1
Rohini
Soni,1
Gilbert K. P.
Wu,1 and
Philip M.
Sherman1,*
Research Institute, Hospital for Sick
Children, Departments of Paediatrics and Laboratory Medicine & Pathobiology, University of Toronto, Toronto,
Ontario,1 and Department of
Pharmacology, University of Calgary, Calgary,
Alberta,2 Canada
Received 18 January 2001/Returned for modification 16 March
2001/Accepted 1 August 2001
 |
ABSTRACT |
Enteropathogenic Escherichia coli (EPEC) and Shiga
toxin-producing E. coli (STEC) induce cytoskeletal changes
in infected epithelial cells. To further characterize host cytosolic
responses to infection, a series of specific cell-signaling inhibitors
were employed. Initial bacterial adhesion to HEp-2 epithelial cells was
not reduced, whereas
-actinin accumulation in infected cells was
blocked by a phosphoinositide-specific phospholipase C inhibitor (ET-18-OCH3), phosphoinositide 3-kinase inhibitors
(wortmannin and LY294002), and a 5-lipoxygenase inhibitor,
nordihydroguaretic acid. A cyclooxygenase-2 inhibitor (NS-398),
however, did not block
-actinin reorganization in response to EPEC
and STEC infections. Understanding signal transduction responses to
enteric pathogens could provide the basis for the development of novel
therapeutic strategies.
 |
TEXT |
Enteropathogenic
Escherichia coli (EPEC) is an enteric pathogen colonizing
the small intestine and colon of infants with persistent watery
diarrhea (28). Shiga toxin-producing E. coli
(STEC), also variously referred to as enterohemorrhagic E. coli and verocytotoxin-producing E. coli, is a
large-bowel pathogen causing both outbreaks and sporadic cases of
hemorrhagic colitis and hemolytic-uremic syndrome (28).
Both EPEC and STEC induce biochemical and morphological changes in
infected eukaryotic cells. The cytoskeletal effects resulting in the
attaching and effacing (A/E) lesion are characterized by intimate
adherence of bacteria to epithelial cells with localized destruction
and vesiculation of brush-border microvilli and rearrangement beneath
adherent organisms of host cell cytoskeletal proteins, including
filamentous actin,
-actinin, talin, ezrin, and myosin light chain
(8).
Induction of A/E lesion formation by EPEC and STEC is associated with a
number of nuclear signaling events (30), as well as
inducing changes in the cytosol of the infected host cell, including
increased levels of inositol-1,4,5-trisphosphate (5, 11),
cytosolic free calcium, and protein phosphorylation (1). Multiple signal transduction pathways converge to induce rearrangements of the actin cytoskeleton. The aim of this study was to further delineate responses in the host cell cytosol to EPEC and STEC infection
by using a series of highly specific inhibitors against signaling
pathways mediated by the enzymes phosphoinositide-specific phospholipase C, phosphoinositide 3-kinase, 5-lipoxygenase, and cyclooxygenase.
EPEC strain E2348/69 (serotype O127:H6) was kindly provided by E. Boedeker (University of Maryland, Baltimore). STEC strain CL56
(O157:H7) was donated by M. Karmali (Hospital for Sick Children, Toronto, Ontario, Canada). UMD864, kindly supplied by J. B. Kaper (University of Maryland), is an espB deletion mutant of
E2348/69. It was used as a negative control because of its inability to trigger host signal transduction events (15). Bacteria
were grown for 3 h in static, nonaerated Penassay broth (Difco,
Detroit, Mich.) at 37°C to provide a mid-logarithmic-phase-growth
culture, since bacteria at this stage induce more rapid formation of
A/E lesions than do organisms grown to stationary phase
(29).
The human laryngeal epithelial cell line HEp-2 (American Type Culture
Collection, Manassas, Va.) was cultured in minimal essential medium
(Gibco Laboratories, Grand Island, N.Y.) supplemented with 15%
heat-inactivated fetal calf serum (Cansera International, Inc.,
Rexdale, Ontario, Canada), 0.5% glutamine (Gibco), 0.1% sodium
bicarbonate (Gibco), and 2% penicillin-streptomycin (Gibco) in
25-cm2 tissue culture flasks (Corning Glass Works, Corning,
N.Y.) at 37°C in 5% CO2.
Localization of
-actinin was detected in infected epithelial cells,
as described previously (12). Briefly, HEp-2 cells were
seeded onto two-well chamber slides (Nunc, Inc., Naperville, Ill.) and
were cultured overnight to obtain a subconfluent growth. Before
bacterial infection the tissue culture medium was replaced with medium
without antibiotics. Monolayers were then infected with 109
E. coli bacteria at a multiplicity of infection of 100:1 at
37°C in 5% CO2. After 3 h, nonadherent organisms
were removed by washing the tissue culture cells six times with
sterile, phosphate-buffered saline at pH 7.4. The monolayers were then
fixed in 100% cold methanol at room temperature for 10 min. After
being washed three times with phosphate-buffered saline, fixed cells
were incubated with a 1-in-100 dilution of murine monoclonal
immunoglobulin G anti-
-actinin (Sigma, Oakville, Ontario, Canada) as
primary antibody for 1 h at 37°C with gentle shaking. Rewashed
monolayers were then incubated with a 1-in-100 dilution fluorescein
isothiocyanate-conjugated rabbit anti-murine immunoglobulin G (Jackson
ImmunoResearch Laboratories, Inc., West Grove, Pa.) as secondary
antibody with protection from light for 1 h at 37°C with
continuous gentle agitation. Slides were then mounted with
SlowFade Antifade Kits (Molecular Probes, Eugene, Oreg.) and
examined by alternating phase-contrast and fluorescence microscopy
(Leitz Dialux 22; Leica Canada, Inc., Willowdale, Ontario, Canada).
Phase-contrast microscopy was used to quantitate the number of adherent
bacteria on 100 randomly selected HEp-2 cells. The number of A/E
lesions, as measured by the number of foci of
-actinin accumulation
in the same epithelial cells, was determined by immunofluorescence
microscopy by three independent observers.
Signal transduction inhibitors were purchased from Calbiochem (San
Diego, Calif.). HEp-2 cells were preincubated with the phosphoinositide-specific phospholipase C inhibitor
1-octadecyl-2-methyl-rac-glycero-3-phosphocholine (ET-18-OCH3) (26), wortmannin or
2-(4-morpholinyl)-8-phenyl-4H-1-benzopyran-4-one (LY294002) as a
phosphoinositide 3-kinase inhibitor (35, 36), the
5-lipoxygenase inhibitor nordihydroguaretic acid (NDGA)
(21), or a cyclooxygenase-2 inhibitor,
N-(2-cyclohexyloxy-4-nitrophenyl)-methanesulfonamide (NS-398) (7), for 30 min to 3 h, at dosages
recommended in previous studies. After removal of the inhibitor, tissue
culture cells were rinsed thoroughly with minimal essential medium
prior to infection with 109 bacteria for 3 h at
37°C. The inhibitory effects of cell-signaling inhibitors were
determined by their ability to disrupt formation of A/E lesions, as
indicated by the number of foci of
-actinin accumulation in infected
epithelial cells.
Synthesis of leukotriene B4 in HEp-2 cells with and without exposure to
a lipoxygenase inhibitor was measured in both culture supernatants and
cell sonicates by immunoassay, as described previously (2). Samples were stored at
70°C and were assayed at 2 weeks using a commercial enzyme immunoassay (Cayman Chemical Co., Ann Arbor, Mich.). Results are expressed as means ± standard
deviation. Analysis of variance (ANOVA) was used to test differences
between multiple groups.
ET-18-OCH3 inhibits
-actinin accumulation in EPEC-
and STEC-infected cells.
Treatment of cell monolayers with various
concentrations of the phosphoinositide-specific phospholipase C
inhibitor ET-18-OCH3, along its ethanol vehicle, did not
affect the ability of EPEC strain E2348/69, STEC strain CL56, or the
signaling-deficient mutant UMD864 to adhere to HEp-2 monolayers. The
number of adherent bacteria on epithelial cells remained comparable
under each of the different treatment conditions (data not shown).
Furthermore, microcolony formation and localized adherence of EPEC were
still detectable (Fig. 1A). The
morphology of the bacterial microcolonies was not altered. When HEp-2
cells were infected with E2348/69 for 3 h at 37°C, the accumulation
of
-actinin, demonstrated by bright foci of fluorescence,
corresponded to sites of bacterial adhesion (Fig. 1B). However, when
tissue culture cells were pretreated with 80 µM
ET-18-OCH3 before infection,
-actinin accumulation was
reduced (Fig. 1C and D). The vehicle alone did not affect the
-actinin reorganization. Similar inhibitory effects, following preincubation of host cells with ET-18-OCH3, were observed
during infection with STEC O157:H7 strain CL56 (data not shown). No
-actinin response was detected using UMD864 as a negative control
(Fig. 1E and F). Table 1 summarizes the
results of semiquantitation of the effects of the
phosphoinositide-specific phospholipase C inhibitor
ET-18-OCH3 on
-actinin accumulation in both EPEC- and
STEC-infected cells. A dose-dependent inhibition on the formation of
A/E lesions on infected epithelial cells induced by these pathogenic bacteria was demonstrated (ANOVA, P < 0.05).

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FIG. 1.
Reduced A/E lesion formation with phospholipase C
inhibitor ET-18-OCH3 (approximate magnification, ×1,250).
(A) Phase-contrast micrograph demonstrating adherent EPEC strain
E2348/69 (arrows) on HEp-2 monolayers after coincubation for 3 h
at 37°C. (B) Corresponding fluorescence micrograph showing
-actinin accumulation, demonstrated by bright foci of fluorescence
(arrows), underneath adherent microcolonies of bacteria. (C)
Phase-contrast micrograph showing adherent E2348/69 on
ET-18-OCH3-pretreated epithelial cells (arrows). (D)
-Actinin accumulation under adherent EPEC was not observed in the
corresponding fluorescence micrograph. (E) Phase-contrast micrograph
demonstrating UMD864 adherent to tissue culture cells. (F) A negative
-actinin response was detected when HEp-2 cells were infected with a
signaling-deficient mutant.
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TABLE 1.
Semiquantitation of the effects of inhibitors on
aggregates of -actinin accumulation in cells infected with
EPEC and STEC strains
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Wortmannin inhibits aggregation of
-actinin in EPEC- and
STEC-infected cells.
Wortmannin suspended in distilled water had
no effect on initial bacterial adherence to HEp-2 epithelial cells. In
the absence of the phosphoinositide 3-kinase inhibitor, formation of
A/E lesions demonstrated by
-actinin accumulation was observed (Fig.
2A and B). By contrast, after wortmannin
treatment, fewer and less intense foci of
-actinin localization were
detected in EPEC strain E2348/69-infected tissue culture cells (Fig. 2C
and D). Preincubation of HEp-2 cells with wortmannin before infection
with STEC strain CL56 resulted in a similar change in the
-actinin
response (data not shown). The presence of 10 nM wortmannin led to 45 and 40% reductions in
-actinin accumulation beneath adherent
E2348/69 and CL56, respectively (ANOVA, P < 0.05). A
dose-dependent effect of wortmannin was not tested because of its
nonspecific inhibitory effects at concentrations higher than those
employed in this study (6). More prolonged incubation (6 h) resulted in toxicity to the host epithelial cells.

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FIG. 2.
Reduced A/E lesion formation with phosphoinositide
3-kinase inhibitor wortmannin (10 nM) (approximate magnification,
×1,250). (A) EPEC strain E2348/69 showing initial adherence to tissue
culture HEp-2 cells by phase-contrast microscopy (arrows). (B) Intense
foci of fluorescence demonstrate reaggregation of -actinin (arrows)
corresponding to areas of bacterial attachment. (C) Phase-contrast
micrograph depicting adherent E2348/69 on wortmannin-pretreated HEp-2
cells (arrows). (D) Fewer foci of -actinin accumulation (arrows)
under attaching bacteria were detected in the corresponding
fluorescence micrograph.
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LY294002 inhibits
-actinin reorganization in EPEC- and
STEC-infected epithelia.
Bacterial adherence to tissue culture
cells was not affected by pretreatment of the epithelial cells with the
phosphoinositide 3-kinase inhibitor LY294002 carried in dimethyl
sulfoxide (DMSO) as the vehicle. Infection of HEp-2 cells with STEC
strain CL56 resulted in recruitment of
-actinin protein at the site
of bacterial attachment. In contrast, LY294002 inhibited
-actinin
accumulation in CL56-infected cells, whereas DMSO alone did not affect
the
-actinin response. Similar inhibitory effects on
-actinin
localization were detected during infection with EPEC strain E2348/69.
The inhibitory effect of LY294002 on EPEC- and STEC-induced A/E lesions was dose dependent (Table 1).
NDGA inhibits
-actinin rearrangement in EPEC- and STEC-infected
cells.
NDGA pretreatment of tissue culture cells did not reduce
the ability of bacteria to adhere to HEp-2 monolayers (data not shown). STEC strain CL56 caused the formation of A/E lesions in the absence of
the leukotriene inhibitor NDGA (Fig. 3A and
B). By contrast, fewer adherent bacteria
were accompanied by foci of
-actinin accumulation when HEp-2 tissue
culture cells were preincubated with the cell-signaling inhibitor (Fig.
3C and D). Similar inhibitory effects on
-actinin rearrangement were
observed during EPEC infection (Fig. 3E and F). As summarized in Table
1, NDGA inhibited the recruitment of
-actinin in both EPEC- and
STEC-infected HEp-2 cells in a dose-dependent pattern.

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FIG. 3.
Reduced A/E lesion formation with 5-lipoxygenase
inhibitor NDGA (approximate magnification, ×1,250). (A) Phase-contrast
micrograph showing initial adherence of STEC O157:H7 strain CL56 to
HEp-2 cells (arrows) following infection for 3 h at 37°C. (B)
Bright foci of -actinin fluorescence were detected in infected HEp-2
cells in regions subjacent to areas of bacterial adhesion (arrows). (C)
Phase-contrast micrograph shows that CL56 adhered to NDGA-pretreated
epithelial cells. (D) A negative -actinin response was detected in
the corresponding fluorescence micrograph. (E) Phase-contrast
micrograph of EPEC strain E2348/69 (O127:H6) binding to epithelial
cells in tissue culture. (F) Few well-defined foci of -actinin
fluorescence in HEp-2 cells below adherent EPEC were observed.
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As shown in Fig. 4, EPEC infection of
tissue culture cells stimulated the production of lipoxygenase products
of arachidonic acid metabolism as measured by the stable leukotriene
B4. As expected, preincubation of tissue culture cells with the
lipoxygenase inhibitor NDGA significantly inhibited the production of
leukotriene B4 (Fig. 4).

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FIG. 4.
Leukotriene B4 (LTB-4) production is enhanced in
EPEC-infected cells and inhibited by lipoxygenase inhibitor NDGA. Lane
1, lysates of HEp-2 cells incubated with DMSO (1 µl/ml); lane 2, lysate derived from cells incubated for 1 h with NDGA (35 µM);
lane 3, cell lysates following incubation with NDGA (75 µM) for
1 h; lane 4, lysates obtained from cells incubated with EPEC
strain E2348/69 (108) for 3 h; lane 5, cell lysates
from HEp-2 cells preincubated for 1 h with NDGA (35 µM) and then
infected with EPEC; lane 6, lysates from cells preincubated with NDGA
(75 µM) for 1 h and then infected with EPEC. Results are the
mean values of four separate experiments each run in duplicate.
***, P < 0.01 (ANOVA).
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NS-398 does not inhibit
-actinin reorganization in EPEC- and
STEC-infected HEp-2 monolayers.
Pretreatment of tissue culture
cells with NS-398 did not reduce initial bacterial attachment. The
cyclooxygenase-2 inhibitor NS-398 did not affect the
-actinin
rearrangement during EPEC and STEC infection, even at concentrations of
up to 50 µM, despite the 50% inhibitory concentration of NS-398 of
3.8 µM (7) (Table 1).
EPEC and STEC are both enteric pathogens that constitute a major risk
to human health. While it is known that both EPEC and STEC are capable
of inducing cytoskeletal rearrangements leading to the formation of A/E
lesions in host epithelial cells, the underlying mechanisms remain
unclear. Human laryngeal epithelial cells are employed as a model
system in many of these studies since they mimic changes observed in
intestinal epithelia during infection in vivo (1).
Indirect immunofluorescence was employed as the technique to detect
aggregates of
-actinin in host epithelial cells following infection
with both EPEC and STEC. Previous studies have shown that this
experimental technique compares favorably with both the
fluorescent-actin test, using phalloidin conjugated to fluorescein to
detect foci of polymerized actin, and transmission electron microscopy,
used to identify the morphological features of the A/E lesion
(12). An advantage of fluorescence microscopy is that it
affords an opportunity to scan a large number of infected host cells
for evidence of changes in the cytoskeleton following bacterial
infection (14).
Four potential signal transduction pathways were investigated in this
study. First, elevations in inositol-1,4,5-trisphosphate are present
within the cytoplasm of both EPEC- and STEC-infected cells (5,
11). Since inositol-1,4,5-trisphosphate is one of the end
products in the hydrolysis of phosphatidylinositol-4,5-bisphosphate by
the enzyme phospholipase C, our hypothesis was that phospholipase C
could play a central role in mediating the activation of the signal
transduction pathway leading to both A/E lesion formation and diarrhea.
To test the hypothesis, the phospholipase C inhibitor ET-18-OCH3 was initially employed.
The ether lipid analogue ET-18-OCH3 inhibits
phosphoinositide-specific phospholipase C, although the precise
mechanism of inhibition remains unknown (26). Since
ET-18-OCH3 blocked
-actinin accumulation in infected
HEp-2 cells in a dose-dependent manner, the present study demonstrates
that phospholipase C is likely to be involved in the signal
transduction pathway, leading to the formation of A/E lesions in
response to both EPEC and STEC infections.
Phosphoinositides are important regulators and signaling molecules of a
variety of proteins linked to the actin cytoskeleton (17,
31). For instance, phosphoinositide 3-kinase is involved in the
regulation of actin polymerization (16). As a result, the
phosphoinositide 3-kinase inhibitors wortmannin and LY294002 were
utilized to determine if phosphoinositide 3-kinase is a component of
the pathway that leads to A/E lesion formation following EPEC and STEC
infections. The fungal metabolite wortmannin inhibits multiple
signaling enzymes at higher concentrations (6). However, at nanomolar concentrations wortmannin selectively targets
phosphoinositide 3-kinase by irreversibly inhibiting the catalytic
subunit of phosphoinositide 3-kinase (36). The inhibition
of
-actinin aggregation below adherent EPEC and STEC by wortmannin
indicates that phosphoinositide 3-kinase is also involved in the
generation of A/E lesion formation. As a complementary assay, LY294002,
a specific inhibitor of phosphoinositide 3-kinase which reversibly
inhibits phosphoinositide 3-kinase by competing with ATP for its
substrate binding site (35), was also shown to inhibit the
formation of A/E lesions. Taken together, these findings demonstrate
that phosphoinositide 3-kinase plays a role in the formation of A/E
lesions following infection of epithelial cells with EPEC and STEC.
The metabolism of arachidonic acid by the enzymes lipoxygenase and
cyclooxygenase results in a wide range of oxidized products with potent
biological activities (34). Both lipoxygenase and cyclooxygenase products of arachidonate are abundant in the human gut
(23, 32). Biological effects include modulation of fluid secretion, electrolyte secretion, and remodeling of cytoplasmic actin
filaments (22, 27). NDGA inhibits the activity of
5-lipoxygenase (21), an enzyme that generates leukotrienes
from arachidonic acid. The concentration-dependent inhibition of
-actinin accumulation observed following EPEC and STEC infection of
HEp-2 cells in the presence of NDGA indicates that leukotrienes are
involved in the signal transduction cascade, leading to
cytoskeletal reorganization in infected eukaryotic cells. In contrast,
whereas cyclooxygenase-2 plays a role in mediating host inflammatory
responses (13), the enzyme appears not to be involved in
the formation of A/E lesions in response to EPEC and STEC infections.
Initial bacterial adherence to host cells is necessary for subsequent
signal transduction and intimate attachment (10). The
number of bacteria adherent to HEp-2 cells did not differ markedly
following pretreatment of cells with each of the inhibitors of cell
signaling. This finding indicates that neither the inhibitors nor the
vehicles in which they were suspended disrupted the first stage of
initial bacterial attachment to host cells following EPEC and STEC
infection. Therefore, the inhibitory effects of the signaling
inhibitors on their protein targets are responsible for the observed
reduction in formation of A/E lesions. Toxicity of each inhibitor,
along with its vehicle, was evaluated to ensure the viability of tissue
culture cells. The observation that neither HEp-2 cell numbers nor
morphology was affected by preincubation with any of the inhibitors or
with the vehicle alone supports the specificity of the observed responses.
Based on the findings reported in this study, multiple signal
transduction events likely are involved in the A/E lesions formed in
response to EPEC and STEC infections. Comparable involvement of
multiple cytosolic second messengers also has been observed in
epithelial cells in response to Salmonella infection
(20). Although the mechanisms by which EPEC and STEC
produce diarrhea are not completely defined, an increase in gut
permeability as a result of changes in the intercellular tight junction
has been postulated (33). Indeed, the tight
junction-associated protein zonula occludens-1 is disrupted following
both EPEC (25) and STEC infections (24).
Recent evidence indicates that a bacterial protein. EspF, mediates the
damage to intercellular tight junction integrity (3, 18).
-Actinin serves as a bridge between the translocated intimin
receptor, Tir, and the reorganized cytoskeleton (9).
-Actinin also provides a link between the C terminus of zonula
occludens-1 in the tight junction and filamentous actin of the cell
cytoskeleton (4). Signaling molecules, such as protein
kinase C and myosin light-chain kinase, are second messengers in the
cytosol and lead to an increase in transepithelial permeability (24). Therefore, future studies should use these enzyme
inhibitors to examine the role of phospholipase C, phosphoinositide
3-kinase, and 5-lipoxygenase as mediators of EPEC- and
STEC-induced changes in tight junction permeability.
 |
ACKNOWLEDGMENTS |
G.K.P.W. was the recipient of an Ontario Graduate Scholarship and a
Restracomp Studentship from the Hospital for Sick Children. N.S.B. was
the recipient of a Summer Student Scholarship from the Crohn's and
Colitis Foundation of Canada. This work was supported by operating
grants from the Canadian Institutes of Health Research. P.M.S. is the
recipient of a Canada Research Chair in Gastrointestinal Disease.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Division of
Gastroenterology and Nutrition, Room 8409, Hospital for Sick Children, 555 University Ave., Toronto, Ontario M5G 1X8, Canada. Phone: (416)
813-7734. Fax: (416) 813-6531. E-mail:
sherman{at}sickkids.on.ca.
Editor:
A. D. O'Brien
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Infection and Immunity, November 2001, p. 7152-7158, Vol. 69, No. 11
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.11.7152-7158.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
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