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Infection and Immunity, February 2001, p. 1072-1083, Vol. 69, No. 2
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.2.1072-1083.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Parameters Underlying Successful Protection with Live Attenuated
Mutants in Experimental Shigellosis
Maria Lina
Bernardini,1,*
Josette
Arondel,2
Irene
Martini,1
Awa
Aidara,3 and
Philippe
J.
Sansonetti2
Dipartimento di Biologia Cellulare e dello Sviluppo,
Sezione di Scienze Microbiologiche, and Istituto Pasteur Fondazione
Cenci Bolognetti, Università `La Sapienza,' 00185 Rome,
Italy1; Unité de Pathogénie
Microbienne Moléculaire, Institut Pasteur, Paris,
France2; and Laboratoire de
Bactériologie Expérimentale, Institut Pasteur de Dakar,
Dakar, Senegal3
Received 5 July 2000/Returned for modification 31 August
2000/Accepted 25 October 2000
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ABSTRACT |
Because the use of live attenuated mutants of Shigella
spp. represents a promising approach to protection against bacillary dysentery (M. E. Etherridge, A. T. M. Shamsul Hoque, and
D. A. Sack, Lab. Anim. Sci. 46:61-66, 1996), it becomes
essential to rationalize this approach in animal models in order to
optimize attenuation of virulence in the vaccine candidates, as well as their route and mode of administration, and to define the correlates of
protection. In this study, we have compared three strains of Shigella flexneri 5
the wild-type M90T, an
aroC mutant, and a double purE aroC mutant
for
their pathogenicity, immunogenicity, and protective capacity.
Protection against keratoconjunctivitis, induced by wild-type M90T, was
used as the protection read out in guinea pigs that were inoculated
either intranasally or intragastrically. Following intranasal
immunization, the aroC mutant elicited weak nasal tissue
destruction compared to M90T and achieved protection correlated with
high levels of local anti-lipopolysaccharide immunoglobulin A (IgA),
whereas the purE aroC double mutant, which also elicited weak tissue destruction, was not protective and elicited a low IgA
response. Conversely, following intragastric immunization, only the
M90T purE aroC double mutant elicited protection compared to both the aroC mutant and the wild-type strain. This
mutant caused mild inflammatory destruction, particularly at the level of Peyer's patches, but it persisted much longer within the tissues. This could represent an essential parameter of the protective response
that, in this case, did not clearly correlate with high anti-lipopolysaccharide IgA titers.
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INTRODUCTION |
Shigella flexneri is the
major etiological agent of endemic bacillary dysentery, a severe form
of diarrhea responsible for approximately 1 million fatalities annually
(20). The disease is characterized by bacterial invasion
of colonic epithelial cells, leading to an intense inflammatory
response with severe destruction of the colonic mucosa
(22). The invasion process requires the concerted action
of specific virulence factors encoded by a plasmid (41,
45) and chromosomally encoded metabolic functions necessary for
the bacteria to survive within the host (3, 34). In
ligated intestinal loops of rabbits, early entry of S. flexneri occurs via M cells of the follicle-associated epithelium
of Peyer's patches (PPs) (51, 44). Similarly, after
intragastric (i.g.) inoculation of macaques, S. flexneri
uses lymphoid structures associated with the colonic and rectal mucosae
as its primary site of entry (43). Once the lymphoid
structures have been reached, bacteria encounter resident macrophages
that are rapidly killed by apoptosis, due to the ability of IpaB, a
62-kDa bacterial invasin, to activate caspase 1 (14, 55,
56). The death of the macrophages may facilitate bacterial
survival in these tissues, but it causes a substantial release of
interleukin-1
(IL-1
), a cytokine that elicits early inflammation
(35) from the dying macrophages (57). Immigration of polymorphonuclear cells (PMNs), recruited to the site of
infection, disrupts intercellular junctions between epithelial cells
and thereby facilitates bacterial access to the basolateral side of the
epithelium where bacteria can efficiently invade (29, 36).
This invasion eventually results in extensive inflammation and tissue
destruction of the villous epithelium adjacent to lymphoid follicles
(35, 43).
Our current understanding of Shigella infection mechanisms
is at a stage in which identification and characterization of the major
factors of the invasion process must be integrated into a scheme that
can be established only by using in vivo models of infection. This
integration is essential for design and improvement of live attenuated
vaccine candidates. However, in vivo studies are complicated by the
relatively innate resistance of most animals to oral infection by
S. flexneri (24), which impairs the coordinated analysis of invasion, inflammation, and immunity. In studies aimed at
exploring protection against shigellosis, Shigella vaccines are often evaluated using methods of inoculation that differ from the
normal route of infection (11). A murine model based on intranasal (i.n.) infection has been developed and used in various protection experiments (25). Virulent shigellae invade
murine bronchial and alveolar epithelia, where they elicit both acute suppurative infiltrates and epithelial necrosis (26, 49). Mice immunized with wild-type S. flexneri strains or
attenuated vaccine strains exhibit partial protective immunity to
subsequent i.n. challenges with a lethal Shigella inoculum
(37). The ability of Shigella spp. to invade
the corneal epithelium of guinea pigs, rabbits, and mice, spread to
contiguous cells, and cause keratoconjunctivitis (i.e., the Sereny test
[46]) has also become a major model system. This model
has been used to test potential vaccine candidates for attenuation
(12, 13, 47) and to evaluate vaccine efficacy (11,
15, 30, 32). Nevertheless, the oral route has also been used to
administer Shigella strains and vaccine candidates to
various animals (18, 24, 31, 54) to stimulate local protective immunity that reflects the natural route of infection. Despite this variety of approaches, the response of the immune system
to Shigella infection and its consequences on both bacterial survival and tissue alteration and repair are still not known in detail.
The purpose of this study is to analyze the relationships that exist
between invasiveness, inflammation, and immunogenicity in order to
define guidelines that would allow the construction of
Shigella vaccine candidates. With this aim we have evaluated the impact of both the route of infection and the intensity of the
innate immune response on the development of adaptive immune responses,
using the guinea pig model. Infection and vaccination were performed
using two routes of administration: the i.n. route to study the immune
potential and pathogenicity of shigellae in the respiratory tract and
the i.g. route to explore the effect of Shigella invasion
under conditions nearest to those that occur during natural infection.
To manipulate the degree of innate immune responses, strains of
Shigella with increasing degrees of attenuation were used:
the wild-type strain M90T and two strains with mutations in metabolic
functions necessary for bacterial growth in tissues, M90T
aroC, which is auxotrophic for p-aminobenzoic
acid (PABA), and M90T purE aroC, which is auxotrophic for
PABA and adenine. These three strains were analyzed for invasion
ability, induction of inflammation, and immunogenicity in guinea pigs.
Our strategy involved the i.n. or i.g. immunization of one set of
guinea pigs to evaluate the immunogenicity and the protective efficacy
of M90T, M90T aroC, and M90T purE aroC by using
the Sereny test and the i.n. or i.g. infection of another set of guinea
pigs to correlate the immune response to the actual degree of
pathogenicity and reactogenicity of the strains. These parameters were
evaluated by monitoring (i) the ability of mutant strains to colonize
different tissues, (ii) the persistence of bacteria within these
tissues, and (iii) the histopathological and immunohistochemical
analysis of infected tissues. Our results show that the ability to
induce a protective immune response depends on the immunization route, which indicates that both persistence of bacteria in infected tissues
and low reactogenicity are the major factors conferring protective immunity.
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MATERIALS AND METHODS |
Bacterial strains and media.
Vaccine strains used in this
study are listed in Table 1. The
wild-type S. flexneri 5 strain M90T and Escherichia
coli 395.1 were routinely grown in Trypticase soy broth (Becton
Dickinson and Co., Cockeysville, Md.) or Trypticase soy broth agar
(TCSA) (Difco Laboratories, Detroit, Mich.). M90T
aroC::Tn10 and M90T
purE
aroC::Tn10 mutants were also cultured in
brain heart infusion (Bacto BHI; Difco). TCSA containing 100 mg of
Congo red dye per liter was used to select invasive clones of
Shigella spp. (28). When necessary,
tetracycline was added at a concentration of 10 µg/ml.
Animals.
Female Hartley guinea pigs weighing approximately
400 g were used for infection and immunization experiments. The
animals were housed in individual cages.
Immunizations.
Guinea pigs were anesthesized with 20 mg of
ketamine per liter (Imalgène 1000; Rhone Mérieux, Lyon,
France) and immunized i.n. or i.g. with 109 microorganisms
harvested from overnight-growth plates. A total of 10 animals were
immunized for each strain (M90T, M90T
aroC::Tn10, M90T
purE
aroC::Tn10, and E. coli 395.1).
The immunization schemes are shown in Fig.
1A and B.

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FIG. 1.
Immunization schedules (A) via the i.g. route and (B)
via the i.n. route. Upper arrows of each schedule indicate the days
of immunization and the day of challenge with the wild-type
strain. The first row of lower arrows indicates the days of bleeding
and the days when saliva and tears were collected while the second
row indicates when IgG and IgA analyses were performed. Inoculation and
challenge doses are also indicated.
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(i)i.g. immunization.
Approximately 0.5 ml of bacterial cell
suspension was delivered into the stomach of a guinea pig through a
1-mm-diameter polyethylene feeding tube inserted into the
esophagus, immediately after administration by the same route of about
0.5 ml of 1.4% sodium bicarbonate in order to buffer gastric acidity.
Animals were immunized twice (day 0 and day 14). At days 0 and 32, sera
were collected from a foot vein. At days 0 and 21, samples of saliva
were recovered as follows: saliva was collected with a wick tampon
(Polyfiltronics Group Inc., Rockland, Mass.) left in the mouth for 3 min for full absorption. The wicks were then soaked in ice, weighed,
dipped in a 0.5-ml solution of phosphate-buffered saline (PBS)
containing 5% milk and protease inhibitors (1 mM phenylmethylsulfonyl
fluoride, 1 mM EDTA, and 0.5 µg of leupeptin per ml, all products of
Sigma Chemical Co., St. Louis, Mo.) (4). Subsequently, the
samples were vortexed and centrifuged for 2 min at 12,700 × g. Finally, the liquid phase was collected and stored at
80°C.
(ii) i.n. immunization.
Before immunization, animals were
treated as described above; then a suspension of 109
bacteria in 0.1 ml was applied dropwise to the nares (0.05 ml for each
nare). At days 0 and 28, sera were collected from a foot vein, whereas
at days 0 and 21, samples of saliva were removed as specified above.
(iii) Intranconjunctival challenge.
At days 32 and 28 for
i.g. and i.n. administration, respectively, guinea pigs were challenged
with 0.01 ml of an M90T suspension containing 109 bacteria.
The suspension was deposited into the conjunctival sac of one eye using
a dropper, and lids were slightly massaged to ensure that the inoculum
was distributed over the entire eye. Following challenge with M90T, the
animals were inspected daily for 7 days for the development of
keratoconjunctivitis. The degree of keratoconjunctivitis was rated on
the basis of time of development, severity, and (when possible) rate of
clearance of the symptoms, using the following scheme: 0, no disease;
1, mild conjunctivitis; 2, keratoconjunctivitis with no purulence; and
3, fully developed keratoconjunctivitis with purulence
(11). The percentage of protection was defined as follows:
full protection, percentage of eyes with rating of 0; partial
protection, percentage of eyes with rating of 1.
Infections.
Nine guinea pigs were infected i.n. or i.g.
using each strain of bacteria (M90T, M90T
aroC::Tn10, and M90T
purE
aroC::Tn10). One untreated animal was
sacrificed, and its relevant tissues were used as a control.
(i) i.g. infection.
Animals were infected i.g. with a
suspension of 109 bacteria following the procedure
described for i.g. immunization. At days 1, 3, and 7, three animals
were sacrificed for each bacterial strain. Samples of liver and PPs
were removed and prepared for both histopathological analysis and
counts of viable bacteria. Briefly, relevant intestinal segments were
dissected longitudinally, opened on their mesenteric side, and
extensively washed with PBS. Four to seven PPs for each animal were
punched off the tissue by using a 4-mm-diameter skin biopsy punch
(Stiefel, Nanterre, France). Most of the overlying mucus was peeled off
by direct contact with absorbing paper, followed by several washings
with PBS. The liver was removed, weighed, and cut, and the sections were kept for further investigation. For histopathological analysis, PPs and liver samples were fixed in 4% formalin, whereas for bacterial counts, saline buffer was added to samples, and they were immediately stored in ice until further manipulation.
(ii) i.n. infection.
At days 1, 3, and 7, three animals were
sacrificed for each bacterial strain. Nasal mucosa or alternatively the
nasal parts of the head in addition to the parotid glands and lungs
were removed for both histopathological analysis and bacterial counts.
Briefly, the nasal section was cut off along the line under the eyes,
and the tip of the nose was removed after stripping the skin from the
head. For bacterial counts, nasal mucosa was removed from the nasal
cavities. For histopathological analysis the nasal section was stored
in a solution of 4% formalin and 5% trichloroacetic acid. Parotid
glands were removed by excision of the skin in the posterolateral
section of each ear, and the lungs were removed from the thoracic
cavity. For histopathological analysis, parotid glands and lungs were
fixed in 4% formalin, whereas for bacterial counts saline buffer was
added, and the samples were immediately stored in ice.
Bacterial counts in tissue samples.
Tissue samples in
ice-cold 0.9% NaCl (10 ml for lungs, 5 ml for nasal mucosa, parotids,
and lungs, and 1 ml for each PP) were ground with an Ultraturrax
apparatus (Janke and Kunkel, GmbH and Co., Staufen, Germany). Serial
dilutions of the resulting solutions were plated on TCSA with or
without tetracycline added and were incubated overnight at 37°C.
Bacterial counts were normalized to the dilution factor and to the
weight of the sample.
Histopathological analysis.
After treatment with formalin,
samples were dehydrated, embedded in paraffin, and sectioned in
5-µm-thick slices at various levels. Cuts were stained with
hematoxylin-eosin or immunostained for observation. Damage to the
architecture of the intestinal villi was evaluated by the index of
intestinal atrophy, which involved measurement of the length of a
villus divided by its width (L/W ratio). About 80 villi were analyzed,
their length and width were recorded, and the L/W ratio was calculated.
For the guinea pig control, the mean L/W ratio was 5.59.
Immunocytochemistry was performed as follows: the sections were
deparaffinated and rehydrated, and endogenous peroxidases were blocked
by 0.3% hydrogen peroxide in methanol. Bacterial lipopolysaccharide
(LPS) was labeled using a biotinylated primary mouse monoclonal
antibody (immunoglobulin G3 [IgG3], kappa chain) directed against the
S. flexneri serotype 5 somatic antigen at a concentration of
5 µg/ml (37, 44). The preparations were incubated
overnight at 4°C. The reaction was amplified by using a Vectastain
ABC kit (Vector Laboratories, Inc., Burlingame, Calif.). Staining was
obtained by incubation with the substrate chromogen (DAB) solution
(3-3' diaminobenzidine tetrahydrochloride-H2O2 [Vector Laboratories, Inc.]). Counterstaining was obtained with Harris hematoxylin (Merck & Co., Rahway, N.J.). Final mounting was done
on glycerol gel (Dako Corp., Carpinteria, Calif.).
Serum and saliva analysis.
An enzyme-linked immunosorbent
assay (ELISA) was used to quantitate serum and salivary IgG and IgA
against LPS.
A solution containing 10 µl of S. flexneri 5 purified LPS
per ml of coating buffer (20 mM Na2CO3 [pH
9.6]) was used to coat 96-well microtiter plates (Immunoplates F96,
Maxi Sorp; Nunc, Roskilde, Denmark) (100 µl per well) overnight at
room temperature. The plates were washed with PBS-0.05% Tween 20, covered with a filler solution (1% bovine serum albumin in washing
buffer), and incubated at room temperature for 1 h. The solution
was aspirated, and the plates were washed with washing buffer. Guinea
pig sera or saliva, serially diluted in filler solution, was added to
the wells and incubated 1 h at 37°C. After this time and
following washes with washing buffer, the plates were treated
separately for the dosage of IgA or IgG.
For anti-LPS IgA, the plates were incubated with a sheep primary
antibody specific for guinea pig IgA (Bethyl Lab. Inc., Montgomery, Tex.), for 1 h at 37°C at a concentration of 1:1,000. After
washing, a horseradish peroxidase (HRP)-conjugated donkey
secondary-antibody anti-sheep IgG (heavy and light chains) (Bethyl Lab.
Inc.) was added at a dilution of 1:5,000 and left 1 h at 37°C.
Total IgA was evaluated as follows. First, a rabbit anti-guinea pig IgA
(
chain) (Bethyl Lab. Inc.) was used at a concentration of 1:2,000
to coat the wells; then different dilutions of saliva were added and
IgA was quantitated with a sheep primary antibody anti-guinea pig IgA
(1:1,000 concentration). The HRP donkey anti-sheep IgG (heavy and light
chains) (1:5,000) (Bethyl Lab. Inc.) was used again in the revelation step.
For anti-LPS IgG, an HRP-conjugated sheep primary antibody against
guinea pig IgG (heavy and light chains) (Bethyl Lab. Inc.) was used at
a dilution of 1:10,000.
After these treatments ELISA plates were washed again and developed
with O-phenylenediamine (Sigma Chemical Co.) (0.3 mg/ml in
citrate buffer [pH 5.6]) and H2O2 (0.03%).
The reaction was blocked with H2SO4 (4 N), and
the absorbance was read at 490 nm in an ELISA reader (model MR 4000;
Dynatech Laboratories, Inc., Alexandria, Va.). The titers were defined
as the reciprocal of the last dilution having an optical density at 490 nm of 0.1 or more.
Statistical analysis.
The attack rates for
keratoconjunctivitis in vaccinated guinea pigs and controls following
conjunctival sac challenge were compared by Fisher's exact test. An
unpaired Student's t test was used to compare the mean
value of CFU of bacteria recovered from infected tissues and the
significance of the differences between the two immunization routes.
The Mann-Whitney U test was performed to compare the mean titers of
antibody elicited by the vaccine strains. The values were considered
statistically significant for P < 0.05, whereas values
of 0.05 < P < 0.09 were considered to be of
borderline significance.
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RESULTS |
Immunizations.
Guinea pigs were immunized with S. flexneri 5 wild-type strain M90T, the auxotrophic mutants M90T
aroC and M90T purE aroC, and E. coli
strain 395.1, following the protocols described in Materials and Methods.
M90T aroC is an attenuated mutant in which auxotrophy for
aromatic amino acids results in a negative Sereny test
(3). In the plaque assay, which is an in vitro test that
measures the ability of virulent shigellae to form areas of necrosis on
a confluent HeLa cell monolayer, M90T aroC induces a
cytopathic effect that is far weaker than that of the wild-type strain.
Its intracellular generation time is longer than that of M90T (119 min
versus 75 min) (3). M90T purE aroC, which
harbors the adenine auxotrophy mutation (purE) in addition
to the aroC mutation, is severely attenuated. It was found
to be negative in the plaque assay and dramatically retarded in
intracellular multiplication (intracellular generation time, 302 min),
and it did not elicit a positive Sereny test (3). Although
the
purE mutant was only weakly attenuated (3), the combination of this mutation with either the
aroC or aroD deletion further impaired the
virulence of these strains (3). E. coli 395.1 was used as a negative control in all immunization trials. Animals were
immunized following the schedule shown in Fig. 1. The Sereny test was
used to evaluate the protective efficacy and immunogenicity of the
vaccine candidates.
Normally, from 96 h postchallenge onwards, the severity of
symptoms decreased up to complete clearance. Therefore, only data relative to this period are shown. Results are summarized in Table 2.
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TABLE 2.
Immune protection of guinea pigs immunized i.g. or i.n.
against the intraconjunctival challenge with the wild-type S. flexneri 5 strain M90T
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i.n. immunization with M90T or M90T aroC provided
significant protection against a challenge with M90T (full protection,
100%), whereas only low levels of protection were obtained in animals vaccinated with M90T purE aroC (full protection, 40%).
There was no protection, either partial or full, against M90T in
animals immunized i.g. or i.n. with E. coli 395.1.
In contrast, among animals immunized i.g., only those treated with the
M90T purE aroC mutant exhibited full protection against challenge with the virulent homologous strain (full protection, 100%).
Surprisingly, wild-type M90T conferred only moderate protection (full
protection, 10%; partial protection, 40%), whereas the
aroC mutant elicited no significant protection (partial
protection, 20%). There was no protection, either partial or full,
against M90T in animals immunized i.g. or i.n. with E. coli
395.1.
Antibody response against M90T somatic antigen.
Immunogenicity
of the vaccine candidates was measured by determining the levels of
serum IgG and saliva IgA directed against S. flexneri 5 LPS.
All guinea pigs showed null antibody titers against S. flexneri before vaccination (data not shown). Approximately 2 weeks after the second immunization (at days 32 and 28 for i.g. and
i.n. immunization, respectively), animals were bled and the serum IgG
response against LPS was evaluated by ELISA. At day 21 postinfection
(p.i.), saliva was collected from animals, and anti-LPS IgA levels were
measured. Results shown in Fig. 2 and Table 3 demonstrate significant
differences in the levels of antibodies elicited by the two different
immunization routes in that higher levels of both IgG and IgA were
observed in animals vaccinated i.n. than in those vaccinated i.g.
(P = 0.0034 for IgG i.n. versus IgG i.g., and
P < 0.0001 for IgA i.n. versus IgA i.g.). At day 21, tears were also collected, and anti-LPS IgA levels in the tears were
measured. The results obtained were comparable to those observed in
saliva (data not shown).

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FIG. 2.
Serum IgG titers against S. flexneri 5 LPS
from animals immunized i.n. (IN) and i.g. (IG) at days 28 and 32 p.i., respectively. Data represent the geometric mean titers for each
group of guinea pigs immunized i.n. or i.g. with M90T, M90T
aroC, M90T purE aroC, and E. coli
395.1 Standard deviations (SDs) are shown. Preimmune serum IgG titers
against S. flexneri 5 LPS were <50. The titers were defined
as the reciprocal of the last dilution having an optical density at 490 nm of 0.1 or more.
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As shown in Fig. 2, in i.n. trials, M90T purE aroC conferred
only low protection compared to M90T, but the IgG response induced in
animals immunized with this strain was comparable to that induced by
M90T (P = 0.2475 for M90T purE aroC versus
M90T). Despite the high total salivary IgA titer found with M90T
purE aroC, the percentage of specific IgA against LPS was
lower for M90T purE aroC than for M90T (P = 0.0286 for M90T purE aroC versus M90T) and
aroC (P = 0.0190 for M90T purE
aroC versus M90T aroC). Results are summarized in Table
3.
In i.g. immunizations, only M90T and M90T purE aroC induced
significant levels of serum anti-LPS IgG. Also, in this case there was
no significant difference (P = 0.3930 for M90T
purE aroC versus M90T) between serum anti-LPS IgG titers
measured in animals immunized with M90T purE aroC, which
induced full protection, and M90T, which induced only partial
protection. Salivary anti-LPS IgA was markedly low; only IgA responses
elicited by M90T and M90T purE aroC appeared significant and
reached a detectable level of anti-LPS specificity (5.41 and 1.71 for
M90T and M90T purE aroC, respectively). It must be stressed
that animals immunized with M90T were 10% fully and 40% partially
protected, whereas those treated with M90T purE aroC were
100% protected. Therefore, no significant correlation was found
between high salivary anti-LPS IgA titers and protection. All results
are shown in Fig. 2 and in Table 3.
Guinea pigs immunized either i.n. or i.g. with the E. coli 395.1 control strain showed no significant antibody
titers against LPS.
Infections.
The results obtained in immunization trials
indicated that the vaccine strains demonstrated different capabilities
for inducing protective immune responses depending on the immunization
route. This finding suggested that the bacterial strains behaved
differently in different host tissues. We reasoned that the probability
of inducing an adaptive immune response relied on various factors including the ability of bacteria to colonize the host, to persist within an infected tissue, and to induce, to various degrees, an
inflammatory response. To address these major points, M90T, M90T
aroC, and M90T purE aroC were used to infect
another pool of guinea pigs, either i.n. or i.g., and the ability of
these strains to persist, disseminate, and induce an inflammatory
response was then evaluated. Our aim was to compare the behavior of
these strains in the tissues they infected in an attempt to detect an association between a specific bacterial trait in the host and the
capacity to induce a protective immune response.
Two sets of guinea pigs were infected and sacrificed at different times
p.i. Three animals for each strain in both infection protocols were
sacrificed on days 1, 3, and 7, respectively. To measure the extent of
bacterial dissemination in the host, several organs and tissues were
processed. Briefly, nasal mucosa, parotids, and lungs were processed
for animals infected i.n., and PPs and liver were processed for those
challenged i.g. The number of bacteria was evaluated, and
immunohistopathological analysis was performed. This analysis allowed
us to monitor three essential parameters: bacterial colonization,
dissemination, and persistence.
In the intranasally infected animals, all bacterial strains tested
reached the lungs, where they persisted for at least 7 days and
disseminated into the parotids, as shown in Fig.
3. Although the number of bacteria
decreased from day 3, approximately 4 × 104 bacteria
were isolated on day 7 from the lungs of animals infected with M90T. In
the nasal mucosa the number of bacteria from animals infected with M90T
dramatically decreased during the 7 days of observation, whereas in
parotid glands the number of bacteria from all infected animals
increased during the same period. M90T colonized the tissues more
efficiently than the other strains, and bacterial counts from animals
infected with M90T purE aroC were the lowest.

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FIG. 3.
Shigella survival and dissemination in lungs,
nasal mucosa, and parotids in guinea pigs infected i.n. with M90T, M90T
aroC, and M90T purE aroC at days 1, 4 and 7 p.i. Data shown represent the mean number of CFU calculated per lung,
within the nasal mucosa and per parotid glands. SDs are shown.
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In animals infected i.g., both M90T and M90T purE aroC
reached the liver whereas M90T aroC failed to do so, as
shown in Fig. 4. The main difference was
that M90T was found in the liver at days 1 and 3 and disappeared at day
7, whereas M90T purE aroC was found in the liver only on day
7. The same kinetics were observed for the PPs, where M90T and M90T
aroC were recovered at days 1 and 3 and cleared at day 7. In
contrast, M90T purE aroC accumulated in the PPs and was
observed only on day 7. M90T aroC behaved in a manner
similar to M90T, although they gave lower bacterial counts.

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FIG. 4.
Shigella survival and dissemination in PPs
and liver in guinea pigs infected i.g. with M90T, M90T aroC,
and M90T purE aroC at days 1, 4 and 7 p.i. Data shown
represent the mean number of CFU calculated per liver and per PP. SDs
are shown.
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Briefly, in the i.n. model, all three bacterial strains disseminated in
the tissues that were investigated, where they persisted for 7 days,
differing only in their ability to colonize the infected organs. In the
i.g. model, the results of dissemination, colonization, and persistence
differed for each strain. M90T colonized better than the other strains,
but it was cleared at day 7, as was M90T aroC. In contrast
to M90T, M90T purE aroC was barely present at days 1 and 3, but it persisted and multiplied at day 7. All three strains were
isolated from PPs, but only M90T and M90T purE aroC disseminated into the liver.
Histopathology and immunohistochemistry performed on intestinal
tissues of animals infected intragastrically.
Histopathological analysis was performed on tissue sections removed
from the intestines of animals sacrificed at days 1, 3, and 7. The
sections usually included PPs and the surrounding area containing villi.
To perform a quantitative evaluation of the damage induced by the
presence of bacteria within the intestine, we measured the L/W ratio of
the villi. Changes in this ratio are provoked by intestinal atrophy
subsequent to Shigella infection. About 80 villi per strain
per day p.i. were examined, their lengths and widths were recorded, and
the ratio was calculated. Data obtained and statistical analysis are
shown in Table 4.
The typical villus from animals infected after 1 day with M90T is shown
in Fig. 5A. At day 1 p.i., the
villus architecture was severely altered with intestinal atrophy (L/W
ratio = 1.99 ± 0.68), depletion of goblet cells, focal
abscesses (arrowheads) and areas of detachment as well as destruction
of the epithelial lining reflecting extensive epithelial necrosis
(arrow). The lamina propria was characterized by the presence of a
massive inflammatory infiltrate (mostly PMNs) causing edema and
hemorrhagic foci. PPs were also altered (Fig. 5B), their
follicle-associated epithelium being infiltrated by the
inflammatory reaction that occurred in the dome area. In flares
(arrowhead), the epithelium was even disrupted, and ulcers
leaking inflammatory cells could be observed.

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FIG. 5.
Hematoxylin-eosin staining of tissue sections
corresponding to villi (A, C, and E) and PPs (B, D, and F) from guinea
pigs infected with M90T (A and B), M90T aroC (C and D) and
M90T purE aroC (E and F) at day 1 p.i. In panels A and
C, arrowheads point to focal abscesses. In panels B and D, arrowheads
define areas of epithelium destruction where PMNs are streaming into
the lumen. In panel A, the arrow points to an area of epithelium
necrosis. Bars, 50 µm (A, C and E) and 20 µm (B, D and F).
|
|
M90T aroC also caused significant intestinal atrophy at day
1 with an L/W ratio of 3.37 ± 0.919. Figure 5C shows massive
release of mucus and shortening of villi, with indentation of the
epithelium reflecting the presence of focal subepithelial inflammatory
infiltrates as well as ulcerated zones (arrowheads). The lamina propria
appeared infiltrated as well as dilated, following development of the
inflammatory infiltrates. Similarly, PPs (Fig. 5D) appeared altered
with infiltrates and, in some areas, rupture of the follicle-associated
epithelium (arrowheads). The severity of these lesions, however, was in
general less dramatic than that observed with wild-type M90T,
reflecting attenuation in response to the aroC mutation.
M90T purE aroC, in general, caused very limited alteration
of the intestinal mucosa. Intestinal atrophy was barely observed at day
1, with an L/W ratio of 4.5 ± 0.76. As shown in Fig. 5E, villi
appeared elongated, with their width being slightly increased due
to lamina propria edema in response to a clear but limited
inflammatory infiltrate. In PPs (Fig. 5F), although the
follicular-associated epithelium appeared somewhat infiltrated by
inflammatory cells, neither abscesses nor ulcerations were observed.
We then attempted to correlate the persistence of bacteria or bacterial
material (i.e., through LPS staining) in infected intestinal tissues
with the quality of immune protection obtained by the wild-type strain
M90T and the M90T mutants aroC and purE aroC.
Immunostaining for LPS was performed on sections from tissues obtained
at day 1, 3, or 7 p.i. Figure 6
shows typical examples from villi and PPs. Whereas a significant amount
of bacterial material was observed in severely altered tissues with
M90T at day 1 (Fig. 6A), in agreement with the strong invasive capacity of this wild-type strain, only a limited amount of bacterial material could be detected after 7 days (Fig. 6B). With regard to M90T aroC, at day 1 (Fig. 6C) a significant amount of bacterial
material was observed to be associated with the tissues. However, at
day 7, all detectable bacterial material had been cleared (Fig. 6D). Although limited amounts of bacterial material were observed at day
1 p.i. with M90T purE aroC (Fig. 6E), mainly associated
with the tip of the villi, it is striking that at day 7 p.i., large amounts of bacterial material could be detected, essentially in the
deep portion of PPs and in the vicinity of crypts (Fig. 6F). These
results are in agreement with the bacterial counts shown in Fig. 4,
indicating that the double mutant has the capacity to survive and
eventually to grow to significant numbers within 7 days. These data
also suggest that the immunostaining corresponds not only to bacterial
material but also to live bacteria.

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FIG. 6.
Immunoperoxidase labeling of serotype 5 somatic antigen
by anti-LPS monoclonal immunoglobulin G. (A, C, and E) Sections of PPs
(A and C) and villi (E) from animals infected i.g. at day 1 p.i;
(B, D, and F) sections of PPs of animals at day 7 p.i. (A and B)
Sections from guinea pigs infected with M90T; (C and D) sections from
guinea pigs infected with M90T aroC; (E and F) sections from
guinea pigs infected with M90T purE aroC. Bars, 50 µm (A,
B, C, D, and F) and 20 µm (E). The inset in panel E shows the tip of
a villus in which LPS material can be observed. Arrowheads point to
bacteria or bacterial components present within villi.
|
|
Histopathology and immunohistochemistry performed on upper
respiratory tissues of animals infected intranasally.
Histopathological analysis was performed on tissue sections from the
nasal mucosa of animals sacrificed at days 1, 3, and 7. As shown in
Fig. 7A, after 1 day of infection, the
wild-type strain M90T was able to cause massive inflammation (mostly
PMNs) of the chorion with ulceration of the associated simple
epithelium (arrowhead), reflecting necrosis of the epithelial lining. A
massive efflux of PMNs was observed through the ulcerations, with
formation of purulent plaques in the nasal cavity. In similar
conditions, the M90T aroC mutant also caused epithelial
alteration with ulceration and efflux of PMNs (arrowhead), although the
inflammatory infiltrate in the chorion appeared weaker (Fig. 7C). It is
interesting, as shown in Fig. 7, that the inflammation and destruction
ceased at the transition between the simple epithelium concerned in the process and the stratified squamous epithelium, which was preserved (arrow), suggesting that bacterial invasion occurred only in simple epithelia. As shown in Fig. 7E, the M90T purE aroC double
mutant also caused epithelial lesions, although of much weaker
intensity, in both the chorion and epithelial lining. The arrowhead in
this panel points to a typical zone of inflammatory infiltrate of the epithelial lining without significant rupture of this lining.

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FIG. 7.
Infection of guinea pig nasal mucosa with M90T (A and
B), M90T aroC (C and D) and M90T purE aroC (E and
F) at day 1 p.i; (G and H) nasal mucosa from an uninfected animal.
(A, C, E, and G) Hematoxylin-eosin stained tissue sections; (B, D, F,
and H) immunoperoxidase labeling of serotype 5 somatic antigen by
anti-LPS monoclonal IgG. Arrowheads (A, C, and E) point to areas of
necrosis of the associated simple epithelium. Arrow (C) indicates the
transition between the stratified squamous epithelium and the simple
epithelium where areas of necrosis are observable. Bar, 20 µm.
|
|
As shown in Fig. 7B, immunolabeling of LPS confirmed massive bacterial
invasion of the simple epithelium by M90T in areas corresponding to
massive inflammatory destruction. The M90T aroC mutant,
which caused weaker lesions, was accordingly present in smaller amounts
than M90T, bacterial LPS being associated with the epithelial lining
and, in very low amounts, with the chorion (Fig. 7D). Weak staining of
the double mutant M90T purE aroC was observed compared to
M90T (Fig. 7F).
 |
DISCUSSION |
To elicit the signaling cascade that ultimately induces the
protective immune response, Shigella vaccine candidates
probably need to retain sufficient invasiveness to deliver the
appropriate signals but also to avoid causing symptomatic lesions by
being sufficiently stealthy. However, finding a fine balance between invasiveness, inflammation, and immunogenicity is a particularly difficult objective to achieve (40), since
Shigella invasiveness is mainly associated with the ability
of the bacteria to induce a strong inflammatory reaction at the site of
infection. In this work, we have attempted to further define rational
bases for live vaccine design by means of virulence attenuation. In
particular, we have analyzed in vivo the correlations existing between
major parameters such as the degree of invasiveness, intensity of the inflammatory response, immunogenicity, and protective capacity of a
S. flexneri 5 wild-type strain and of two of its attenuated mutants, auxotrophic for PABA (aroC) and for PABA and
adenine (aroC purE), in guinea pigs infected by
either the i.g. or the i.n. route. Immunogenicity was evaluated by
assessing the ability of these strains to protect guinea pigs
vaccinated either i.n. or i.g. against Shigella
intraconjunctival challenge. In this way, we attempted to address
several questions. (i) How does the route of inoculation influence the
quality of the immune response with regard to protection against a
virulent challenge? (ii) What differences can be observed among the
wild-type strain and its mutants with regard to interaction with nasal
and intestinal tissues (i.e., their ability to colonize, persist,
disseminate within the host, and elicit an inflammatory reaction)?
(iii) Is there a link between the degree of invasiveness, the
inflammatory potential of strains, and their capacity to induce
protective immunogenicity?
The first two questions focus on the differences between the two
immunization routes. Our results indicate that the immune responses
elicited by vaccine candidates are strongly influenced by the
immunization routes, with the i.n. route being more efficient than the
i.g. route (i.n. versus i.g.: P = 0.0063). Protection generated by i.n. immunization is accompanied by high specific anti-LPS
IgA titers in saliva and tears (not shown). Accordingly, M90T
purE aroC, which elicited the highest titer of total
salivary IgA, was less protective than M90T and M90T aroC in
that it elicited the lowest levels of specific salivary anti-LPS IgA.
This issue is consistent with previous studies that reported, in the
i.n. model of guinea pig vaccination, that high titers of anti-LPS IgA
(31, 32) were associated with protection
(33). Moreover, in the guinea pig keratoconjunctivitis
model, high levels of antigen-specific antigen-secreting cells occur in
superficial ventral cervical lymph nodes and correlate with the vaccine
protective efficacy (12). In the mouse pulmonary model of
shigellosis, high levels of IgA-ASC and high mucosal anti-LPS IgA
titers were detected following two i.n. immunizations with wild-type
S. flexneri 2a (49). Specifically, a monoclonal
IgA directed against a serotype-specific epitope of S. flexneri LPS was demonstrated to confer protective immunity
(37). However, this rationale does not completely account for the results obtained in i.g. immunizations. In this case, M90T and
M90T purE aroC were the only strains conferring protective immunity, with the significant difference that M90T was only partially protective, whereas M90T purE aroC was fully protective. It
is intriguing that only animals immunized with these two strains exhibited observable levels of anti-LPS IgA in tears (not shown) and
saliva. Nevertheless, these titers were significantly lower than those
measured in i.n. immunizations (P < 0.0001). The
question of whether a low level of anti-LPS IgA alone supports the
protection generated by the i.g. delivered M90T purE aroC
and M90T remains unsolved.
Consistent with other studies (53) that focused on the
differences between the immune responses following either i.g. or i.n.
antigen administration, higher titers of serum anti-LPS IgG were found
in guinea pigs vaccinated i.n. than in those immunized i.g. However, it
has been shown that in the murine pulmonary model of shigellosis there
is no correlation between high anti-LPS IgG and protection
(25). In our study, under the i.g. regimen, only M90T and
M90T purE aroC stimulated significant levels of anti-LPS IgG, perhaps suggesting that these antibodies influence protection. In
humans, a significant correlation between anti-LPS IgG and resistance
to shigellosis was observed (5, 6), and
Shigella-LPS conjugates (composed of the O-specific
polysaccharides conjugated to a carrier protein) are protective and
induce high levels of anti-LPS IgG (7). Briefly, in the
model of i.n. vaccinated guinea pigs, protective immunity appears to be
correlated essentially with high levels of anti-LPS IgA, whereas in
animals vaccinated i.g., protection seems to be a multifactorial
process in which both anti-LPS IgA and IgG may contribute to the
response. These findings also suggest a possible role for cell-mediated
immune mechanisms in protective immunity following i.g. vaccination. In
fact, several studies implicate cell-mediated immunity as an essential
defense mechanism against shigellosis on the basis of results obtained
in animal models (49) and in human natural infections
(16, 17). A high production of both IL-10 and gamma interferon (IFN-
) from peripheral blood mononuclear cells of volunteers experimentally infected with Shigella spp. was
reported (39) to be accompanied by poor proliferative
response to all Shigella antigens accounted for by the
synergic effects of IL-10, IFN-
, and transforming growth factor
in decreasing IL-2 and IL-15 production. We hypothesize that this
pattern of cytokine induction and repression might be reversed in i.g.
immunization with the M90T purE aroC mutant, which, being
sufficiently stealthy, is able to persist longer in infected tissues.
Therefore, T-cell proliferation might occur, thus further potentiating
the immune response. Consistent with this hypothesis, a stronger CD45
response was observed at day 7 p.i. in T-cell areas of PPs of
animals infected with M90T purE aroC than in those infected
with M90T (data not shown).
In recent years, a certain number of Shigella attenuated
strains have been constructed and evaluated as vaccine candidates (8, 23). These strains could be roughly classified into
two groups: (i) mutants in which genes governing one or two main steps of the metabolism were inactivated (e.g., thyA,
aroD, and aroA aroD) (1, 24, 50) and
(ii) mutants harboring the icsA deletion in addition to one
of the above-mentioned gene inactivations (2, 10, 21, 32, 34, 43,
54). The rationale underlying these constructions is that
strains belonging to the first group are impaired in intracellular
tissue replication, whereas the mutants in icsA are impaired
also in intercellular dissemination. In the colonic and rectal mucosa
of experimentally infected animals (43), inactivation of
icsA restricts S. flexneri invasion to the
epithelial cells overlying the lymphoid structures, strongly reducing
bacterial colonization. The mutants used in this study are expected to
disseminate into the infected tissues because they do not carry the
icsA deletion. Their attenuation is based exclusively on a
metabolic defect that reduces their intracellular multiplication, as
previously shown in the tissue culture invasion assay (3).
Following i.g. administration, M90T purE aroC was not
recovered from PPs at day 1 p.i., but the number of bacteria progressively increased during the 7-day infection period. M90T bacterial counts showed opposite kinetics. Tissue lesions and inflammation were seldom seen with M90T purE aroC. By
contrast, extensive alteration of the epithelial lining was seen in
animals infected with M90T and M90T aroC, consistent with
previous results obtained with M90T-infected ligated ileal loops in
rabbits (44). At day 1 p.i., M90T was observed to be
associated with the areas of intense destruction. Consequently,
bacteria were rarely observed within the infected tissues
after this point in time. At day 1 p.i., M90T purE aroC
was located within the tips of villi and, at day 7 p.i., to a
greater extent near the crypts. This latter observation indicates that
this mutant is able to move within the epithelial layer and to reach
areas far from the sites of entry. It was reported that in PPs, the
number of dendritic cells (DCs) increases during infections at the
sites of bacterial entry (19, 48). It could be
hypothesized that M90T purE aroC may enter DCs in PPs and,
through these cells, may reach the deeper layers of the intestinal
epithelium. In fact, DCs were recently proposed as a vector for viable
salmonellae or for Salmonella material during the course of
salmonellosis (27). This tight interaction between
salmonellae and DCs results in cytokine production and an increase in
Salmonella dissemination. In support of this idea, M90T and
M90T purE aroC were also isolated from liver tissue at days
1 and 3 and day 7, respectively, thus indicating that bacteria pass
into the portal blood stream. Accordingly, S. flexneri 2a
was also found to enter the blood stream in a rabbit model of
shigellosis (9).
In i.n. infections, a great number of bacteria were isolated from
infected tissues, and all strains persisted longer than 1 week and
disseminated within the nose-associated organs, including the parotid
glands. Broad damage characterized by abscesses showing PMN
infiltrations was observed within the ciliated epithelium in the nasal
tract, which appears to be the primary site of bacterial entry.
Intensity of the lesions was inversely correlated with the attenuation
of the strain. The numbers of both bacteria cultured from and bacteria
detectable within these infected tissues were consistent with the
alterations produced. Therefore, at day 7 p.i. higher numbers of both
M90T and M90T aroC were found in all of the tissues examined
when compared to M90T purE aroC. As also reported for the
mouse model of shigellosis, the guinea pig nasal-infection model is
mainly characterized by the development of an intense inflammatory
reaction in the lungs with a leukocytic exudate that accumulates in
bronchi (data not shown). In a study by Van de Verg et al., challenging
of mice within injected S. flexneri 2a (49) led
to a prolonged increase in the proportion of monocytes or macrophages
in the lungs. Pulmonary IFN-
levels were elevated, but only at
earlier time points of infection, and these levels then rapidly
decreased. Therefore, this early IFN-
response could enhance
the microbicidal activity of infiltrating macrophages at
this time (49). Moreover, in humans, the frequency of
IFN-
mRNA-expressing cells is significantly reduced during the acute stage of shigellosis compared to that observed during the
convalescent stage (38, 52). In guinea pigs infected
with all strains used in this study, the number of bacteria recovered
from lungs also decreased after 3 days p.i. However, after 7 days of
infection, this number did not change. This finding may indicate that,
as in humans and mice, the production of IFN-
, responsible for the first clearance of bacteria, might be reduced in the acute stage of
infection, thus allowing maintenance of shigellae within the lungs.
On the basis of the results obtained following the two routes of
infections, it can be concluded that, in our model, bacterial persistence within the infected tissues is a prerequisite for establishment of protective immunity. This might partially explain the
success of i.n. immunization compared to the i.g. regimen. After i.g.
administration, M90T purE aroC, although more attenuated, was able to persist longer in the tissues and was the only strain able
to confer protective immunity. On the other hand, after i.n. administration, all strains persisted for extended periods within the
tissues analyzed but to different extents. In these tissues, M90T
purE aroC was more easily cleared, thus resulting in less protective immunity compared to that induced by M90T aroC
and M90T.
This study highlights the need to investigate further the mechanisms
that mediate the transition from the innate immune response to the
adaptive immune response and, consequently, to develop better
experimental animal models that more closely mimic the naturally
occurring disease.
 |
ACKNOWLEDGMENTS |
We thank Michel Huerre and Nicole Wuscher for histopathological
procedures, Daniele Remotti and Mariateresa Taffuri for advice in
microscopical analysis, Armelle Phalipon for providing us with the
anti-S. flexneri 5 LPS antibody and for helpful discussions, and Dana Philpott for careful reading of the manuscript and suggestions.
This work was supported in part by grants from the World Health
Organization (V27/181/79) and from the European Union
(QLK2-1999-00938).
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Dipartimento di
Biologia Cellulare e dello Sviluppo, Sezione di Scienze
Microbiologiche, Università `La Sapienza,' Via dei Sardi 70, 00185 Rome, Italy. Phone: 3906 49917579. Fax: 3906 49917594. E-mail:
bernardini{at}axcasp.caspur.it.
Editor:
J. D. Clements
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