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Infection and Immunity, September 2001, p. 5430-5439, Vol. 69, No. 9
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.9.5430-5439.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Changes in Availability of Oxygen Accentuate
Differences in Capsular Polysaccharide Expression by Phenotypic
Variants and Clinical Isolates of Streptococcus
pneumoniae
Jeffrey N.
Weiser,1,2,*
Deborah
Bae,1,2
Henry
Epino,3
Stephen B.
Gordon,3,4
Miki
Kapoor,1,2
Lauren A.
Zenewicz,1,2 and
Mikhail
Shchepetov1,2
Departments of Microbiology1 and
Pediatrics,2 University of Pennsylvania
School of Medicine, Philadelphia, Pennsylvania 19104, and
Malawi-Liverpool-Wellcome Trust Clinical Research Programme,
Universities of Malawi and Liverpool,3 and
Liverpool School of Tropical Medicine,4
Liverpool L3 5QA, United Kingdom
Received 11 April 2001/Returned for modification 16 May
2001/Accepted 24 May 2001
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ABSTRACT |
Most isolates of Streptococcus pneumoniae are mixed
populations of transparent (T) and opaque (O) colony phenotypes.
Differences in the production of capsular polysaccharide (CPS) between
O and T variants were accentuated by changes in the environmental
concentration of oxygen. O variants demonstrated a 5.2- to 10.6-fold
increase in amounts of CPS under anaerobic compared to atmospheric
growth conditions, while CPS production remained low under all
conditions for T variants. Increased amounts of CPS in O compared to T
pneumococci were associated with increased expression of
cps-encoded proteins. The inhibitory effect of oxygen on
expression of CPS in O variants correlated with decreased tyrosine
phosphorylation of CpsD, a tyrosine kinase and regulator of CPS
synthesis. Modulation of CpsD expression and its activity by tyrosine
phosphorylation may allow the pneumococcus to adapt to the requirements
of both colonization, where decreased CPS allows for adherence, and
bacteremia, where increased CPS may be required to escape from opsonic
clearance. In patients with invasive infection, paired isolates from
the same patient were shown to have predominately a T colony phenotype without phosphotyrosine on CpsD when cultured from the nasopharynx, and
an O phenotype that phosphorylates CpsD in response to oxygen when
cultured from the blood. Differences in the availability of oxygen,
therefore, may be a key factor in allowing for the selection of
distinct phenotypes in these two host environments.
 |
INTRODUCTION |
Streptococcus pneumoniae
(the pneumococcus) colonizes the mucosal surface of the human
nasopharynx. Unlike the many other species of streptococci carried in
the human respiratory tract, the pneumococcus is also a common cause of
disease. Infection generally occurs when host factors allow the
organism access to the normally sterile parts of the upper (resulting
in otitis media and sinusitis) and lower respiratory tract (resulting
in pneumonia). From these sites it may also pass through tissue
barriers into the bloodstream, resulting in the most serious forms of
pneumococcal disease, sepsis and meningitis.
The characteristic of the pneumococcus most clearly associated with its
ability to cause disease and that distinguishes it from closely related
but non pathogenic oral streptococci is its expression of a
polysaccharide capsule (40). S. pneumoniae is capable of synthesizing at least 90 structurally unique capsular polysaccharide (CPS), which form the basis of serotyping. The expression of CPS renders the organism resistant to the major mechanism
of clearance, opsonophagocytosis, in hosts lacking type-specific antibody of sufficient quantity or avidity (13, 24).
Expression of anti phagocytic CPS, however, has been shown to inhibit
adherence of pneumococci to host cells, a critical step in carriage and possibly later aspects in the pathogenesis of disease
(23). Similar findings in other encapsulated bacterial
pathogens, including Haemophilus influenzae, Neisseria
meningitidis, and Streptococcus pyogenes and
Streptococcus agalactiae, have led to an appreciation that
the amounts of CPS must be varied at different stages in the
pathogenesis of invasive infection to allow both for adhesive interactions with host cells and for resistance to humoral clearance mechanisms (7, 10, 15, 28, 29, 31).
Previous reports from this laboratory have demonstrated both intra- and
interstrain variability in the quantity of CPS produced by the
pneumococcus, although the regulatory mechanisms controlling its
expression remain incompletely understood (13, 16). The majority of clinical isolates consist of heterogeneous populations of at least two phenotypes distinguished by their differences in colony
opacity (37, 38). Opaque (O) and transparent (T) colony
variants of the same strain differ in the amounts of CPS produced, as
well as in other characteristics (13). It is also well
established that relatively minor differences in amounts of CPS may
have a major impact on virulence (16). The 1.2- to 5.6-fold-higher quantities of CPS in the O form compared to the T form
of the same strain correlates with increased resistance to
opsonophagocytosis following exposure to human serum containing type-specific antibody (14). In addition, only the O
variant of several strains was able to cause sepsis in a murine model of systemic infection (13). In contrast, the T variants
express greater amounts of the other major cell surface polysaccharide, the cell wall teichoic acid. The pneumococcal cell wall teichoic acid
to which CPS is covalently linked contains an unusual host-like constituent, phosphorylcholine, that contributes to pneumococcal adherence to epithelial cells through binding of the receptor for
platelet-activating factor (3, 4, 13, 30). The T form also
displays an altered distribution of cell surface choline-binding proteins, including CbpA, which functions in adherence and colonization (25). During carriage in an infant rat model, there is a
selection for variants of the T phenotype, which expresses increased
amounts of these adhesins and diminished quantities of
adherence-inhibiting CPS (38). Taken together, these
observations suggest that the pneumococcus varies between a form with
cell surface characteristics optimized for adherence and carriage (T
pneumococci) and a form that adheres poorly but is better adapted for
survival during inflammation or invasive infection, when the amounts of
antibody, complement, and phagocytic cells might otherwise limit the
viability of the organism (O pneumococci). This transition from one
form to the other is seen in the predominant phenotype isolated during the course of experimental otitis media following intranasal challenge in chinchillas. Initially, there is a preponderance of the T
variant but, as inflammation progresses over time, there is an
increasing selection for the O form (34). The relationship
between the opacity phenotype and pneumococcal infection in humans has
yet to be described.
In this report we examine the hypothesis that differences in ambient
oxygen concentration affect the regulation of CPS synthesis. The
results of this study suggest that (i) the oxygen availability on the
airway surface suppresses CPS production and, therefore, may facilitate
adherence of pneumococci during the commensal state, and that (ii) the
less-aerobic microenvironment encountered, for example, in the dense
consolidation of the alveolar spaces during pneumonia or the
inflammatory exudate in the middle ear space during otitis media may
enhance virulence by triggering increased expression of CPS (8,
9, 26). Phenotypic differences in clinical isolates,
furthermore, support the concept that different host environments
select for distinct subpopulations of pneumococci in natural infection.
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MATERIALS AND METHODS |
Bacterial strains and growth conditions.
The clinical
isolates of S. pneumoniae P303, P324, P68, P10, and D39 used
in this study were previously described (14). Broth
cultures were plated onto tryptic soy plates solidified with 1% agar
onto which 5,000 U of catalase (Worthington Biochemical, Freehold,
N.J.) was spread and incubated at 37°C in a candle extinction jar
unless otherwise specified. The O and T phenotypes of each isolate were
separated and studied as uniform populations (>99.9% the desired
phenotype). Colony morphology was determined on transparent medium
under magnification and oblique, transmitted illumination as previously
described (38). Bacteria were grown to mid-log phase
(A620 = 0.3) or for 16 h (stationary phase) with
gentle shaking at 100 rpm for atmospheric conditions (aerobic growth) or without shaking for microaerophilic and anaerobic conditions in
unsealed shallow vessels at 37°C in a semisynthetic (C+Y medium; pH
6.8) or tryptic soy medium as specified (33). Different
concentrations of environmental carbon dioxide in aerobic conditions
were provided in an incubator with adjustable levels of
CO2. Strict anaerobic growth conditions were obtained with
the BBL GasPak System (Becton Dickinson, Cockeysville, Md.) either with
or without the sodium bicarbonate component for generating an
atmosphere with or without 10% carbon dioxide, respectively, according
to the manufacturer's specifications. After harvesting of the
bacteria, the pH of the growth medium was measured to ensure that there
was no differential effect of different culture conditions. Unless
otherwise stated, chemicals and reagents were purchased from Sigma
Chemical Co. (St. Louis, Mo.).
Cloning and nucleotide sequencing of cpsD.
The
complete sequence of cpsD from the O and T variants of P303
was obtained by inverse PCR by using primers based on a conserved 5'
portion of the gene in order to obtain the sequence at the more
variable 3' region. Chromosomal DNA digested with DraI was ligated to itself and amplified with primers
5'-TACAGACCTATCACAAGGGC-3' and
5'-CCTGTAATCTTATCCCTTGC-3'. The PCR product was cloned into the pCR2.1 TOPO vector (Invitrogen Co., Carlsbad, Calif.) for sequencing of the insert. This region was then extended in the 5'
direction with primers based on the more-conserved 5' portion of gene
to obtain the entire cpsD sequence from both the O variant and the T variant. The accession number is AF359247.
Generation of antisera to CpsD.
The entire cpsD
gene from P303 was amplified by PCR using primers
5'-CATATGCCAACATTAGAAATCTCAC-3' and
5'-CTCGAGTTTTTTATTTTTCCCGTAATCT-3' and digested with
NdeI and XhoI for cloning into these sites in pET29b(+) (Novagen, Madison, Wis.). Production of the protein was
induced in Escherichia coli host strain BL21(DE3)/pLysS by the addition of IPTG
(isopropyl-
-D-thiogalactopyranoside) at a final
concentration 2 mM. The protein was isolated from these cells and
purified with a Ni2+ column (His-Bind Resin) according to
the manufacturer's standard protocol for denaturing conditions at pH
7.2 (Novagen). After the purity of the protein was confirmed in
Coomassie blue-stained sodium dodecyl sulfate-polyacrylamide gel
electrophoresis (SDS-PAGE) gels, it was used to immunize rabbits to
generate immune serum at a commercial facility according to its
standard protocol (Cocalico Biologicals, Reamstown, Pa.).
Analysis and quantification of CPS.
The expression of CPS
was confirmed by the quellung reaction. The presence and size of
refractile zones were determined after an equal volume of cells grown
in liquid culture to mid-log phase and type-specific antisera (Statens
Seruminstitut, Copenhagen, Demark) in 1% methylene blue were mixed on
a glass slide and agitated for 1 min.
Amounts of CPS were measured in O and T variants grown in semisynthetic
medium as described above. Cells were harvested at 2,000 × g and washed in phosphate-buffered saline (PBS), and the cell
fraction was sonicated for three 10-s intervals on ice prior to storage
at
20°C. A capture enzyme-linked immunosorbent assay (ELISA)
technique was used to determine quantities of CPS present in variants
grown under different conditions (13). Type-specific rabbit anti serum (Statens Seruminstitut) at a dilution of 1:5,000 in
0.05 M Na2CO3 (pH 9.6) was fixed overnight at
room temperature on microtiter plates. Between each incubation step,
the plate was washed five times with Tris buffer (10 mM Tris, 150 mM
NaCl, 0.05% Brij, 0.02% sodium azide). Purified type 6A, 6B, 9V, or 18C CPS at a known concentration purchased from the American Type Culture Collection (Rockville, Md.) was used as a standard. CPS in cell
sonicate fractions was detected with Monoclonal antibodies (MAbs) HASP
4 (against group 6 CPS), HASP 22 (against type 18C CPS), and HASP 33 (against type 9V CPS) obtained from Uffe B. Skov-Sørenson and used at
a concentration determined in pilot experiments. Binding of MAbs was
detected with an antiserum to mouse immunoglobulin M conjugated to
alkaline phosphatase and developed as previously described
(13). The total cellular protein determination was carried
out on sonicated cells with the Micro Bicinchoninic Acid Kit according
to the manufacturer's directions (Pierce Chemical Co., Rockford,
Ill.). The amount of CPS in the supernatant fraction was normalized to
the protein concentration in the corresponding cell sonicate fraction.
A similar capture ELISA was used to compare amounts of total teichoic
acid in cell sonicates as previously described (13). All
experiments were performed in duplicate at least three times and
expressed as mean values per total cellular protein concentration.
Western analysis.
Bacteria were grown in semisynthetic
medium to mid-log phase under atmospheric conditions or under anaerobic
conditions with or without supplemental carbon dioxide as described
above. The bacteria were maintained at 4°C, collected at
1,500 × g, washed in an equal volume of PBS (pH 7.2)
and resuspended in 2.5% of the original culture volume in PBS. For
cells to be treated with alkaline phosphatase, 50 mM Tris-Cl (pH 7.2),
100 mM NaCl, and 1 mM dithiothreitol were used instead of PBS. The
washed, concentrated cells were then sonicated as described above. When
specified, the sonicates were treated with or without calf intestinal
alkaline phosphatase at 25 U per 25 µl of sonicate for 10 min at
30°C. An aliquot of the sonicate was used to measure the total
protein content as described above. Equal amounts of sample based on
the protein concentration were added to gel loading buffer and heated to 100°C for 5 min before separation on 12.5 or 15% SDS-PAGE gels prior to transfer to Immobilon-P membranes as previously described (36). Equal loading of sonicates was confirmed by Ponseau
S staining of membranes prior to immunoblotting. Antisera to CpsD from
P303 was used at a dilution of 1 in 1,000, and binding of the antibody
was detected with antisera to rabbit immunoglobulins conjugated to
alkaline phosphatase. Immunoblotting was carried out with
antiphosphotyrosine MAb (P-Tyr-102; Cell Signaling Technology, Inc.,
Beverly, Mass.) according to the manufacturer's specifications for
blocking, binding, and developing using the ECL Kit (Amersham, Arlington, Ill.). In some experiments, after the membranes were developed the antibody was stripped off according to protocol provided
in the ECL Kit (Amersham), and equal loading of specimens was confirmed
by reimmunobotting membranes with antiserum raised in rabbits to
pneumolysin and then detected using an antisera to rabbit
immunoglobulins conjugated to alkaline phosphatase.
Analysis of clinical isolates.
We were initially
unsuccessful in isolating pneumococcus from the nasopharynx of
bacteremic patients because of prior antibiotic treatment. It was
necessary to obtain paired isolates from the same patient for this
comparison because of marked strain-to-strain heterogeneity in colony
morphology that was unrelated to opacity. Cultures of the nasopharynx
and blood, therefore, had to be obtained at the same time and before
the initiation of antimicrobial therapy. This limitation required that
the study be carried out in a location with a high rate of pneumococcal
bacteremia to allow a sufficient numbers of paired isolates to be
obtained. Paired blood-cerebrospinal fluid and nasopharyngeal isolates
were obtained from adult patients at the Queen Elizabeth Central
Hospital in Blantyre, Malawi. These isolates were minimally passaged,
avoiding selection of single colonies to minimize selection of a
variant population. Isolates were only considered as paired isolates if
subsequently shown to be of the same type by the quellung reaction and
by identical patterns of restriction fragment length polymorphisms
following digestion of chromosomal DNA with EcoRI and
ClaI. Many of the patients were also positive for the human
immunodeficiency virus (HIV), thus accounting for the high incidence of
invasive pneumococcal disease.
 |
RESULTS |
Effect of oxygen on CPS expression.
Initial studies addressed
whether differences in the environmental concentration of oxygen or
carbon dioxide affected the rate of spontaneous switching between the O
and T forms. Single colonies of the O or T variants of type 6A clinical
isolate, P303, were passed and grown under atmospheric and anaerobic
conditions with or without supplemental carbon dioxide (5 to 10%).
None of the conditions compared had a significant effect on the
previously described background rate (10
3 to
10
4/generation) of spontaneous switching from the T to
the O phenotype or from the O to the T phenotype (38).
Growth under anaerobic or microaerophilic conditions, however, was
associated with a shift to a larger and more mucoid colony phenotype
with the greatest effect on the O variant (Fig.
1, upper panels).

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FIG. 1.
The effect of environmental oxygen and carbon dioxide on
colony morphology and capsule size. Opaque (O) and transparent (T)
variants of a type 6A isolate were grown in nutrient broth at 37°C to
mid-log phase under the following conditions: atmospheric (A),
microaerophilic (B), or anaerobically with supplemental carbon dioxide
(C). The upper panels shows colony size and opacity with oblique,
transmitted illumination (magnification, ×45). The lower panels show
the refractile zone occupied by the capsule as visualized using the
quellung reaction with group 6 antiserum (magnification, ×3,200).
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Since organisms of the O phenotype have been shown to express an
increased amount of CPS compared to the those of the T form,
the
possibility that the greater colony size resulted from increased
production of this material was examined (
13). In initial
studies,
the refractile zone of CPS surrounding the bacterium was
visualized
by using the quellung reaction with group 6 antisera (Fig.
1,
lower panels). This refractile zone was larger for the O variant
grown under anaerobic or microaerophilic conditions (in 10%
CO
2)
compared to growth of the same phenotype in
atmospheric conditions
or compared to that of the T variant under any
of the conditions
tested, including the absence of oxygen. Under
atmospheric conditions,
capsular material could not be visualized on T
pneumococci when
we used this technique. This result confirmed the
ability of the
O variant to synthesize increased quantities of
cell-associated
CPS and indicated that reduced oxygen and/or higher
carbon dioxide
tension may accentuate these
differences.
The effect of the environmental oxygen and/or the carbon dioxide
concentration was then assessed in a quantitative assay developed
for
measuring amounts of CPS (Fig.
2)
(
13). The amounts of cell-associated
CPS expressed
relative to total cellular protein content was measured
using a capture
ELISA. For P303, the quantity of CPS correlated
with colony surface
area and with capsular volumes calculated
on the basis of refractile
zones in quellung experiments (Table
1).
As expected, P303-O pneumococci grown to either mid-log phase
or
stationary phase under all conditions tested showed increased
amounts
of cell-associated CPS in comparison to P303-T. The growth
of P303-O
under anaerobic conditions (in 10% CO
2) compared to
atmospheric conditions was associated with a 7.9-fold rise in
the
quantity of CPS expressed. In contrast to P303-O, there was
little
effect of the different conditions tested on the low level
of
expression of CPS in P303-T. When the T and O variants of P303
were
compared under anaerobic conditions (in 10% CO
2), there
was
29-fold more CPS synthesized by the O form. Growth to mid-log
phase
compared to growth to the stationary phase changed the absolute
amounts
of CPS (with CPS amounts generally higher in organisms
at
mid-log-phase) but did not affect the relative differences
between
variants or growth conditions. The effect of environmental
conditions
for P303 was similar for spontaneous O and T variants
of two unrelated
clinical isolates, P324 and P68, of types 6B
and 18C, respectively. In
addition, the amounts of CPS in the
culture supernatant of the type 18C
strain were measured after
growth to stationary phase. The higher
amounts of CPS in the culture
supernatant of the O variant as the
concentration of oxygen was
lowered and carbon dioxide raised showed
that the environmental
effect of could not be accounted for by
decreased release from
the cell. A type 9V isolate, P10, was used to
determine whether
the increased synthesis of CPS was caused by
decreased oxygen
or increased carbon dioxide. The O variant of the type
9V isolate
grown to stationary phase in an environment of 10% carbon
dioxide
expressed 12-fold more CPS in the absence of oxygen compared to
that expressed in the presence of oxygen. This suggested that
changes
in the availability of oxygen rather than carbon dioxide
are sufficient
to explain the observed effect. There was no effect
of different
environmental conditions on the amount of teichoic
acid as measured in
similar capture ELISAs.

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FIG. 2.
Effect of environmental oxygen and carbon dioxide and
the opacity phenotype on the amounts of CPS measured by a capture
ELISA. O and T variants of isolates of the four pneumococcal types
indicated were grown to mid-log phase (solid bars) or stationary phase
(stippled bars) in the concentrations of oxygen and carbon dioxide
shown above the bars. Amounts of CPS were determined in sonicated cell
pellets (solid and stippled bars) or in culture supernatants (hatched
bars) and are expressed relative to the quantity of total cellular
protein in sonicates. An asterisk indicates that this variant did not
grow under this condition. Values represent the mean of at least two
separate experiments performed in duplicate ± the standard
deviation (when n 3).
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Association of CpsD and CPS expression.
The next phase of the
study examined the control of CPS synthesis. In order to examine the
transcription of the cps locus, which is required for
expression of the capule by S. pneumoniae, a probe based on
cps6A was generated and used in Northern blots. The probe
detected a large transcript (>9.5 kb) that could represent the entire
cps region (data not shown). The lack of stability of this
mRNA species, however, prevented accurate, consistent comparisons of
the level of transcription between O and T variants, as well as under
different growth conditions. Since it was not possible to assess levels
of transcription, the expression of proteins in this locus was
compared. CpsD, expressed by the last gene in the region common to
cps loci of different types, from P303 was generated in
E. coli and purified, and antiserum was raised to detect and
compare the levels of expression in the pneumococcus (12).
In Fig. 3 (upper panels), the level of
expression of CpsD as detected in whole-cell sonicates of P303-O in
Western blots was not affected by ambient levels of oxygen or carbon
dioxide (atmospheric versus anaerobic with 10% CO2). In
contrast, when T and O variants of the same strain were compared under
the same growth conditions, the expression of CpsD was uniformily
diminished in the T pneumococci. A similar correlation of CpsD
expression and opacity phenotype was observed in the unrelated type 9V
isolate, P10. Since the T variants produce decreased amounts, of CPS,
this result was consistent with the hypothesis that T pneumococci
synthesis less CPS due to lowered expression of cps gene
products.

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FIG. 3.
Western analysis showing expression and tyrosine
phosphorylation of CpsD in S. pneumoniae. (Upper panels) The
opaque (lanes 1 and 2) and transparent (lane 3) colony forms of type 6A
isolate P303 (A to C) and type 9V isolate P10 (D and E) were grown to
mid-log phase under anaerobic (lane 1) or atmospheric (lanes 2 and 3)
growth conditions. Equal amounts of cell sonicates based on total
protein content were separated by SDS-PAGE, transferred to a membrane,
and analyzed in serial immunoblots with antisera raised against CpsD (A
and D), an MAb to phosphotyrosine (B and E), and antiserum to
pneumolysin to demonstrate equivalent loading (C). Size markers are in
kilodaltons. (Lower panels) Prototype pneumococcal strain D39 (lanes 3 and 4) or the nonencapsulated mutant of this strain, R6 (lanes 1 and
2), lacking a region of the cps locus, including
cpsD, were grown under anaerobic (lanes 1 and 3) or
atmospheric conditions (lanes 2 and 4). Equivalent amounts of
whole-cell sonicates were separated by SDS-PAGE and, following transfer
to membranes, immunoblotted with an MAb to phosphotyrosine (A) or
antiserum to CpsD (B). The marker indicates the predicted size of the
P303 CpsD based on its sequence.
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Environmental oxygen affects tyrosine phosphorylation of CpsD.
In the course of these studies, it was reported that CpsD which
resembles the autophosphorylating protein kinase Wzc involved in chain
length regulation of the exopolysaccharide colonic acid of E. coli may also be phosphorylated on tyrosine residues (17, 35). Based on these findings, we determined whether opacity phenotype or differences in environmental oxygen and carbon dioxide affect tyrosine phosphorylation of CpsD. An MAb to phosphotyrosine recognized a single broad band of the predicted size for CpsD in
Western blots of whole-cell sonicates of the prototype strain D39 (Fig.
3, lower panels). Additional evidence that this band was CpsD included
the observations that (i) this band was not present in strain R6, a
mutant of D39 with a 7-kb deletion spanning cpsD, and (ii)
the antisera to CpsD recognized a similar band of the equivalent size.
In fact, as shown in Fig. 4, the
increased resolution of a larger gel format revealed that the antiserum to CpsD recognized at least a triplet of bands of approximately 25 kDa
in P303-O grown under anaerobic conditions (with 10% CO2). Only the two higher-molecular-weight bands also reacted with the MAb to
phosphotyrosine in serial immunoblots of the same membrane. The
elimination of the two higher-molecular-weight bands and the phosphotyrosine epitopes after the cell sonicates were pretreated with
alkaline phosphatase prior to loading confirmed that these molecular
species represented distinct tyrosine phosphorylated forms of CpsD and
that the lower band was the unphosphorylated protein.

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FIG. 4.
Western analysis showing the effect of growth conditions
and alkaline phosphatase treatment on tyrosine phosphorylation of CpsD.
The O variant of the isolate P303 was grown under atmospheric
conditions (lane 2 and 6) or anaerobic conditions without supplemental
CO2 (lane 4) and anaerobic conditions with 10%
CO2 (lanes 1, 3, 5, and 7), whole-cell sonicates were
separated using a larger gel format, transferred to a membrane, and
serially immunoblotted with antiserum to CpsD (lanes 1 to 4) and an MAb
to phosphotyrosine (lanes 5 to 7). In lanes 1 and 5 the cell sonicates
were treated with alkaline phosphatase prior to loading. The marker
indicates the predicted size (in kilodaltons) of the P303 CpsD based on
its sequence.
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For the unrelated isolates D39, P10-O, and P303-O growth in anaerobic
conditions (in 10% CO
2) was associated with increased
expression of the tyrosine phosphorylated forms of CpsD compared
to the
same strain grown under atmospheric growth conditions (Fig.
3). For
P303-O there was no difference in expression of the tyrosine
phosphorylated forms when grown under anaerobic conditions with
or
without supplemental carbon dioxide. This observation was consistent
with ELISA data showing that O
2 rather than CO
2
is the major determinant
of the level CPS production. For the T
variants of each of these
isolates, there was little to no apparent
tyrosine phosphorylation
of CpsD. The nucleotide sequences of the O and
T variants of
cpsD in P303 were identical and, therefore,
differences in amino acid
sequence were unlikely to explain the lack of
tyrosine phosphorylation
in the T variants (data not shown). The lack
of phosphotyrosine
could be a consequence of the diminished expression
of CpsD in
T pneumococci. Together, these observations suggested an
association
between ambient levels of oxygen and tyrosine
phosphorylation
of CpsD, a putative regulatory protein controlling the
amount
of CPS produced by the
pneumococcus.
Characteristics of S. pneumoniae in human carriage and
infection.
In order to test whether or not there is a selection
for phenotypes producing different amounts of CPS in carriage and
bacteremia in humans, paired isolates of the same type were obtained
from the nasopharynx and blood-cerebrospinal fluid of patients
presenting with signs of sepsis. Of the 19 paired isolates analyzed, 17 (89%) were of the T phenotype in the nasopharynx, whereas 12 (63%)
were of the O phenotype in the blood (Table
2). This pattern was similar in the
groups with or without known HIV infection. Of the 10 paired isolates
in which the phenotype from the two sites were discordant, all showed
more of the T form in the nasopharynx (P < 0.001,
Student t test). Therefore, it was possible based solely on
colony morphology to detect phenotypic differences in most of the
paired isolates.
Some these isolates reacted with the antibodies used in this study.
This allowed for two of the paired isolates (types 1 and
4) with
discordant colony phenotypes to be analyzed in Western
blots as an
additional and more objective assessment of whether
survival in the
nasopharynx versus the bloodstream selected for
different phenotypes
(Fig.
5). For these two sets of paired
isolates,
tyrosine phosphorylation of CpsD was detected in the isolate
obtained
from the bloodstream but not in the isolate of the same type
cultured
at the same time from the nasopharynx. In the two isolates
obtained
from the bloodstream, tyrosine phosphorylation was most
prominent
when grown in the absence of oxygen, as predicted. The
results,
therefore, confirmed that there may be differences in the
isolates
from two sites in the same patient and that, based on both
colony
morphology and Western analysis, there may be selection for the
O variant, the form in which tyrosine phosphorylation of CpsD
is
detected, in invasive infection.


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FIG. 5.
S. pneumoniae of the same type was cultured
from both the bloodstream and the nasopharynx of two individuals:
patient A (type 1 isolate) and patient B (type 4 isolate). (Upper
panels) Colony morphology of the paired isolates grown under
microaerophilic conditions and viewed with oblique, transmitted
illumination (magnification, ×45). (Lower panels) Western analysis
showing tyrosine phosphorylation of CpsD in paired clinical isolates
from the nasopharynx and bloodstream. Isolates obtained from blood
culture (lanes 1, 2, 5, and 6) and nasal swabs (lanes 3, 4, 7, and 8)
were grown under atmospheric (lanes 2, 4, 5, and 7) or anaerobic (lanes
1, 3, 6, and 8) conditions. The marker indicates the predicted size (in
kilodaltons) of the P303 CpsD based on its sequence.
|
|
 |
DISCUSSION |
We present evidence that the ambient oxygen concentration may be
an important factor in the ability of S. pneumoniae, an
acrotolerant streptococcus, to regulate the characteristics of its cell
surface. Our approach took advantage of observations that the
pneumococcus varies between two phenotypes previously shown to differ
in their amounts of CPS (13). Findings in the current
study show that oxygen levels affect the O and T phase variants
differently. There is greatly enhanced production of CPS in O variants
in conditions of reduced oxygen, whereas synthesis of CPS in T variants
remains comparatively low under both aerobic and anaerobic conditions. The effect of oxygen on CPS expression was shown by two different methods, quellung, which allows visualization of the capsule size, and
a capture ELISA, which enables amounts of CPS to be quantified. Both of
these methods rely on the use of type-specific antiserum to detect CPS.
Results from experiments using either technique show that
microaerophilic growth conditions (O2 levels at 17% or
lower) are sufficient to induce a significant increase in CPS expression when compared to atmospheric growth conditions. A maximal effect, however, is observed in strict anaerobiasis.
Although it is not clear when and if this species would be exposed to
strict anaerobic conditions, ambient oxygen levels would be diminished
whenever the organism is not in its commensal state on the airway
surface. In particular, the availability of oxygen is decreased in the
common manifestations of pneumococcal disease such as pneumonia,
empyema, and otitis media where the exudative inflammatory response
occludes air spaces and limits gas exchange. Oxygen levels in the
uninflamed middle ear space, for example, resemble that of venous
blood, are less than a third that of the airway, and may be further
reduced by the presence of effusion (8, 9, 26). If an
effect similar to that described in this study occurs in vivo, the
reduced-availability of oxygen would select for an upregulation in CPS
expression. Since even-relatively small difference in the amounts of
CPS can be critical to the expression of virulence, the effect of
oxygen might provide a survival advantage during infection in
situations whenever O variants are represented (13).
The analysis of paired isolates from human carriage and bacteremia is
consistent with previous animal studies and supportive of the
hypothesis that environments with lower oxygen content promote
selection for the more virulent O form. It was found that in bacteremic
infection of humans, which is generally a complication of pneumococcal
pneumonia, most isolates from the bloodstream (or cerebrospinal fluid)
are as opaque or more compared to the isolate from the same patient
cultured from the nasopharynx (22). This difference in
colony morphology is indicative of increased amounts of CPS in these
blood isolates. In contrast, the T variant found in 89% of the
colonizing isolates in the natural host produces relatively little CPS
regardless of the ambient oxygen concentration. T variants may
predominate in this setting since smaller amounts of CPS may be
sufficient to inhibit phagocytosis on the airway surface where there is
relatively little complement and antibody, while still allowing for
efficient adherence to host cells. Another consideration is that
because it was necessary to carry out this study in a largely
HIV-positive population due to their high rates of pneumococcal
infection, these findings may or may not be relevant to immunocompetent
hosts. Results from this limited study of human isolates, however, add
support to the hypothesis that phenotypic variation confers on the
pneumococcus the flexibility to alter its surface characteristics for
the differing requirements of colonization and infection.
Since the expression of a large capsule may be detrimental to the needs
of carriage but necessary to evade opsonsophagocytic clearance during
infection, the amounts of CPS may need to be precisely regulated. At
least two factors are described as contributing to the differences in
CPS levels: the variation in opacity phenotype noted in the majority of
clinical isolates and the availability of oxygen in the environment.
For a pathogen such as the pneumococcus residing on the surface of the
airway, the concentration of oxygen in its environment would seem to be
an effective means of sensing changes in its host environment that
might require adaptation. There has been little specific evidence to
suggest that environmental signals, which are important, for instance,
in the induction of competence, may also contribute to the pathogenesis
of pneumococcal disease (19). A recent study from our
laboratory demonstrated that the expression of pyruvate oxidase (SpxB),
the major factor in production of unusually high concentrations of
hydrogen peroxide by the pneumococcus, is differentially regulated in O
and T variants by ambient oxygen levels (20, 21). The
generation of H2O2 by the pneumococcus under
aerobic conditions has cytotoxic effects on host cells as well as on
other bacterial species that inhabit and potentially compete for the
same niche in the upper respiratory tract (5, 21). Oxygen
has also been implicated as a factor in the regulation of natural
transformation (2). In another streptococcal species
(Streptococcus pyogenes), it is carbon dioxide rather than
oxygen tension that mediates changes in the expression of virulence
factors. Our findings for the pneumococcus do not suggest that carbon
dioxide concentration affects the regulation of its major virulence
factor, CPS. In group A streptococci, the amounts of the hyaluronic
capsule are also regulated but not through signaling involving carbon
dioxide concentration (18). Instead, the amounts of the
hyaluronic capsule are regulated through an unknown environmental
signal transmitted through differential phosphorylation of a
two-component signal transduction system (15). In the case
of the pneumococcus it is oxygen that triggers these changes and there
is no evidence for a substantial effect when mutants in 11 of the 12 known two-component signal transduction systems were tested
(32; data not shown). This leaves it unclear how signals
related to oxygen content in the environment are transmitted so as to
affect gene expression in CPS synthesis.
One implication of this study is further evidence that the amounts of
CPS are not uniform for a given strain. We have previously documented
that genetic transformation tends to cause a selection bias for T
variants, since the lower amount of CPS in this form appears to allow
for more efficient uptake of DNA (39). Virulence studies
that depend on the analysis of mutants generated by transformation of
encapsulated strains would, therefore, tend to demonstrate decreased
virulence regardless of the specific mutation. In addition to the
contribution of the opacity phenotype, differences in growth conditions
and, in particular, oxygenation have the potential to bias studies that
depend on encapsulation. Vaccine efficacy studies, for example, will
increasingly depend on in vitro correlates of protection, since there
is now an effective product for use in childhood that will restrict
further clinical trials. The opsonophagocyctic titer of anti-CPS
antibody, one of few in vitro assays that is predictive of vaccine
efficacy, has been shown to be highly sensitive to variations in the
amount of CPS (14). These assays, as well as virulence
studies, could be affected by differences in opacity phenotype and
oxygenation during growth of test organisms.
Although the genes involved in the expression of the pneumococcal
capsule have been described, the mechanism controlling the levels of
CPS expression remain largely undefined. In this report, we focused on
cpsD, a gene common to the capsulation loci of all serotypes
thus far examined which appears to be a negative regulator of CPS
synthesis in S. pneumoniae and other encapsulated bacteria. Homologues of CpsD are present in many other pathogens that express surface polysaccharides, such as Streptococcus agalactiae,
Staphylococcus aureus, Klebsiella pneumoniae, and
Acinetobacter johnsonii and A. lwoffii (1,
6, 27, 41). This family comprises one of the few known examples
of bacterial proteins that are phosphorylated on tyrosine residues
(11). One of the common features of this group of
bacterial tyrosine kinases is a C terminus with a tyrosine-rich repeat
which has been proposed as the target of autophosphoryltation activity.
For the pneumococcus, changing the tyrosine residues in the C-terminal
region (YGX)4 in Cps 19fD to phenylalanine residues resulted in a loss of immunodetectable phosphotyrosine and a mutant with a mucoid colony phenotype under standard aerobic growth
conditions. This led to the proposal that tyrosine phoshorylation of
CpsD involving this motif increases the negative regulatory activity of
the protein on CPS biosynthesis. A similar C terminus containing multiple tyrosine residues
(215-CGSYGNYGDYGKNKK-229)
was found in CpsD of the type 6A strain analyzed in this study.
An unexpected observation was that anaerobic conditions which resulted
in the highest level of CPS production in this and several other
isolates also had the most immunodetectable phosphotyrosine on CpsD.
This suggests that although the levels of tyrosine phosphorylation correlate with differences in the amounts of CPS, its effect may not be
associated with increased negative regulatory activity and lower
expression of CPS. Alternatively, if tyrosine phosphorylation acts to
enhance the negative regulation of CpsD as proposed, there must be
other unknown upstream or downstream factors affecting the degree of
phosphorylation and mediating the oxygen effect. In E. coli
the autophosphorylating enzyme Wzc is linked to a
phosphotyrosine-protein phosphatase Wzb, which has no significant
homologue in the pneumococcal genome. Rather, it has been suggested
that CpsB functions in dephosphorylating CpsD and could be an
additional factor affecting tyrosine phosphorylation (17).
We also observed an absence of phosphotyrosine on CpsD in the T
variants of the several strains analyzed. Although it was not
technically feasible to show that this was due to decreased transcription of the cps locus in this phenotype, the lack
of immunodetectable phosphotyrosine correlates with decreased
expression of CpsD. These data support the conclusion that there is a
downregulation of cps expression in the T variant accounting
for the low levels of CPS found in T pneumococci. Thus, there appear to
be at least two separate levels of regulation of CPS synthesis: one
associated with the phosphorylation of two or more tyrosine residues in
CpsD and the other affecting the expression of protein(s) in this
locus, including CpsD. The analysis of two sets of paired clinical
isolates showed that pneumococci recovered from the nasal swabs did not have the phosphotyrosine epitope regardless of the growth conditions. These data could be explained by selection for a phenotype with diminished expression of the capsulation locus when resident in the
nasopharynx, a result that, together with observations on colony
morphology and capsule synthesis, suggests that in contrast to invasive
infection pneumococci may express relatively little CPS during human carriage.
 |
ACKNOWLEDGMENTS |
We thank R. Austrian (University of Pennsylvania) for critical
review and for providing clinical isolates and assistance with quellung
experiments. We gratefully acknowledge the support of the patients and
staff of the Queen Elizabeth Central Hospital, Blantyre, Malawi, and
the support of E. E. Zijlstra, Head of the Department of Medicine
at the University of Malawi College of Medicine. Antiserum to
pneumolysin was generously provided by T. Mitchell.
Stephen Gordon is a Wellcome Trust Fellow in Clinical Tropical
Medicine. Henry Epino holds a Fulbright Scholarship. This work was
supported by grants from the U.S. Public Health Service (AI38436 and
AI44231 to J.N.W.).
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Department of
Microbiology, University of Pennsylvania, 301B Johnson Pavilion,
Philadelphia, PA 19104-6076. Phone: (215) 573-3511. Fax: (215)
898-9557. E-mail: weiser{at}mail.med.upenn.edu.
Editor:
: E. I. Tuomanen
 |
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Infection and Immunity, September 2001, p. 5430-5439, Vol. 69, No. 9
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.9.5430-5439.2001
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