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Infection and Immunity, February 2004, p. 1107-1115, Vol. 72, No. 2
0019-9567/04/$08.00+0 DOI: 10.1128/IAI.72.2.1107-1115.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Institute for Medical Microbiology, Technische Universität München, D-81675 Munich, Germany
Received 7 August 2003/ Returned for modification 12 September 2003/ Accepted 28 October 2003
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Cell death by apoptosis is a frequent event in the human body, and evidence is accumulating that apoptosis plays an important role in the defense against infectious microorganisms. Cell death by apoptosis results from the activation of a specialized signal transduction pathway. On a molecular level, the release of cytochrome c from the mitochondria appears to be a critical signaling event in most cases of apoptosis. The release of cytochrome c is largely controlled by members of proteins of the Bcl-2 family, which can act to promote or to inhibit this release. Free cytosolic cytochrome c initiates the formation of a signaling complex (the so-called apoptosome) that encompasses the molecules Apaf-1 and the proteases caspase-9 and caspase-3. In the formation of this complex, caspase-9 is activated, which in turn activates caspase-3. Active caspase-3 then cleaves cellular substrates to bring about the morphological changes of apoptosis such as nuclear condensation.
An alternative activation of the apoptotic pathway can occur through stimulation of a death receptor. Death receptors are plasma membrane receptors that can, upon binding of the specific ligand (or stimulating antibodies) directly activate the apoptotic pathway. A well-studied death receptor is CD95 (fas/APO-1). Upon stimulation, CD95 recruits a "death-inducing signaling complex" (DISC) to the membrane. The principal signaling components in the DISC are the adapter protein FADD/MORT1 and procaspase-8. During DISC formation, procaspase-8 is activated. A distinction has been proposed to classify cells according to the events that occur following this step. In some cells active caspase-8 is sufficient to activate caspase-3 directly ("type I cells"). In some cells, however, CD95-mediated caspase-8 activation is not enough to activate caspase-3, and in these cells a mitochondrial amplification is necessary: the cleavage of the proapoptotic Bcl-2 family member Bid by caspase-8 causes the release of mitochondrial cytochrome c, thus feeding into the central apoptosis pathway ("type II cells") (28).
Their dependency on the intact host cell suggested that chlamydiae might interfere with the apoptotic apparatus, and several recent studies have found that this is indeed the case. Both pro- and antiapoptotic activities have been detected: C. trachomatis and C. pneumoniae have been reported to inhibit externally induced apoptosis (5, 6, 26). C. psittaci has been described to induce apoptosis in epithelial cells and macrophages (22) and to inhibit apoptosis against external proapoptotic stimuli (3).
This earlier study has indicated that the main inhibitory quality generated by chlamydiae in infected cells prevents the release of cytochrome c from mitochondria. In the study reported here we analyzed the potential inhibition of a CD95 death signal in infected cells with two issues in mind: first, this pathway has been very well studied; the events that lead to cytochrome c release are at least partly understood and can be studied closely. The distinction of type I and type II cells further provides a tool to analyze and map an inhibitory potential. Second, one important mechanism in the immune system's attack on infected cells is the deployment of cytotoxic T lymphocytes (CTL), and one effector mechanism of CTL is the CD95-mediated induction of apoptosis in infected cells. The sensitivity of an infected cell to a CD95 death signal may therefore bear on the efficiency of the antichlamydial immune response.
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For the propagation of chlamydiae, Hep2 cells were infected in cell culture plates at an MOI of 1 to 3 inclusion forming units (IFU). At 48 h of C. trachomatis infection, and 72 h of C. pneumoniae infection, bacterial organisms were released from the cells by homogenization and purified on a density gradient as described previously (11, 13). Infectious titers were determined by a serial dilution of preparations in HeLa-fas, SKW6.4 and Jurkat cells followed by intracellular staining for chlamydial inclusions with a fluorescence-labeled anti-Chlamydia-lipopolysaccharide (LPS) antibody (Progen, Heidelberg, Germany). Harvests were checked for mycoplasmal contamination by PCR, and purified elementary bodies were frozen in aliquots at -70°C for up to 2 months and thawed immediately before infection.
Infection of cells and induction of apoptosis. HeLa-fas cells (2.5 x 105 cells/well in six-well plates), SKW6.4 cells, or Jurkat cells (106 cells/well in 12-well plates) were infected with C. pneumoniae or C. trachomatis. The infectious dose used was in the range of 1 to 3 IFU per cell. In none of the experiments where apoptosis was investigated was cycloheximide added. Infection was controlled morphologically, and >95% of cells were found to be infected by using this protocol. Cells in medium without FCS were infected by the addition of C. trachomatis or C. pneumoniae, followed by centrifugation for 45 min at 800 x g at 35°C (centrifugation only for C. pneumoniae); 10% FCS was added after 3 h. Mock-infected cells were subjected to the same procedure in the absence of chlamydiae. For UV inactivation, chlamydial suspensions were exposed for 10 min to UV light in a transilluminator box (Stratagene) as described previously (23). Apoptosis was induced by addition of staurosporine (1 µM; Sigma) or anti-CD95 MAb (CH11, 100 ng/ml; Upstate Biotechnology).
Assay for nuclear apoptosis. Cells were infected with chlamydiae or mock infected. At 24 h (C. trachomatis) or 48 h (C. pneumoniae) after infection, three replicates each were treated with staurosporine or anti-CD95 for 5 h. Cells were then stained with 20 µM Hoechst 33258 (Sigma) for 30 min at 37°C and washed with phosphate-buffered saline (PBS), and nuclear morphology was assessed under a fluorescence microscope. At least 300 nuclei per sample were counted.
Assay for caspase activity. HeLa-fas, SKW6.4, or Jurkat cells were infected with chlamydiae, and caspase-3 activity was measured as described previously (6). Briefly, cells were treated with staurosporine or with anti-CD95 for the indicated times. The cells were then lysed in NP-40 lysisbuffer (150 mM NaCl, 1% Ipegal CA-630, 50 mM Tris [pH 8.0]) for 15 min on ice. Cell lysates were cleared by centrifugation for 5 min at 15,000 x g at 4°C. Triplicates of 10-µl aliquots of the supernatant were added to 90 µl of caspase-3-recognition sequence (DEVD) assay buffer (50 mM NaCl, 2 mM MgCl2, 40 mM ß-glycerophosphate, 5 mM EGTA, 0,1% CHAPS {3-[(3-cholamidopropyl)-dimethylammonio]-1-propanesulfonate}, 100 µg of bovine serum albumin/ml, 10 mM HEPES [pH 7.0]) containing 10 µM (final concentration) DEVD-AMC fluorimetric substrate. Reactions were incubated for 1 h, free AMC was measured, and values are presented as arbitrary relative fluorescence units (mean ± the standard error of the mean of the triplicate reactions described above).
Detection of active caspase-3 by flow cytometry. HeLa-fas cells were infected with C. trachomatis or left uninfected and treated with anti-CD95 or staurosporine. Cells were harvested, fixed in 0.5% paraformaldehyde for 30 min, permeabilized with 1% saponin, and incubated with anti-active caspase-3 (Pharmingen) and fluorescein isothiocyanate (FITC)-conjugated goat anti-rabbit (Dianova) as a secondary antibody. Flow cytometry was performed in a FACScalibur (Becton Dickinson), and at least 106 cells per sample were recorded.
Western blot analysis. Infected or mock-infected HeLa-fas cells were treated with anti-CD95 or staurosporine, harvested at the times indicated, washed, and lysed in NP-40 lysis buffer. Lysates were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis, transferred to nitrocellulose membranes, and probed with antibodies specific for human caspase-3 (Becton Dickinson), active caspase-9, caspase-8 (Cell Signaling Technology), Bid (R&D Systems), and ß-actin (Sigma). Proteins were visualized by using peroxidase-conjugated secondary antibodies and a chemiluminescence detection system (Perkin-Elmer Lifescience, Boston, Mass.).
Intracellular staining for cytochrome c. HeLa-fas cells were mock infected or infected with C. trachomatis as described above. At 24 h after infection, replicate wells were treated with staurosporine or anti-CD95 for 5 h and fixed with 2% formalin. For costaining of cytochrome c and mitochondria, cells were stained with anti-cytochrome c MAb (Becton Dickinson)-Cy3-labeled anti-mouse antiserum (Jackson), followed by staining with Mito Tracker Green FM (Molecular Probes). For costaining of cytochrome c and chlamydiae, cells were stained for cytochrome c-FITC-labeled anti-mouse antiserum (Dianova) as described above, followed by the addition of Alexa Fluor 546-labeled mouse anti-chlamydial-LPS antibody (Progen). Pictures were obtained with a Zeiss laser scanning microscope.
Statistical analysis. Continuous variables are expressed via the mean and the standard deviation (SD). Kruskal-Wallis test was performed for overall comparison of more than two groups. In case of significant differences bivariate post hoc tests were performed by using the method of Schefe to adjust for multiple testing.
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HeLa-fas cells were infected with C. trachomatis for 24 h, and apoptosis was induced by stimulation with anti-CD95. In most experiments staurosporine was used as a control. We and others have shown before that staurosporine-induced apoptosis is potently inhibited by infection with chlamydiae. Cells treated identically but without chlamydiae were included in parallel in all experiments (mock infected).
When cells were treated with anti-CD95 for 5 h about half of the mock-infected cells showed nuclear morphological changes typical of apoptosis (condensation of DNA, nuclear fragmentation; Fig. 1, arrows show apoptotic cells). Treatment with staurosporine for 5 h induced apoptosis in ca. 90% of the cells (Table 1). In chlamydia-infected cells, the percentage of apoptotic nuclei was much lower than in uninfected cells both when cells were treated with anti-CD95 and when treated with staurosporine. Infection with C. trachomatis therefore reduces the sensitivity of HeLa-fas cells to anti-CD95-induced apoptosis. Infection with C. trachomatis in the absence of further treatment caused apoptosis in a small percentage of cells (Table 1). This is consistent with earlier observations of apoptosis induction by this organism (24, 25) and suggests that the outcome of the infection is determined by the balance of apoptosis-inducing and -inhibiting mechanisms. During the normal course of infection, however, a pronounced resistance to apoptosis induction can be seen.
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FIG. 1. Infection with C. trachomatis inhibits CD95-induced nuclear apoptosis in HeLa-fas cells. HeLa-fas cells were either left uninfected or infected with C. trachomatis at about 2 IFU per cell. At 24 h after infection, anti-CD95 MAb (100 ng/ml) was added to some aliquot cultures. After 5 h, cells were stained with Hoechst dye, and photos of representative areas were taken under a fluorescence microscope. Similar results were obtained in three similar experiments.
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TABLE 1. Quantitation of C. trachomatis-mediated protection against CD95 signaling in HeLa-fas cellsa
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FIG. 2. Infection with C. trachomatis blocks CD95-induced apoptosis upstream of caspase activation. (A) HeLa-fas cells were mock infected or infected with C. trachomatis at about 2 IFU/cell. At 48 h after infection, cells were either treated with anti-CD95 (100 ng/ml) or staurosporine (1 µM) for 4 h or left untreated as indicated. Cells were then lysed, and DEVD-cleaving activity was measured in cell extracts. Each bar represents one well of a six-well plate, with the SD as indicated. Inhibition of caspase activity was statistically significant (P < 0.001 for both anti-CD95 and staurosporine [Kruskal-Wallis test]). The data are representative of five experiments. (B) HeLa-fas cells were either mock infected or infected with C. trachomatis or UV-treated C. trachomatis at about 2 IFU/cell. After 48 h of infection, cells were treated with with anti-CD95 (100 ng/ml) for 4 h or left untreated. Cells were lysed and caspase-3-like activity was measured as DEVD-cleaving activity. Each bar represents one well of a six-well plate, with the SD as indicated. (C) HeLa-fas cells were either mock infected or infected with C. trachomatis at about 2 IFU per cell. At 24 h postinfection anti-CD95 (100 ng/ml) or staurosporine (1 µM) was added. After the indicated time intervals cells were extracted, and extracts were analyzed by Western blotting for active caspase-9 (top; only the active enzyme is detected irrespective of the amount of total caspase-9) and ß-actin as a loading control. In a similar experiment caspase-3-processing was measured by Western blotting (bottom; the inactive procaspase is 32 kDa [closed arrow], the active caspase-3 is 17 kDa [open arrow]). (D) HeLa-fas cells were infected with either C. trachomatis (2 IFU/cell) or mock infected, and anti-CD95 (100 ng/ml) or staurosporine (1 µM) was added after 24 h. For flow cytometry, cells were collected and stained for active caspase-3 (the antibody used recognizes only the cleaved caspase-3 but not inactive procaspase-3). Normal line, chlamydia-infected cells; bold line, mock-infected cells.
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The release of cytochrome c from mitochondria during CD95-dependent apoptosis is reduced in cells infected with C. trachomatis. Activation of caspase-9 is normally caused by apoptosome formation upon release of cytochrome c into the cytosol, and the inhibitory potential of chlamydial infection on cytochrome c release was next investigated. Using subcellular fractionation experiments, Fan et al. have found that infection with C. trachomatis blocked CD95-induced cytochrome c release in U937 human myeloid cells (5). We analyzed cytochrome c release during CD95 signaling in HeLa-fas cells by immunostaining and confocal microscopy. HeLa-fas cells were infected and treated with anti-CD95. Confocal microscopy revealed the typical mitochondrial pattern of cytochrome c distribution in both mock-infected and chlamydia-infected cells. Anti-CD95 treatment resulted in morphological changes and the release of cytochrome c, visible as a reduction in staining intensity (26). In infected cells, cytochrome c release was prevented, but it still occurred in uninfected cells from infected cultures (Fig. 3A). Cells were then infected and costained with a mitochondrial marker (Mito Tracker Green FM) and anti-cytochrome c antibody. In untreated cells, both markers showed colocalization in infected and in uninfected cells (Fig. 3B). Upon treatment with anti-CD95 for 5 h, cytochrome c was released into the cytosol in the majority of the mock-infected cells, whereas mitochondria were still stained by Mito Tracker Green FM (Fig. 3B). In contrast, in C. trachomatis-infected cells cytochrome c was largely still found in a mitochondrial pattern in the cells, and a partial colocalization of the two dyes was still seen (Fig. 3). Since it has been shown earlier that chlamydial infection blocks the staurosporine-induced cytochrome c release (5, 6), staurosporine treatment was included as a control; staurosporine-induced cytochrome c release was also prevented in infected cells (data not shown). Infection with chlamydiae therefore blocks the release of cytochrome c from the mitochondria into the cytosol during CD95 signaling.
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FIG. 3. Infection with C. trachomatis inhibits the CD95-dependent release of cytochrome c from mitochondria. HeLa-fas cells were plated onto glass coverslips in a 12-well plate. Cells were either mock infected or infected with C. trachomatis at about 0.5 IFU/cell (A) or 2 IFU/cell (B). At 24 h after infection, cells in some cultures were treated with anti-CD95 (100 ng/ml) for 5 h. Pictures were obtained by confocal laser scanning. (A) Cells were doubly labeled with FITC-anti-cytochrome c (green) and Alexa Fluor 546 antichlamydial antibodies (red). Arrows point to infected cells that have retained cytochrome c in their mitochondria; asterisks indicate uninfected cells where mitochondria have released cytochrome c. (B) Cells were costained with Cy3 anti-cytochrome c (red) and Mito Tracker Green FM (green). In uninfected and anti-CD95-treated cells, cytochrome c becomes almost undetectable upon its release as in panel A. In infected and anti-CD95-treated cells, partial colocalization of cytochrome c and the mitochondrial marker is retained (yellow). The pictures represent three similar experiments.
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FIG. 4. CD95-dependent signal transduction upstream of mitochondria is normal in C. trachomatis-infected cells. HeLa-fas cells were either mock infected or infected with C. trachomatis at about 2 IFU per cell. At 24 h postinfection anti-CD95 (100 ng/ml) or staurosporine (1 µM) was added. After the indicated time intervals, cells were extracted and extracts were analyzed by Western blotting for caspase-8 (top) and uncleaved Bid (middle; the antibody only recognizes the uncleaved form but not the truncated form of Bid). ß-Actin served as a loading control (for better comparison, the same blot as in Fig. 2 probed with additional antibodies is shown here). Filled arrows indicate procaspases; open arrows indicate activated forms. This experiment was performed three times with similar results.
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FIG. 5. Infection with C. pneumoniae inhibits the generation of effector caspase activity but not CD95-induced activation of caspase-8 in HeLa-fas cells. (A) HeLa-fas cells were mock infected ( ) or infected with C. pneumoniae at about 2 IFU/cell ( ). At 72 h after infection, cells were either treated with anti-CD95 (100 ng/ml) or staurosporine (1 µM) for 4 h or left untreated as indicated. Cells were then lysed, and DEVD-cleaving activity was measured in cell extracts. Each bar represents one well of a six-well plate, with the SD as indicated. Inhibition of caspase activity was statistically significant (P < 0.001 for both anti-CD95 and staurosporine in mock-infected and chlamydia-infected cells [Kruskal-Wallis test]). The data are representative of three experiments. (B) HeLa-fas cells were either mock infected or infected with C. pneumoniae at about 2 IFU per cell. At 48 h postinfection anti-CD95 (100 ng/ml) or staurosporine (1 µM) were added. After the indicated time periods cells were extracted, and extracts were analyzed by Western blotting for caspase-8. Filled arrows indicate procaspases; open arrows indicate activated forms. This experiment was performed three times with similar results.
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FIG. 6. Infection with C. trachomatis protects Jurkat cells (type II), but not SKW6.4 cells (type I), against CD95-mediated apoptosis. SKW6.4 cells (A and C) or Jurkat cells (B and D) were mock infected ( ) or infected with C. trachomatis ( ) at about 5 IFU/cell (by morphology, >95% of cells were found to be infected by using this protocol in both cell lines). At 24 h after infection, cells were either treated with anti-CD95 (100 ng/ml) or staurosporine (1 µM) for 5 h or left untreated. (A and B). Nuclear apoptosis. After 4 h, cells were stained with Hoechst dye, and nuclear morphology was scored as normal or apoptotic as described above. (C and D). Effector caspase activity. Cells were lysed, and caspase activity was measured as the DEVD-cleaving activity in cell extracts. Each bar represents 1 well of a 12-well plate, with the SD as indicated. For Jurkat cells inhibition of caspase activity was statistically significant (P < 0.001 for both anti-CD95 and staurosporine [Kruskal-Wallis test]). For SKW6.4 cells, no reduction was seen in CD95-induced caspase activity but staurosporine-mediated caspase activation was significantly inhibited by chlamydial infection (P < 0.001 [Kruskal-Wallis test]). The data are representative of three experiments.
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Although there is still the possibility that chlamydiae may induce apoptosis later in the infection cycle (22) by a process involving the activation of Bax (25), the ability of chlamydiae principally to inhibit apoptosis has been demonstrated several times. This antiapoptotic ability is seen in various cell types, such as epithelial cells, monocytes, and macrophages (1, 5, 6, 26). The protective capacity has been found to extend to a number of different stimuli: infection inhibited apoptosis induced by staurosporine, tumor necrosis factor alpha, etoposide, granzyme B/perforin, and UV light (5, 6). In most of these cases of apoptosis induction, cytochrome c release from the mitochondria appears to be an important step in signal transduction. However, the steps leading to cytochrome c release are not completely understood but are likely to involve the activation of BH3-only proteins and the proteins Bax and/or Bak (21). The CD95 death receptor pathway is, on the other hand, well characterized, and the individual steps upstream of mitochondria are known in some detail. Formation of the DISC allows for activation of caspase-8 which then cleaves and thereby activates the BH3-only protein Bid. After activation, Bid can activate monomeric Bax and Bak. Bax/Bak translocate from the cytosol to the mitochondrial membrane to form mixed clusters containing thousands of molecules, and Bid-mediated activation of Bax is sufficient to cause the release of cytochrome c (14, 20). Infection by chlamydiae did not affect caspase-8 activation or -activity (measured as the cleavage of Bid) but prevented the release of cytochrome c. The most likely explanation is therefore that chlamydiae block the Bid-induced activation of Bax (the protein expression levels of Bax/Bak do not change during chlamydial infection [unpublished results]).
Since the apoptosis-inducing stimuli that are inhibited by chlamydial infection are also blocked by cellular Bcl-2, it would be easiest to argue that chlamydial infection induces the expression of a Bcl-2-like protein. However, our searches of the genome of C. pneumoniae failed to find such a protein, and the published results of analyses of the cellular transcription in infected cells likewise yielded no indication that a cellular Bcl-2-like protein may be strongly upregulated (10, 31). Another possibility, although not supported by any experimental evidence and perhaps unlikely, is that chlamydiae generate different antiapoptotic activities that counter different stimuli. A further possibility that should be taken into account is the following: we have described earlier that cytosol prepared from cells infected with C. pneumoniae is refractory to cytochrome c, i.e., externally added cytochrome c fails to activate caspases in these preparations (6). Although cytochrome c release may be the first step in activating caspases, a feedback loop is likely to provide amplification by caspase-3-driven mitochondrial desintegration. Although there are some other early reports, a sophisticated study is the recent investigation of granzyme B action (19) that indicates that such amplification is critical for bringing about the apoptotic changes. If, therefore, chlamydiae blocked the caspase activation by the initial release of a small quantity of cytochrome c, the lack of feedback amplification may account for a slower release of remaining cytochrome c, thereby explaining the results we describe here.
We can still only speculate what the precise role is that chlamydial antiapoptotic activities play for the infection (for a discussion, see reference 9). One possible function is a protection against the host cell's (likely) propensity to undergo apoptosis upon infection. Another possibility is the defense against an immune attack. T cells play a role in the clearance of infection with C. pneumoniae in mice (27), and one of the mechanisms by which cytotoxic T cells kill infected target cells is by triggering CD95-dependent apoptosis (16). Whether target cells of chlamydial infection in vivo will be type I or type II (with respect to CD95-induced apoptosis) is unknown. Although the available data indicate that ocular, genital, and respiratory infections by chlamydia are effectively cleared by the body's defense systems, it remains a distinct possibility that the blockade of apoptosis that is afforded by chlamydial infection contributes in a small number of individuals to a resilience to the immune system's efforts to clear the infection.
We are grateful to Regina Hollweck, Institute for Medical Statistic and Epidemiology, TU-Munich, Germany, for statistical analysis. Alexa Fluor 546-labeled mouse antichlamydial antibody was kindly provided by Susanne Dürr, Institute for Medical Microbiology, TU-Munich, Germany.
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B signaling pathway. J. Biol. Chem. 271:30354-30359.
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