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Infection and Immunity, March 2004, p. 1832-1836, Vol. 72, No. 3
0019-9567/04/$08.00+0 DOI: 10.1128/IAI.72.3.1832-1836.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Impacts of sarA and agr in Staphylococcus aureus Strain Newman on Fibronectin-Binding Protein A Gene Expression and Fibronectin Adherence Capacity In Vitro and in Experimental Infective Endocarditis
Yan-Qiong Xiong,1,2 Arnold S. Bayer,1,2* Michael R. Yeaman,1,2 Willem van Wamel,3 Adhar C. Manna,4 and Ambrose L. Cheung4
Department of Medicine, Division of Infectious Diseases, Harbor-UCLA Research and Education Institute, Torrance,1
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California,2
Eijkman-Winkler Institute, UMC-Utrecht, Utrecht, The Netherlands,3
Department of Microbiology, Dartmouth Medical School, Hanover, New Hampshire4
Received 22 September 2003/
Returned for modification 23 October 2003/
Accepted 2 December 2003

ABSTRACT
We investigated the impacts of
sarA and
agr on
fnbA expression
and fibronectin-binding capacity in
Staphylococcus aureus in
vitro and in experimental endocarditis. Although
sarA up-regulated
and
agr down-regulated both
fnbA expression and fibronectin
binding in vitro and in vivo,
fnbA expression was positively
regulated in the absence of both global regulators. Thus, additional
regulatory loci contribute to
fnbA regulation and fibronectin-binding
capacities in
S. aureus.

INTRODUCTION
Staphylococcus aureus is the most common cause of endovascular
infections (
2). The capacity of
S. aureus to cause human diseases
involves a variety of cell surface-associated and extracellular
virulence factors (
5,
7,
11,
15). Two fibronectin-binding proteins
(FnBPA and FnBPB), have been ascribed multiple functions, including
cell-specific binding (e.g., epithelial and endothelial cells),
invasion and persistence within such cells, and triggering of
host cell apoptosis (
1,
14,
21,
26). Additionally, FnBPA has
been shown to be involved in adherence to damaged heart valves
(
23). Moreover, FnBPs expressed on the
S. aureus surface may
be degraded by extracellular proteases (
17,
18), suggesting
that such enzymes participate in the transition of
S. aureus cells from an adhesive to invasive phenotype.
Classically, the expression of FnBPs and the synthesis of extracellular proteases are controlled in vitro by at least two global regulatory loci: the accessory gene regulator (agr) and the staphylococcal accessory regulator (sarA) in S. aureus (3, 22, 24). There is a complex interaction between sarA and agr to coordinately regulate S. aureus virulence factor expression, including selected adhesins and extracellular proteases (7, 9, 22). In the present study, we have characterized the impacts of the sarA and agr loci upon fnbA expression, fibronectin-binding capacity, and protease activity in a set of isogenic S. aureus Newman strains in vitro and in an experimental rabbit endocarditis model.

fnbA promoter expression in vitro.
The
S. aureus strains and plasmids used in this study are listed
in Table
1 (strain Newman is
agr type 1). Flow cytometry (FACScalibur;
Becton-Dickinson, San Jose, Calif.) was utilized for quantification
of
fnbA promoter expression, employing a promoter-green fluorescent
protein (GFP) reporter fusion, as previously described (
28,
30). As expected,
fnbA promoter expression was maximal during
exponential growth of the parental strain and then plateaued
(Fig.
1). In addition, the anticipated positive and negative
regulatory effects of
sarA and
agr, respectively, on
fnbA promoter
expression were observed (Fig.
1) (
3,
24,
29). Interestingly,
the percentage of
fnbA-expressing cells in the
sarA agr double
mutant paralleled that of the
sarA single knockout mutant during
exponential and early postexponential growth phases but increased
to near-parental levels in late stationary growth phase (Fig.
1). These data suggest that environmental cues (e.g., low pH,
nutrient limitation) or other regulatory loci contribute to
fnbA expression during the stationary growth phase in the absence
of
sarA and
agr in vitro (e.g.,
sae) (
27).

Northern blot analysis of fnbA transcription.
RNA isolation and Northern blot analysis were performed as described
previously (
29). The transcription of
fnbA in the parental strain
was maximal during mid-log phase (Fig.
2). As expected, in the
agr mutant, there was substantial up-regulation in
fnbA transcription
during the late log phase, while
fnbA transcription in the
sarA mutant was markedly reduced compared to that in the parental
strain (Fig.
2) (
24,
29). It is noteworthy that the level of
fnbA transcription in the
sarA agr double mutant was between
the levels of the single
agr and
sarA mutants. Interestingly,
we also observed a bimodal increase in
fnbA transcription in
the double mutant, with the first peak occurring during the
mid-log phase and a smaller but noticeable peak occurring during
the late stationary phase (overnight culture). Therefore, these
in vitro transcriptional data concurred with those of the GFP
reporter gene fusion data sets above.

Protease activity in vitro.
To quantify overall protease activity, a microplate assay kit
(Molecular Probes, Eugene, Oreg.) was utilized as previously
described (
4). Protease activity was slightly decreased in the
agr mutant (

0.8-fold) but significantly increased in the
sarA mutant (three- to fivefold;
P < 0.05) compared to the parental
strain (Fig.
3). These data are consistent with the documented
repression of protease production by
sarA (
17,
18). The
sarA agr double mutant had a quantitative protease phenotype that
was intermediate between those of the
sarA and
agr single mutants.
No protease activity was observed from any study strain after
4 h of incubation (data not shown).
To evaluate the effect of the global protease inhibitor,

2-macroglobulin
(Boehringer-Mannheim, San Diego, Calif.), the above experiments
were repeated with cultures preexposed to the inhibitor (range,
0.4 to 1.6 U/ml). Protease activity was inhibited (>80% for
all study strains) in the presence of

2-macroglobulin (1.2 U/ml)
(data not shown).

Fibronectin adherence in vitro.
To quantitate correlation between
fnbA expression and fibronectin
adherence phenotypes, we evaluated the fibronectin-binding capacities
of
S. aureus by direct binding to immobilized human fibronectin
as previously described (
17,
19). It is noteworthy that fibronectin-binding
properties of the set of strains paralleled the individual
fnbA promoter expression profiles of the strains in vitro (Fig.
4).
For example, fibronectin binding was higher in the
agr mutant
than in the parental strain, but it was lower in the
sarA mutant
(binding of the parental strain to fibronectin reached

5% of
the inoculum after 24 h of incubation). In addition, the fibronectin-binding
capacity of the
sarA agr double mutant exceeded that of the
sarA mutant during the stationary growth phase (16 to 24 h).
Since the production of proteases is down-regulated in the
agr mutant but up-regulated in the
sarA mutant and since FnBPs can
be degraded by such proteases, it was conceivable that alterations
in fibronectin-binding phenotypes might be related to variations
in their individual protease production profiles. To test this
hypothesis, all study strains were preexposed to

2-macroglobulin
(1.2 U/ml), and the fibronectin adherence properties were then
determined. For all study strains grown in the presence of

2-macroglobulin,
there was a

30% increase in fibronectin-binding
activities throughout the growth cycle compared to strains grown
in the absence of the inhibitor. These data suggest that extracellular
protease production contributes modestly to the overall fibronectin-binding
capacity of
S. aureus strains. However, the fact that all strains
were equally affected by protease inhibition and only to a modest
extent indicates that the predominant mechanisms dictating phenotypic
fibronectin binding probably occur at the level of
fnbA transcription.

Experimental rabbit endocarditis model.
Recent studies have demonstrated that
S. aureus virulence gene
regulation profiles defined in vitro are often not precisely
mirrored in vivo (
6,
8,
28,
30). These data imply that host
environmental cues play a major role in the activation of key
S. aureus virulence genes. Thus, we sought to correlate
fnbA promoter activation profiles defined in vitro with those delineated
in experimental rabbit endocarditis. A well-characterized rabbit
endocarditis model was used in these studies as previously described
(
28,
30).

(i) Microbiologic evaluation.
S. aureus densities achieved in vegetations were significantly
higher than in kidney and spleen for all study constructs at
48 h postinfection (
P < 0.05) (Table
2). In addition, all
the mutants had lower target tissue bacterial densities than
the parental strain, although these differences did not reach
statistical significance. By comparison,
S. aureus densities
in vegetations were comparable in all study strains at 8 h postinfection
(data not shown).
View this table:
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|
TABLE 2. S. aureus fnbA::gfpuvr Newman parental strain and its isogenic agr and/or sarA mutant densities in target tissues of animals with endocarditis challenged with 107 CFU/animal
|

(ii) fnbA promoter expression in vivo.
Flow cytometry and a protein A-based immunodetection system
were used for detection of
fnbA promoter expression in the endocarditis
model as previously detailed (
28,
30). Interestingly,
fnbA promoter
expression profiles defined in vivo in all target tissues for
the various constructs paralleled in vitro
fnbA expression profiles
(Fig.
5). Compared to the parental cells, we observed increased
fnbA expression in the
agr mutant and decreased
fnbA expression
in the
sarA mutant, with expression in the double mutant being
greater than that of the
sarA mutant in all target tissues (Fig.
5) (
P < 0.05 for the parent versus the
agr mutant in vegetations
at 48 h). As in prior studies (
28,
30), there were target tissue-specific
differences in gene expression, with maximal
fnbA expression
seen in vegetations and kidneys, with reduced expression in
the spleen. It is interesting that the extent of GFP expression
for the various constructs paralleled the percentage of GFP
expression in the target tissues studied (data not shown).

(iii) Fibronectin adherence ex vivo.
To determine the relative ability of the study strains (obtained
directly from vegetations) to adhere to fibronectin, a modification
of the above in vitro adherence assay was performed. Briefly,
S. aureus cells (

5
x 10
3 CFU based on anticipated vegetation
densities) from each vegetation sample (at 24 h after infection
[10
7 CFU/animal]) were directly assessed ex vivo for fibronectin-binding
capacity by the in vitro assay detailed above. The in vivo
fnbA expression profiles noted above roughly paralleled the fibronectin-binding
capacities of the various constructs isolated directly from
cardiac vegetations (data not shown). For example, compared
to parental cells, the
agr mutant cells adhered slightly more
to fibronectin, but the
sarA mutant adhered significantly less
to fibronectin (
P < 0.05). Remarkably, the
sarA agr double
mutant adhered to fibronectin to a higher extent than the
sarA single mutant (
P < 0.05 for
sarA single mutant versus parental
strain), mirroring the in vitro and in vivo (intravegetation)
profiles of
fnbA expression.
Several interesting observations emanated from this investigation. As expected, fnbA promoter expression in vitro was maximal during exponential growth of the parental strain and then plateaued. In addition, using single knockout mutants, the anticipated positive and negative regulatory effects of sarA and agr, respectively, on fnbA promoter expression in vitro were confirmed (3, 24, 29). Surprisingly, the extent of fnbA promoter expression in the sarA agr double mutant paralleled that of the sarA single knockout mutant during exponential and early postexponential growth phases but increased to near-parental levels in late stationary growth phase. Similarly, utilizing Northern blot analysis, Blevins et al. (3) noted fnbA transcription in sarA agr double mutants to be at or above the levels observed for the sarA single mutants in two clinical S. aureus strains. Collectively, these data suggest that during the stationary growth phase, environmental cues (e.g., low pH, nutrient limitation) or other regulatory loci that influence fnbA expression contribute to fnbA regulation in the absence of sarA and agr in vitro (e.g., the sae regulon seems to be required for fnbA activation in the Newman strain [27]). Further, delineation of the regulatory functions of the growing family of sarA homologs may also yield relevant information in this context (10, 12, 20, 25).
To correlate the above differences in fnbA expression profiles in vitro with a key functional phenotype, we compared the temporal fibronectin-binding capacities of this set of strains. It is noteworthy that the growth phase-related fibronectin-binding properties of this set of strains in our solid-phase assay paralleled their individual fnbA promoter expression profiles in vitro (results which are consistent with those reported by Blevins et al. [3], who utilized a liquid-phase fibronectin-binding assay). As with our sarA agr double mutant, in six of the seven strains Blevins et al. (3) studied (including the Newman strain), the fibronectin-binding capacity of the sarA agr double mutant exceeded that of the sarA single mutant by as much as twofold. Importantly, fnbA promoter expression profiles and fibronectin-binding phenotypes defined in vitro for the various constructs in the current study roughly paralleled the profiles and phenotypes defined in vivo in all target tissues in early and well-established infections.
It has been reported that sarA and agr mediate their effects on fnbA at the transcriptional level; this same regulatory pattern has been demonstrated in the Newman strain by Western blot analysis (29). These data indicate that the fibronectin-binding activities of S. aureus strains are at least partially due to direct regulation of fnbA transcription by sarA and agr. However, the overall S. aureus fibronectin-binding capacity is likely multifactorial, including extracellular protease production as well as production of a cadre of other FnBPs (e.g., FnbB, Ebh [host extracellular matrix binding protein homologue], and Emp [extracellular matrix protein binding protein]) (13, 16). Taken together, it is likely that the collective fibronectin-binding capacity of a given S. aureus strain reflects a composite of the activation and regulation of these various loci. Future studies will be required to evaluate the in vitro and in vivo expression paradigms of these other FnBPs, using animal models and gene reporter systems similar to those used in this study, to determine their relative contributions to net fibronectin binding in vitro and in vivo.

ACKNOWLEDGMENTS
This work was supported in part by grants from the American
Heart Association to Y.-Q.X. (0265054Y) and the National Institutes
of Health to A.S.B. (AI-39108), A.L.C. (AI-47441), and M.R.Y.
(AI-48031 and RR-13004).
We thank Yin Li for excellent technical assistance. We thank Battouli Said-Salim (Newark, N.J.) for agr genotyping of the Newman strain.

FOOTNOTES
* Corresponding author. Mailing address: Division of Infectious Diseases, St. John's Cardiovascular Research Center, Harbor-UCLA Research and Education Institute, 1124 W. Carson St., Torrance, CA 90502. Phone: (310) 222-6422. Fax: (310) 782-2016. E-mail:
bayer{at}humc.edu.

Editor: F. C. Fang

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Infection and Immunity, March 2004, p. 1832-1836, Vol. 72, No. 3
0019-9567/04/$08.00+0 DOI: 10.1128/IAI.72.3.1832-1836.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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