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Infection and Immunity, July 2004, p. 4279-4281, Vol. 72, No. 7
0019-9567/04/$08.00+0 DOI: 10.1128/IAI.72.7.4279-4281.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Increased Susceptibility of Secretor Factor Gene Fut2-Null Mice to Experimental Vaginal Candidiasis
Elizabeth A. Hurd and Steven E. Domino*
<[ERROR]zaff;1[ERROR]>Department of Obstetrics and Gynecology, Cellular and Molecular Biology Program, University of Michigan Medical Center, Ann Arbor, Michigan
Received 18 December 2003/
Returned for modification 26 January 2004/
Accepted 2 April 2004

ABSTRACT
Fut2-LacZ-null mice, which are a model of the human ABO and
Lewis nonsecretor group, display increased susceptibility to
experimental yeast vaginitis, indicating a role for

(1,2)fucosylated
cervical glycans in mucosal defense. However, the lack of significant
effect of competitive inhibition by exogenous neoglycoproteins
in this study emphasizes the complexity of
Candida-epithelial
cell adhesion events.

TEXT
Recurrent vulvovaginal candidiasis (RVVC) is a mucosal infection
caused by the opportunistic fungus
Candida albicans which affects
up to 5 to 10% of women of reproductive age (
22,
23). The immune
response elicited during an episode of RVVC differs from the
classical host defense mechanism, as infection occurs despite
normal
Candida-specific Th1-type cell-mediated immunity (
9,
16). Protection from RVVC is believed to be acquired locally,
possibly involving incompletely defined vaginal epithelial carbohydrate
adhesion molecules (
2,
24).
A common null mutation within the coding region of the
(1,2)fucosyltransferase gene, FUT2 (secretor factor gene), leads to ABO and Lewis histo-blood group antigen nonsecretion from mucosal tissues in approximately 20% of humans, with ethnic variation (13, 14). Nonsecretor status has been associated with differences in susceptibility to several infections, including infections with Norwalk virus (15), human immunodeficiency virus (1), Escherichia coli (17, 21), Staphylococcus aureus (20), Campylobacter jejuni (19), calicivirus (18), and C. albicans (5). While the mechanism of how C. albicans interacts with nonsecretors is not known, a host-microbe adhesion mechanism is supported by in vitro studies that have demonstrated binding of various fucosylated oligosaccharides to germ tubes of C. albicans (3, 4, 6, 25). We report here the development of a mouse model for the nonsecretor phenotype to test the importance of
(1,2)fucosylated glycans in vivo during experimental vaginal candidiasis.
Absence of endocervical and vaginal
(1,2)fucosylated glycans in Fut2-LacZ-null mice.
The expression pattern of Fut2 and resulting
(1,2)fucosylated glycans in the female lower reproductive tract was examined in 8- to 10-week-old female mutant mice (Fut2-LacZ-null mice) that contained a targeted replacement of the Fut2 open reading frame with a bacterial lacZ reporter gene (8). The original mutant mice were backcrossed 10 generations to C57BL/6J mice (Jackson Laboratory, Bar Harbor, Maine), and the resulting congenic strain used for this study was designated B6.129X1-Fut2tm1Sdo (MGI accession ID no. 2183220). A second line of mutant mice lacking the coding region of another
(1,2)fucosyltransferase gene, Fut1, was similarly backcrossed for 10 generations to C57BL/6J mice and was designated B6.129X1-Fut1tm1Sdo (MGI accession ID no. 2183219) and used as genetic background controls.
Using a 5-bromo-4-chloro-3-indolylß-D-glucuronic acid (X-Gal) staining method (7), specific nuclear LacZ staining was detected in the glandular and lumenal epithelium of the endocervix of Fut2-LacZ-null mice in estrus (Fig. 1A), but not in wild-type mice (Fig. 1B). Lectin staining with Ulex europaeus agglutinin I (UEA-I) showed loss of
(1,2)fucosylated glycans from the endocervix and upper vagina of Fut2-LacZ-null mice (Fig. 1C), while lectin staining was preserved at the apical surface of the epithelium of the endocervix and upper vagina in wild-type mice (Fig. 1D), indicating that Fut2 is essential for the production of
(1,2)fucosylated glycans within the endocervix and vagina. Given epidemiological evidence that nonsecretors are more susceptible to RVVC (5) and the implication of fucose involvement in C. albicans adhesion from various in vitro studies (4, 25), we postulated that
(1,2)fucosylated glycans carried on secreted endocervical mucins protect the vaginal epithelium by sequestering and thereby preventing C. albicans from adhering to vaginal epithelial cells. This potential defense mechanism would be reduced in nonsecretor women. The estrogen-regulated expression of FUT2 may thus represent innate protection against monthly infection with C. albicans by increasing
(1,2)fucosylated glycan secretion at times most risky for colonization associated with elevated estrogen.
Fut2-LacZ-null mice display increased susceptibility to C. albicans during experimental vaginal candidiasis compared to wild-type and Fut1-null control mice.
To test for and quantify potential differences between wild-type
and mutant mice during experimental vaginal candidiasis, female
C57BL/6J wild-type, Fut1-null, and Fut2-LacZ-null mice were
maintained in pseudoestrus by using subcutaneous 0.5-mg, 21-day
controlled release 17ß-estradiol pellets (Innovative
Research of America, Sarasota, Fla.). Following intravaginal
inoculation with 10 µl containing 5
x 10
5 stationary-phase
C. albicans (3153A) cells (
10,
11) mice were euthanized at 4,
7, or 14 days, and the vagina and cervix were removed en bloc,
homogenized in phosphate-buffered saline (
12), and plated on
Sabouraud dextrose agar plates to determine CFU counts (CFU
per organ). This study was approved for humane animal use. Hematoxylin
and eosin staining of paraffin-embedded vaginas of infected
mice at 4 days displayed hyphal yeast and neutrophils throughout
the vagina, confirming
C. albicans infection (data not shown).
Similar to human nonsecretors, Fut2-LacZ-null mice displayed
an increased vaginal fungal burden compared to that in wild-type
mice of 4.8- and 2.4-fold at 4 and 7 days postinoculation, respectively
(Fig.
2). Analysis of variance (ANOVA) determined that the higher
colonization rates in Fut2-LacZ-null mice compared to those
in wild-type mice cannot be accounted for by expected variation.
Upon post-hoc analysis using Tukey's honestly significant difference
test and Dunnett's T3 test, Fut2-LacZ-null mice had statistically
significant increased susceptibility (
P < 0.01) versus wild-type
mice at 4 and 7 days postinoculation. While displaying the same
trend seen at earlier time points, there was an absence of statistical
significance at 14 days postinoculation, perhaps as a result
of the limited number of mice used in the study. There was no
variation difference in fungal burden between the control Fut1-null
and C57BL/6J wild-type mice.
Neoglycoprotein competitive inhibitors to yeast colonization.
To address the mechanism of
Fut2 involvement during
C. albicans infection, we coinoculated mice with
C. albicans and exogenous
neoglycoproteins to directly saturate adhesin binding sites
and potentially reduce colonization by sequestering, and thereby
preventing, adhesion to host epithelium (
25). Groups of pseudoestrous
wild-type and Fut2-LacZ-null mice were intravaginally inoculated
with a total of 13 µl composed of 10 µl of 5
x 10
5 stationary-phase
C. albicans cells preincubated for 15 min with
3 µl of a 10-mg/ml solution of either bovine serum albumin
(BSA), fucose-conjugated BSA (Fuc-BSA), or galactose-conjugated
BSA (Gal-BSA) (EY Laboratories, Inc., San Mateo, Calif.). The
vagina and cervix were removed en bloc from all mice 4 days
postinoculation, and the CFU per organ was quantified as described
above. Comparisons of the mean vaginal fungal burden between
treatments in Fut2-LacZ-null and wild-type control mice did
not show statistically significantly effects from Fuc-BSA or
Gal-BSA pretreatments compared to BSA alone, based on a one-way
ANOVA and Dunnett's T3 post-hoc test (Fig.
3). Possible explanations
include an inability of simple neoglycoproteins to adequately
bind
C. albicans adhesins, insufficient dosing with the competitive
sugars due to rapid turnover or elimination, or an inappropriate
growth phase of
C. albicans. Future studies will include more
complex oligosaccharides and lectins that may show greater efficacies
to sequester yeast and prevent adhesion to host epithelium.
These data provide evidence that Fut2-LacZ-null mice may serve
as an animal model to investigate host-microbe interactions
in the gastrointestinal and genitourinary systems, where epidemiological
data support an association between ABO and Lewis blood group
secretion and genetic predisposition to infection.

ACKNOWLEDGMENTS
We thank personnel of the University of Michigan IPOX histology
core and Histoserv Inc. for histological processing, Brady West
of the University of Michigan Center for Statistical Consultation
and Research, and the laboratory of Paul Fidel for the gift
of
C. albicans strain 3153A.
This work was supported in part by a University of Michigan Rackham Grant (S.E.D.). E.A.H. is a recipient of a University of Michigan Biomedical Research postdoctoral fellowship award.

FOOTNOTES
* Corresponding author. Mailing address: Department of Obstetrics and Gynecology, 6428 Medical Science I, Box 0617, University of Michigan, Ann Arbor, MI 48109-0617. Phone: (734) 647-9562. Fax: (734) 936-8617. E-mail:
sedomino{at}med.umich.edu.

Editor: T. R. Kozel

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Infection and Immunity, July 2004, p. 4279-4281, Vol. 72, No. 7
0019-9567/04/$08.00+0 DOI: 10.1128/IAI.72.7.4279-4281.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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