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Infection and Immunity, August 2004, p. 4344-4350, Vol. 72, No. 8
0019-9567/04/$08.00+0 DOI: 10.1128/IAI.72.8.4344-4350.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
1-Antitrypsin Binds to and Interferes with Functionality of EspB from Atypical and Typical Enteropathogenic Escherichia coli Strains
Sabine Knappstein, Tina Ide, M. Alexander Schmidt,* and Gerhard Heusipp
Institut für Infektiologie, Zentrum für Molekularbiologie der Entzündung (ZMBE), Universitätsklinikum Münster, 48149 Münster, Germany
Received 8 January 2004/
Returned for modification 10 February 2004/
Accepted 6 May 2004

ABSTRACT
Enteropathogenic
Escherichia coli (EPEC), including diffusely
adhering atypical
E. coli, strains use a type III secretion
system to deliver effector proteins into the membrane and cytoplasm
of infected cells. The
E. coli secreted proteins A, B, and D
(EspA, EspB, and EspD) are required for the formation of the
characteristic attaching and effacing (A/E) lesions. EspB and
EspD are thought to form a translocation pore in the host cell
membrane through which effector proteins are injected into the
host cytosol. Besides its function in pore formation, EspB has
been found in the cytosol and implicated to function as an effector
protein. We screened for putative host cell proteins interacting
with EspB of atypical EPEC strains and identified
1-antitrypsin
(AAT) as a binding partner for EspB. AAT binds to EspB in pull-down
and overlay experiments and also to EspD in overlay experiments.
In agreement with the role of EspB and EspD in pore formation,
EPEC-mediated hemolysis of red blood cells is strongly reduced
by AAT in a concentration-dependent manner, indicating that
AAT interferes with type III secretion by inhibiting the formation
of the translocation pore. This is further supported by a decreased
actin polymerization after infection of HeLa or CaCo-2 cells
with EPEC in the presence of physiologically relevant concentrations
of AAT. In this study, we identify AAT as a new binding partner
for EspB and EspD, suggesting a previously unappreciated role
for AAT in host cell defense against EPEC infections and potentially
also against other bacterial pathogens.

INTRODUCTION
Locally adhering typical enteropathogenic
E. coli (LA-EPEC)
and diffusely-adhering atypical EPEC (DA-EPEC) are implicated
as a major cause of infantile diarrhea in children in developing
countries (
25,
26). Typical EPEC strains possess the EAF plasmid,
coding for bundle-forming pili, which confers the local-adherence
phenotype on host cells. In contrast, the EAF plasmid is missing
in atypical EPEC strains, resulting in diffuse adherence of
the bacteria (
26). In typical as well as in atypical EPEC strains,
pathogenesis and the characteristic attaching and effacing (A/E)
phenotype is associated with a 35-kb pathogenicity island termed
the locus of enterocyte effacement (LEE) (
3,
22). The LEE encodes
a type III secretion system designed to deliver effector proteins
across the bacterial and host cell membranes into the cytosol
of the host cell, a recurring theme in the pathogenesis of many
gram-negative bacteria (
11). The importance of the LEE pathogenicity
island for virulence is further documented by the fact that
LEE homologues were identified in enterohemorrhagic
E. coli (EHEC), rabbit diarrheagenic
E. coli (RDEC), and the mouse pathogen
Citrobacter rodentium, where they are also responsible for the
induction of A/E lesions on epithelial cells (
7,
29,
40). The
A/E phenotype is characterized by intimate attachment of the
bacteria to the host cell, effacement of brush border microvilli,
and formation of pedestals on which the bacteria reside (
9).
Intimate attachment is mediated by binding of the bacterial
adhesin intimin to Tir, which, after translocation into the
target cell membrane, serves as a receptor. Both proteins are
encoded on the LEE pathogenicity island. Binding of intimin
to Tir results in a rearrangement of the host cytoskeleton and
subsequent pedestal formation (
16). The type III secreted proteins
EspA, EspB, and EspD are required for translocation of the effector
proteins into the host cytosol (
9). EspA forms a filamentous
structure on the surface of the bacteria, connecting it to the
host cell and thereby forming a conduit through which effector
proteins are translocated (
20,
30). EspB and EspD insert into
the membrane of infected cells, where they are thought to form
a translocation pore. Pore formation correlates with the induction
of hemolysis of red blood cells (RBC) (
12,
32,
37,
38). Additional
type III-secreted proteins include EspF, EspG, EspH, and Map.
EspF disrupts intestinal barrier function and induces apoptosis
(
5,
23). Until now, there has been no experimental evidence
for a function of EspG during infection; however, homology to
VirA of
Shigella flexneri suggests a role in intestinal colonization
(
8). EspH localizes to membranes of infected cells and interferes
with the formation of filopodia and pedestals (
36). Map (Orf19)
localizes to mitochondria and disrupts their membrane potential
(
18). In addition, Map induces the formation of Cdc42-dependent
filopodia in host cells and is involved in EPEC invasion (
14,
17). Although EspB inserts into the host membrane and, once
there, plays a structural role in effector protein translocation,
it can also be detected in the cytoplasm of infected cells,
implying an additional function as a type III-secreted effector
protein (
35). Accordingly, overproduction of EspB in HeLa cells
leads to a change in cellular morphology and reduction in the
number of stress fibers (
34). Moreover,
espB mutant strains
of EPEC, RDEC, and
C. rodentium are reduced for virulence in
humans (EPEC) and animal models (RDEC and
C. rodentium) (
1,
27,
33). Further support for a role of EspB as an effector protein
comes from studies with EHEC, in which

-catenin was identified
as a binding protein for EspB (
21). To expand the current understanding
of EspB function during host cell infection, we aimed at identifying
putative host cell proteins interacting with EspB of atypical
EPEC. In this study, we show that EspB binds to
1-antitrypsin
(AAT). This interaction interferes with hemolysis of RBC and
actin accumulation in infected host cells.
AAT is an acute-phase protein and the most abundant circulating serine protease inhibitor. The concentration of acute-phase proteins in serum increases in response to inflammation or injury, providing a nonspecific protection of the host against microorganisms. AAT concentrations in the serum vary between 1.5 and 3.5 mg/ml but may increase fourfold during inflammation (31). Although AAT is synthesized primarily in the liver, it can also be found in extrahepatic tissues and intestinal enterocytes (24). AAT is a physiological inhibitor of various proteases, but its primary role is to protect the lower respiratory tract from proteolytic destruction by neutrophil elastase (6). In this paper, we describe a novel role for AAT in host defense that might have implications for the virulence of pathogens besides EPEC.

MATERIALS AND METHODS
Bacterial strains, tissue culture cell lines, and culture conditions.
The atypical DA-EPEC strain 3431 was described previously (
13).
The typical EPEC strain E2348/69 was obtained from J. B. Kaper
(Baltimore, Md.). The EPEC E2348/69
espB and
espD mutant strains
UMD864 and UMD870, respectively, were provided by M. Donnenberg
(Baltimore, Md.). All strains were routinely grown in Standard-I
medium. For the induction of type III secretion, EPEC strains
were statically grown in Dulbecco's minimal essential medium
(DMEM) under a 10% CO
2 atmosphere. HeLa cells (ATCC CCL 2) were
routinely grown at 37°C, under a 10% CO
2 atmosphere, in
DMEM supplemented with 10% (vol/vol) fetal calf serum, 1 mM
glutamine, 100 U of penicillin per ml, and 100 µg of streptomycin
per ml. CaCo-2 cells (subclone BBe2; American Type Culture Collection)
were routinely grown at 37°C, under a 5% CO
2 atmosphere
in DMEM supplemented with 10% (vol/vol) fetal calf serum, 4
mM glutamine, 10 µg of human transferrin per ml, 100 U
of penicillin per ml, and 100 µg of streptomycin per ml.
Western blot analysis of type III secreted proteins and overlay experiments.
Bacteria were grown without agitation (static cultures) in DMEM for 3 h at 37°C in the presence of 10% CO2. Bacterial supernatants were precipitated by the addition of 10% (final concentration) trichloroacetic acid, subjected to sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) (12.5% polyacrylamide), and transferred to nitrocellulose membranes for immunoblot analysis. The blots were blocked for 1 h at room temperature in 5% (wt/vol) skim milk-Tris-buffered saline (TBS), incubated for 1 h at room temperature with primary antibody diluted in 0.5% skim milk-TBS, washed with TBS, and incubated for 1 h at room temperature with secondary antibody diluted in 0.5% skim milk-TBS. Primary antibodies were polyclonal rabbit antiserum against AAT (Biomeda) at a 1:1,000 dilution and polyclonal rabbit antiserum against EspB at a 1:10,000 dilution. As a secondary antibody, we used alkaline phosphatase-conjugated goat anti-rabbit antibody (Jackson ImmunoResearch, West Grove, Pa.) at a 1:7,500 dilution. For overlay experiments, the blots were blocked as described above and incubated for 2 h at room temperature with 1 mg of AAT per ml in 0.5% skim milk-TBS. The membranes were washed with TBS and subsequently incubated with AAT antiserum as described above.
Quantification of hemolysis of SRBC induced by bacteria and bacterial supernatants.
The hemolysis assays were performed essentially as described previously (12, 13). Briefly, sheep RBC (SRBC) were mixed 1:1 with bacteria that were grown for 3 h in DMEM without agitation or with an equal volume of bacterial supernatant and incubated for 1 h at 37°C in the presence of 10% CO2; various concentrations of AAT (Sigma, St. Louis, Mo.) (1 to 200 µM) were added to the bacterial culture or the supernatant immediately before incubation with SRBC. The SRBC were pelleted, and lysis was monitored by photometrically measuring the release of hemoglobin into the supernatant at 450 nm.
Plasmid construction and protein purification.
The espB gene was amplified with oligonucleotides THisB+ (5'-GGAATTCCATATGAATACTATTGATAATAAT-3') and THisB (5'-CCGCTCGAGCCCGGCTAAGCGACCCGATTG-3') (NdeI and XhoI restriction sites are underlined) and with chromosomal DNA from atypical EPEC strain 3431 as the template. The amplified fragment was digested with NdeI and XhoI and ligated into pET24b (Novagen, Schwalbach, Germany), a vector encoding a His6 epitope tag, resulting in plasmid pEspB3431His. Expression results in the production of a C-terminally His-tagged EspB protein. For the production of His-tagged EspB, overnight cultures of E. coli BL21(DE3) harboring plasmid pEspB3431His were diluted 1:200 in 150 ml of Standard-I medium containing 100 µg of ampicillin per ml and grown to an optical density at 600 nm of 0.6. After addition of 1 mM isopropyl-ß-D-thiogalactopyranoside (IPTG) to induce EspB expression, the cultures were further incubated for an additional 3 h at 37°C. Subsequently, bacteria were harvested by centrifugation. His-tagged proteins were purified by Ni-nitrilotriacetate (NTA)-agarose affinity purification under nondenaturing conditions as recommended by the supplier (Qiagen, Hilden, Germany). Protein concentrations were evaluated by Coomassie brilliant blue staining of SDS-polyacrylamide gels in comparison with standard proteins.
Pull-down experiments.
Lysates of E. coli BL21(DE3) (pEspB3431His) grown under conditions to allow the expression of EspB with a C-terminal His tag were incubated with Ni-NTA agarose for at least 1 h at 4°C to allow binding of EspB-His to the matrix. The mixture was subsequently washed twice with washing buffer (50 mM Tris [pH 8.0], 500 mM NaCl, 20 mM imidazole, 10% glycerol, 0.1% Triton X-100) and once with Dulbecco's phosphate-buffered saline (D-PBS) to remove nonspecifically bound proteins. HeLa or Caco-2 cell monolayers were washed with D-PBS and lysed with lysis buffer (50 mM Tris [pH7.6], 150 mM NaCl, 1 mM EDTA, 1 mM EGTA, 30% [vol/vol] glycerol, 1% [vol/vol] Triton X-100) containing complete EDTA-free protease inhibitor cocktail (Roche Applied Science, Mannheim, Germany). The cell lysates were diluted 1:10 in D-PBS and preincubated with Ni-NTA-agarose for 30 min at 4°C. After removal of the matrix by centrifugation, the cellular lysates were added to the matrix suspension containing EspB-His and incubated for at least 2 h at 4°C. The suspension was loaded onto a column, and after it was washed twice with D-PBS, proteins were eluted with elution buffer (50 mM Tris [pH 8.0], 500 mM NaCl, 250 mM imidazole, 10% glycerol, 0.1% Triton X-100) in four 500-µl fractions and further investigated by SDS-PAGE and immunoblot analysis.
Immunofluorescence analysis.
HeLa cells were seeded at a density of 105 cells per well in 24-well tissue culture plates on round coverslips and grown in DMEM to 60 to 80% confluency. The cells were washed twice with D-PBS (containing MgCl2 and CaCl2) before being infected with 108 bacteria per well (grown statically in Standard-I medium for 15 h at 37°C) in 500 µl of low-serum DMEM (2% [vol/vol] fetal calf serum, 2 mM glutamine) containing 1% (wt/vol) methyl-
-D-mannoside (to block adhesion mediated by type I fimbriae) and incubated for 3 h at 37°C in a 10% CO2 atmosphere. Infected HeLa cells were washed with D-PBS to remove nonadherent bacteria and fixed for 15 min in 4% paraformaldehyde plus D-PBS. The fixed cells were washed three times with D-PBS, quenched in 1 M NH4Cl plus D-PBS for 10 min, and permeabilized with 0.1% Triton X-100 in D-PBS plus 4% paraformaldehyde for 4 min. The cells were blocked with 3% (wt/vol) bovine serum albumin in D-PBS for 1 h. For fluorescent-actin staining (FAS) assays, phalloidin-Texas Red was used at a 1:100 dilution. For AAT detection, we used polyclonal rabbit antiserum against AAT at a 1:400 dilution and Cy2-conjugated goat anti-rabbit antiserum as the secondary antibody. All antibodies were diluted in 0.3% bovine serum albumin.

RESULTS
Identification of AAT as a binding partner of EspB.
To identify host cell proteins that bind to EspB of the atypical
EPEC strain 3431, we incubated recombinant EspB harboring a
carboxy-terminal His
6 tag (rEspB) with HeLa cell lysates and
analyzed the lysates for cellular proteins that copurify with
rEspB after Ni-NTA-agarose affinity purification of rEspB. SDS-PAGE
analysis of eluted fractions revealed a prominent band corresponding
to a polypeptide with an apparent molecular mass of approximately
60 kDa that was absent when cell lysates were incubated with
Ni-NTA-agarose alone (data not shown). Determination of the
N-terminal amino acid sequence of this protein by Edman degradation
revealed the sequence X-Val-Leu-Gln-Gly-His-Ala-Val-Gln-Glu.
A database search identified this protein clearly as AAT. Pull-down
experiments were performed using rEspB and Caco-2 cell lysates,
and the precipitates obtained were analyzed by SDS-PAGE and
Western blot analysis with AAT-specific antibodies for detection.
AAT can be detected in elution fractions of rEspB incubated
with HeLa and CaCo-2 cell lysates but not in control fractions
(Fig.
1). To confirm the binding of AAT to rEspB, we incubated
purified AAT with rEspB and Ni-NTA-agarose. AAT was precipitated
with Ni-NTA-bound rEspB but not with Ni-NTA-agarose alone, indicating
a direct interaction between rEspB and AAT (Fig.
1). These results
show that rEspB interacts directly with AAT derived from HeLa
and Caco-2 cells.
Purified AAT binds to EspB from EPEC culture supernatants.
To determine if AAT also binds to type III-secreted EspB, we
employed an overlay assay to investigate the binding of purified
AAT to supernatants of the atypical EPEC strain 3431 grown under
conditions that induce the type III secretion system. Esp-containing
supernatants were separated by SDS-PAGE and blotted onto a nitrocellulose
membrane, which was subsequently blocked and incubated with
purified AAT. After the membrane was washed, bound AAT was detected
on the membrane by using anti-AAT antibody. We identified two
bands that correspond in size to the EspB and EspD proteins,
respectively, of the atypical EPEC strain 3431 (Fig.
2). The
identity of these proteins was confirmed in Western blot analysis
with EspB- and EspD-specific antibodies (data not shown). Furthermore,
AAT is able to bind to type III-secreted EspB and EspD from
typical EPEC strain E2348/69 in an overlay assay, whereas the
corresponding band is specifically missing in the respective
mutant strains UMD864 (
espB) and UMD870 (
espD) (Fig.
2 and data
not shown). These results indicate that EspB is able to bind
AAT in solution, as assayed by the pull-down analysis, and also
immobilized on a membrane, as demonstrated by the overlay assay.
Furthermore, the results of the overlay experiments also show
that not only EspB but also EspD from typical and atypical EPEC
strains is able to bind to AAT.
AAT inhibits hemolysis mediated by EPEC.
Classical LA-EPEC as well as atypical EPEC strains are able
to induce hemolysis of RBC (
12,
38). The hemolytic activity
of atypical EPEC 3431 is contact independent and involves the
type III-secreted proteins EspB and EspD (
12). We speculated
that the interaction of AAT with EspB might influence the hemolytic
activity of atypical EPEC supernatants. Therefore, we performed
hemolysis assays employing SRBC with atypical EPEC 3431 grown
under conditions that induce the secretion of Esp proteins in
the presence of different concentrations of AAT. AAT inhibited
the hemolytic activity of atypical EPEC in a concentration-dependent
manner (Fig.
3B). While 25 µM AAT reduced hemolysis by
about 10%, only about one-third of the initial activity remained
in the presence of 200 µM AAT. Contact-independent hemolytic
activity was measured by incubating SRBC with supernatants of
bacteria grown under conditions inducing Esp secretion in the
presence or absence of AAT (Fig.
3A). Although hemolysis caused
by supernatant alone is generally less pronounced than hemolysis
mediated by whole bacterial cells (
12), the effect of AAT in
this assay is even more striking: 200 µM AAT leads to
an approximately fivefold reduction of hemolytic activity, indicating
that AAT inhibits Esp-mediated hemolysis, presumably by interacting
with free EspB and/or EspD. To analyze the effect of AAT on
lysis of SRBC independent of secreted EspB and EspD, we performed
hemolysis assays using the typical EPEC strain E2348/69, which
is able to lyse RBC in only a contact-dependent matter. As demonstrated
in Fig.
3C, very small amounts of AAT were needed to inhibit
hemolysis, indicating that the activity of AAT is not restricted
to binding of free EspB and EspD from bacterial supernatants.
Importantly, the AAT concentrations used in the experiments
had no influence on growth of the bacteria (data not shown)
and are of physiological relevance. A 50% inhibition of hemolysis
is achieved with AAT concentrations ranging from 0.3 mg/ml (contact-dependent
hemolysis by EPEC strain E2348/69) to 5.2 mg/ml (contact-dependent
hemolysis by DA-EPEC strain 3431) and with a concentration of
2.6 mg/ml for contact-independent hemolysis by supernatants
from DA-EPEC strain 3431.
AAT inhibits atypical EPEC-induced actin polymerization.
EspA, EspB, and EspD are necessary for the induction in host
cells of pedestal formation characteristic of EPEC and atypical
EPEC (
9). Since AAT binds EspB and inhibits EPEC-induced hemolysis,
we were interested in whether AAT also affects actin polymerization
in host cells after infection with atypical EPEC. Therefore,
HeLa and Caco-2 cells were infected with atypical EPEC strain
3431 in the presence or absence of 2.6 mg of AAT per ml. The
actin polymerization induced by the infection was analyzed in
a FAS test (
19). As shown for HeLa cells (Fig.
4), the number
of FAS-positive cells was greatly reduced in the presence of
AAT. We measured the reduction in the number of FAS-positive
cells by counting a subset of cells infected with atypical EPEC
in the presence or absence of AAT. AAT inhibited actin polymerization
mediated by atypical EPEC by more than 60%. To exclude the possibility
that this effect is due to an influence of AAT on adherence
of atypical EPEC to HeLa cells, we determined the number of
adherent bacteria per cell in the presence or absence of AAT.
No effect of AAT on adherence of the atypical EPEC strain 3431
to HeLa cells could be detected (data not shown). To analyze
if AAT has a similar effect on actin polymerization after infection
with the typical LA-EPEC strain E2348/69, HeLa cells were infected
in the presence or absence of 2.6 mg of AAT per ml. As expected,
the presence of AAT led to a 40% decrease in the number of FAS-positive
cells compared to infection in the absence of AAT (data not
shown). These results indicate that AAT is able to inhibit EPEC-induced
actin polymerization in host cells, presumably by binding to
EspB and/or EspD.
AAT is not recruited to the site of atypical EPEC adherence.
AAT is a secreted protease inhibitor that is abundant in human
serum but can also be found intracellularly in enterocytes (
24).
In cells infected with typical LA-EPEC, EspB can be found in
the cytosol as well as in the membrane (
37,
39). EspB of the
classical EPEC strain E2348/69 seems to be localized immediately
beneath attached bacteria (
39). To determine if AAT can be detected
at the site of bacterial attachment in cells infected with atypical
EPEC strain 3431, HeLa and Caco-2 cells were mock infected or
infected for 3 h, fixed, stained with AAT-specific antiserum,
and analyzed by immunofluorescence microscopy. It was found
that AAT was localized throughout the cells that were either
mock infected or infected with atypical EPEC strain 3431, and
no difference in the distribution of AAT as a result of infection
could be observed. In summary, we conclude that EspB or another
protein derived from atypical EPEC apparently does not recruit
AAT to the site of bacterial adherence.

DISCUSSION
The type III-secreted EspB protein has multiple functions for
the virulence of LEE-positive pathogenic
E. coli strains. First,
together with EspD, it inserts into host cell membranes and
is thought to constitute part of a pore through which effector
proteins are translocated into the host cell (
12,
37). Second,
it can be detected in the cytoplasm of infected host cells,
where it might function as a cytoskeletal toxin (
34,
35,
39).
Third, it was shown that EspB recruits

-catenin to the site
of EHEC infection in host cells, where it is essential for A/E
lesion formation (
21). For these reasons, it is not surprising
that EspB represents a critical determinant for the pathogenesis
of EPEC infections (
1,
33).
In this study, we have identified AAT as a novel binding partner for the type III-secreted EspB protein. Recombinant as well as type III-secreted EspB proteins from culture supernatants of atypical EPEC strains bound to AAT in pull-down and overlay assays. Further analysis revealed that AAT binding to EspB and presumably also to EspD interferes with the function of these proteins, since AAT reduced the ability of EPEC bacteria and supernatants to lyse RBC. Furthermore, when HeLa and Caco-2 cells were infected with atypical or typical EPEC in the presence of AAT, this interaction resulted in a reduction in the number of FAS-positive cells compared to cells infected in the absence of AAT. These results point to a previously unidentified role of AAT in host defense against infection and expand our knowledge about the role of EspB in EPEC infection.
AAT is one of the most abundant circulating protease inhibitors in humans and plays a role as an acute phase protein. It is synthesized primarily in the liver but is also produced in extrahepatic tissues and cells in the intestinal epithelium of the small bowel (24). The physiological role of AAT is the maintenance of the protease/antiprotease balance. The primary site of activity of AAT is in the lower respiratory tract, where it prevents damage from proteolytic destruction by inhibiting neutrophil elastase (6, 15). As a result of the relatively common genetic disorder leading to AAT deficiency, the risk of developing pulmonary emphysema is enhanced (4). Interaction of AAT with a bacterial virulence factor has not been described so far. One would expect that AAT as a serpin would preferentially bind to serine proteases; however, a protease motif could not be identified in EspB. Therefore, AAT has to interact with other domains of EspB and potentially also with other bacterial proteins that remain to be identified in future studies. Recently, the binding domain for
-catenin was identified in the N-terminal region of EspB by sequential deletion analysis (21). Similar experiments directed at the identification of EspB domains involved in AAT binding are under way in our laboratory.
Decreased hemolysis and reduced actin accumulation, as indicated by a FAS assay in the presence of AAT after atypical EPEC infection, indicate that AAT interferes with the stability or function, or both, of EspB and EspD. This interaction presumably inhibits the integration of EspB and EspD into the host cell membrane and the formation of the type III translocation pore. It has been described that AAT is able to inhibit human immunodeficiency virus type 1 (HIV-1), presumably by blocking viral entry into the cell, a process that is mediated by the viral gp120 and gp41 envelope glycoproteins (31). However, it has been speculated that AAT disrupts the interaction of gp120 with cell surface proteases involved in the fusion process. In a different study, the AAT variant
1-PDX is able to inhibit membrane fusion of HIV-1 by inhibiting furin-dependent cleavage of gp160 to gp120 and gp41, a processing step that is necessary for HIV-1 infectivity (2). In contrast to the effect of AAT on HIV-1 infection, the reduced infectivity of atypical EPEC in the presence of AAT presumably does not involve an inhibition of host proteases. Instead, AAT seems to inhibit EspB/EspD-dependent pore formation by directly interacting with the bacterial proteins, thereby inhibiting their membrane fusogenic potential.
Our results indicate that EspB interacts primarily with secreted AAT. While atypical and typical EPEC strains showed reduced hemolytic activity and a reduced potential to polymerize actin in host cells in the presence of AAT, we did not observe a recruitment of AAT to the site of atypical EPEC infection or a colocalization of EspB with AAT in infected cells (data not shown). However, a putative intracellular association of AAT with EspB cannot be excluded and should be investigated in more detail in future studies.
Besides AAT, other protease inhibitors have been identified to play a role in host defense against infection by bacteria, fungi, and viruses. Like antimicrobial peptides, these proteins have a microbicidal activity that is distinct from their protease inhibitory activity (10). Again, AAT seems to act in a distinctly different fashion on atypical EPEC, since bacteria grow in the presence of AAT without any growth impairment or other obvious defect (data not shown). Recently, lactoferrin was identified as a protein of the innate immune system that has proteolytic activity against the EPEC proteins EspA, EspB, and EspD, with the strongest effect on EspB (28). Although the mechanism by which lactoferrin impairs EPEC virulence functions appears to be distinct from the mechanism of the effect of AAT on EspB described in our study, it emphasizes the concerted function of multiple host defense factors to counteract the effects of type III-secreted proteins on the host. In addition, it can be speculated that AAT might act not only on proteins secreted by atypical EPEC but also on virulence-associated proteins of other pathogens. Future studies will be aimed at identifying the mechanism underlying the binding of AAT to EspB and EspD.

ACKNOWLEDGMENTS
This study has been supported by grants of the Deutsche Forschungsgemeinschaft
(DFG) (DFG SFB 293/B5) and the Federal Ministry for Science
and Technology (BMFT) (PTJ-BIO/03U213B VBIII PG3) and an Innovative
Medical Research grant (IMF) (HE 120201) of the Medical School
of the University of Münster.

FOOTNOTES
* Corresponding author. Mailing address: ZMBE, Institut für Infektiologie, von-Esmarch-Str. 56, 48149 Münster, Germany. Phone: 49-251-8356466. Fax: 49-251-8356467. E-mail:
infekt{at}uni-muenster.de.

Editor: J. B. Bliska

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Infection and Immunity, August 2004, p. 4344-4350, Vol. 72, No. 8
0019-9567/04/$08.00+0 DOI: 10.1128/IAI.72.8.4344-4350.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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