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Infection and Immunity, September 2004, p. 5004-5011, Vol. 72, No. 9
0019-9567/04/$08.00+0 DOI: 10.1128/IAI.72.9.5004-5011.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Mycoplasma fermentans Binds to and Invades HeLa Cells: Involvement of Plasminogen and Urokinase
Amichai Yavlovich,1 Avigail Katzenell,1 Mark Tarshis,1 Abd A.-R. Higazi,2 and Shlomo Rottem1*
Department of Membrane and Ultrastructure Research, The Hebrew University-Hadassah Medical School,1
Department of Clinical Biochemistry-Hadassah Hospital, Mount Scopus, Jerusalem, Israel2
Received 10 October 2003/
Returned for modification 27 April 2004/
Accepted 3 June 2004

ABSTRACT
Adherence of
Mycoplasma fermentans to HeLa cells followed saturation
kinetics, required a divalent cation, and was enhanced by preincubation
of the organism at 37°C for 1 h in a low-osmolarity solution.
Proteolytic digestion, choline phosphate, or anti-choline phosphate
antibodies partially inhibited the adherence, supporting the
notion that
M. fermentans utilizes at least two surface components
for adhesion, a protease-sensitive surface protein and a phosphocholine-containing
glycolipid. Plasminogen binding to
M. fermentans greatly increased
the maximal adherence of the organism to HeLa cells. Anti-plasminogen
antibodies and free plasminogen inhibited this increase. These
observations suggest that in the presence of plasminogen the
organism adheres to novel sites on the HeLa cell surface, which
are apparently plasminogen receptors. Plasminogen-bound
M. fermentans was detected exclusively on the cell surface of the infected
HeLa cells. Nevertheless, plasminogen binding in the presence
of the urokinase-type plasminogen activator (uPA) promoted the
invasion of HeLa cells by
M. fermentans. The latter finding
indicates that the invasiveness of
M. fermentans does not result
from binding plasminogen but from activation of the bound plasminogen
to plasmin. Cholesterol depletion and sequestration with ß-cyclodextrin
and filipin, respectively, did not affect the capacity of
M. fermentans to adhere, but invasion of HeLa cells by uPA-activated
plasminogen-bound
M. fermentans was impaired, suggesting that
lipid rafts are implicated in
M. fermentans entry.

INTRODUCTION
Mycoplasmas (class
Mollicutes) are wall-less prokaryotes that
are widely distributed in nature. Most mycoplasmas are parasites,
exhibiting strict host and tissue specificities, and almost
all of them are bound to the surface of the host cells. Almost
all animal mycoplasmas depend on adhesion to host tissues for
subsequent colonization and infection (
26,
31). In these mycoplasmas,
adherence is the major virulence factor, and adherence-deficient
mutants are avirulent (
3,
32). The best-studied adherence system
is that of
Mycoplasma pneumoniae, the causative agent of primary
atypical pneumonia in humans. Adherence of this organism to
cells in the respiratory tract is an initial and essential step
in tissue colonization and the subsequent development of disease
(
20). A surface 169-kDa protein designated P1 (
18) and a 30-kDa
protein designated P30 (
11) are densely clustered at the tip
organelle of virulent
M. pneumoniae and are associated with
the adherence process.
The human pathogen Mycoplasma fermentans was isolated from the urogenital tract several decades ago (33). Interest in this organism has recently increased because of its possible role in the pathogenesis of rheumatoid arthritis and reports indicating that this organism may function as a cofactor accelerating the progression of human immunodeficiency virus disease (22, 28). Although M. fermentans is a typical extracellular microorganism able to adhere to human epithelial cells, ultrastructural studies performed with engulfed M. fermentans revealed mycoplasmas within membrane-bound vesicles (38, 39). However, the underlying mechanisms for the adherence to and invasion of host cells are only poorly understood.
Plasminogen (Pg) is a 92-kDa plasma glycoprotein. This protein is activated in vivo to the serine protease plasmin by the urokinase-type Pg activator (uPA) and the tissue-type Pg activator by cleavage of a single peptide bond (R561-V562), yielding two chains that remain connected by two disulfide bridges (34). The binding of Pg to mycoplasmas has been described previously (7, 40), and in M. fermentans two Pg binding proteins with molecular masses of about 32 and 55 kDa were identified (40). Pg binding to M. fermentans enhances the activation of Pg to plasmin by uPA, and it has been suggested that the ability of this organism to invade host cells stems from its potential to bind Pg and to activate it to plasmin (40). In the present study the adherence of M. fermentans to HeLa cells was characterized, and the roles of Pg binding and Pg activation by uPA in adherence and invasion were analyzed.

MATERIALS AND METHODS
Bacterial strains, cell lines, and culture conditions.
M. fermentans strain PG-18 (kindly provided by S.-C. Lo, Armed
Forces Institute of Pathology, Washington, D.C.) was used throughout
this study. In some experiments the respiratory isolate
M. fermentans M-52 (kindly provided by P. C. T. Hannan, Mycoplasma Experience
Ltd., Reigate, Surrey, United Kingdom) and
M. pneumoniae strain
M129 (obtained from the American Type Culture Collection, Rockville,
Md.) were also utilized.
M. fermentans strains were grown for
24 to 48 h at 37°C in a modified Chanock medium (
13) supplemented
with 5% heat-inactivated horse serum (Biological Industries,
Beit Haemek, Israel).
M. pneumoniae was grown for 72 h in the
same medium supplemented with 20% horse serum. For metabolic
labeling, the organisms were grown in a medium containing 0.5
µCi of [9,10(n)-
3H]palmitic acid (53.0 Ci/mmol; New England
Nuclear) per ml. The cells were harvested at the mid-exponential
phase of growth (
A640, 0.10 to 0.12; pH 6.6) by centrifugation
for 20 min at 12,000
x g, washed once, and resuspended in a
solution containing 0.25 M NaCl, 10 mM CaCl
2, and 10 mM Tris
adjusted to pH 7.5. The number of viable mycoplasmas was determined
by plating and was expressed as the number of CFU per milliliter.
The epithelial cell line HeLa-229 (ATCC CCL2.1) was grown in T-25 flasks or in 24-well plates containing Dulbecco modified Eagle medium supplemented with 10% fetal calf serum (Biological Industries), 2 mM L-glutamine, 100 U of penicillin per ml, and 100 µg of streptomycin per ml. The flasks were incubated at 37°C in a 5% CO2 atmosphere. For the adherence or internalization assays the cells were washed twice in phosphate-buffered saline (PBS) (pH 7.4).
Adherence assay.
Adherence of M. fermentans to HeLa cells was determined in a reaction mixture containing 106 HeLa cells and [3H]palmitate-labeled M. fermentans (100 µg of cell protein, 10,000 dpm) in 1 ml of PBS containing 10 mM CaCl2. The adherence mixtures (in duplicate) were incubated for up to 4 h in a 5% CO2 atmosphere. The nonadhering mycoplasmas were removed by washing the HeLa cells three times with 1 ml of PBS. The washed HeLa cells were trypsinized for 3 to 4 min and resuspended in PBS, aliquots were transferred to scintillation vials containing scintillation liquid, and radioactivity was counted. To determine the effects of Pg and uPA on the adherence, the native M. fermentans preparation in the adherence reaction mixture was replaced with M. fermentans that was preincubated for 1 h at 37°C with Pg (25 µg/ml) with or without uPA (100 U/ml). To test the effect of proteolysis on the adherence, intact M. fermentans cells (1 mg of cell protein/ml, 1011 CFU/ml) were treated for 15 to 60 min at 37°C with trypsin (25 µg/ml) or proteinase K (10 µg/ml). The proteolytic activity was stopped by adding trypsin inhibitor (50 µg/ml; Sigma) or by intensive washing with cold A buffer.
In vitro internalization assay.
Internalization of mycoplasmas was quantified by a standard antibiotic protection assay (2, 40) and by confocal laser scanning microscopy of immunofluorescent preparations. For immunofluorescence staining, M. fermentans-infected HeLa cells grown on coverslips were fixed at room temperature for 10 min with 4% formaldehyde in PBS. After three washes with PBS, the cells were permeabilized by incubation for 3 min with 0.2% Triton X-100 in PBS containing 1% bovine serum albumin (PBS-BSA), washed twice with PBS, and blocked by overnight incubation with 2% horse serum. The cultures were then overlaid for 60 min at room temperature with rabbit polyclonal anti-M. fermentans MfGL-II antiserum (4) diluted 1:100 in PBS-BSA. Nonbound antibody was removed by dipping the coverslips three times in PBS, and the cells were then incubated for 1 h at room temperature with goat anti-rabbit fluorescein isothiocyanate-conjugated immunoglobulin G serum (Jackson) diluted 1:150 in PBS-BSA. The coverslips were rinsed four times with PBS and mounted in a solution containing 90% glycerol, 7% PBS, 3% 1,4-diazabicyclo-(2,2)-octane as an antifading agent, and 0.1% sodium azide. The specificity of immunostaining was evaluated by omitting the antimycoplasma antibodies or by utilizing nonspecific antibodies (nonimmune rabbit serum). Immunofluorescent samples were analyzed by using a Zeiss 410 laser scanning confocal microscope (Zeiss, Oberkochen, Germany) equipped with an argon ion laser tuned at 488 nm.
Analytical methods.
The total protein content was determined as described by Bradford (8). Qualitative determination of Pg binding to mycoplasmas was performed by immunodot blotting (41). To assess the number and viability of HeLa cells, the cells were detached from the wells by EDTA-trypsin treatment, suspended in a 0.15% trypan blue solution, and analyzed microscopically. Pg was purified from human plasma as described by Deutsch and Mertz (12). Pg was activated as previously described (40) in a reaction mixture containing 1 mg of M. fermentans protein, 25 µg of Pg, and 100 U of uPA (American Diagnostic Inc.). For cholesterol depletion, HeLa cells were treated with methyl-ß-cyclodextrine (MeCD) (Sigma) as previously described (17, 21). Lipids were extracted from HeLa cells by the method of Bligh and Dyer (6). Unesterified cholesterol and cholesterol esters were separated on Merck Silica Gel G glass plates and developed at room temperature with benzene-ethyl acetate (5:1, vol/vol). The unesterified cholesterol spot was extracted with chloroform at room temperature for 30 min, and the sterol content was determined by the phthaldialdehyde method (30). Radioactivity was determined with a scintillation spectrometer by using Opti-Flour scintillation liquor (Packard).

RESULTS AND DISCUSSION
Adherence of M. fermentans to HeLa cells.
The adherence of
M. fermentans to the HeLa cell line was measured
as a function of time and temperature (Fig.
1). The extent of
binding was calculated from the amount of radioactivity associated
with the host cells after incubation for various periods of
time. Binding was observed within 15 min of incubation and increased
linearly during the next 120 min. Binding was significantly
reduced at 4°C and reached about 50% of the binding measured
at 37°C. Figure
1 shows that divalent cations had a marked
influence on binding. Both Mg
2+ and Ca
2+ were effective, and
the highest binding levels were observed at concentrations of
5 to 10 mM. Binding was almost the same with
M. fermentans cells
harvested at the early exponential (
A640, 0.08; pH 7.2), late
exponential (
A640, 0.23; pH 6.4), and stationary (
A640, 0.25;
pH 6.0) phases of growth (data not shown). Pretreatment of
M. fermentans with 4% paraformaldehyde for 15 min at 37°C reduced
the binding to HeLa cells by only 15% ± 5%. However,
the binding of native
M. fermentans to paraformaldehyde-treated
HeLa cells was 85% ± 5% lower than the binding to native
HeLa cells. The ability to adhere was not influenced by pretreating
M. fermentans for 15 min at 37°C with the uncoupler carbonyl
cyanide
m-chlorophenylhydrazone (5 µM), the ATPase inhibitor
dicyclohexylcarbodiimide (20 µM), or the K
+ ionophore
valinomycin (5 µM) with or without 100 mM KCl, suggesting
that adherence is not affected by the proton or electrochemical
gradients across the
M. fermentans membrane. Binding was not
affected by pretreating HeLa cells for 30 min at 37°C with
vinblastine, cytochalasine B, or taxol (5 µg of each per
ml), suggesting that cytoskeletal components, including microtubules
and microfilaments, do not play a role in the adherence process.
Preincubation of
M. fermentans in an isosmotic NaCl solution
(0.25 M NaCl) containing 10 mM CaCl
2 at 37°C for 1 to 2
h resulted in increased competence for adherence (Fig.
2). The
same level of competence was observed in the presence or absence
of glucose (10 mM) and was not affected by adding chloramphenicol
(100 µg/ml), carbonyl cyanide
m-chlorophenylhydrazone
(5 µM), dicyclohexylcarbodiimide (20 µM), or valinomycin
(5 µM) to the incubation buffer (data not shown). These
results suggest that neither the energetic state of
M. fermentans nor the proton and electrochemical gradients across the cell
membrane nor protein synthesis plays a role in increasing the
competence of
M. fermentans for adherence. The increased competence
was much more pronounced when preincubation was performed in
solutions having lower osmolarities (Fig.
2). As the wall-less
mycoplasmas swell readily in solutions having low osmolarities
(
26), it can be proposed that stretching of the cell membrane
upon cell swelling activates the adhesins either by improving
the exposure of their active epitope(s) on the cell surface
or by inducing conformational changes. The exposure to low osmolarities
had no effect on the integrity and viability of
M. fermentans,
as indicated by plating experiments (data not shown).
Pretreatment of intact
M. fermentans cells with trypsin and
proteinase K to remove surface proteins reduced the binding
to HeLa cells by 60% ± 8% and 75% ± 10%, respectively.
The proteolytic treatments did not affect the intracellular
NADH dehydrogenase activity of
M. fermentans; thus, proteolysis
apparently did not affect cell intactness. These results suggest
that although a protein is the major ligand on the cell surface
of
M. fermentans, mediating the binding to HeLa cells, a nonproteinaceous
surface determinant is associated with the binding as well.
Figure 3 shows that in the presence of 10% polyethylene glycol 8000 (PEG), binding of native M. fermentans to HeLa cells was only slightly increased, whereas a two- to threefold increase in binding was observed with trypsin-treated M. fermentans preparations. It has been proposed that PEG functions as a dehydrating agent (23). This molecule alters the physical state of bulk water adjacent to the cell surface and the water of hydration of the polar groups of membrane phospho- and glycolipids, allowing more intimate contact between the two participating membranes (23). The more pronounced PEG effect on binding of the trypsin-treated mycoplasmas suggests that PEG is required for the binding of the protease-insensitive component of the adherence system. However, with native M. fermentans, binding to HeLa cells was only slightly affected by PEG (Fig. 3), suggesting that for adherence through the protease-sensitive component of the adherence system the proximity between the cell surface of HeLa cells and the cell membrane of M. fermentans is achieved even without PEG.
To identify possible receptor molecules on the cell surface
of HeLa cells, simple carbohydrates were tested for adherence
inhibition activity. The carbohydrates tested were
D-glucose,

-methyl-
D-glucoside,
D-glucosamine,
N-acetylglucosamine,
D-mannose,
D-mannitol,

-methyl-
D-mannoside,
D-galactose,

-methyl-
D-galactoside,
L-arabinose,
D-galacturonic acid, xylose, rhamnose, maltose,
raffinose, sucrose, lactose, inositol, ribitol, sorbitol, and
dulcitol (all products of Sigma). All carbohydrates were tested
in the adherence assay at a concentration of 1%. None of the
carbohydrates tested had inhibitory activity. Nevertheless,
adherence of
M. fermentans to HeLa cells was significantly inhibited
by 0.5 to 1.0% phosphocholine (Fig.
4), whereas free choline
had no effect (data not shown). Phosphocholine-containing lipids
(Fig.
4, inset) were detected in all
M. fermentans strains tested
(
5). However, whereas type strain PG-18 contains almost exclusively
MfGL-II (
42), the respiratory strains (e.g., strain M-52) contain
no MfGL-II but contain mainly MfGL-I and a phosphocholine-containing
ether lipid (MfEL). Our data showing that the inhibitory effect
of phosphocholine observed with strain PG-18 was almost identical
to the inhibitory effect observed with the respiratory isolate
(strain M-52) suggest that in addition to MfGL-II (
4) other
phosphocholine-containing lipids play a role in the
M. fermentans-host
cell interaction. The adherence inhibition induced by phosphocholine
was much more pronounced when trypsin-treated
M. fermentans was used in the adherence assay (90% ± 6% of inhibition
obtained with 1% phosphocholine). Furthermore, antiserum against
the phosphocholine-containing glycoglycerolipid MfGL-II inhibited
the adherence of
M. fermentans PG-18 to HeLa cells in vitro
(data not shown), supporting preliminary data presented previously
(
4). As the anti MfGL-II repertoire is composed primarily of
anti-phosphocholine antibodies (
4), the data suggest that phosphocholine-containing
glycolipids decorating the surface of
M. fermentans play an
important role in the adherence of
M. fermentans to HeLa cells.
The ability to adhere to eukaryotic cells is characteristic
of all pathogenic
Mycoplasma species, and in some of them expression
of surface proteins that mediate the binding to host cells has
been demonstrated (
20,
37). The data reported here suggest that
there is a second surface anchor mechanism in
M. fermentans.
By this mechanism
M. fermentans is held at the host cell surface
through the interaction of the phosphocholine-containing glycolipid
of
M. fermentans (
5,
42) and a surface protein of the host cells.
This conclusion is based on the following observations: (i)
adherence was only partially inhibited by proteolysis; (ii)
antibodies to the phosphocholine moiety of the surface glycolipid
MfGL-II inhibited adherence; and (iii) adherence was inhibited
by phosphocholine. It seems that
M. fermentans utilizes at least
two surface components for adhesion to HeLa cells, a protease-sensitive
surface protein, apparently the lipoprotein recently described
(
37), and a phosphocholine-containing glycolipid. Involvement
of choline-containing teichoic acid or lipoteichoic acid in
the adhesion of streptococci has been described previously (
29).
Pg binding mediates adherence and internalization.
Figure 5 shows that Pg markedly increased the adherence of M. fermentans but had no effect on the adherence of M. pneumoniae to HeLa cells. Pg increased the maximal adherence of M. fermentans, which strongly suggests that in the presence of Pg, M. fermentans adheres to novel sites on the HeLa cells. In other words, the presence of Pg creates a novel epitope on the HeLa cells capable of binding M. fermentans. Figure 6 shows that in the presence of Pg, adherence of M. fermentans was dose dependent and saturable, two kinetic properties that argue for the specificity of the adherence in the presence of Pg. Furthermore, addition of exogenous Pg or anti-Pg antibodies caused substantial inhibition of the adherence (data not shown). Whereas native Pg had a pronounced effect on M. fermentans adherence, the Pg fragment containing the first three kringles (Pg site 1) or the fragment containing kringle 4 (Pg site 2) had no effect on the adherence process (Fig. 7), although these fragments were shown to bind to M. fermentans to about the same extent as native Pg (40). These findings suggest that the C-terminal domain of the Pg molecule, rather than the loop structures (kringles) located at the NH2 terminus, mediates the interaction of Pg-treated M. fermentans with HeLa cells.
Although
M. fermentans is a parasite associated with the cell
surface of host cells (
26), it was shown recently that under
certain conditions this organism has also been detected within
cells (
40). The intracellular location of
M. fermentans in HeLa
cells was shown by the antibiotic protection assay (Table
1)
by utilizing gentamicin to kill mycoplasmas that did not enter
the host cells (
1). When native
M. fermentans was incubated
with HeLa cells, no internalization was observed. However, when
M. fermentans was preincubated with Pg and the Pg activator
uPA, intracellularly located microorganisms were detected as
early as 3 h postinfection. Up to 24 h postinfection the intracellular
M. fermentans did not cause obvious damage to the host cells,
as determined by the trypan blue viability assay, but as the
infection proceeded, the number of intracellular organisms increased,
and at a late stage of infection (>24 h) host cell integrity
was disrupted and cell death followed (data not shown). Since
Pg facilitates the adherence to HeLa cells and the formation
of small clusters or microcolonies on the cell surface of the
host cells (data not shown), it is possible that the escape
from the killing effect of gentamicin in the antibiotic protection
assay may have been due to aggregation and intimate adherence
rather than internalization. To further establish the notion
that
M. fermentans does invade HeLa cells, immunofluorescence
staining followed by analysis with a confocal laser scanning
microscope was performed. HeLa cells were infected by uPA-treated
Pg-bound
M. fermentans, fixed with formaldehyde, permeabilized
by treatment with Triton X-100, and incubated with anti-
M. fermentans antibodies and then with a second fluorescein isothiocyanate-conjugated
antibody. To obtain three-dimensional information on the cellular
location of the fluorescence, a series of optical sections were
made through infected HeLa cells. The results clearly demonstrated
that in HeLa cells infected with the uPA-treated Pg-bound
M. fermentans, there were both surface and intracellular foci of
fluorescence corresponding to intracellular and extracellular
mycoplasmas (Fig.
8B). Internalization was not detected in control
HeLa cells infected with native
M. fermentans, in which numerous
foci of fluorescence corresponding to extracellular bound mycoplasmas
were seen (Fig.
8A). Although
M. pneumoniae binds Pg to the
same extent as
M. fermentans, as determined by the immunoblot
assay (
41), and the Pg-bound
M. pneumoniae was activated to
plasmin by uPA in a manner similar to the manner observed with
Pg-bound
M. fermentans (
41), no internalization was detected
with HeLa cells infected with uPA-treated Pg-bound
M. pneumoniae (Fig.
8C). The amounts of intracellularly located
M. fermentans increased during the first 24 h of infection, and internalization
was temperature dependent. Thus, at 4°C fluorescence was
predominantly associated with the surface of the host cells
(data not shown). Our finding that Pg, which acts as an adherence
factor, also mediates internalization by eukaryotic cells is
not unique. The Inv, YadA, and Ail surface proteins of
Yersinia enterocolitica (
24) and AfaE of uropathogenic and diarrhea-associated
Escherichia coli strains (
19) have been shown to mediate both
adhesion and internalization.
Bacterial invasion of eukaryotic cells is a complex process
that involves a variety of bacterial and host cell factors.
It has been shown recently that bacterial invasion is based
on the abilities of several bacteria to bind sulfated polysaccharides
(
14) or fibronectin (
15). It was suggested that these compounds
form a molecular bridge between the bacteria and eukaryotic
surface proteins (
9,
14) that enables invasion. The finding
that in the presence of uPA internalization was apparent indicates
that the ability of
M. fermentans to invade host cell stems
from its potential to bind Pg and to activate it to plasmin,
a protease with broad substrate specificity. Pg and uPA are
two proteins that play an important role in the invasion of
several human malignant tumors (
25); therefore, it is not surprising
that the same system stimulates
M. fermentans invasion. Our
observation that
M. pneumoniae cells pretreated with Pg and
uPA are not internalized by HeLa cells (Fig.
8) (
41), although
this organism binds Pg to the same extent as
M. fermentans (
40),
suggests that the role of Pg binding and activation is not solely
to increase the proteolytic activity. It is possible that plasmin
alters
M. fermentans cell surface proteins and thereby enables
internalization. The enhanced invasiveness of plasmin-coated
Borrelia burgdorferi was described recently (
10). Proteolytic
modification of a bacterial and/or host cell surface protein(s)
is an emerging theme among bacterial pathogens. Thus, the Pg
activator of
Yersinia pestis modifies specific bacterial outer
membrane proteins and is associated with virulence (
36), and
a secreted protease has been shown to stimulate the fibronectin-dependent
uptake of
Streptococcus pyogenes into eukaryotic cells (
9).
Membrane cholesterol regulates internalization.
To evaluate the importance of membrane cholesterol in the internalization process, we assessed the effects of MeCD and filipin on adherence and internalization of M. fermentans pretreated with Pg and uPA. MeCD has been reported to extract cholesterol from the membrane, whereas filipin, a polyene antibiotic from Saccharomyces filipinensis, sequesters cholesterol by forming multimeric globular complexes with it (16). Cholesterol depletion and sequestration by MeCD and filipin, respectively, result in the disruption of raft microdomains (21, 30). For cholesterol depletion cells were treated with 10 mM MeCD for 1 h at 37°C in Dulbecco modified Eagle medium without fetal calf serum. MeCD at this concentration did not cause cell death, as determined by trypan blue staining. Table 2 shows that after 1 h of treatment with MeCD the unesterified cholesterol content of HeLa cells dropped by over 70%. Cholesterol depletion had little effect on the binding of M. fermentans to HeLa cells but almost completely inhibited the internalization of M. fermentans pretreated with Pg and uPA. When filipin was used (1 µg/ml), the results were similar to the results obtained with MeCD (Table 2).
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TABLE 2. Effect of cholesterol depletion or sequestration on M. fermentans adherence to and invasion of HeLa cellsa
|
Lipid rafts are specialized lipid microdomains enriched in glycosphingolipids,
cholesterol, and glycosylphosphatidylinositol-anchored proteins.
It is generally believed that cholesterol depletion or sequestration
disrupts lipid rafts (
35). These microdomains are most abundant
at the plasma membrane, and they are involved in many important
cellular processes, such as generation and maintenance of cellular
polarity, chemotactic migration, and receptor signaling (
19,
35). Our observation that internalization is reduced after cholesterol
extraction but that binding is not impaired suggests that
M. fermnetans binds to HeLa cells in a raft-independent manner
but then triggers patching of raft domains and de novo caveole
formation around the microorganism, a process required for internalization.
The internalization of several viruses and bacteria has been
shown to be cholesterol dependent (
1,
16,
21,
27), and it has
been suggested that interfering with raft assembly by cholesterol
extraction may affect cell signaling or destroy the integrity
of the actin network structure required for internalization
(
24,
27,
30).

FOOTNOTES
* Corresponding author. Mailing address: Department of Membrane and Ultrastructure Research, The Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel. Phone: (972) 2-6758148. Fax: (972) 2-6438205. E-mail:
rottem{at}cc.huji.ac.il.

Editor: V. J. DiRita

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Infection and Immunity, September 2004, p. 5004-5011, Vol. 72, No. 9
0019-9567/04/$08.00+0 DOI: 10.1128/IAI.72.9.5004-5011.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
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