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Infection and Immunity, November 2005, p. 7629-7636, Vol. 73, No. 11
0019-9567/05/$08.00+0 doi:10.1128/IAI.73.11.7629-7636.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Department of Microbiology, Immunology, and Molecular Genetics, University of Kentucky College of Medicine, Lexington, Kentucky,1 Sections of Immunobiology,2 Rheumatology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut3
Received 11 May 2005/ Returned for modification 13 July 2005/ Accepted 22 July 2005
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Bacterial pathogens can freely acquire necessary nutrients from their hosts, except for iron, which is essential for the growth of nearly all bacterial species (37, 45). The concentration of free iron in mammals, however, is exceptionally low, because it is sequestered by iron-withholding proteins. Maintenance of proper intracellular iron levels involves its uptake, utilization, and storage. Extracellular iron is bound by transferrin, which docks to its receptor, is endocytosed, and releases the iron before recycling back to the cell surface (24, 42). The delivered iron becomes part of the labile iron pool (LIP), which can either be used immediately for metabolic processes or stored (23, 47, 49). It is crucial that proper iron homeostasis be maintained, as excess iron provides a source for the growth of intracellular bacteria (37, 42). Furthermore, excess levels promote formation of cytotoxic reactive oxygen species (ROS). Excess iron from the LIP can participate in the Fenton reaction [Fe(II) + H2O2
Fe(III) + OH + OH], which yields a hydroxyl radical, the most potent oxidant in biological systems (47). The toxicity of iron is largely attributable to its capacity to generate such reactive species.
Ferritin is the major intracellular iron storage protein of prokaryotes and eukaryotes (23, 47). Mammalian ferritin is a 24-mer protein composed of various proportions of heavy (H) and light (L) subunits and has an extremely high storage capacity of up to 4,500 iron atoms. Steps in iron storage within ferritin molecules consist of Fe(II) oxidation, Fe(III) migration, and iron core formation. H chains are important for Fe(II) oxidation, while L chains assist in core formation (23). Ferritin molecules with greater proportions (
67 to 83%) of ferritin light chains (FLC) are most efficient at incorporating and storing iron (23, 47). By removing excess iron from the LIP, ferritin also serves as a cytoprotectant against ROS- mediated damage (4, 11, 21, 26, 30-32, 39, 50). Indeed, ferritin levels increase as a direct response to oxidative stress. Other factors that regulate ferritin expression include intracellular iron concentration, gamma interferon (IFN-
), proinflammatory cytokines, growth factors, and differentiation (47).
We have previously shown that A. phagocytophilum infection of HL-60 cells and all-trans retinoic acid-differentiated HL-60 (rHL-60) cells results in an up-regulation of ferritin H-chain (fhc) mRNA expression (14). The influence of A. phagocytophilum on flc transcription and ferritin protein levels is unknown. We have also demonstrated that A. phagocytophilum binding and invasion of neutrophils in vitro stimulates NADPH oxidase assembly and degranulation, two processes that result in ROS release (12). Because ferritin could serve as an intracellular source of iron for A. phagocytophilum and because ferritin functions as a major cytoprotectant against oxidative stress, we further investigated the effects of A. phagocytophilum on ferritin mRNA and protein expression in HL-60 cells and human neutrophils during in vitro infection and in murine neutrophils during in vivo infection. These studies shed light onto the influence of A. phagocytophilum on the ferritin levels of its mammalian host cell.
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Isolation of human neutrophils. Human neutrophils were isolated from peripheral blood from healthy donors by centrifugation through an equal volume of Polymorphprep (Axis-Shield; Greiner Bio-One, Frickenhausen, Germany) at 470 x g for 30 min. The resulting neutrophil band was removed by aspiration and mixed with equal volumes of 0.45% NaCl and Iscove's modified Dulbecco's medium (IMDM; Invitrogen, Carlsbad, CA)-0.5 mM EDTA to restore isotonic conditions. The cells were centrifuged at 210 x g for 10 min, and the supernatant was removed. The resulting pellet was resuspended and incubated in 10 ml of red blood cell lysing buffer (Sigma, St. Louis, Mo.) for 10 min followed by two successive washes in IMDM-0.5 mM EDTA and enumeration using a hemacytometer.
In vitro A. phagocytophilum infection. Host-cell-free A. phagocytophilum cells were recovered from infected HL-60 cells and added to 5 x 106 HL-60 cells (0.5 x 105/ml) in IMDM-10% fetal bovine serum. The ratios of A. phagocytophilum organisms per HL-60 cell were determined as described previously (12). For in vitro infection of human neutrophils, 5 x 105 neutrophils (1 x 106/ml) in IMDM were added to individual wells of either 6- or 24-well Ultra Low Attachment plates (Corning, Inc.; Corning, NY). To these were added suspensions of host-cell-free A. phagocytophilum. In some cases, zymosan A particles from Saccharomyces cerevisiae (Sigma) that had been opsonized with autologous serum (OpZ) or Escherichia coli were added to neutrophils as previously described (12). At 1, 3, and 6 h postinfection, either total RNA or protein was isolated as described below.
RNA isolation and reverse transcription-PCR (RT-PCR). Total RNA from uninfected or A. phagocytophilum-infected cells was isolated using Trizol (Invitrogen) according to the manufacturer's instructions followed by treatment with RNase-free DNase (1 U/500 µg; Roche Molecular Biochemicals, Indianapolis, IN) for 2 h at 37°C. DNA-free RNA was reextracted using Trizol, ethanol precipitated, and resuspended in diethyl pyrocarbonate-treated water. cDNA stocks (50 µl) were prepared from 5 µg of total RNA using random hexamers and the ProSTAR First Strand RT-PCR kit (Stratagene, La Jolla, CA), followed by PCR amplification using 1 µl of cDNA template. The thermal cycling conditions used were 94°C for 2 min followed by 35 cycles of 94°C for 60 s, 55°C for 60 s, 72°C for 60 s, and a final extension step of 72°C for 7 min. The reaction mixture contained final concentrations of 1.5 mM MgCl2, 200 µM deoxynucleoside triphosphates, 0.8 µM of each primer, and 2.5 U of Taq polymerase (Roche Molecular Biochemicals). To ensure that RNA templates were free from contaminating DNA, identical reactions were performed in the absence of reverse transcriptase (data not shown). The primers used are listed in Table 1.
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TABLE 1. Oligonucleotide primers used in this study
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Immunoblot analyses. Whole-cell lysates of uninfected or A. phagocytophilum-infected cells were prepared, quantified, fractionated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and transferred to Immobilon-P membranes (Millipore, Bedford, MA) as described previously (14). Human actin and A. phagocytophilum P44 were detected using mouse anti-human actin MAb (Sigma) and rabbit polyclonal anti-A. phagocytophilum serum, respectively, followed by goat anti-rabbit immunoglobulin G-Alexa Fluor 680 (Molecular Probes, Eugene, OR) and goat anti-mouse immunoglobulin G-IRDYE800CW (Rockland Immunochemicals, Gilbertsville, PA), respectively. Bound antibodies were detected using the Odyssey Infrared Imager (LI-COR Biosciences, Lincoln, NE).
Ferritin enzyme-linked immunosorbent assay (ELISA). Whole-cell lysates were examined for ferritin content using the Human Ferritin ELISA kit (Alpha Diagnostic, San Antonio, TX) according to the manufacturer's instructions. Briefly, 30 µg of whole-cell lysate, 30 µg bovine serum albumin (BSA), or 10 µl of recombinant ferritin standards, ranging from 0 to 800 ng/ml, were added in duplicate to wells of a 96-well plate coated with anti-ferritin MAb. One-hundred microliters of horseradish peroxidase-conjugated anti-ferritin MAb were added, followed by a 30-min incubation at room temperature. The plate was washed three times with 300 µl deionized water, followed by the addition of 200 µl detection substrate per well. After 10 min, 50 µl stop solution was added and the absorbance at 450 nm was recorded using an AD 340 Absorbance Detector (Beckman Coulter, Fullerton, CA).
Assessment of fhc and flc mRNA expression during murine A. phagocytophilum infection. Infected blood from C3H-scid mice was used to initiate infection in immunocompetent C3H/HeN mice (3 per group) as previously reported (13). Nine percent of peripheral blood neutrophils in the inoculum had detectable morulae. Control groups were injected with uninfected C3H-scid mouse blood. On days 2 and 8, the respective groups were sacrificed and assessed for bacterial burden by determining the percentage of morulae-positive neutrophils using light microscopy and by PCR. Neutrophils were isolated from pooled splenocytes via positive selection using fluorescein isothiocyanate-conjugated rat anti-mouse Ly6G (Gr-1; a neutrophil-specific marker) MAb (BD Pharmingen, San Diego, CA) followed by anti-fluorescein isothiocyanate MAb conjugated to magnetic beads (Miltenyi Biotec, Auburn, CA). Total RNA was isolated from Gr-1-positive and -negative cells as described above and used as template for RT-PCR.
Statistical analyses. Statistical analyses were performed using the Prism 4.0 software package (Graphpad, San Diego, CA). If one-way analysis of variance (ANOVA) or two-way ANOVA indicated a group difference (P < 0.05), then Tukey's or Bonferroni's test was used, respectively, to test for a significant difference among groups. In some instances, the means for uninfected and infected samples per time point were examined using the Student t test.
Study approval. The Human Investigation Committees at Yale University and the University of Kentucky and the Yale University Institutional Animal Care and Use Committee approved these studies.
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10 organisms per cell) to HL-60 cells, isolated total RNA, and performed quantitative RT-PCR (QRT-PCR) to assess changes in fhc and flc expression over 96 h of infection. For all samples, flc mRNA levels exceeded those of fhc by as much as 57.0- to 297.1-fold (Fig. 1). For the initial 12 h of infection, fhc mRNA levels of A. phagocytophilum-infected cells were 1.2- to 1.7-fold lower than those of uninfected control cells. Consistent with our previous study (14), however, fhc expression by A. phagocytophilum-infected cells increased significantly above those of uninfected controls by 24 h postinfection (hpi) and remained so throughout the duration of the time course. The largest rise in fhc message, a 2.6-fold increase, was observed at 96 hpi. With the exception of 30 min postinfection, little to no change was observed in flc transcription between infected and uninfected control HL-60 cells. These data demonstrate that the increased fhc mRNA levels associated with A. phagocytophilum infection of HL-60 cells are not observable until at least 24 hpi.
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FIG. 1. Ferritin mRNA expression in A. phagocytophilum-infected HL-60 cells. Host-cell-free A. phagocytophilum organisms were added to HL-60 cells, and infection was allowed to proceed for 0, 0.5, 1, 3, 6, 12, 24, 48, or 96 h. Uninfected HL-60 cells served as controls. At the appropriate time postinfection, total RNA was isolated from 5 x 106 infected HL-60 cells and used as template for cDNA synthesis. Quantitative PCR was performed using the cDNA templates to assess the relative expression levels of fhc and flc. Data are presented as the mean copies of either fhc or flc transcript per 103 ß-actin transcript copies. Samples were analyzed in triplicate. The error bars indicate standard deviations. The mean results for uninfected and infected cells were compared per time point using the Student t test. Values are statistically significant (*, P < 0.05; **, P < 0.01; and ***, P < 0.001). The results are representative of three independent experiments.
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FIG.2. Ferritin protein levels in HL-60 cells decrease in a time- and dose-dependent manner following A. phagocytophilum infection. Host-cell-free A. phagocytophilum (Ap) organisms were added to 5 x 105 HL-60 cells at ratios of 0.4, 1.1, 3.3, and 10 per cell. Uninfected HL-60 cells served as controls. Four days postinfection, (A) whole-cell lysates (10 µg) were fractionated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis followed by Western immunoblot analysis using antibodies directed against A. phagocytophilum P44 and actin, and (B) whole-cell lysates (30 µg) were assayed for ferritin content by ELISA. Bovine serum albumin (BSA; 30 µg) served as a negative control. Statistical significance was determined using one-way ANOVA followed by Tukey's test. (C) Dose-dependent infection time course. A. phagocytophilum was added to 5 x 105 HL-60 cells at approximate ratios of 0 (white bars), 1 (gray bars), and 10 (black bars) per cell. Whole-cell lysates (30 µg) were assessed for ferritin content at 24, 48, and 96 h postinfection. Statistical significance was determined using two-way ANOVA followed by Bonferroni's test. The mean values indicated by different letters are significantly different. (D) Host-cell-free A. phagocytophilum organisms were added to HL-60 cells at a ratio of approximately 10 organisms per cell, and infection was allowed to proceed for 0, 0.25, 0.5, 1, 2, 5.5, 8, 12, 24, 48, 72, or 96 h. Uninfected HL-60 cells served as controls. Whole-cell lysates (30 µg) generated from 5 x 106 cells per time point were assayed for ferritin content. The means ± standard errors of duplicate samples are presented. Statistical significance (*, P < 0.05; **, P < 0.01) was determined using two-way ANOVA followed by Bonferroni's test. Results are representative of four to six independent experiments. Ctrl, control.
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FIG. 3. Ferritin mRNA expression in A. phagocytophilum-infected neutrophils. (A) RT-PCR analyses. Neutrophils (5 x 105) were incubated in the presence and absence of host-cell-free A. phagocytophilum (Ap; 10 per cell) for 1, 3, or 6 h. At the appropriate time point, total RNA was isolated and RT-PCR was performed targeting human fhc and flc as well as ß-actin and A. phagocytophilum 16S rRNA genes and p44 transcripts. Results are representative of three experiments. (B) Quantitative RT-PCR analyses. Neutrophils (5 x 105) were incubated with host-cell-free A. phagocytophilum (10 per cell), E. coli (Ec; 10 per cell), or OpZ (10 per cell) for 1, 3, or 6 h. Total RNA was isolated and converted to cDNA, which was used as template for real-time PCR to quantify the relative expression levels of fhc and flc. Samples were analyzed in triplicate. Data are presented as the mean copies of either fhc or flc transcript per 103 ß-actin transcript copies. Error bars indicate standard deviations. Statistical significance was determined using one-way ANOVA followed by Tukey's test. The mean values indicated by different letters are significantly different. Results are representative of four independent experiments. ctrl, control.
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Neutrophil ferritin protein levels increase during the initial hours of A. phagocytophilum infection in vitro. Neutrophil fhc transcription exhibits a low level of increase, while flc mRNA expression increases dramatically during the initial hours of A. phagocytophilum infection. Similar transcriptional profiles were also observed upon incubating neutrophils with E. coli and OpZ. We therefore examined whether the observed increases in ferritin transcription in neutrophils translates to rises in ferritin protein levels following incubation with each of these stimuli. Host-cell-free A. phagocytophilum, E. coli, or OpZ was added to neutrophils, after which whole-cell lysates were examined for ferritin content at 1, 3, and 6 hpi. At 1 hpi, neutrophil ferritin levels exhibited a three- to fourfold increase for all stimuli relative to uninfected controls (Fig. 4). Ferritin levels of A. phagocytophilum-infected cells remained high throughout the time course, while those of cells exposed to E. coli had declined to levels that were not significantly different from those of uninfected controls by 3 hpi. Ferritin expression by neutrophils exposed to OpZ had also dropped considerably at 3 and 6 hpi. Thus, exposure of neutrophils to A. phagocytophilum results in a sustained rise in ferritin levels, while exposure to either E. coli or OpZ stimulates an initially pronounced spike followed by a subsidence in ferritin amounts. The kinetics of ferritin expression induced by A. phagocytophilum, E. coli, and OpZ parallel the effects each of these stimuli has on NADPH oxidase assembly and degranulation in vitro (14). These data are consistent with the induction of ferritin expression as a cytoprotective response to ROS.
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FIG. 4. Ferritin protein levels in neutrophils following A. phagocytophilum infection. Neutrophils (5 x 105) were incubated with A. phagocytophilum (Ap; 20 per cell), E. coli (20 per cell), or OpZ (20 per cell) for 1, 3, or 6 h. Uninfected cells served as controls. Whole-cell lysates (30 µg) were analyzed for ferritin content. The means ± standard errors of duplicate samples are presented. Statistical significance was determined using two-way ANOVA followed by Bonferroni's test. The mean values indicated by different letters are significantly different. Results are representative of four independent experiments.
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response (47), which is a common manifestation of A. phagocytophilum infection (2, 20, 33). Thus, in vivo A. phagocytophilum infection results in a pronounced increase in neutrophil fhc expression, a pattern that is consistent with the IFN-
-dominated cytokine profile associated with infections by obligate intracellular pathogens.
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FIG. 5. Ferritin mRNA expression in neutrophils recovered from A. phagocytophilum-infected mice. C3H/HeJ mice were inoculated with A. phagocytophilum (Ap). Sham-inoculated mice served as controls. On days 2 and 8, the mice were sacrificed and Gr-1-positive and -negative cells were isolated. Total RNA was extracted and used as template for RT-PCR analyses targeting murine fhc and flc and A. phagocytophilum p44. Samples were normalized according to murine hypoxanthine phosphoribosyltransferase (HPRT) transcript levels. Transcript levels for fhc, flc, and the HPRT gene for Gr-1-negative cells on day 2 are similar to those observed for day 8 and thus are not shown. Results are representative for four separate experiments. ctrl, control.
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As such, ferritin expression during the initial hours of A. phagocytophilum infection in vitro likely occurs as a response to ROS production during bacterial binding and invasion. Neutrophil transcription of ferritin heavy and light subunits is induced by as much as 12.8- and 62.9-fold, respectively, following exposure to A. phagocytophilum, E. coli, or OpZ, with a concomitant three- to fourfold rise in ferritin protein levels. The elevated protein levels in response to A. phagocytophilum are maintained throughout the course of infection, while those in response to E. coli and OpZ subside. The initial spike and subsidence of ferritin expression in response to E. coli and OpZ are consistent with the kinetics of ROS production associated with phagocytosis of each of these stimuli (12). Similarly, the maintained elevation in neutrophil ferritin content throughout the initial hours of A. phagocytophilum infection is consistent with a sustained, low-level stimulation of NADPH oxidase. We have previously demonstrated that internalization of A. phagocytophilum in vitro occurs over several hours following bacterial binding to neutrophil surfaces and that this process is associated with some degree of host cell activation, NADPH oxidase mobilization, and degranulation (12). Furthermore, A. phagocytophilum infection also stimulates neutrophil transcription of superoxide dismutase, which further evidences the induction of a cytoprotective response (8, 38).
The rises in ferritin content observed for neutrophils upon exposure to A. phagocytophilum were not noted for HL-60 cells. This is likely because promyelocytic HL-60 cells lack specific granules and express low levels of NADPH oxidase components compared to mature neutrophils (1, 7, 46). Consequently, stimulation of HL-60 cells elicits O2 at levels that are orders of magnitude lower than those observed upon neutrophil stimulation. As such, the addition of A. phagocytophilum to HL-60 cells yields little ROS production relative to that observed for neutrophils (5, 12).
The induction of fhc expression in neutrophils over 6 h of A. phagocytophilum infection in vitro is minor compared to the considerable increase in fhc message observed on day 8 of in vivo infection. It is well established that IFN-
plays a major role in host defense against intracellular pathogens. Accordingly, IFN-
dominates the host cytokine response to A. phagocytophilum infection, with the highest levels being produced between days 5 and 10 (2, 20). It has been demonstrated that incubation of THP-1 cells in the presence of IFN-
strongly up-regulates fhc mRNA expression with a concomitant increase in ferritin protein (44). Given the influence of IFN-
on fhc expression, it is not surprising that the ferritin transcription profile of the entire neutrophil population of A. phagocytophilum-infected mice at the peak of bacteremia displays a pronounced shift from flc to fhc.
HL-60 cells demonstrate a marked increase in fhc mRNA synthesis during the course of A. phagocytophilum infection, as confirmed by cDNA microarray screening (14) as well as semiquantitative and QRT-PCR. A similar result was noted for THP-1 cells infected with Mycobacterium bovis BCG (28). Thus, an increase in fhc expression may exemplify a common theme among host expression profiles associated with intracellular bacterial infection.
Current knowledge supports that, with the exception of Borrelia burgdorferi (41), all pathogenic bacteria require iron as a metabolic cofactor (37). The mechanism by which A. phagocytophilum obtains iron from its host cell or whether acquiring iron is necessary for this bacterium's survival is unknown. Barnewall and colleagues demonstrated that Ehrlichia chaffeensis and E. sennetsu, but not A. phagocytophilum, exploit the transferrin receptor pathway as a means for obtaining iron that is brought into the host cell before it can be utilized for host metabolic processes or stored by ferritin (6, 34). Within 30 min of A. phagocytophilum infection, HL-60 cell ferritin protein levels are lowered relative to uninfected controls, though the reduction is not statistically significant until at least 24 hpi. Given the slow doubling time of A. phagocytophilum (9), it is not surprising that the decline in ferritin content relative to uninfected cells does not become significant until this time point, as this effect is bacterial dose dependent. Ferritin light-subunit mRNA expression exhibits little to no change for infected HL-60 cells at all time points, while fhc mRNA levels are significantly elevated at 24, 48, and 96 hpi. Thus, the loss of ferritin protein is not a consequence of transcriptional inhibition. This suggests the possibility that A. phagocytophilum may either degrade or promote the degradation of ferritin protein, which would release iron for use by the bacterium. Support for this speculation is offered by the recent report by Larson and colleagues that Neisseria meningitidis accelerates degradation of ferritin within A431 epithelial cells to yield a useable iron source (27). As observed for A. phagocytophilum-infected HL-60 cells, fhc and flc mRNA levels of N. meningitidis-infected epithelial cells remain relatively unchanged while ferritin protein levels are significantly reduced over the course of infection. This may represent a common theme among intracellular pathogens, as Legionella pneumophila (10, 22), Mycobacterium tuberculosis (35), and Listeria monocytogenes (45) have also been shown to access intracellular iron stores by undefined mechanisms.
While a mechanism for Fe(III) release via host cell ferritin degradation has been documented for N. meningitidis, a corresponding neisserial iron binding protein has yet to be identified. Doyle and colleagues recently identified a ferric ion-binding protein (FBP) homolog in Ehrlichia canis and E. chaffeensis (18). Putting this information into context with data presented in this report and by Larson et al. (27), it is tempting to surmise whether A. phagocytophilum also expresses an FBP homolog and whether it plays a role in acquiring Fe(III) released from degraded ferritin.
These studies provide insight into the effects A. phagocytophilum has on the ferritin levels of its mammalian host at different stages of infection. The potential role of ferritin degradation by A. phagocytophilum as a means for obtaining iron and whether an Ehrlichia-like FBP is involved in this process represent exciting areas for further investigation.
This work was supported by grants KO1DK065039 (J.A.C.), P20 RR20171 (J.A.C.), and AI041440 (E.F.) from the National Institutes of Health and the Burroughs Wellcome Fund (E.F.).
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