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Infection and Immunity, November 2005, p. 7697-7704, Vol. 73, No. 11
0019-9567/05/$08.00+0 doi:10.1128/IAI.73.11.7697-7704.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Department of Physiology,1 Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, Georgia 303102
Received 5 July 2005/ Returned for modification 18 July 2005/ Accepted 24 July 2005
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The numerous diverse microsporidian species share one hallmark stage, an environmentally resistant spore. This spore contains a unique invasion apparatus and the infectious sporoplasm (17). On exposure to an appropriate signal a coiled tube within the spore, the polar tube, rapidly everts and extends. This process is variously known as germination or hatching. The infectious sporoplasm is then forced through the tube and injected into any cell that may have been impaled, continuing the cycle of infection. The force that causes the polar tube to evert and the sporoplasm to be extruded appears to be osmotic (29). A posterior vacuole within the spore plays a role in this process (10).
The major target cell of the microsporidia infecting humans is the polarized epithelium of the gastrointestinal tract and the presumed mechanism of infection is the impaling of target cells by germinating spores. Recently it has been suggested that cultured intestinal epithelial cells, and in particular Caco-2 cells, may become infected by spore phagocytosis (11, 12, 20). Other cell lines have also been shown to phagocytize microsporidian spores (5, 12). While one might expect undifferentiated cultured cells to exhibit phagocytosis, it seems less likely that differentiated and/or polarized cultured cells or enterocytes in vivo would exhibit this type of endocytosis. The present study employed several human intestinal epithelial cell lines and Encephalitozoon intestinalis spores to determine if phagocytosis is a significant mode of infection of enterocytes by intestinal luminal spores, and if host cell differentiation reduces the incidence of any such phagocytosis.
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Human mononuclear cells were isolated from peripheral blood using Ficoll-Hypaque gradients (Amersham Bioscience, Piscataway, NJ). The cells were plated at a density of 1 x 106 cells per well in a 48-well plate on 15-mm Permanox coverslips (NUNC, Naperville, IL) in Iscove's modified Dulbecco's medium (MediaTech Inc., Herndon, VA) with 10% pooled human male serum (Lampire Biologicals, Inc., Pipersville, PA). After 24 h of incubation at 37°C with 5% CO2, the nonadherent cells were removed by washing with Hanks balanced salt solution. The remaining cells were 98% macrophages as determined by nonspecific esterase staining.
For phagocytosis experiments, cells were plated separately onto eight-well chambered slides for 3 (HCT-8 and Caco-2 cells), 5 (Caco-2, HCT-8 cells, SW480 cells, and HT-29 cells), or 7 (Caco-2 and HCT-8) days. Cultures that were 7 days old contained more differentiated cells than did 3-day-old cultures. Culture media were changed twice a week.
Parasite culture and purification. African green monkey kidney (E6) cells were cultured in Dulbecco's modified Eagle medium supplemented with 10% fetal bovine serum, 50 µg/ml gentamicin, 2 µg/ml amphotericin B, and 44 mM NaHCO3. Cells were infected with isolated Encephalitozoon intestinalis (ATCC CDC V307) spores and cultured at 37°C in CO2 (31).
Heavily infected cells were collected twice a week by gentle mechanical agitation and stored at 4°C for no more than 14 days prior to spore purification, at which time the infected cells were concentrated by centrifugation for 30 min at 1,200 x g. This and all subsequent steps were performed at 4°C. The supernatant solution was removed and the remaining sample was expressed through a 27-gauge needle three times to rupture host cells. In order to eliminate excessive debris, the sample was filtered through a sterile non-pyrogenic 5-µm-pore-size Cameo filter (GE Osmonics, Minnetonka, MN). The sample was then placed in a discontinuous Percoll gradient (5.5 ml of Percoll and 4.5 ml of phosphate-buffered saline) and centrifuged for 30 min at 1,200 x g. After centrifugation, the pellet containing the intact microsporidian spores was washed three times in phosphate-buffered saline by suspension and centrifugation. Spores were counted with a hemacytometer.
Infection assay. Human colonic carcinoma cells (3, 5, and 7 days old) were cultured to confluence in eight-well chamber slides. Cells were infected with E. intestinalis (1 x 106 spores) for three days. The culture-specific media were changed daily. Infection was assessed by counting the number of cells with clearly defined parasitophorous vacuoles per five fields as illustrated in Fig. 1A.
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FIG. 1. Immunofluorescent images of undifferentiated Caco-2 cells showing host cell tight junction ZO-1 (green), extracellular E. intestinalis stages (yellow), and intracellular E. intestinalis stages (red). (A) Cells infected for 5 days showing intracellular parasite stages within parasitophorous vacuoles (arrows). (B) Cells exposed to spores for 4 h showing multiple spores attached to the cell surface and one phagocytized spore (arrow). (C) Cells exposed to spores for 4 h showing four spores, three of which have clearly germinated and impaled a large undifferentiated cell (arrowheads). Extracellular spore and polar tube (yellow) can be distinguished from intracellular segments of the polar tube and sporoplasm (red). Bar, 2 µm.
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In order to distinguish internalized from attached extracellular spores, plated cultured cells were fixed with 3.7% paraformaldehyde (pH 7.4) for 15 min. Cells were then washed three times with Tris-buffered saline (TBS), 5 min per rinse. Samples were blocked with 2% bovine serum albumin (BSA; Sigma Chemical Co.) in TBS for 10 min at room temperature. External spores were labeled with a 1:500 dilution of rabbit anti-E. intestinalis polyclonal antibody in TBS containing 2% BSA. Samples were incubated for 1 h at 37°C, washed three times in TBS and labeled with Oregon Green 488 goat anti-rabbit immunoglobulin G (IgG) (Molecular Probes, Eugene, OR) diluted 1:700 in TBS containing 2% BSA, and incubated for 1 h at 37°C. After washing of the samples three times, the cells were permeabilized with 0.02% Triton X-100 in TBS for 10 min, washed three times with TBS, and blocked with 2% BSA in TBS at room temperature. Intracellular structures were labeled with the rabbit polyclonal anti-E. intestinalis antibody (diluted 1:500 in TBS containing 2% BSA) and a mouse anti-zona occludens 1 (ZO-1) monoclonal antibody (BD BioSciences Pharmingen, San Jose, CA) diluted 1:25 in TBS containing 2% BSA. Cells were incubated for one hour at 37°C, washed three times with TBS, and labeled with goat anti-rabbit IgG AlexaFluor 594 (Molecular Probes) (diluted 1:500 in TBS containing 2% BSA) and Biotin-SP conjugate AffiniPure goat anti-mouse antibody (Jackson Immuno Research, West Grove, PA) diluted 1:300 in TBS containing 2% BSA. Cells were washed three times with TBS and then labeled with Streptavidin Alexa Fluor 488 conjugate dye (Molecular Probes) diluted 1:300 in TBS containing 2% BSA. The sample was washed three times with TBS and mounted on glass slides using mounting media. Extracellular and intracellular parasites were visualized with an epifluorescence microscope and counted. Intracellular parasite spores appeared red, target cell tight junction ZO-1 appeared green, and adherent extracellular spores were double labeled and appeared yellow (Fig. 1). For each slide, 300 attached spores and 20+ fields were assessed by using a 63x oil immersion objective.
Assessment of differentiation. SW480 cells are generally considered undifferentiated, and HT-29 cells are poorly differentiated when cultured in the type of medium used here (2). Caco-2 and HCT-8 cells exhibit a continuum of degrees of differentiation depending on the age of the culture and regional cell density. Criteria were established to divide the Caco-2 and HCT-8 cells into undifferentiated, intermediate, and differentiated cells. The criteria included the x-y surface area of each cell, which decreased as the cell become more differentiated and columnar (Table 1) and was readily measured by visualization of the ZO-1 probe outline which localized the tight junction and by the location of the cell on a dome or plateau (villus-like structure) of differentiated cells. Differentiated Caco-2 cells were columnar and small in x-y surface area, often located on domelike structures. Intermediate Caco-2 cells surrounded these differentiated cells. HCT-8 cells were considered differentiated when they were located on the tips of villi and crests, and intermediate cells had a larger x-y surface area and surrounded the villi and crests. Both Caco-2 and HCT-8 undifferentiated cells were large and flat. Undifferentiated HCT-8 cells predominated in 3-day-old cultures and were found in small clusters in 5-day-old cultures. In practice, a transparent template of the cells used to generate Table 1 was placed over the computer screen to act as a guide in determining the degree of differentiation of a field of Caco-2 or HCT-8 cells. Cells were also fixed with cacodylate-buffered 2.5% glutaraldehyde and prepared for scanning electron microscopy (SEM) (30). The apical brush border of undifferentiated and differentiated Caco-2 and HCT-8 cells was then imaged and the brush border development was used to confirm the assessment of differentiation (Fig. 2).
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TABLE 1. The x-y area of cultured cells categorized as undifferentiated, intermediate, or fully differentiated
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FIG. 2. Scanning electron microscope images of the apical surface of HCT-8 and Caco-2 cells categorized on the basis of x-y surface area and location on the monolayer as undifferentiated, intermediate, and differentiated cells. The density of microvilli increased in both cell lines as the cells became more columnar and differentiated. Bar, 1 µm.
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Infection and attached and phagocytized spores were distinguished by color. Double-labeled extracellular spores appeared yellow while intracellular parasite stages and internalized spores appeared red (Fig. 1A and B). Intracellular parasitophorous vacuoles were clearly evident from two days following spore exposure (1) and these were used to assess the incidence of infected cells. Individual red (internalized) spores that were seen in 4-h experiments were considered to have been phagocytized (5). Impalement was detected when a polar tube was seen extending from an attached extracellular spore (yellow) and, at the point at which the polar tube entered the host cell, the filament and any extruded sporoplasm appeared red (Fig. 1C). In germinated spores that did not impale a cell, the spore, polar tube and sporoplasm all appeared yellow.
To determine if spore germination was affected by the apical microclimate of individual host cells, the incidence of germination was determined in undifferentiated individual Caco-2 cells to which three or more spores were attached.
Statistical evaluation. Analysis of variance tests were used to determine the significance of differences between groups and Tukey's protected t tests were used as post hoc tests to determine the significance of differences between group mean values. Group mean differences were considered statistically significant when P was <0.05. In one experiment, the germination rates of spores were assessed when multiple spores were attached to individual cells. Frequency distributions of the percentage of spores germinating on individual host cells were plotted for cases where three to eight spores were attached/cell. In cases where the number of spores attached per cell was three, four, five, six, or eight, the distributions was bimodal and these data are illustrated showing the percentage of cells in which either all or none of the attached spores had germinated.
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FIG. 3. Spore attachment, spore germination, host cell impalement by germinating spores (hatched bars), and host cell spore phagocytosis (solid bars) in cultures of SW480 and HT-29 cells exposed to E. intestinalis spores for 4 h. Different from SW480: *, P < 0.05.
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FIG. 4. Spore attachment, spore germination, host cell impalement by germinating spores (hatched bars), and host cell spore phagocytosis (solid bars) in fields of undifferentiated, intermediate, and differentiated Caco-2 cells exposed to E. intestinalis spores for 4 h. Different from undifferentiated group: *, P < 0.05; **, P < 0.01.
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FIG. 5. Spore attachment, spore germination, host cell impalement by germinating spores (hatched bars), and host cell spore phagocytosis (solid bars) in fields of undifferentiated, intermediate, and differentiated HCT-8 cells exposed to E. intestinalis spores for 4 h. Different from other group(s): *, P < 0.01; **, P < 0.01.
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The differences between and within cultures with respect to 4 -h spore attachment paralleled the degree of infection observed 3 days postinfection (Table 2).
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TABLE 2. Number of E. intestinalis-infected cells per five fields 3 days postinfection
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As all cultures were maintained in the same medium in these experiments, cell line differences in attached spore germination were considered likely due to some aspect of the host cell apical membrane. In the case of large undifferentiated Caco-2 cells multiple spores were frequently attached to a single cell. The percentage of attached spores germinating on the surface of individual cells was measured. Figure 6 illustrates the percentage of cells in which all or none of the attached spores had germinated for cells to which three, four, five, six, seven, or eight spores had attached. In all but the case of seven spores/cell the frequency distribution of germination was bimodal. For example, in the case of cells to which five spores had attached, in 63% of the cells all or none of the spores had germinated, while in the remaining 37% of the cells, one, two, three, or four of the attached spores had germinated. This bimodal frequency distribution suggests that the apical surface of individual cells differed such that some cell surfaces favored germination while others did not. The examples using large undifferentiated Caco-2 cells shown in Fig. 1B and C exemplify this phenomenon of most of the spores attached to a single cell being either not germinated or germinated, as none of the seven spores seen attached to a single cell in Fig. 1B germinated, while three and possibly four of the spores attached to a single cell in Fig. 1C had germinated.
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FIG. 6. Percentage of undifferentiated Caco-2 cells on which germinated spores were either none (solid bars) or all (hatched bars) of the attached spores. Numbers represent the number of cells to which three, four, five, six, seven, or eight spores had attached.
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FIG. 7. Scanning electron microscopic image of a germinated E. intestinalis spore impaling an undifferentiated Caco-2 cell (arrow). Bar, 1 µm.
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The methods we employed allowed us to readily distinguish microsporidian spores that were attached to the host cell surface from those that had been phagocytized (Fig. 1B) and to distinguish attached spores that had germinated but not impaled a host cell from those that had impaled a cell, although the latter may have been undercounted due to difficulties in distinguishing intracellular polar tubes and sporoplasms (Fig. 1C). Spore attachment to host cells differed significantly between cell lines and between cells of the same cell line that were at different stages of differentiation (Fig. 3, 4, and 5). Because of differences in cell surface area and spore attachment between cell lines, we normalized the number of spores used in the assays to well surface area and the count of spore attachment to fields of a known area. The number of spores used in these experiments averaged about four spores/cell, considerably less than that generally used in the literature (e.g., 14). However, the number of spores we used is still probably higher than that found in the intestinal lumen within range of the mucosal epithelium, especially at the onset of an infection.
Hayman and colleagues (14) provided evidence that E. intestinalis spores adhere to surface sulfated glycoaminoglycans of Vero and CHO cells. Such attachment was reduced when a number of exogenous sulfated glycoaminoglycans were included in their adherence assay. Similarly, we found that chondroitin sulfate A inhibited attachment in all four cell lines used in our study, suggesting that the observed cell line and differentiation-dependent differences in attachment were the result of differences in the cell surface sulfated glycoaminoglycan expression. We did not observe the preferential spore attachment to intercellular junctions as has been reported elsewhere (11). Infection sites per field in the various cell lines (Table 2) paralleled attachment, in that the greatest infection was seen in SW480 cells, and undifferentiated Caco-2 and intermediate HCT-8 cell infections were greater than those seen in differentiated Caco-2 and HCT-8 cells. The infection seen in fields of differentiated Caco-2 cells was higher than one would have predicted based on the low spore attachment to such cells. However, the 3-day duration of the infection assay allowed time for infected undifferentiated and intermediate cells to differentiate. While it is known that infecting cells with Encephalitozoon spp. inhibits mitosis (23), the effects of infection on differentiation are not known.
Because there were such large differences in spore attachment between and within cell lines, spore germination was normalized to the number of attached spores. Germination was significantly less when spores were attached to the undifferentiated SW480 cell line and to undifferentiated Caco-2 and HCT-8 cells. This suggests that the degree of host cell differentiation influenced germination and that this effect was separate from any effect of the bulk phase (medium) environment and was probably independent of the cell surface sulfated glycoaminoglycan spore attachment effect. When spore germination was assessed in large, flat undifferentiated Caco-2 cells to which three or more spores had attached, a bimodal distribution was noted that suggested that while the surface of some cells was conducive to the germination of all attached spores, this was not the case for other cells (Fig. 6). These differences could not be attributed to the medium, as all cells in an assay were from the same slides and were exposed to the same bulk phase environment. Most studies of microsporidian spore germination have focused on the environmental effects of medium pH or ionic composition (13, 16, 19, 28) and not on the microenvironment of the unstirred layer that occurs at the brush border.
Impalement of the host cell by the polar tube at germination appears to be the major way in which infection came about in these cell lines. This was particularly true with the differentiated Caco-2 and HCT-8 cells and the moderately differentiated HT-29 cells. This might be explained by the fact that spores attached to undifferentiated cells would be likely to attach so that their long axis paralleled the apical surface while spores attached to a well developed brush border might be more likely to be oriented so that on germinating the polar tube would be pointing towards the target cell (20). The present study was not able to distinguish between cells that had been impaled and cells that had phagocytized the sporoplasm released from a spore germinating at the cell surface as has been suggested (11), although SEM data did not support this suggestion. In SEM studies, we were unable to find a suggestion of phagocytosis of surface sporoplasm but observed numerous examples of clear penetration of polar filaments through the host cell plasma membrane (Fig. 7). There are examples in the literature of germinating microsporidian spores caught in the act of impaling a cell and injecting sporoplasm into that impaled cell (for an example, see Fig. 1B) (5). Schottelius and colleagues (24) have suggested that with Encephalitozoon spp., the host cell plasma membrane forms an invagination at the site of contact with the polar filament, perhaps by some endocytic process. The polar tube then continues into the host cell cytoplasm within a membranous channel into which the sporoplasm is subsequently injected. There is also equivocal transmission electron microscopy data to support such a channel (22). Whether the polar tube impalement of host cells observed here involves any type of endocytosis of the polar tube is not known.
As expected, E. intestinalis whole spore phagocytosis was greater in the least differentiated cell line (SW480) and in the less differentiated Caco-2 and HCT-8 cells. In experiments in which the assay was conducted in serum-free medium, phagocytosis was not observed in HT29 cells or differentiated Caco-2 and HCT-8 cells (Fig. 3, 4, and 5). In experiments in which serum was included in the assay medium there was modest phagocytosis, but again it was significantly less in differentiated than undifferentiated cells and the incidence was very small when compared to that seen in human macrophages exposed to spores for half the time (0.10 to 0.44% versus 72%). More significantly, as Caco-2 and HCT-8 cells became more differentiated the incidence of phagocytosis decreased while the incidence of cells being impaled by germinating spores increased.
This study addresses only the mode of microsporidian infection at the apical pole of differentiated intestinal epithelial cells, the presumed site of the initial infection by ingested spores. The phagocytic activity of the basolateral surface of such cells may be different from that of the apical membrane, as has been observed with several enteric bacteria (e.g., Shigella) (21). While spore phagocytosis is undoubtedly the most important mode of entry of many microsporidia into macrophages, the present study supports the concept that the initial invasion of the intestinal epithelium by ingested parasite spores involves spore germination and host cell impalement rather than spore phagocytosis.
We thank Amad Al-Mahmoud, Morehouse School of Medicine Clinical Research Center, for assistance with statistical analyses.
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