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Infection and Immunity, June 2005, p. 3471-3478, Vol. 73, No. 6
0019-9567/05/$08.00+0 doi:10.1128/IAI.73.6.3471-3478.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Division of Infectious Diseases,1 Division of Pulmonary and Critical Care Medicine, Department of Medicine,2 Department of Microbiology, University at Buffalo, State University of New York,3 VA Western New York Healthcare System, Buffalo, New York,4 Institute for Infectious Diseases,5 Department of Pediatrics, University of Bern, Bern, Switzerland6
Received 6 January 2005/ Returned for modification 4 February 2005/ Accepted 14 February 2005
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Moraxella catarrhalis is isolated from the sputum of 5 to 32% of adults with COPD in point prevalence studies (6, 9, 10, 20). Several lines of evidence implicate M. catarrhalis as a cause of exacerbations of COPD, and these have been reviewed (19). More recently, we have evaluated and characterized the roles of bacterial infection in general and of M. catarrhalis in particular in adults with COPD prospectively (2, 14, 14a, 17). During 81 months of follow-up of 104 patients with COPD, 120 episodes of acquisition and clearance of M. catarrhalis were observed. Interestingly, the organism is cleared efficiently after a relatively short duration of carriage (median, 34 days), and patients appear to develop strain-specific protection following clearance of M. catarrhalis from the respiratory tract (14a).
To assess the immune responses in these patients who cleared M. catarrhalis from their respiratory tracts, whole-cell enzyme-linked immunosorbent assays (ELISAs) were performed with paired serum samples obtained before acquisition and after clearance of M. catarrhalis. Whole-cell ELISAs detect antibodies that bind specifically to the surface of the bacterium. The majority of patients who cleared M. catarrhalis from the respiratory tract developed a new serum immunoglobulin G (IgG) antibody response to their homologous infecting strain of M. catarrhalis. The intensity of the serum IgG response was greater following exacerbations compared to the intensity of the response following asymptomatic colonization (14a). The previous study demonstrated the development of new immune responses to surface-exposed antigens but did not identify the antigens to which these new antibodies were directed. The goal of the present study is to identify the antigens of M. catarrhalis to which these new serum IgG antibodies are directed, with emphasis on identifying immune responses directed specifically against surface-exposed epitopes. These results will identify surface antigens that are important targets of the human immune response following clearance of M. catarrhalis from the respiratory tract and, thus, help guide vaccine development.
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Bacteriological methods. Study personnel who processed sputum samples were unaware of the clinical status of patients. Sputum samples that were spontaneously expectorated the morning of the clinic visit were homogenized, diluted, and plated in a quantitative manner as previously described (17). Bacterial pathogens were identified with the use of standard techniques. The identity of an isolate as M. catarrhalis was confirmed by colony morphology and the presence of butyrate esterase.
Bacterial strains. Isolates of M. catarrhalis were recovered from sputum samples of adults followed in the COPD Study Clinic. Isolates were subjected to molecular typing by pulsed-field gel electrophoresis as part of previously described studies (17). An exacerbation strain was defined as a newly acquired strain isolated from sputum during symptoms of an exacerbation.
The characteristics of M. catarrhalis O35E and its isogenic knockout mutants used in this study are shown in Table 1 and were described previously (11, 22).
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TABLE 1. M. catarrhalis mutants used in this study
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Serum samples. Preacquisition serum samples were obtained 2 to 6 weeks prior to acquisition of a strain of M. catarrhalis determined by results of monthly sputum cultures. Postclearance serum samples were obtained 4 to 8 weeks following clearance of M. catarrhalis from the respiratory tract. Blood samples were obtained by venipuncture and allowed to clot. Serum samples were prepared by centrifugation and stored at 80°C.
Immunoblot assays and densitometry. Purified outer membranes of infecting strains of M. catarrhalis were subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblot assays. Outer membranes of homologous strains were probed with preacquisition and postclearance serum samples at serial twofold dilutions of 1:200 to 1:6,400; selected pairs of serum samples were assayed at higher dilutions as well.
Immunoblot assays were analyzed by densitometry using an Alpha Innotech imaging system. The integrated density values were determined for individual bands in preacquisition and postclearance serum samples run at identical dilutions in adjacent lanes. The results of densitometric analysis were expressed as a percentage based on the relative integrated density value for each band analyzed.
Adsorption and elution assays.
Adsorption and elution assays were performed to identify antibodies that bind to epitopes that are exposed on the bacterial surface (13, 18). Assays were performed with the homologous patient isolate of M. catarrhalis. The bacterial strain was grown to late logarithmic phase (optical density at 600 nm [OD600] of
0.75) in BHI broth. Bacteria were harvested by centrifugation at 1,000 x g for 15 min at 4°C. After being washed once by suspension and centrifugation, bacterial cells were suspended in 1 ml of serum diluted 1:10 in phosphate-buffered saline (PBS) containing 0.15 mM CaCl2 and 0.5 mM MgCl2 (PCM) and incubated for 30 min at 4°C. Bacteria were removed by centrifugation at 16,000 x g for 10 min at 4°C. The supernatant was filter sterilized and saved at 4°C. Escherichia coli strain JM109 was subjected to the identical procedure simultaneously as a negative control.
To elute antibodies from the bacterial surface, the bacterial pellet following incubation with serum was washed three times with PCM and resuspended in 0.5 ml of elution buffer (0.2 M glycine, 0.2 M NaCl, pH 2.8). The mixture was incubated for 30 min at room temperature on a nutator mixer and then centrifuged at 16,000 x g for 10 min. The supernatant was transferred to another tube and titrated to a pH of
7.4 with 1 M Tris. The elution was performed concurrently with E. coli as a negative control.
Aliquots of unadsorbed serum, M. catarrhalis-adsorbed serum, E. coli-adsorbed serum (negative control), antibodies eluted from the surface of M. catarrhalis, and antibodies eluted from the surface of E. coli (negative control) were subjected to immunoblot assays. The bands to which antibodies were directed were identified by a combination of analysis with monoclonal antibodies of known specificity, amino-terminal sequencing of protein bands, and analysis of well-defined mutants as described below.
Flow cytometry.
Aliquots of serum were subjected to flow cytometry to assess the specificities of the adsorption and elution assays in identifying antibodies that bound epitopes on the surface of the intact bacterial cell (2). The isolate of M. catarrhalis to be studied was grown in broth to mid-logarithmic phase (OD600 of
0.2). An aliquot of 0.2 ml was harvested by centrifugation at 16,000 x g for 5 min. The bacteria were resuspended in 0.2 ml of serum diluted in PBS. The mixture was incubated on a nutator mixer for 1 h at 37°C and then centrifuged. The pellet was resuspended in 0.2 ml of a 1:10 dilution of goat anti-human IgG conjugated to fluorescein isothiocyanate (Kirkegaard & Perry Laboratories, Inc.) and mixed on a nutator for 30 min at 37°C. A volume of 1.8 ml of PBS was added, and the cells were subjected to flow cytometry with a fluorescence-activated cell sorter (FACScan; Becton Dickinson). A total of 20,000 cells were counted in a gated region corresponding to unclumped cells. Data were acquired by using an instrument with a logarithmic mode for forward scatter, side scatter, and fluorescence.
Purification of outer membranes. Bacteria were grown on BHI agar overnight and harvested by suspension in 0.01 M HEPES, pH 7.4. Cells were disrupted by sonication on ice with four 15-second periods of sonication at 100 W. Unbroken cells and debris were removed by centrifugation at 10,000 x g for 2 min at 4°C. The suspension was centrifuged at 100,000 x g for 45 min at 4°C to collect cell envelopes. The pellets were suspended in 1% sarcosyl in 0.01 M HEPES and incubated at room temperature for 1 h to solubilize cytoplasmic membranes. The sarcosyl-insoluble fraction was obtained by centrifugation at 100,000 x g for 45 min at 4°C.
Purification of lipooligosaccharide (LOS). LOS of isolates of M. catarrhalis was prepared using a microphenol method (2). Bacteria were grown on BHI agar overnight and harvested into 10 ml PBS to an OD490 of 0.4. Bacteria were centrifuged at 1,000 x g for 10 min at 4°C. The pellet was suspended in PCM and centrifuged as described above. The pellet was resuspended in 1 ml of 1 mg/ml lysozyme (Ready-Lyse; Epicentre, Madison, WI) in PCM and incubated at room temperature for approximately 45 min or until the suspension became viscous. DNase was added to a concentration of 1 µg/ml, RNase was added to a concentration of 10 µg/ml, and the suspension was incubated for 30 min at 37°C. Proteinase K was added to a final concentration of 46 µg/ml, and the suspension was incubated for 15 min at 65°C. An equal volume of prewarmed 90% phenol was added, followed by incubation with vigorous shaking at 65°C for 15 min. After the suspension was placed on ice for 10 min, the suspension was vortexed and then centrifuged at 16,000 x g for 10 min at 4°C. The aqueous (top) layer was saved. A volume of 1 ml of distilled water was added to the phenol phase, and the incubation and centrifugation steps were repeated. The aqueous phase was added to the previously saved aqueous phase. NaCl was added to a final concentration of 0.5 M, 10 volumes of cold absolute ethanol were added, and the LOS was allowed to precipitate overnight at 20°C. The suspension was centrifuged at 10,000 x g for 15 min at 4°C. The pellet was resuspended in 1 ml H2O and heated in a boiling water bath for 10 min and vortexed to resuspend fully. A volume of 10 µl was added to 10 µl of sample buffer for SDS-PAGE.
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FIG. 1. Diagram of strategy used to identify the antigens to which human antibodies are directed.
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FIG. 2. Immunoblot assay of M. catarrhalis strain 32P6B1. All lanes contain purified outer membrane of M. catarrhalis strain 32P6B1 and were probed with homologous preacquisition serum sample 32E6 (lanes a) or with postclearance serum sample 32E8 (lanes b) with dilutions noted at the top. Antibodies were detected with peroxidase-conjugated anti-human IgG. The positions of molecular mass markers (in kilodaltons) are shown on the left.
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TABLE 2. Summary of outer membrane antigens to which serum IgG is directed following M. catarrhalis carriage in adults with COPDa
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FIG. 3. Immunoblot assay of M. catarrhalis strain 87P15B1. All lanes contain purified outer membrane of M. catarrhalis strain 87P15B1. Lanes were probed with aliquots of homologous postclearance serum sample 87E16 as follows: a, unadsorbed; b, adsorbed with M. catarrhalis strain 87P15B1; c, adsorbed with E. coli; d, serum fraction eluted from the surface of M. catarrhalis strain 87P15B1; e, serum fraction eluted from E. coli. Antibodies were detected with peroxidase-conjugated anti-human IgG. The positions of molecular mass markers (in kilodaltons) are shown on the right. The arrows indicate bands to which antibodies were adsorbed (lane b) and/or eluted (lane d).
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To further characterize antibodies to surface epitopes, antibodies that bound to the bacterial surface following incubation of serum with whole bacterial cells were eluted from the bacterial surface and tested in immunoblot assays. Figure 3, lane d, shows that antibodies to selected bands were eluted from the surface of the homologous strain of M. catarrhalis. To assess the specificities of the elution assays, E. coli cells were subjected to the identical elution method; Fig. 3, lane e, shows the absence of detectable bands eluted from the surface of E. coli, providing evidence for the specificity of the elution assays for identifying antibodies to surface epitopes.
To further evaluate the adsorption and elution assays to detect antibodies specifically to surface-exposed epitopes, serum fractions were subjected to flow cytometry. Flow cytometry has previously been shown to effectively detect antibodies to surface-exposed epitopes of M. catarrhalis (2). Figure 4 (top) shows that adsorption with M. catarrhalis caused a prominent reduction in fluorescence as detected by a shift to the left of the adsorbed serum compared to unadsorbed serum. The minor shift observed on adsorption with E. coli is due to either nonspecific loss of antibody with adsorption, cross-reactive surface epitopes between M. catarrhalis and E. coli, or a combination of both. Figure 4 (bottom) shows that eluted antibodies recognize epitopes on the surface of M. catarrhalis. We conclude from these experiments that adsorption and elution effectively identify human antibodies that bind to surface-exposed epitopes.
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FIG. 4. Results of flow cytometry with M. catarrhalis strain 87P15B1. Fluorescence is shown on the x axis (in arbitrary units), and the number of cells is shown on the y axis. Serum fractions of the homologous postclearance serum sample 87E16 are noted. (Top) Adsorption with M. catarrhalis (M. cat) caused a prominent reduction in fluorescence as detected by a shift to the left of the adsorbed serum compared to unadsorbed serum. (Bottom) Eluted antibodies recognize epitopes on the surface of M. catarrhalis as indicated by prominent staining of M. catarrhalis cells by the eluted antibodies.
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Analysis of eluted serum fractions with mutants. As another approach to determining the identities of antigens to which human serum IgG antibodies were directed, a series of isogenic knockout mutants of M. catarrhalis were studied in immunoblot assays with eluted antibodies. The characteristics of the mutants are noted in Table 1 and have been described previously (22). In Fig. 5, postexacerbation serum sample 80E22 was incubated with the homologous infecting strain, and antibodies were eluted from the bacterial surface. The eluted antibodies were subjected to immunoblot assays with purified outer membranes of the homologous strain (Fig. 5, lane a) along with the mutants described in Table 1. Figure 5 clearly shows that antibodies recognize epitopes on UspA2, UspA1, and TbpB on the basis of the patterns of bands recognized. In the case of UspA1, lanes c, e, and i contain mutants that are deficient in expression of UspA1. The eluted antibodies bind to the corresponding UspA1 band in all lanes except for those three, allowing the conclusion that antibodies recognize UspA1. Similarly, the eluted antibodies bind to the broad UspA2 band at the top of the gel in all lanes except those that contain mutants deficient in UspA2 (lanes d, e, and i), supporting the conclusion that the serum sample contains antibodies to surface epitopes of UspA2. Aliquots of all 12 postexacerbation sera were subjected to elution from the homologous strain and analysis with mutants. The results are summarized in Table 2, which includes data from multiple approaches to identify the target of new serum IgG antibodies as outlined in Fig. 1.
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FIG. 5. Immunoblot assay with postexacerbation serum sample 80E22 eluted from the surface of the homologous strain 80P20B1. Lanes contain purified outer membrane preparations of strains a) 80P20B1, b) O35E, c) UspA1 mutant, d) UspA2 mutant, e) UspA1 UspA2 double mutant, f) CopB mutant, g) TbpB mutant, h) Hag mutant, and i) UspA1 UspA2 Hag triple mutant. The positions of molecular mass markers (in kilodaltons) are shown on the left. The positions of UspA2, UspA1, and TbpB are indicated by arrows on the right.
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FIG. 6. Immunoblot assay of purified LOS of M. catarrhalis strain 87P15B1 (all lanes). Lanes were probed with aliquots of homologous postclearance serum sample 87E16 as follows: a, unadsorbed; b, adsorbed with M. catarrhalis strain 87P15B1; c, adsorbed with E. coli; d, serum fraction eluted from the surface of M. catarrhalis strain 87P15B1. Antibodies were detected with peroxidase-conjugated anti-human IgG. The positions of molecular mass markers (in kilodaltons) are shown on the left.
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Two elements of the design of the present study should be emphasized. The approach of using adsorption and elution assays detects antibodies specifically directed at surface-exposed epitopes. Bacterial outer membrane proteins contain a large proportion of epitopes that are buried in the outer membrane and are thus not accessible to antibodies that would be capable of binding to the intact bacterium. Immunoblot assays of purified outer membranes, for example, do not distinguish between antibodies to surface-exposed and non-surface-exposed epitopes. Antibodies that are likely to mediate protection bind to surface-exposed epitopes. Such antibodies would include, for example, bactericidal antibodies, opsonizing antibodies, and antibodies that block adherence to host cell receptors. The antibodies detected in the present study bind epitopes on the bacterial surface.
A second important feature of the present study is that serum samples were obtained from patients followed prospectively with monthly sputum cultures (17). Long-term follow-up established that patients cleared M. catarrhalis from the respiratory tract and did not reacquire the strain, indicating that a protective response occurred (14a). The protective responses appear to be strain specific because while reacquisition of the same strain did not occur, some patients acquired new strains of M. catarrhalis after clearing previous strains. These serum samples are valuable with regard to identifying antibodies that have the potential to mediate protective immune responses; however, one cannot yet conclude that the antibodies detected in the present study are mediating protection.
The adsorption and elution assays are complementary assays, yielding somewhat different results. For example, Fig. 3, lane b, illustrates adsorption of antibodies to five bands (noted by arrows); by contrast, the corresponding elution assay (lane d) detected exclusively antibodies to a band of
80 kDa. Several explanations likely account for the differences in the assays. Antibodies may bind with an affinity high enough to result in adsorption but may be removed from the bacterial surface by washing prior to elution. High-affinity antibodies may bind to the bacterial surface and resist elution. Some antibodies may undergo denaturation and loss of binding during the conditions of elution. If a serum sample were to contain a combination of antibodies to surface and nonsurface epitopes, one would expect the elution assays to be positive (by virtue of the presence of antibodies to surface epitopes) but the adsorption assay to be negative (by virtue of the presence of antibodies to non-surface-exposed epitopes). The results of adsorption and elution assays should be interpreted with these considerations in mind.
Limitations of the approach used in this study should be considered. The current study relies on immunoblot assays to identify antigens to which human antibodies bind. Therefore, antibodies to conformational epitopes that are denatured in SDS-PAGE and immunoblot assay will not be detected. The methods used in this study will detect antibodies to major surface proteins expressed during growth of bacteria in the laboratory. However, the method will not detect antibodies to minor surface antigens and will not detect antibodies to antigens that are expressed exclusively in vivo. Therefore, the results of this study are highly specific, demonstrating that the antigens noted in Table 2 are unequivocally the targets of a human immune response. However, the sensitivity of the approach is limited by the methods, indicating that antibodies to other antigens are likely present and alternative experimental approaches will be necessary to characterize these antibodies. Finally, while the focus of the present study is the serum IgG response, analysis of mucosal immune responses to M. catarrhalis will be important in characterizing potentially protective immune responses as well.
Previous work characterizing the human antibody response to M. catarrhalis following infection with laboratory strains and immunoblot assays revealed the presence of antibodies to multiple proteins, including UspA1, UspA2, TbpB, CopB, and a 60-kDa band that is probably OMP CD (4, 5, 8). TbpB (previously called OMP B1) is a target of serum IgG antibody responses in adults with respiratory tract infections and children with otitis media (3, 15, 18, 24). Analysis of paired serum samples from adults with COPD by ELISA using recombinant purified protein has demonstrated that some patients make new serum IgG to OMP CD (14). More recently, analysis of mucosal IgA antibodies in saliva from healthy adults and from children with otitis media using the mutants used in the present study demonstrated the presence of antibodies to similar antigens identified here as important targets of serum IgG (11, 22). The observation that both salivary IgA of healthy adults and serum IgG following infection in adults with COPD are directed at similar major antigens suggests conservation of the human immune response.
The present study extends the previous work in several ways. (i) The current study utilizes serum samples from adults with COPD who have cleared M. catarrhalis from the respiratory tract based on monthly sputum cultures, thus providing the opportunity to identify potentially protective antibodies. (ii) Antibodies that bind specifically to surface epitopes were measured by eluting antibodies from the bacterial surface. (iii) The homologous infecting strains of M. catarrhalis were used in adsorption and elution assays, enhancing the capability to detect strain-specific antibody responses. (iv) Complementary methods to identify surface antigens were used, including analysis with a set of well-defined mutants, analysis with monoclonal antibodies of known specificity, and amino-terminal sequence determination of antigens. (v) Detection of antibodies to surface epitopes of LOS by analysis of adsorbed and eluted serum fractions with purified LOS from homologous infecting strains.
In summary, analysis of carefully chosen serum samples from adults with COPD who have cleared M. catarrhalis from the respiratory tract and who have developed new antibodies to surface epitopes were studied to identify the surface antigens to which antibodies were directed. Most patients made serum IgG to surface-exposed epitopes of UspA1, UspA2, Hag, TbpB, and OMP CD. In addition, a smaller proportion made antibodies to CopB, OMP E, and LOS. These results contribute important new data on elucidating the surface antigens to which human antibody responses are directed following infection due to M. catarrhalis. Future work will address the potential protective capacity of antibodies to these major surface antigens.
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