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Infection and Immunity, September 2005, p. 5426-5437, Vol. 73, No. 9
0019-9567/05/$08.00+0 doi:10.1128/IAI.73.9.5426-5437.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
Department of Microbiology, University of Virginia Health Sciences, Charlottesville, Virginia,1 Structural Biology and Biochemistry, The Hospital for Sick Children, Toronto, Ontario, Canada2
Received 4 February 2005/ Returned for modification 13 April 2005/ Accepted 4 May 2005
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Bacterial adherence to host cells is an important step in infection and determines the host specificity and tissue tropism, due to specific interactions between bacterial adhesins and host receptors (13). Members of the Bcc have been shown to bind to a variety of epithelial cells, including those from nasal polyps, bovine trachea, and human buccal and airway epithelia and also to alveolar type II pneumocytes (A549) (3, 12, 23, 29, 31). To date, two classes of host cell receptors have been identified for Bcc. Lipid receptors (such as digalactosylceramide, globotriosylceramide, and gangliosides) are expressed mainly on the basolateral surface of all the above-mentioned cell types and are utilized primarily by nonpiliated strains (12, 45). Cytokeratin 13 (CK13), a member of a family of intermediate filaments, is expressed in tracheobronchial epithelial cells and in cells differentiated into a squamous phenotype. Although CK13 is essentially a cytoplasmic protein, it is expressed on the apical surface of airway epithelium undergoing squamous metaplasia after repeated injury and repair (14, 22, 43). Previously, we have shown that CK13 expression is increased in CF airways, mainly in bronchiolar and respiratory epithelium (27). Therefore, we presume that B. cenocepacia capable of binding to CK13 may have a greater potential to cause infection, particularly in CF patients.
The cbl operon consists of at least seven genes: cblB, a proposed chaperone-like protein; cblA, the major pilin subunit; cblC, a proposed usher protein; cblD, a minor pilin protein; and the regulatory genes cblS, cblT, and cblR (32, 48). The first four genes in the operon, cblB, cblA, cblC, and cblD, are sufficient for pilus biogenesis, as determined by heterologous expression in Escherichia coli (32). However, the regulatory genes cblS, cblT, and cblR are necessary for pilus biogenesis in B. cenocepacia (48). Although the organization of genes necessary for pilus biogenesis in the cbl operon and their predicted products are very similar to enterotoxigenic E. coli CS and CFA/I families (33, 35), they differ from the CS and CFA/I class of pili with regard to the adhesin. In E. coli CS1 and CFA/I pili, the adhesin protein is a minor component that is located at the tip of the pili and is encoded by one of the genes in the pilus gene cluster (cooD and cfaE in gene clusters of CS1 and CFA/I pili, respectively) (34). In contrast, the Cbl pilus-associated 22-kDa adhesin of B. cenocepacia, which mediates binding to CK13, is distributed along the shaft of the pili and is not encoded by any of the genes identified in the cbl operon (28, 32).
Our previous studies using nonisogenic strains indicated that both Cbl pili and the 22-kDa adhesin are necessary for optimal binding to isolated CK13 and probably also for transmigration across squamous epithelium, as the latter depends on bacterial adhesion to CK13 (32). However, we were not able to directly relate CK13 binding to expression of Cbl pili or the adhesin. To investigate the individual role of these factors in mediating the binding of B. cenocepacia to CK13 and transmigration across squamous epithelium, we identified the gene (adhA) that encodes the 22-kDa adhesin in B. cenocepacia isolate BC7, constructed isogenic mutants lacking expression of this adhesin or the Cbl pili, and characterized these mutants with respect to these processes.
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TABLE 1. Bacterial strains and plasmids used in this study
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Antibodies. Monoclonal antibody to CK13 was purchased from Vector Diagnostics Inc. (Burlingame, CA). Polyclonal antibodies to B. cenocepacia (R418, which recognizes multiple antigens), Cbl pili, and the 22-kDa adhesin have been previously described (27, 32, 45).
Construction and screening of genomic library from BC7.
Genomic DNA was randomly sheared, and >8-kb DNA fragments were isolated. EcoRI restriction endonuclease recognition sites were added to both the ends of sheared fragments and cloned into the EcoRI site of the
zap II expression vector according to the manufacturer's instructions (Stratagene, La Jolla, CA). The unamplified library was screened with a polyclonal antibody specific to the 22-kDa adhesin. The positive clones were rescued as phagemids, generated nested deletion clones of insert DNA using Erase a base kit (Promega, Madison, WI), and subjected to sequencing using vector- and gene-specific primers by automated sequencing at the sequencing facility of the Hospital for Sick Children, Toronto, Ontario, Canada. DNA sequence from nested deletion clones was assembled manually.
Bacterial extracts. Whole-cell and heat extracts were prepared as previously described (32). Briefly, for whole-cell extracts, B. cenocepacia cells were grown overnight on LB agar plates with appropriate antibiotics at 37°C and suspended in phosphate-buffered saline (PBS) to an optical density at 600 nm of 10.0 (1 x 1010 CFU/ml). Samples were diluted 1:4 with Laemmli reducing buffer, boiled for 10 min, and centrifuged, and supernatant was stored at 20°C. Heat extracts were prepared by suspending bacteria grown in trypticase soy broth overnight to 3 x 1010 CFU/ml in PBS containing complete protease inhibitors (Roche Diagnostics Canada, Laval, Quebec City, Canada), heating at 60°C for 20 min with occasional mixing, and centrifugation. Supernatant enriched in surface proteins with minimal contamination with cytoplasmic and periplasmic proteins (38) was collected and stored at 70°C until needed. Heat extracts are suitable to detect less-abundant surface proteins such as the adhesin.
Amino acid sequence analysis of the 22-kDa adhesin. Heat extract from BC7 or ATCC 25416 was incubated with cytokeratins isolated from buccal epithelial cells (27, 31) for 1 h at 37°C. After removing unbound proteins, cytokeratins along with the bound bacterial proteins were solubilized in a solution containing 8 M urea, 1 M thiourea, 2% CHAPS {3-[(3-cholamidopropyl)-dimethylammonio]-1-propanesulfonate}, 20 mM dithiothreitol, and 2% IPG buffer (Amersham Biosciences, Piscataway, NJ) and subjected to two-dimensional electrophoresis. Separated proteins were visualized either by staining with Coomassie blue or by Western blot with an antibody to the 22-kDa adhesin. A protein spot at approximately 22 kDa, which reacted with antibody, was observed only in cytokeratins incubated with the BC7 extract. The corresponding protein spot from the Coomassie-stained gel was cut out and subjected to in-gel trypsin digestion, as described previously (39). Briefly, the protein spot was reduced with 10 mM dithiothreitol, alkylated with 55 mM iodoacetamide, and incubated with 0.02 µg of sequencing-grade trypsin (Promega Corp., Madison, WI) overnight at 37°C. Tryptic peptides were extracted from the gel slice in 0.1% trifluoroacetic acid followed by acetonitrile. The extractions were pooled, desalted with a C18 ZipTip (Millipore, Nepean, Ontario, Canada), and subjected to peptide mapping and tandem mass spectrometry (MS/MS) sequencing with Applied Biosystems/MDS Sciex API QSTAR XL MALDI QTOF (Foster City, CA). Sequences were then compared with the predicted open reading frame of the 22-kDa adhesin adhA.
Plasmid construction. The gene replacement plasmid pEX-cblA-Tp was constructed by amplifying a 511-bp fragment of the cblA gene from B. cenocepacia strain J2315 genomic DNA with Vent DNA polymerase (NEB) using the following primers: 5'-GCTGCTGCTCTGATGTCGAT-3' (cblA-3) and 5'-CATTCAGGCGCGCCCCGTCG-3' (cblA-4). The J2315 cblA gene (http://www.sanger.ac.uk/Projects/B_cenocepacia) was used, as it shares >99% identity with the cblA gene from strain BC7 (GenBank accession no. U10244). This fragment was ligated into pEX18Tc and was insertionally inactivated with a trimethoprim resistance (Tp) cassette from plasmid p34ETp (7) at an SmaI site in cblA.
pEX-cblS-Tp was constructed by amplifying a 760-bp fragment of the cblS gene from strain BC7 with Taq polymerase with the following primers: 5'-GGAAGCAAGGTTCTCCGCGC-3' (cblS-1) and 5'-TGATCGATGCGAGGATCGGCAGGTC-3' (cblS-2). This fragment was insertionally inactivated with a trimethoprim resistance (Tp) cassette at a blunted MluI site. The interrupted gene was then ligated into pEX18Tc.
pEX-adhA-Tp was constructed by amplifying an 830-bp fragment with Taq polymerase in the proposed B. cenocepacia 22-kDa adhesin (adhA) gene of strain BC7 with the primers 5'-ACTACGTCGATGTTCCGGTCGCCAAC-3' (adhA-1) and 5'-GCGTCGGCTCGTATCGCTCGTCGGCACCGCCGAT-3' (adhA-2) and was inactivated by inserting a trimethoprim resistance (Tp) cassette at a blunted AgeI site. The interrupted gene fragment was then ligated into pEX18Tc.
The complementing plasmid, pUCP18Tc-cblS, was constructed by amplifying the full-length cblS gene with Taq polymerase using the primers 5'-CCACAAGCTGACGATCACGTTTACG-3' (cblScompF) and 5'-CACGTTGCCGGAAACCCGACAGCGGG-3' (cblScompR) and was subsequently ligated into pUCP18Tc in the same orientation as the plasmid-encoded promoter.
Allelic exchange in B. cenocepacia. Biparental matings were performed to transfer pEX-adhA-Tp, pEX-cblA-Tp, or pEX-cblS-Tp from E. coli SM10 to B. cenocepacia strain BC7, as previously described (37). Transconjugants were plated onto Pseudomonas isolation agar supplemented with 1.2 mg/ml trimethoprim to select for crossover events in B. cenocepacia. Gene replacements were selected from plates containing 1.2 mg/ml trimethoprim and 5% sucrose.
Bacterial binding and transmigration assays. Binding of the wild-type or mutant strains to isolated CK13 was determined by bacterial overlay assay, as described previously (29). Semiquantification of bacterial binding to CK13 was performed using a Kodak Gel Logic 200 imaging system furnished with 1-D image analysis software (Mandel Scientific Company Inc., Guelph, Ontario, Canada).
Bacterial binding to squamous epithelial cell cultures was determined as previously described (29). Briefly, B. cenocepacia BC7 or described mutants (106 CFU [multiplicity of infection of 1] in 10 µl) were incubated with the apical surface of squamous-differentiated cultures for 2 h at 37°C in 5% CO2. The apical surface of the culture was washed gently with PBS to remove unbound bacteria, and the number of bound bacteria was determined by plating the culture lysates. In some experiments, after removal of unbound bacteria, cultures were dissociated, fixed with cold methanol, and immunostained with antibodies to CK13 and B. cenocepacia (R418). The number of bacteria bound to CK13-positive and CK13-negative cells was counted under a fluorescent microscope. To examine whether the bacterial invasion of cells accounts for binding, cultures were pretreated with 2 or 5 µM of cytochalasin D and incubated with bacteria for 2 h, and cells were lysed and plated to determine the binding.
To determine the capacity of bacteria to transmigrate across the squamous epithelial cell cultures, and to persist and replicate, cell cultures were infected with bacteria (106 CFU) as described above and incubated for 2 h, and the apical surface was washed gently with PBS to remove nonadherent bacteria and incubated further, for a total of 24 h. Cell cultures were then lysed with 0.5% Triton X-100, and serial dilutions were plated to determine the number of bacteria. Samples of the basolateral chamber medium from the same experiment were plated to determine the number of bacteria that had transmigrated across the squamous culture.
Western blot analysis. Proteins from whole-cell extracts or heat extracts (extracted from an equal number of bacteria [1 x 108 CFU]) were separated by 12% sodium dodecyl sulfate-polyacrylamide gel electrophoresis, transferred onto a polyvinylidene difluoride membrane (Millipore Corp., Billerica, MA), and stained with Ponceau S to confirm the equivalent protein load in each lane. The blots were then briefly rinsed with 10 mM Tris-HCl buffer (pH 7.8), blocked with 5% skim milk, and probed with purified antibody to CblA protein or the 22-kDa adhesin protein (AdhA) (26, 27). After washing, bound antibody was detected by using anti-rabbit immunoglobulin G (IgG) (for detection of CblA) or anti-mouse IgG (for detection of the 22-kDa adhesin) conjugated to horseradish peroxidase and chemiluminescent substrate (Pierce Biotechnology Inc., Rockford, IL). Blots were semiquantified using a Kodak Gel Logic 200 imaging system.
Aggregation of bacteria. Bacteria (wild-type BC7 or mutants) were suspended in cell culture medium to a concentration of 1 x 106 CFU/ml and incubated for 2 h at 37°C. Bacteria were sampled carefully using a flat-tipped 18-gauge needle (to minimize dissociation of bacterial aggregates) from the bottom of the tube and observed under a light microscope to determine the aggregation pattern of bacteria.
Morphology of cultures. Squamous cultures before or after infection with bacteria were fixed in 10% buffered formalin overnight at 4°C and embedded in agar-paraffin (1). Sections (5 µm thick) were stained with hematoxylin and eosin for morphological evaluation. To localize CK13 or B. cenocepacia, sections were treated with antibody to CK13 or antibody to B. cenocepacia, respectively, as described previously (24, 25) and observed under a fluorescence microscope.
Transmission electron microscopy. Bacteria grown on agar plates in the presence of appropriate antibiotics were transferred to Formvar-coated grids and negatively stained with 1% phosphotungstic acid, as described previously (26, 32). Immunogold labeling of bacteria was carried out essentially as described previously (30). Antibody specific to the 22-kDa adhesin was used at a 1:20 dilution, and the secondary antibody, conjugated with 10-nm gold particles, was used at a 1:50 dilution. Grids were counterstained with 1% phosphotungstic acid and observed under a JEOL 1200 EXII transmission electron microscope at 80 kV.
Statistical analysis. Percentages of bacteria that were adherent, persistent, and proliferated or that had transmigrated were analyzed using analysis of variance (ANOVA) by modeling the natural logarithm transformation based on two ANOVA factors: infection type [wild-type, adhA::Tp, cblA::Tp, cblS::Tp, or cblS::Tp(pUCP18Tc-cblS)] and experimental variation. Model-based fold ratios (reported percentages of wild type) and 95% confidence intervals were calculated between strains of interest, and statistical tests were performed at the 0.05 level.
Nucleotide sequence accession number. Sequence data have been deposited in the GenBank database under accession number AY608695.
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FIG. 1. Deduced amino acid sequence of the 22-kDa adhesin gene. The signal peptide cleavage site is shown by an arrow pointing down between amino acids 136 and 137. Repeat regions are represented by alternate shading of the amino acid residues. Numbers on the right correspond to the repeat number. Asterisks on the repeats 1, 7, and 12 represent shorter repeats. The end of the last repeat is shown by an arrow pointing up. The amino acid sequence (determined by MS/MS analysis) of tryptic peptides generated from the isolated 22-kDa adhesin molecule is underlined.
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Construction of BC7 cblA, cblS, and adhA mutants. To understand the role of Cbl pili and the 22-kDa adhesin in the binding of B. cenocepacia to CK13 and transmigration across the squamous epithelial cell cultures, isogenic mutants of isolate BC7 were made by insertional mutagenesis in genes encoding the major Cbl pilin subunit, cblA, and the 22-kDa adhesin, adhA (Fig. 2). To determine whether expression of the adhesin is regulated by genes that control the expression of Cbl pili, we created an isogenic mutant of cblS, one of the regulatory genes of a multicomponent regulatory system that regulates the biogenesis of Cbl pili (48). Successful insertion of the trimethoprim resistance cassette in all three mutants was confirmed by PCR and Southern blot analysis (data not shown).
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FIG. 2. Construction of B. cenocepacia BC7 mutants in the 22-kDa adhesin and cbl pilus operon. (A) Physical map of the B. cenocepacia adhA gene with insertion of the trimethoprim resistance cassette. The adhA gene in BC7 corresponds to nucleotide numbers 2383022 through 2391644 on chromosome 2 in J2315. The adhA gene was interrupted at the AgeI site (344 bp from the start of translation) with a trimethoprim resistance (Tpr) cassette in the B. cenocepacia BC7 chromosome. The large arrow indicates the direction of adhA transcription. Primers generated for gene replacement strategy (adhA-1 and adhA-2) are represented by directional arrows. Asterisks indicate repeats with deletions or truncations. The scale legend corresponds to the size of an intact repeat unit. (B) Physical map of the cbl operon with insertion of trimethoprim resistance cassettes. Arrows indicate the direction of transcription. cblA and cblS were interrupted individually in the B. cenocepacia BC7 chromosome with a trimethoprim resistance cassette.
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FIG. 3. Immunoblot analysis of CblA and AdhA expression in BC7 and mutants. Whole-cell (a) or heat (b) extracts of B. cenocepacia (obtained from 1 x 108 CFU) were subjected to 10% sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and proteins were transferred to a polyvinylidene difluoride membrane. The membrane was probed with CblA antiserum (a) or with 22-kDa antibody (b). The bound antibody was detected by using the appropriate secondary antibody conjugated to horseradish peroxidase and chemiluminescent substrate. Molecular masses are indicated.
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FIG. 4. Transmission electron microscopy of bacteria. Bacteria grown on LB agar with appropriate antibiotics were transferred to Formvar-coated grids and negatively stained with 1% phosphotungstic acid. Panels a, b, and c represent wild-type BC7, cblS::Tp, and cblS::Tp(pUCP18Tc-cblS), respectively. Bars represent 100 nm.
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FIG. 5. Immunolocalization of adhesin. Bacteria grown on LB agar with appropriate antibiotics were transferred to Formvar-coated grids, incubated with 22-kDa antibody, and then incubated with anti-mouse IgG conjugated to colloidal gold. Samples were negatively stained with 1% phosphotungstic acid. Panels a, b, and c represent wild-type BC7, cblA::Tp, and adhA::Tp, respectively. Bars represent 500 nm.
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TABLE 2. Binding of wild-type and mutant BC7 to isolated CK13a
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TABLE 3. Adherence to and transmigration across the squamous epithelium by wild-type and mutant BC7a
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FIG. 6. Aggregation of bacteria. Wild-type BC7 or mutants (1 x 106 CFU/ml) were suspended in cell culture medium and incubated for 2 h at 37°C. Bacteria sampled from bottom of the tube were observed under a phase-contrast microscope. Panels a, b, and c represent wild-type BC7, cblA::Tp, and adhA::Tp, respectively. Bar represents 50 µm.
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FIG. 7. Immunolocalization of CK13. Paraffin sections of squamous culture were stained with either hematoxylin and eosin (a) or monoclonal antibody to CK13 antibody, and the bound antibody was detected by anti-mouse IgG conjugated with CY3 (b). Bar represents 100 µm.
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Basolateral medium from cultures infected with wild-type BC7 for 24 h showed 6.7 x 102 CFU/culture, demonstrating that wild-type BC7 transmigrates across squamous cultures (Table 3). In contrast, no bacteria were detected in medium from adhA::Tp-infected cultures, indicating that the adhesin is required for transmigration across the culture. Basolateral medium from cultures infected with cblA::Tp and cblS::Tp mutants showed 93 to 98% less bacteria than wild-type BC7 (P < 0.001 for both strains). Complementation of cblS::Tp with the wild-type cblS gene in trans restored the transmigration capacity of the cblS mutant.
Cell lysates from the cultures infected for 24 h with cblA::Tp, cblS::Tp, and adhA::Tp mutants showed slightly less bacteria than the cultures infected with wild-type BC7. The cblS::Tp mutant complemented with wild-type cblS in trans showed persistence and proliferation capacity that were comparable to those of wild-type BC7. In an independent experiment, we examined the growth rate of the wild type and mutants in cell culture medium alone up to 24 h. No difference in growth rate was observed between wild-type BC7 and mutants (data not shown). These results suggest that the observed attenuated transmigration capacity of Cbl and Adh mutants is not due to differential bacterial growth or persistence but rather correlates with the 22-kDa adhesin-mediated binding of B. cenocepacia to squamous epithelial cell cultures.
Damage to culture correlates with bacterial density. We examined hemotoxylin- and eosin-stained sections of cultures incubated with bacteria for 2 or 24 h to evaluate the damage to culture caused by BC7 or mutants. Neither the wild type nor any of the mutants caused damage to cultures during the first 2 h of infection (data not shown). In contrast, cultures infected for 24 h showed varying damage which corresponded to bacterial density. Cultures infected with wild-type BC7 showed localized damage to squamous epithelium (Fig. 8a) that was severe in areas where the bacterial density was high (Fig. 8b). Superimposition of Fig. 8a and b revealed the presence of bacteria on the apical surface as well as in the basal and suprabasal layers of culture (Fig. 8c). In contrast, cultures treated with the CblA mutant showed mild or no damage (Fig. 8d). Similar results were observed in cultures treated with CblS or AdhA mutants (data not shown). Immunolocalization experiments revealed that the majority of bacteria remain associated with the apical surface of cultures and are rarely found in the basal or suprabasal layers (Fig. 8e and f). Cultures treated with cblS::Tp complemented with cblS in trans showed damage and distribution of bacteria similar to that of wild-type BC7 (data not shown).
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FIG. 8. Morphology of cultures and immunolocalization of bacteria. Paraffin sections of squamous culture, incubated with wild-type BC7 (a, b, and c) or cblA::Tp (d, e, and f) for 24 h, were stained with hemotoxylin and eosin (a and d) or incubated with anti-B. cenocepacia antibody (R418). The bound antibody was detected by anti-rabbit IgG conjugated with CY3 (b and e). Panels c and f represent the superimposition of panels a and b and panels d and e, respectively. Bar represents 50 µm.
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The adhesin, which was previously identified as a protein with a molecular mass of 22 kDa by various biochemical methods (28, 29), is encoded by a large gene with a predicted sequence that is similar to putative hemagglutinins from Ralstonia solanacearum and Myxococcus xanthus, putative surface adhesins from Bordetella pertussis and Pseudomonas putida, an autotransporter adhesin of Vibrio vulnificus, and RTX toxins and related Ca2+-binding proteins from several bacterial species (4, 11, 19, 21, 36). The biochemically determined amino acid sequence of two tryptic peptides of the purified 22-kDa adhesin matched the inferred amino acid sequence of the adhA gene in the N terminus, suggesting that the 22-kDa adhesin may be a proteolytic product from the N terminus of a large polypeptide. Whether the large polypeptide precursor has a role in binding to CK13 is currently under investigation.
Although immunolocalization studies indicated physical association of the adhesin with Cbl pili, the present study suggests that the adhesin is not an integral member of Cbl pili, unlike well-studied E. coli pilin adhesins such as CooD, CFAE, PapG, and FimH, which are integral members of CS1, CFAI, P, and type I pili, respectively (10, 15, 34). Furthermore, expression of AdhA appears to be independent of CblA, as the inactivation of CblS, a regulator of cbl operon (48), completely abrogated the expression of CblA but not AdhA. Based on these observations, we speculate that Cbl pili and the adhesin protein are expressed independently of each other, that interaction of the adhesin with Cbl pili occurs after it is translocated to the surface, and that this event maintains the adhesin molecules at the bacterial surface. Attenuated binding to isolated CK13 exhibited by Cbl mutants and natural B. cenocepacia variants lacking only Cbl pili but not the adhesin (32) and partial loss of secreted adhesin from the surface of Cbl mutants further support the notion that in the presence of Cbl pili, the secreted adhesin remains attached to the surface pili, thereby facilitating bacterial binding to CK13 in the presence of Cbl pili.
Previously, by using nonisogenic strains lacking either Cbl pili or the adhesin, we have shown that the binding of B. cenocepacia to the CK13 receptor is necessary for the subsequent invasion and transmigration of bacteria across squamous epithelial cell cultures via paracellular and transcellular routes (24). B. cenocepacia expressing both Cbl pili and the adhesin is more efficient in binding to and transmigrating across squamous epithelium than the nonisogenic isolates expressing either Cbl pili or the adhesin alone. However, it was not possible to correlate the specific contribution of Cbl pili and the adhesin to these processes. In the present study, using isogenic strains, we have established that although the 22-kDa adhesin is sufficient for bacterial binding to isolated CK13 in bacterial overlay assays, the adhesin acting alone does not account for the maximal binding of B. cenocepacia to its CK13 receptor in a purified form or cell-associated form or bacterial transmigration across the multilayered squamous epithelial cell cultures. While the cblA and cblS mutants, which lacked Cbl pili but expressed the adhesin, showed significantly reduced binding and transmigration capacity, the adhA mutant, which lacked the adhesin but expressed Cbl pili, showed minimal binding to squamous cultures and failed to transmigrate across the multilayer squamous cultures as monitored by fluorescence microscopy and sampling of basolateral medium for bacteria. These studies confirmed that adhesin-mediated binding of B. cenocepacia to the CK13 receptor on squamous epithelial cell cultures is absolutely necessary for subsequent invasion and transmigration, but Cbl pili are also required, presumably to stabilize the interaction. The presence of Cbl pili probably also increases the amount of secreted adhesin that can be tethered to the bacterial surface, which, in turn, potentiates binding and transmigration capacity of bacteria.
In contrast to our findings, Tomich and Mohr recently reported that Cbl pili have a minimal role in B. cenocepacia binding to porcine gastric mucin or monolayers of A549 cells (47). This is not surprising, as those investigators were likely observing interactions between nonpilin adhesins and glycolipid receptors, as commercially available porcine mucin is not purified and contains abundant amounts of nonmucin peptides, proteoglycans, and glycolipids. Likewise, A549 cells grown as monolayers do not express CK13 (31) but have exposed basolateral glycolipid receptors. We and others have shown that members of Bcc, including nonpiliated B. cenocepacia, also bind to glycolipid receptors (12, 45). In the present study, we have either used purified CK13 or polarized and differentiated airway epithelial cells enriched in surface CK13, in which basolateral glycolipid receptors are not available for binding. These differences in cell preparations and receptor availability likely explain the different binding results obtained. Those same authors also showed that disruption of cable pilus biogenesis promotes autoaggregation and influences binding of the CblA mutant to epithelial and nonepithelial surfaces. However, in the present study, no such differences in autoaggregation patterns between the parent and mutants were observed, indicating that the observed binding is due to specific interaction between the CK13 receptor and the adhesin. This discrepancy may be due to a low number of bacteria and/or the presence of divalent cations in the suspension medium used in the present studies.
In summary, we have shown that both Cbl pili and the adhesin are necessary for optimal binding to CK13 and transmigration capacity of the B. cenocepacia ET12 lineage. Thus, the presence of Cbl pili and the associated adhesin may increase the infection potential of B. cenocepacia in cystic fibrosis patients. Although CK13 is predominantly a cytoplasmic protein and expressed in the basal layer of tracheal and bronchial epithelium under normal conditions, its expression is increased in airways undergoing squamous metaplasia due to repeated injury and repair. This state is frequently observed in cystic fibrosis patients (27, 40). Since CK13 is readily available on the apical surface of airway epithelium undergoing squamous metaplasia (27), we speculate that CF airways provide a suitable environmental niche for highly transmissible and potentially virulent Cbl- and adhesin-positive B. cenocepacia strains.
We thank Mark E. Smolkin, Department of Health Evaluation Sciences, University of Virginia, for advice on the statistical analyses. We thank Arlene Vinion-Dubiel for her invaluable insights regarding analysis of the adhesin amino acid sequence. Assistance from Yew Meng Heng (Department of Pediatric Laboratory Medicine, the Hospital for Sick Children) in electron microscopy is greatly appreciated.
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