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Infection and Immunity, April 2006, p. 2442-2445, Vol. 74, No. 4
0019-9567/06/$08.00+0 doi:10.1128/IAI.74.4.2442-2445.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Wolbachia- and Onchocerca volvulus-Induced Keratitis (River Blindness) Is Dependent on Myeloid Differentiation Factor 88
Illona Gillette-Ferguson,1
Amy G. Hise,2
Yan Sun,1
Eugenia Diaconu,1
Helen F. McGarry,3
Mark J. Taylor,3 and
Eric Pearlman1,2*
Department of Ophthalmology,1
Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio,2
Filariasis Research Laboratory, Molecular and Biochemical Parasitology, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, United Kingdom3
Received 11 January 2005/
Returned for modification 15 February 2005/
Accepted 9 January 2006

ABSTRACT
Endosymbiotic
Wolbachia bacteria that infect the filarial nematode
Onchocerca volvulus were previously found to have an essential
role in the pathogenesis of river blindness. The current study
demonstrates that corneal inflammation induced by
Wolbachia or
O. volvulus antigens containing
Wolbachia is completely dependent
on expression of myeloid differentiation factor 88.

TEXT
The presence of intracytoplasmic bacteria in
Onchocerca volvulus was first described in 1977 (
13), and these bacteria were later
identified as endosymbiotic
Wolbachia (
10). Proinflammatory
responses in filarial-infected individuals and animals exposed
to filaria have indicated that
Wolbachia rather than the nematode
is the cause of inflammation (
3,
4,
12,
21).
Wolbachia bacteria
are essential for the pathogenesis of
O. volvulus-induced keratitis,
since (i) corneal inflammation was not induced by extracts derived
from
O. volvulus depleted of
Wolbachia by doxycycline treatment
of infected individuals and (ii) related filarial species containing
Wolbachia induce keratitis but aposymbiotic species lacking
Wolbachia do not (
18). Both the systemic inflammatory response
and the inflammatory response in the cornea were significantly
reduced in C3H/HeJ mice (
18,
21), which have a point mutation
in the gene encoding Toll-like receptor 4 (TLR4) (
16). Furthermore,
the major surface protein of
Wolbachia activates TLR2 and TLR4
(
2). As TLR2 and TLR4 signal through the common myeloid differentiation
factor 88 (MyD88) adaptor molecule, (
19,
20,
22), we utilized
MyD88
/ mice to examine the role of this intracellular
signaling molecule in
Wolbachia- and
O.volvulus-induced keratitis.
Although our previous study demonstrated that Wolbachia has an essential role in O. volvulus-induced keratitis, we did not determine whether Wolbachia could induce keratitis in the absence of filarial antigens. Since insect Wolbachia from the Aa23 mosquito cell line activates macrophages (21), we determined whether this Wolbachia also induces keratitis. Isolated insect Wolbachia and a soluble O. volvulus antigen extract containing Wolbachia (OvAg) were quantified by PCR for the single-copy wsp gene as described previously (5, 14). Four microliters was injected into the corneal stroma of MyD88/ mice and wild-type littermates, and the mice were sacrificed 18 h later at the peak of neutrophil infiltration (6). Eyes were embedded in paraffin, and 5-µm sections of the corneal stroma were immunostained with NIMP-R14, which is specific for neutrophils (6). As shown in Fig. 1A, Wolbachia induced a dose-dependent neutrophil infiltrate in the corneal stroma of immunocompetent mice. In marked contrast, no neutrophils were detected in the corneal stroma of MyD88/ mice, even with the largest inoculum (Fig. 1A). Neutrophils were also absent in the corneas of MyD88/ mice inoculated with O. volvulus extract compared with control mice (Fig. 1B). Figure 1C shows that the corneas of inoculated MyD88/ mice were similar to saline controls.
The presence of neutrophils in the corneal stroma leads to loss
of corneal transparency and can be measured by determining corneal
haze by in vivo confocal microscopy (
11).
Wolbachia or
O. volvulus extract containing
Wolbachia was injected into the corneal stroma
of control and MyD88
/ mice as described above,
and corneal haze was calculated from stromal thickness and light
intensity in combined images of the corneal stroma (
11). Figure
2 shows that injection of
Wolbachia induced elevated levels
of corneal haze in wild-type, immunocompetent mice compared
with the haze in saline-inoculated mice. In contrast, there
was no increase in corneal haze in
Wolbachia-inoculated MyD88
/ mice compared with saline-inoculated corneas. Similar results
were obtained for control and MyD88
/ mice inoculated
with OvAg (Fig.
2B). Together with the impaired neutrophil recruitment
to the corneas of MyD88
/ mice, these findings
demonstrate that keratitis induced by
Wolbachia and
O. volvulus extracts is completely dependent on MyD88.
We previously demonstrated that neutrophil recruitment to the
corneal stroma in immunized mice is dependent on CXCR2 and that
intrastromal injection of
O. volvulus stimulates CXC chemokine
production by resident corneal cells (
6). To determine if MyD88
is required for CXC chemokine production,
O. volvulus antigen
containing
Wolbachia was injected into the corneal stroma of
control and MyD88
/ mice. After 6 h, the peak time
for CXC chemokine production and prior to neutrophil infiltration
(
6), corneas were dissected and sonicated, and the levels of
chemokines were determined by an enzyme-linked immunosorbent
assay (ELISA). As shown in Fig.
3, the levels of both KC/CXCL1
and MIP-2/CXCL2 were significantly elevated in wild-type corneas
inoculated with OvAg compared with the levels in saline-treated
corneas (
P < 0.05). However, neither chemokine was detected
in MyD88
/ mice, indicating that production of
these CXC chemokines by resident cells in the cornea was completely
dependent on MyD88.
As neutrophils also produce CXC chemokines in response to filarial
antigens containing
Wolbachia (
5), which likely exacerbates
neutrophil infiltration into the cornea, we examined the role
of MyD88 in neutrophil activation. Peritoneal neutrophils from
control and MyD88
/ mice were isolated and incubated
with isolated
Wolbachia. Figure
4 shows that neutrophils incubated
with
Wolbachia produced KC/CXCL1, MIP-2/CXCL2, and tumor necrosis
factor alpha. In contrast, neutrophils from MyD88
/ mice did not produce any of these cytokines in response to
Wolbachia or lipopolysaccharide (LPS), although MyD88
/ neutrophils
produced CXCL2/MIP-2 in response to phorbol myristate acetate,
a non-TLR stimulus. Together, these data show that MyD88 has
an essential role in
Wolbachia-induced neutrophil activation
and cytokine production.
In summary, the results of the current study show that
Wolbachia-
and
O. volvulus-induced keratitis is completely ablated in MyD88
/ mice, demonstrating that the MyD88-dependent pathway has an
essential role in this model of river blindness. Given that
specific activation of TLR2, TLR4, and TLR9 in the mouse cornea
requires MyD88 to induce corneal inflammation (
11) and that
neutrophils express TLRs and are activated by
Wolbachia (
5,
9), we propose that the response to
Wolbachia is initiated by
TLRs on resident cells in the corneal stroma. Secretion of CXC
chemokines by these cells mediates neutrophil recruitment from
the peripheral, limbal vessels into the avascular cornea and
migration through the stromal matrix to the site of microfilaria
degradation and release of
Wolbachia (
5). A second role for
MyD88 in the inflammatory process is to initiate neutrophil
activation and production of CXCL1/KC, CXCL2/MIP-2, and tumor
necrosis factor alpha in response to
Wolbachia, further mediating
neutrophil recruitment. Neutrophil activation also leads to
secretion of cytotoxic products, such as nitric oxide and oxygen
radicals that disrupt the normal function of resident corneal
cells, thereby leading to loss of corneal clarity.
Results of previous studies suggested that the inflammatory responses induced by Wolbachia and filaria extracts were mediated by LPS-like activity in Wolbachia (15, 18, 21); however, complete genome sequencing of Wolbachia from insects and Brugia malayi indicated that Wolbachia lacks the biosynthetic machinery for LPS (23; http://tools.neb.com/wolbachia). Although Wolbachia peptidoglycan and lipoproteins have not been tested yet, ligands for TLR2 and TLR4 are present in the Wolbachia surface protein, which is abundantly expressed in insect and filaria Wolbachia, is highly conserved among filarial species, and is recognized by filaria-infected individuals (1, 2, 17). Wolbachia surface protein from Dirofilaria immitis activates cells through TLR2 and TLR4 signaling in transfected fibroblasts, murine dendritic cells, and macrophages (2). As TLR2 and TLR4 signal through MyD88, these findings are consistent with our current findings and suggest that MyD88-independent pathways do not contribute to Wolbachia-mediated inflammatory responses.
In chronically infected individuals, adaptive immunity is established before significant microfilaria invasion of the corneal stroma; however, innate responses to Wolbachia in the cornea appear to be the triggering events for neutrophil infiltration and loss of corneal clarity, which is exacerbated in the presence of antibody and after recruitment of eosinophils (7, 8). Further studies of Wolbachia surface protein and other possible Wolbachia TLR ligands should reveal the contribution of the TLR pathways to the activation of innate and acquired immune responses to Wolbachia and filarial antigens associated with disease pathogenesis.

ACKNOWLEDGMENTS
This work was supported by NIH grants EY10320 (to E.P.), AI-07024
(to I.G.-F.), K08 AI054652 (to A.G.H.), and EY11373, by the
Research to Prevent Blindness Foundation, and by the Ohio Lions
Eye Research Foundation. M.T. thanks the Wellcome Trust for
Senior Fellowship support and the EC (grant ICA4-CT2002-10051).
MyD88/ mice were generously provided by S. Akira, Osaka, Japan.

FOOTNOTES
* Corresponding author. Mailing address: Department of Ophthalmology and Center for Global Health and Diseases, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-7286. Phone: (216) 368-1856. Fax: (216) 368-4825. E-mail:
Eric.Pearlman{at}case.edu.

Editor: J. F. Urban, Jr.

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Infection and Immunity, April 2006, p. 2442-2445, Vol. 74, No. 4
0019-9567/06/$08.00+0 doi:10.1128/IAI.74.4.2442-2445.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
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