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Infection and Immunity, September 2006, p. 4982-4989, Vol. 74, No. 9
0019-9567/06/$08.00+0 doi:10.1128/IAI.00476-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Division of Infectious Diseases, Department of Internal Medicine,1 Center for the Study of Emerging and Re-emerging Pathogens,2 Department of Microbiology and Molecular Genetics, University of Texas Medical School, Houston, Texas 770303
Received 23 March 2006/ Returned for modification 27 April 2006/ Accepted 12 June 2006
| ABSTRACT |
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| INTRODUCTION |
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Knowledge of the factors that influence the ability of E. faecalis to colonize host tissues is beginning to emerge. During the past decade, E. faecalis has been shown in various studies using different methodologies to adhere to one or more host extracellular matrix (ECM) proteins such as collagen types I and IV (CI and CIV), laminin (LN), fibronectin, lactoferrin, vitronectin, and thrombospondin (6). Using a standard in vitro adherence assay, Xiao et al. (29) reported that adherence of E. faecalis to collagen and LN was seen only after growth under a nonphysiological stress condition (i.e., at 46°C). Seemingly in contrast to this observation, Tomita et al. (27) recently demonstrated collagen and LN adherence phenotypes of several E. faecalis clinical isolates by using a microscopic technique; however, this assay appears to be more sensitive than adherence studies that assess the percentage of bacteria bound.
By searching for homologues of known adhesins, Rich et al. (22) identified a gene in E. faecalis subsequently named ace (for adhesin of collagen from E. faecalis) and localized the specific CI binding property of Ace to the A domain based on biochemical evidence. Our further genetic analyses with an isogenic mutant demonstrated that Ace mediates the conditional (i.e., after growth at 46°C) adherence of E. faecalis to CIV and LN (19), in addition to dentin, a stabilized form of collagen (10). The study by Tomita et al. (27) that scored transposon insertion mutants of E. faecalis tissue-specific adhesive clinical strain also found that ace knockouts lacked CIV and LN adherence.
Our subsequent analyses of the ace gene from E. faecalis strains recognized that this gene is ubiquitous (2) and occurs in at least four different forms due to variation in the number of repeats of the B domain (20). Conditional in vitro production of Ace by different strains, detected by using polyclonal anti-Ace antibodies, was correlated with the conditional adherence of these E. faecalis strains to collagen and LN (20). Most recently, a role for Ace as a virulence factor was shown by using an arthritis model by expressing it in a surrogate host; in that study, Ace-expressing Staphylococcus aureus showed increased arthritogenic potential, to a level similar to that of S. aureus expressing Cna, a collagen-binding S. aureus homologue of Ace (30).
It is well known that bacteria can alter the expression of certain genes upon binding and replicating on a substrate, possibly via the mediation of various environment signals including collagen (1, 4, 9, 28). Previous studies have suggested that physiologically relevant cues, such as serum, may increase the adhesion of E. faecalis to heart cells (7, 8), to cultured renal tubular cells (11), and to CI (13). However, the specific signals that are sensed in serum remain largely unknown. An exploratory study by Shepard and Gilmore (24) compared mRNA levels of predicted E. faecalis virulence factors in cultures grown in serum, urine, or laboratory medium and identified environment- and growth-phase-specific variations in several virulence-related genes, including ace. However, an effect of these gene expression changes on phenotype(s) has yet to be elucidated. The present study was designed to examine ace transcription during in vitro growth conditions that mimic more physiological ones. Here, by measuring the levels of ace mRNA using quantitative reverse transcription-PCR (qRT-PCR), we demonstrate the upregulation of ace transcription when E. faecalis cultures were grown in the presence of CIV. Surface-localized Ace was detectable after growth in the presence of CIV, and it was correlated with increased adherence to CIV and LN.
| MATERIALS AND METHODS |
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ECM proteins and collagenase digestion. Bovine CI was purchased from Cohesion Technologies, Inc. (Palo Alto, Calif.), human-placenta-derived CIV was from Sigma Chemical Co. (St. Louis, Mo.), fibrinogen was from Enzyme Research Laboratories (South Bend, Ind.), and bovine serum albumin (BSA) was from MP Biomedicals, Inc. (Irvine, Calif.).
To eliminate collagen for certain reactions, CIV was suspended (0.5 mg/ml) in 50 mM Tris-HCl (pH 7.0) containing 40 mM CaCl2 and then incubated at 10°C for 18 h with Clostridium histolyticum collagenase (Sigma Chemical Co.) at a substrate/enzyme ratio of 10:1 (14). The reaction mixture was dialyzed against 0.25% (wt/vol) acetic acid at 4°C for 4 days with five changes, freeze-dried, and resuspended in 0.25% (wt/vol) acetic acid.
Gene expression analysis. (i) Extraction of total RNA. Total RNA was isolated from E. faecalis cultures by using an RNeasy minikit (QIAGEN, Valencia, Calif.) according to the protocol of the supplier with some modifications. A lysozyme solution at 10 mg/ml was used instead of 3 mg/ml for the lysis step. Total RNA (20 to 40 µg) was treated three times with 20 U of RQ1 DNase (Promega Corp., Madison, Wis.) for 30 min at 37°C, and the DNase was removed by using the RNeasy minikit. The RNA concentration was determined by using a spectrophotometer. Part of each sample was electrophoresed through an agarose-formaldehyde gel in morpholinepropanesulfonic acid buffer as previously described (23).
(ii) RT-PCR. Total RNA (between 5 ng to 250 ng) was reverse transcribed with ace specific primers (AceMF, 5'-ACGATTGAAGGAGTGACTAACACA-3'; AceMR; 5'-AAGTGTAACGGACGATAAAGGAAG-3') using the SuperScript One-Step RT-PCR with a Platinum Taq kit (Invitrogen Corp., Carlsbad, Calif.) according to the manufacturer's instructions. As an internal control, a 528-bp fragment of gdh (encoding GAPDH [glyceraldehyde-3-phosphate dehydrogenase]) was amplified by using the gdhF (5'-AGTGGCGCACTAAAAGATATGG-3') and gdhR (5'-AGTTGTATTGAACCCTTGACCG-3') primers. Reactions without reverse transcriptase were performed as controls to detect DNA contamination in the total RNA preparations.
(iii) Real-time qRT-PCR.
Amplification, detection, and real-time analysis were performed by using the ABI Prism 7500 sequence detection system (Applied Biosystems, Foster City, Calif.). Primers designed to produce amplicons of equivalent length were selected by using Primer Express software (Applied Biosystems). The primer pairs used in qRT-PCR included AceQF1 (5'-GGAGAGTCAAATCAAGTACGTTGGTT-3')-AceQR1 (5'-TGTTGACCACTTCCTTGTCGAT-3') and 23S-rRNAF (5'-GTGATGGCGTGCCTTTTGTA-3')-23S-rRNAR (5'-CGCCCTATTCAGACTCGCTTT-3'). For each sample, cDNA synthesis and PCR amplification were performed in a two-step process. For cDNA synthesis, 4 µg of total RNA was added to 20-µl reaction solution containing 40 U of RNase OUT, and RT reactions were performed with random primers and SuperScript II reverse transcriptase (Invitrogen). The reaction was stopped by heating at 70°C for 15 min. After the RNA complementary to the cDNA was removed with E. coli RNase H (Invitrogen), the cDNA was purified by using QiaQuick PCR purification kit (QIAGEN). The resulting cDNA diluted up to 500 times was used for subsequent PCR amplification with the appropriate forward and reverse gene specific primers and the SYBR Green PCR Master Mix kit (Applied Biosystems). The following PCR conditions were used: 10 min at 95°C for the initial denaturation, followed by 40 cycles of 95°C for 15 s and 60°C for 1 min. All PCR fragments yielded a single band on an agarose gel. Relative quantification of gene expression was performed by using 23S rRNA mRNA as the internal standard. The 
CT method (12) was used to calculate the relative amount of specific RNA present in a sample, from which the fold induction of transcription of the gene was estimated by comparing to the values of OG1RF grown in BHI. The data were expressed as the mean ± the standard deviation. The statistical significance was determined by using the Student unpaired t test. Amplifications were performed on four independent RNA samples from each milieu.
Immunofluorescence microscopy. E. faecalis cells either cultured in the presence or absence of ECM proteins in BHI or grown in 40% horse serum in BHI were washed thrice with Dulbecco phosphate-buffered saline (D-PBS) without CaCl2 and MgCl2 and then resuspended in D-PBS to a final optical density at 600 nm (OD600) of 0.5. Next, 400 µl of cell suspensions were applied to Lab-Tek-II chamber slides (Nalge Nunc International Corp., Naperville, Ill.) that were coated with poly-D-lysine (Sigma) and incubated for 30 min at room temperature with shaking at 100 rpm. After four washes with D-PBS, chamber slides were blocked with 1 ml of D-PBS containing 2% BSA at room temperature for 45 min, washed once with D-PBS, and then incubated with 400 µl of a 1:3,000 dilution for anti-Ace polyclonal serum (19) for 1 h. After four washes with D-PBS, attached bacteria in chamber slides were incubated with 400 µl of rhodamine red-labeled goat anti-rabbit immunoglobulin G (1:1,000 dilution) (Molecular Probes, Eugene, Oreg.) at room temperature for 1 h in the dark. After four washes, excess D-PBS was removed and a coverslip was mounted. The slides were examined by epifluorescence microscopy using an Olympus BX51 microscope with a x100 oil immersion objective lens (Olympus, Tokyo, Japan). Digital images were acquired by using an Olympus DP-70 digital camera. Preimmune serum was used as a negative control.
Adherence assay. Adherence of E. faecalis to CIV- and LN-precoated six-well plates (Becton Dickinson Biosciences, Bedford, Mass.) was determined by using an Olympus BX51 microscope. Each well of ECM-precoated plates were blocked with 5 ml of 0.2% BSA in PBS, incubated at 4°C for 2 h, and then washed with PBS three times. Cell pellets from E. faecalis cells either cultured in the presence or in the absence of ECM proteins were washed two times in PBS and resuspended in 0.1% Tween 80-0.1% BSA in PBS. The cell density was adjusted to an OD600 of 0.2, and 1 ml of bacteria was added into each well, followed by incubation at room temperature for 2 h with gentle shaking at 70 rpm. Wells were washed three times with 0.1% Tween 80-0.1% BSA in PBS. The numbers of bacterial cells that adhered to the surface of the ECM were counted from 10 randomly chosen fields of vision. Each experiment was performed four times. Statistical analysis was determined by using the Mann-Whitney test, and the differences were considered significant when the P value was <0.05.
| RESULTS AND DISCUSSION |
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Minimal transcription of ace after growth in vitro in BHI. Total RNA of OG1RF grown at 37°C in BHI was isolated during mid-exponential phase, late-exponential phase, entry into stationary phase, and 5 h after the cultures entered stationary phase (Fig. 1A), and the levels of ace and gdh (housekeeping control) mRNA were analyzed. The ace mRNA was barely detected at the mid-exponential and late exponential phases, as well as at entry into stationary phase, and was not detectable in cells at stationary phase (Fig. 1B and C, lanes 2 to 5). As anticipated, the control gdh gene was constitutively expressed in all phases, although, at stationary phase, gdh mRNA levels were slightly reduced (Fig. 1B and C, lanes 6 to 9). This result suggests that ace transcription is very low during standard in vitro growth conditions. We next analyzed the RNA of OG1RF grown at 46°C isolated at mid-exponential phase and at entry into stationary phase (Fig. 1A). Increased ace mRNA was detected at both growth phases (Fig. 1B and C, lanes 15 and 16) and the ace RT-PCR band intensities were almost comparable to control gdh RT-PCR band intensities at all of the concentrations of total RNA tested (Fig. 1B and C, lanes 17 and 18). These results are in agreement with our previous findings of detectable levels of Ace from mutanolysin surface extracts (19) of OG1RF grown at 46°C.
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Intact collagen peptides but not collagenase-derived digests induce ace expression. To investigate whether induction of ace transcripts was associated with the structure and/or sequence of collagen peptides or with its primary repeat tripeptides (Gly-X-Y), RT-PCR was carried out by using cultures incubated with collagenase-digested CIV. No change in transcript levels of ace was observed, and the levels remained similar to those for BHI-grown cells (Fig. 2B, lane 9), suggesting that induction of the ace transcripts was associated with intact collagen peptides.
A serum-rich environment affects the expression of ace gene. In an effort to identify other physiological conditions that upregulate ace expression, we tested ace transcript amounts after growth in BHI supplemented with serum. As shown in Fig. 2A, lane 7, growth in 40% horse serum increased the levels of ace mRNA. This observation is in agreement with a previous study (24) that showed a 3.3-fold increase in ace mRNA abundance upon growth in serum compared to growth in 2xYT (yeast extract, tryptone, sodium chloride) medium. Of note, growth in serum resulted in the formation of aggregates both in OG1RF and in TX5256 (ace mutant), indicating that this phenomenon is not dependent upon Ace.
Quantification of ace transcript induction. To measure the fold differences in ace transcription, real-time qRT-PCR was used. The transcription level of 23S rRNA was not significantly affected by growth under any of the conditions tested and, hence, was used for normalization. Comparisons were made between values obtained from the total RNA of E. faecalis cultured in the presence CIV, fibrinogen, or growth at 46°C relative to those from BHI cultures grown at 37°C. Thus, ace mRNA after growth in BHI at 37°C was normalized to a value of 1 as the baseline for comparison. The results showed that there is an 18-fold increase in the ace mRNA levels in cultures grown in BHI containing CIV compared to cells grown in BHI alone (Fig. 3). As anticipated from semiquantitative RT-PCR, the levels of ace mRNA was not altered either in the presence of fibrinogen or by pH. Furthermore, ace mRNA levels of 46°C grown cells was observed to be 2.3-fold more than the levels of cells grown in the presence of CIV (41-fold versus BHI).
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Collagen- and laminin-binding ability of E. faecalis as a function of upregulated ace expression. E. faecalis OG1RF and its isogenic ace disruption mutant, TX5256, were tested for their ability to adhere to immobilized CIV and LN by using microscopy. The cells of OG1RF grown in BHI in the presence of CIV, but not in those grown in BHI alone, adhered to CIV (Fig. 5A) and LN (Fig. 5B), whereas the ace mutant (TX5256) was completely defective in adherence to CIV and LN regardless of its growth conditions. This corroborates our earlier observation that Ace mediates the adherence of E. faecalis OG1RF grown at 46°C to immobilized CIV and LN. Thus, these results demonstrate that E. faecalis adhesion is enhanced directly in response to a host matrix-derived peptide signal. This mechanism of modulation of E. faecalis-collagen interaction is different from the mechanisms reported in S. aureus (5) and E. faecium (21) to alter their collagen adherence.
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Although the ability to adhere to the most abundant host protein, collagen, would intuitively appear to be beneficial to E. faecalis during colonization, it may be of a selective disadvantage during growth in the environment, during transmission or dissemination of infection, and also during chronic infection to avoid the immune response. Therefore, we speculate that E. faecalis may have developed this strategy of programmed response to express proteins such as Ace.
In summary, upregulation of ace gene transcription in the presence of collagen type IV in E. faecalis OG1RF was demonstrated. Although we have yet to delineate the precise mechanism, we have confirmed that expression of Ace, and thereby collagen and laminin adherence, occurs under more physiological conditions than growth at 46°C. Ace induction by other environmental conditions, such as growth in serum and growth at high temperature, suggests the possibility that ace gene expression may be regulated by different mechanisms. Conservation of this induction mechanism in four of four different strains tested suggests that this may be a common programmed response in E. faecalis. Furthermore, understanding of this host matrix protein-associated triggering of a microbial pathogenic response may have important future clinical implications for this emerging multiresistant pathogen.
| ACKNOWLEDGMENTS |
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This study was supported by NIH grant R37 AI 47923 from the Division of Microbiology and Infectious Diseases to B.E.M.
| FOOTNOTES |
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