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Infection and Immunity, May 2007, p. 2225-2233, Vol. 75, No. 5
0019-9567/07/$08.00+0 doi:10.1128/IAI.01513-06
Copyright © 2007, American Society for Microbiology. All Rights Reserved.


Department of Microbiology and Immunology, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd., Bethesda, Maryland 20814
Received 20 September 2006/ Returned for modification 6 December 2006/ Accepted 24 January 2007
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Professional phagocytes utilize both O2-independent and O2-dependent mechanisms to kill bacteria. An important arm of the O2-dependent defense is the production of reactive oxygen species (ROS) via a cascade of reactions known as the phagocytic respiratory burst. Fueled by molecular O2 and glucose, the first step of the respiratory burst is the generation of superoxide anion (O2), which is catalyzed by NADPH oxidase within the phagocytic vacuolar membrane. O2 is rapidly converted to H2O2 in the presence of iron or spontaneously dismutates to H2O2 in the low pH of the phagocytic vacuole. H2O2 reacts with Fe2+ to produce OH· or with myeloperoxidase to generate hypochlorous acid (HOCl). The ROS produced by this chain of reactions are deleterious to microbes through their effects on DNA, protein, and other macromolecular structures (45).
N. gonorrhoeae is equipped with a battery of antioxidant factors that may neutralize ROS produced by phagocytes during infection (40). The increased sensitivity of genetically defined kat mutants to H2O2 or chemical inducers of oxidative stress (25, 43, 48) and the fact that this enzyme is produced at relatively high levels among bacteria (1, 20) suggests that catalase protects N. gonorrhoeae against the phagocytic respiratory burst. This hypothesis is indirectly supported by the detection of increased catalase activity in N. gonorrhoeae exposed to PMNs (54). Recently, however, Seib et al. (39) questioned the role of catalase in defense against PMN killing by demonstrating that N. gonorrhoeae mutants in kat and other antioxidant genes were not more susceptible to killing by human PMNs. Although this result may be predictive of the importance of gonococcal catalase in vivo, the use of in vitro assays to study the bacterial evasion of PMNs may be compromised by the difficulty in reproducing the intricate balance of bacterial and host factors in inflammatory foci. Most investigations of gonococcal evasion of PMN killing have been performed under conditions that do not reproduce the O2 tension and iron concentration of specific body sites, which along with glucose are critical in dictating the potency of the respiratory burst. The design of appropriate assay conditions is further complicated by the dramatic effect of pH on O2 consumption by PMNs (16) and the fact that lactate also influences the oxidative capacity of PMNs when in the presence of N. gonorrhoeae (8). In addition, sialylation of lipooligosaccharide (LOS), which in N. gonorrhoeae requires exogenous substrate provided artificially or by the host, should also be considered in the design of such studies since LOS sialylation clearly influences gonococcal interactions with phagocytes (18, 37, 52). Environmental stimuli may also influence the expression of catalase and other antioxidant factors (40), which may or may not be present in certain assay media.
Although several host restrictions limit the usefulness of nonhuman primates in studying gonococcal pathogenesis, N. gonorrhoeae can infect the lower genital tract of female mice provided they are given 17ß-estradiol to promote a proestrus, followed by an estrus-like state, which we (13) and others (6, 24) have shown to be the stages of the murine estrous cycle that are transiently susceptible to gonococcal colonization. The appropriateness of the mouse model for testing predictions about the role of gonococcal catalase in vivo includes the presence of several important similarities between the lower genital tracts of mice and women such as O2 and iron concentrations, the presence of glucose and lactate (14), commensal flora (22, 23), and a vaginal pH in mice that is similar to that of the human endocervix (6). Importantly, ca. 50% of infected mice elicit a localized PMN response to gonococcal infection (22), gonococci become sialylated during murine infection, and interactions between mouse PMNs and sialylated gonococci closely parallel that which has been reported for human PMNs (52). Accordingly, here we focused on catalase as a potentially critical player in gonococcal survival during experimental genital tract infection of mice. We also examined the interactions between murine PMNs and N. gonorrhoeae to further define the usefulness of the mouse model for studying gonococcal evasion of an inflammatory response.
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1.2 kb) is a mutant of FA1090 in which the kat gene was inactivated via an in-frame deletion (43). The frozen stocks of wild-type and kat mutant gonococci used here consisted primarily of piliated, OpaB variants that expressed a single LOS species on an 8 to 16% gradient of sodium dodecyl sulfate-polyacrylamide gel as assessed by silver staining of proteinase K-treated bacterial lysates (46). All Neisseria strains were cultured in 7% CO2 at 37°C on GC agar supplemented with Kellogg's supplement I and FeNO3 as described previously (22). Supplemented GC broth with 5 mM NaHCO3 was used for in vitro growth curves, which were determined with shaking under ambient conditions. GC-VCNTS (vancomycin, colistin, nystatin, trimethoprim sulfate, and streptomycin) agar was used to isolate N. gonorrhoeae from vaginal mucus. All media were from Difco Laboratories (Detroit, MI). Isolation of murine PMNs. Murine PMNs were elicited by intraperitoneal injection of 2.5 ml of 3% thioglycolate broth (3) and collected by peritoneal lavage 5 h later using cold Hanks balanced salt solution (HBSS) and an 18-gauge needle. Thioglycolate broth was prepared in endotoxin-free water (29.5 g/liter); the broth was gently boiled for 20 min, autoclaved for 30 to 45 min, and stored at 4°C in 50-ml conical tubes after cooling. All glassware was baked overnight at 225°C and autoclaved for 1 h before use. For each experiment, PMNs from two to three mice were pooled, centrifuged, and washed as described previously (52) before resuspending them in 4 to 5 ml of HBSS complete buffer (HBSS with 10 mM glucose, 0.1% gelatin, 1 mM CaCl2, and 1 mM MgCl2). The final concentration of PMNs was determined by using a hemacytometer; trypan blue was used to confirm that >95% of the PMNs were viable.
Acridine orange-trypan blue staining. Gonococcal association with and internalization by PMNs were measured by the acridine orange fluorescence staining assay described by others (4) with the modification that trypan blue was used to visualize intracellular bacteria. Trypan blue is excluded by PMNs and thus quenches only the fluorescence of extracellular bacteria stained with acridine orange. Incubation of gonococci with PMNs was as described previously (52) except that phorbol myristate acetate (10 ng) was added 10 min before bacteria was added to the wells. Gonococci were preincubated with 10% normal mouse serum (NMS) or heat-inactivated mouse serum (HI-NMS) (56°C, 10 min) before it was added to the PMNs at a multiplicity of infection of 10:1 (bacteria to PMN). After 30, 60, 90, and 135 min of incubation at 37°C under 5% CO2, two sets of triplicate coverslips were washed with 1 ml of HBSS. One set was stained for 45 s with acridine orange (Difco), rinsed with HBSS, and mounted onto a slide. The second set was stained as described above, counterstained with 0.5 ml of 0.4% trypan blue for 45 s, and washed with HBSS. Inverted, stained coverslips were sealed onto glass slides with nail polish. One hundred PMNs were examined per coverslip by using a fluorescence microscope, and the number of PMNs with 0, 1 to 2, 3 to 10, or more than 10 bacteria was recorded. The average number of PMNs in each category was calculated from three coverslips stained with acridine orange alone or acridine orange plus trypan blue.
Opsonophagocytic killing assay. A modification of the "tumbling tube" protocol described by Rest et al. (36, 37) was utilized to assess PMN killing. Briefly, 1-ml suspensions containing 5 x 105 PMNs in complete HBSS buffer containing NMS or HI-NMS at a final concentration of 10% were pipetted into 2-ml polypropylene microcentrifuge tubes. Cell suspensions were placed on a rotary shaker in room air for 10 min at 37°C. Wild-type or GP501 bacteria (2.5 x 105 to 5.0 x 105 CFU) that were preincubated in 10% NMS or HI-NMS for 15 min were added to the PMNs. After 45, 90, and 135 min of incubation, 10-µl samples were serially diluted in GC broth with 0.05% saponin and cultured on GC agar. Killing was measured by comparing the average number of CFU recovered from tubes containing NMS-opsonized bacteria to that from tubes containing bacteria incubated in HI-NMS. A control tube with no PMNs was included in each assay to assess bacterial viability over time. Serum was from mice treated with 17ß-estradiol; we have since found no difference in the degree of killing when serum from untreated mice is used. Staphylococcus aureus (strain RN6390B) was used to standardize the assay (provided by Guangyong Ji, Catholic University).
Chemiluminescence assay. The oxidative response of murine PMNs to N. gonorrhoeae was measured by luminol-dependent chemiluminescence (LDCL) (7, 29). Briefly, gonococci were opsonized for 15 min at 37°C in 10% NMS, centrifuged, and washed once with HBSS complete buffer. Murine PMNs were suspended at a concentration of 5 x 105 PMNs/ml in complete HBSS buffer and preincubated with luminol (0.1 mg/ml in HBSS) in a 5-ml scintillation vial for 2 min at 37°C (final volume, 1 ml). Bacteria were added at ratios ranging from 5:1 to 50:1 (bacteria to PMN). In some experiments, cytochalasin B (5 µg/ml) was added to the PMNs. The production of primarily extracellular versus intracellular ROS was assessed by incorporating bovine catalase (2,000 U) or horseradish peroxidase (HRP; 4 U) and 1 mM NaN3 to the reaction vials, respectively. Chemiluminescence signal was measured in a scintillation counter (model LS6100) at 0.2-min intervals using the preset full tritium window with the counter in normal in-coincidence mode for a defined period of time.
Experimental murine infection. Treatment of female BALB/c mice (6 to 8 weeks old; National Cancer Institute) with 17ß-estradiol and antibiotics was as described previously (22) except that a lower dose of streptomycin sulfate (0.24 mg, twice daily) was used. Mice were inoculated intravaginally with wild-type FA1090 or kat mutant GP501 bacteria (five to eight mice per group) harvested from GC agar into phosphate-buffered saline with 1 mM MgCl2 and 2 mM CaCl2 after 19 h of incubation. Inocula were filtered to eliminate bacterial aggregates and quantitatively cultured on GC agar to verify the dose. Vaginal mucus from mice was quantitatively cultured on GC-VCNTS agar daily for 12 days, except for infections using 105 CFU in which qualitative cultures were performed. Stained vaginal smears were examined under light microscopy to visualize gonococci associated with PMNs during infection and to determine the percentage of PMNs among vaginal cells as described previously (22). Samples from mice inoculated with saline (placebo controls) were evaluated to provide a baseline for measuring the host PMN response to infection, which was defined as the average percentage of PMNs detected in control mice plus one standard deviation. Animal experiments were conducted in the laboratory animal facility at the Uniformed Services University, which is fully accredited by the Association for the Assessment and Accreditation of Laboratory Animal Care under a protocol approved by the University's Institutional Animal Care and Use Committee.
Statistical analysis. Data were analyzed by using the standard versions of SPSS and GraphPad Prism 4 for Windows software. PMN killing assays were first analyzed by the nonparametric Mann-Whitney U test, followed by an unpaired t test for comparison of the means. An unpaired t test was used to analyze the results of the acridine orange-trypan blue staining assay, the duration of the recovery of wild-type or kat mutant bacteria from mice, and the number of CFU recovered at individual time points.
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FIG. 1. Association and internalization of wild-type or kat mutant N. gonorrhoeae by murine PMNs. The average number of PMNs with bacteria was determined as described in Materials and Methods, and the data were stratified to show different degrees of uptake or adherence as indicated by the key. Standard error bars are shown. (A) FA1090 (associated); (B) FA1090 (associated and internalized); (C) GP501 associated; (D) GP501 associated and internalized.
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FIG. 2. LDCL response of murine PMNs upon exposure to N. gonorrhoeae FA1090. PMNs from normal or 17ß-estradiol-treated female BALB/c mice were incubated with increasing numbers of wild-type gonococci. The results shown are representative of six replicas of each experiment. (A) PMNs from untreated mice; (B) PMNs from estradiol-treated mice.
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FIG. 3. Opsonophagocytic killing of wild-type or kat mutant gonococci. The average number of viable gonococci recovered after incubation of gonococci with PMNs from estradiol-treated mice for 45, 90, or 135 min is shown. The data were analyzed by comparing the recovery of gonococci that were preincubated with NMS ( ) versus HI-NMS ( ). Levels of significance are denoted as follows: *, P < 0.05; **, P < 0.005 (as determined by unpaired Student t test). (A) Wild-type FA1090; (B) kat mutant GP501. The increased recovery of the kat mutant from the HI-NMS at 135 min was not reproducible in two other experiments.
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FIG. 4. LDCL response of murine PMNs to wild-type or catalase-deficient gonococci. (A) LDCL over time after exposure to FA1090 or GP501 gonococci; (B) percentage of peak LDCL response in samples treated with catalase or HRP and NaN3 to analyze the location of the ROS (extracellular versus intracellular). The results represent combined data from six different experiments; standard error bars represent variability between experiments. PMNs were from 17ß-estradiol-treated mice and the multiplicity of infection was 10:1.
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0.013) (Fig. 5). In a single experiment in which 105 CFU were used, there was no significant difference in the duration of infection (averages of 10.5 days [wild type] versus 9 days [kat mutant]; six mice per group). In two of three experiments in which quantitative culture of vaginal mucus was performed, a higher average number of CFU was recovered from mice infected with the wild-type strain compared to that from mice infected with the kat mutant (Fig. 6); however, the difference was not significant.
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FIG. 5. Duration of colonization of wild-type versus catalase-deficient gonococci. Mice were inoculated with 106 CFU of FA1090 or GP501 gonococci and cultured for 12 days. The last positive culture day for each individual mouse is indicated by closed (wild type) and open (kat mutant) circles. The results shown are combined data from six experiments. The average duration of recovery is shown by the horizontal bar and was significantly different when kat mutant and wild-type bacteria were compared (P 0.013). The P values for the individual experiments were 0.107, 0.013, 0.54, 0.35, 0.38, and 0.001 (five to eight mice per group).
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FIG. 6. Colonization load during infection with wild-type versus catalase-deficient gonococci. Mice were inoculated with 106 CFU of FA1090 or kat mutant GP501 gonococci. The average number of viable wild-type FA1090 and kat mutant GP501 CFU recovered from vaginal swab suspensions over time. Standard error bars are shown.
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FIG. 7. Stained vaginal smears from mice infected with wild-type or kat mutant gonococci. (A) Uninfected mouse; (B and D) mouse inoculated with FA1090; (C and E) mouse inoculated with kat mutant GP501. Samples were from day 8 of infection. Numerous PMNs with high numbers of wild-type or kat mutant gonococci are seen. The images are shown at magnifications of x400 (A, B, and C) and x1,000 (D and E).
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TABLE 1. Duration of colonization and periods of PMN influx for individual mice inoculated with N. gonorrhoeae FA1090 or kat mutant GP501
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Due to the dependency of the respiratory burst on molecular oxygen, the O2 tension at the site of infection can be critical for the capacity of PMNs to efficiently kill microbes. The lower female genital tract is a relatively anaerobic environment, as indicated by direct measurements of vaginal O2 tension (34, 51) and an abundance of anaerobic commensal flora (19). It is not known whether ROS are produced by phagocytes during cervical infections or if ROS challenge gonococci in vivo. However, a growing body of work suggests that N. gonorrhoeae are strongly resistant to ROS produced by phagocytes, the most definitive evidence being a study by Rest et al. (36), which showed no difference in the killing capacity of PMNs from normal individuals and those with chronic granulomatous disease. Other evidence includes studies on PMN killing under aerobic versus anaerobic conditions (9) and a recent report that showed gonococci replicate within PMNs that are actively producing ROS (41). The basis for gonococcal resistance to PMN killing is not known. At this time we cannot fully rule out that catalase may at least partially protect N. gonorrhoeae from ROS produced by phagocytes in the murine genital tract. N. gonorrhoeae has a rich layer of antioxidant factors and a functional redundancy of these potentially protective factors may obscure the role of catalase in vivo. In addition to catalase, cytochrome c peroxidase (Ccp) (48), nonenzymatic quenching of O2 by manganese cations (47), methionine sulfoxide reductase (which repairs oxidatively damaged proteins) (42), a potential thiol-disulfide oxidoreductase (Sco) (38), azurin (53), bacterioferritin (11), and newly described peroxidase-induced genes of unknown function (44) may protect the gonococcus from ROS in vivo. Seib et al. recently reported that a double kat ccp mutant and a kat sco mutant were not more susceptible to PMN killing than the wild-type strain (39). Although several combinations of other mutations were not tested, these results are consistent with the highly resistant nature of N. gonorrhoeae to oxidative defenses of PMNs (9, 36, 41).
Clues from the literature regarding the role of catalase in the pathogenesis of other bacteria vary with the pathogen and the site of infection. Gonococcal catalase belongs to the typical monofunctional group of bacterial catalases (30, 43); among other members of this group, katA mutants, but not katB or katE mutants, of Pseudomonas aeruginosa were attenuated in a mouse peritonitis model (28), and an htkE catalase mutant of Haemophilus influenzae showed reduced survival in rats after intraperitoneal injection. No role for HtkE catalase was detected during H. influenzae bloodstream infection after dissemination from an intranasal site, however (5). Similarly, a katE mutant of Brucella melitensis colonized internal organs as well as the wild-type strain after conjunctival inoculation of pregnant goats; colonization of the fetus was also not impaired (17). With regard to localized mucosal infections, the HtkE catalase of H. influenzae did not confer a survival advantage for intranasal colonization (5) and a Bordetella pertussis katA mutant was not attenuated for colonization of the mouse respiratory tract (26). The overall consensus of in vivo studies on typical monofunctional catalases suggests that the evolution of catalases in this family often may have been driven by the need to protect against ROS produced by respiration. This conclusion is in contrast to that shown for some members of the catalase-peroxidase family of bacterial catalases, which clearly play a role in pathogenesis (2, 32). Alternatively, and as proposed in each study that detected no role for a monofunctional catalase during infection, a functional redundancy in antioxidant factors may mask the contribution of catalase in pathogenesis.
We did observe that the kat mutant used here was more sensitive to killing by murine PMNs in vitro. Attempts to confirm our PMN killing data via genetic complementation with a wild-type kat gene have been frustrating. We believe interpretation of PMN killing assays should also be tempered by recognizing both the lack of complementation data and the fact that many physiological variables play a role in the PMN killing of N. gonorrhoeae. As described previously (43), the kat mutant used here was only partially complemented for catalase activity using a plasmid shuttle vector. The recombinant catalase expressed by this vector was aberrant in charge or size, as evidenced by an altered mobility on activity gels, and was unable to restore resistance to H2O2. More recently, we integrated a wild-type copy of the kat gene into the chromosome of kat mutant GP500, a derivative of GP501 (43). Although the resultant strain produced a catalase species that appeared to be similar to wild-type catalase on activity gels, expression was low and unstable.
Seib et al. (39) recently showed no difference in the survival of wild-type or kat mutant bacteria in human PMNs using a system in which PMNs are adherent to an extracellular matrix, which may better mimic the interaction with PMNs in vitro. In contrast, we assessed PMN killing by using an assay in which suspensions of PMNs and gonococci were incubated in tubes that were rotated end to end. This method increases contact between bacteria and PMNs in a way that might not mimic infection and maximizes aeration to a level that might be artificially high compared to that available in inflammatory foci. Our inability to correlate clearance of the kat mutant with a strong PMN response during infection is in conflict with the observed increased susceptibility of the kat mutant to PMN killing in vitro. Therefore, the PMN killing assay we used may not be predictive of events that occur during mucosal infection of this body site. Strain differences may also contribute to different observations, based on recent evidence from our lab that a kat mutant in strain MS11 was not attenuated for PMN killing using the tumbling tube assay (53a).
A second objective of our study was to further characterize the usefulness of murine infection in studying gonococcal evasion of innate defenses. Estradiol is known to have immunosuppressive effects. Notably, Kita et al. (27) reported that PMNs from estradiol-treated mice were less able to kill N. gonorrhoeae compared to PMNs from untreated or progesterone-treated mice. We found no evidence that estradiol treatment impaired the capacity of PMNs to kill N. gonorrhoeae or S. aureus. Differences in the estradiol dose and delivery systems used may explain this discrepancy. We also showed that PMNs from estradiol-treated versus normal mice responded similarly to wild-type and kat mutant bacteria in terms of the intracellular nature of the respiratory burst and the capacity of murine PMNs to adhere to and take up N. gonorrhoeae. Known differences between mouse and human PMNs include lower levels of myeloperoxidase and other enzymes in mouse PMNs (35) and the inability of gonococci to utilize mouse lactoferrin as an iron source, which is contained within PMN granules. Gonococci do utilize the mouse hemoglobin that exudes into the vaginal lumen during periods of inflammation, however, which may help balance any detrimental effects caused to gonococci by the inflammatory response (23). An additional limitation to the murine system is the absence of human carcinoembryonic antigen cellular adhesion molecules on PMNs, which when bound to certain gonococcal opacity proteins results in nonopsonic uptake. The murine system, in contrast, requires serum for uptake and therefore most likely mimics phagocytic events that occur later in infection when complement components are increased with the onset of inflammation.
In summary, we have shown that catalase is not required for gonococci to survive the innate defenses of the female genital tract by using a surrogate infection model. Comparative studies of mutants in more than one antioxidant factor and the use of mice that are functionally defective in phagocytic killing should help further define the interplay between N. gonorrhoeae and phagocytes in vivo.
Published ahead of print on 12 February 2007. ![]()
Present address: Center for Genetic Medicine Research, Division of Nephrology, Children's Research Institute, Children's National Medical Center, 111 Michigan Ave., NW, Washington, DC 20010. ![]()
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