Immunization with a Double-Mutant (R192G/L211A) of the Heat-Labile Enterotoxin of Escherichia coli Offers Partial Protection against Campylobacter jejuni in an Adult Mouse Intestinal Colonization Model.

We have previously shown that antibodies to cholera toxin (CT) reacted with the major outer membrane proteins (MOMPs) from Campylobacter jejuni strains on Western blot. Further, oral immunization with CT significantly protected against challenge with C. jejuni in an adult mouse colonization model of infection. CT and the heat-labile enterotoxin (LT) of enterotoxigenic Escherichia coli are structurally and functionally related. LT and its mutants including the double-mutant LT (R192G/L211A) (dmLT), are powerful mucosal adjuvants. Unlike LT which is reactogenic, dmLT has been shown to be safe for human use. In the current study, we determined whether rabbit anti-dmLT antibodies reacted with MOMPs from C. jejuni strains and whether immunization with dmLT would afford protection against C. jejuni. On Western blot, the MOMPs from C. jejuni 48 (Penner serotype O:19), C. jejuni 75 (O:3) and C. jejuni 111 (O:1,44) were probed with rabbit antibodies to dmLT or LT-E112K (a non-toxic LT mutant), which showed a lack of reaction. Adult BALB/c mice were orally immunized with dmLT and orally challenged with C. jejuni 48 or 111. Protection from colonization with the challenge bacteria was studied by enumerating Campylobacter colonies in feces daily for 9 days. Vaccination produced robust serum and stool antibody responses to dmLT and no antibody responses to C. jejuni MOMP. Vaccinated mice showed reduced colonization and excretion of both challenge strains compared to control mice. However, the differences were not statistically significant. The protective efficacy of the dmLT vaccine varied from 9.1% to 54.5%. The lack of cross-reaction between the MOMP and dmLT suggests that protection is not mediated by cross-reacting antibodies, but may be due to activation of innate immunity. As dmLT is safe for humans, it could be incorporated into a C. jejuni vaccine to enhance its efficacy.

Oral immunization with cholera toxin provides protection against Campylobacter jejuni in an adult mouse intestinal colonization model.

UNLABELLED: Immunity to Campylobacter jejuni, a major diarrheal pathogen, is largely Penner serotype specific. For broad protection, a vaccine should be based on a common antigen(s) present in all strains. In our previous study (M. J. Albert, S. Haridas, D. Steer, G. S. Dhaunsi, A. I. Smith, and B. Adler, Infect. Immun. 75:3070-3073, 2007), we demonstrated that antibody to cholera toxin (CT) cross-reacted with the major outer membrane proteins (MOMPs) of all Campylobacter jejuni strains tested. In the current study, we investigated whether immunization with CT protects against intestinal colonization by C. jejuni in an adult mouse model and whether the nontoxic subunit of CT (CT-B) is the portion mediating cross-reaction. Mice were orally immunized with CT and later challenged with C. jejuni strains (48, 75, and 111) of different serotypes. Control animals were immunized with phosphate-buffered saline. Fecal shedding of challenge organisms was studied daily for 9 days. Serum and fecal antibody responses were studied by enzyme-linked immunosorbent assay (ELISA) and immunoblotting. The cross-reactivity of rabbit CT-B antibody to MOMP was studied by immunoblotting. The reactivity of 21 overlapping 30-mer oligopeptides (based on MOMP's sequence) against rabbit CT antibody was tested by ELISA. Test animals produced antibodies to CT and MMP in serum and feces and showed resistance to colonization, the vaccine efficacies being 49% (for strain 48), 37% (for strain 75), and 34% (for strain 111) (P, ≤0.05 to ≤0.001). One peptide corresponding to a variable region of MOMP showed significant reactivity. CT-B antibody cross-reacted with MOMP. Since CT-B is a component of oral cholera vaccines, it might be possible to control C. jejuni diarrhea with these vaccines. IMPORTANCE: Campylobacter jejuni is a major cause of diarrhea worldwide. Patients who recover from C. jejuni diarrhea develop immunity to the infecting serotype and remain susceptible to infection with other serotypes. A vaccine based on a common protective antigen(s) present in all C. jejuni serotypes is expected to provide broad protection. In our previous study, we showed that antibody to cholera toxin (CT) reacted with the major outer membrane proteins (MOMPs) from different strains of C. jejuni. We assumed that the B subunit of the toxin (CT-B), which is nontoxic and a component of licensed oral cholera vaccines, might be the component that cross-reacts with MOMP. In the current study, we showed that orally immunizing mice with CT protected them against colonization upon challenge with different serotypes of C. jejuni. We also showed that CT-B is the component mediating cross-reaction. Therefore, it might be possible to use cholera vaccines to prevent C. jejuni diarrhea. This could result in significant savings in vaccine development and treatment of the disease.

Tetracycline resistance is frequent among Campylobacter jejuni isolates from Kuwait.

Campylobacter jejuni is a major cause of diarrhea worldwide, including Kuwait. Kuwait is an important destination for commerce, employment for expatriates, and stationing of multinational troops. Knowledge about antimicrobial susceptibility of C. jejuni will be helpful for empirical treatment of infection. Tetracycline is one of the antibiotics recommended for treatment, but no data exist for tetracycline resistance in C. jejuni for the Arabian Gulf region. We characterized the tetracycline susceptibility of 85 C. jejuni isolates from diarrheal stools of patients seen at a teaching hospital in Kuwait during 2003-2006. Thirty-four (40%) isolates were tetracycline resistant (minimum inhibitory concentration >or=16 microg/ml), with 30 isolates carrying the tet(O) gene, including 19 isolates that carried the gene on a 35 kb plasmid. Four selected tetracycline-resistant donor strains transferred the plasmids and tetracycline resistances to a tetracycline-susceptible C. jejuni strain on conjugation. Tetracycline-resistant C. jejuni isolates were genetically unrelated to each other by pulsed-field gel electrophoresis. Thus, tetracycline resistance is common in C. jejuni isolates from Kuwait with the resistance determinant carried on transmissible plasmids. We conclude that tetracycline resistance is a feature of C. jejuni in Kuwait as in other parts of the world and that empirical therapy with tetracycline will yield variable results in Kuwait.

Major outer membrane proteins from many Campylobacter species cross-react with cholera toxin.

We have previously shown that Campylobacter jejuni strains do not produce a functional cholera toxin-like toxin (CTLT) detectable in a Chinese hamster ovary cell assay. Instead, the 53-kDa major outer membrane protein (OMP) of C. jejuni, PorA, reacts with cholera toxin (CT) antibody on immunoblots. Here, we have extended this observation to other species of Campylobacter, including C. coli, C. lari, C. fetus, C. hyointestinalis, and C. upsaliensis, the common 53-kDa OMP of which reacted with CT antibody in immunoblotting assays. There were additional reactive bands for C. fetus. As with C. jejuni, this finding may lead to the erroneous conclusion that these additional species produce a functional CTLT. However, this common cross-reactive OMP can be explored as a vaccine candidate to prevent campylobacteriosis.

Identification of a Campylobacter jejuni protein that cross-reacts with cholera toxin.

The question of whether Campylobacter jejuni produces a cholera toxin-like toxin (CTLT) has been controversial. The objective of this study was to identify the factor that cross-reacts with CT from C. jejuni. Filtrates of C. jejuni grown in four different liquid media reported to promote CTLT production were tested by Chinese hamster ovary (CHO) cell elongation assay and for reactivity with CT antibody using GM1 ganglioside enzyme-linked immunosorbent assay (ELISA) and immunoblotting. Protein sequence was determined by matrix-assisted laser desorption ionization-time of flight (MALDI TOF-TOF). Filtrates from seven reference strains reported to produce CTLT and from 80 clinical strains were negative in the CHO cell assay, but those from three reference strains and 16 clinical strains were positive by GM1 ELISA. All strains tested, including C. jejuni NCTC 11168, which does not contain a CT gene homologue, possessed a 53-kDa protein which reacted with CT antibody by immunoblotting. This band was identified as the major outer membrane protein, PorA, of C. jejuni. CT antibody reacted by immunoblotting with a recombinant PorA, but antibody to the recombinant PorA did not react with CT. Our results indicate that C. jejuni does not produce a functional CTLT, but the reactivity of PorA with CT antibody would lead to the erroneous conclusion that C. jejuni produces a functional CTLT.

Ciprofloxacin resistance and its molecular mechanism in Campylobacter spp. isolated in Kuwait.

Campylobacter spp. are an important cause of diarrhea in Kuwait. Because susceptibility data for ciprofloxacin and erythromycin, the two recommended drugs for treatment, are not available for this part of the world, 64 Campylobacter spp. isolates obtained from human diarrheal stools in Kuwait during 2000--2003 were studied for susceptibility to these antimicrobials by E-test. The utility of a simple mismatch amplification mutation assay (MAMA) PCR to detect base substitution in the gyrA gene mediating resistance to ciprofloxacin was also explored. Approximately, 53% (34/64) of the isolates were resistant to ciprofloxacin (MIC, 4-64 microg/ml) and 5% (3/64) to erythromycin (MIC>256 microg/ml). MAMA PCR showed a Thr-86-to-Ile mutation in gyrA gene of 23/26 ciprofloxacin-resistant C. jejuni, and in all resistant C. coli. Sequencing of PCR product showed that two resistant strains of C. coli studied had Thr-86-to-Ile (ACT--> ATT) gyrA mutation and three resistant strains of C. jejuni studied had Thr-86-to-Ile (ACA--> ATA) gyrA mutation. In addition, all the three C. jejuni strains had silent mutations. Thus, ciprofloxacin is of limited use for treatment in Kuwait and MAMA PCR is a useful assay to study gyrA mutation. Because Kuwait has a large expatriate population of workers, it can be a focus of spread of antimicrobial resistance.

PorA protein of Campylobacter jejuni is not a cytotoxin mediating inflammatory diarrhoea.

Campylobacter jejuni is a major food-borne pathogen and a leading cause of diarrhoea. A cytotoxin is most likely involved in the pathogenesis of inflammatory diarrhoea due to C. jejuni. A 45-kDa outer membrane protein encoded by the porA gene was reported to exhibit cytotoxic activity for cultured mammalian cells in vitro. We cloned and expressed the porA gene in Escherichia coli BL21 codon plus RIL strain using the fusion vector pGEX-4T-1. The fusion protein solubilised in urea in denatured form or solubilised in Empigen BB in native form or their thrombin-cleaved products did not exhibit cytotoxic activity for Chinese hamster ovary (CHO) cells. The urea-solubilised fusion protein did not induce fluid accumulation in the rabbit ileal loop assay. All 76 clinical isolates of Campylobacter spp. tested were positive for porA by PCR, but only 13 isolates were positive for cytotoxin on CHO cells. Both cytotoxin-positive as well as cytotoxin-negative strains expressed PorA as determined by immunoblot analysis. These findings show that the porA gene product of C. jejuni is not a cytotoxin mediating inflammatory diarrhoea.