Elevated iron status increases bacterial invasion and survival and alters cytokine/chemokine mRNA expression in Caco-2 human intestinal cells.

Iron status affects both microbial growth and immune function. Mammalian iron homeostasis is maintained primarily by regulating the absorption of the micronutrient in the proximal small intestine. The iron concentration of the enterocyte can fluctuate widely in response to both dietary and whole body iron status, as well as in response to infections. The possibility that an enterocyte with an elevated iron concentration is more susceptible to invasion by enteric pathogens is not known. Therefore, we examined the impact of enterocyte iron status on the invasion and survival of an enteric pathogen, as well as on the levels of several cytokine and chemokine mRNAs by the host cell. The enterocyte-like Caco-2 human intestinal cell line and Salmonella enteritidis served as the models to examine the effect of iron on the host-parasite interaction. Iron status of Caco-2 cells was altered by incubation in serum-free medium supplemented with varying levels of iron. Elevated iron status of Caco-2 cells increased the efficiency of the invasion and the number of bacteria surviving in the intracellular environment. Caco-2 cells constitutively expressed transforming growth factor-beta1, interleukin-8, monocyte chemotactic protein-1, tumor necrosis factor-alpha and interleukin-1beta, and infection with S. enteritidis increased the relative quantities of all cytokine/chemokine mRNAs except interleukin-1beta. Elevated iron status of Caco-2 cells decreased the levels of cytokine/chemokine mRNAs by 25-45% in uninfected cells. In contrast, bacterial infection was associated with a 21-95% increase in cytokine/chemokine mRNAs levels in Caco-2 cells with higher iron concentration compared with infected cells with lower iron concentration. These data support the hypothesis that elevated enterocyte iron status increases susceptibility to infection and exacerbates the mucosal inflammatory response initiated by microbial invasion by increasing cytokine/chemokine expression.

Amplified Assay for Specific Dual-Labeled DNA Using the Coagulation Cascade (EDNA-ELCA).

Detection of the products of the PCR reaction using nonisotopically labeled DNA molecules containing biotin, fluorescein, or digoxigenin has become a popular method for identification of specific products of polymerase chain reaction (PCR) (1,3). These labeled molecules are prepared either by PCR synthesis in the presence of labeled deoxyuridine triphosphate (1,3) or by hybridization of labeled probes to the unlabeled PCR product (1,2). Detection is then in a format very similar to enzyme-linked immunosorbent assays (ELISA) using similarly labeled antigens and antibodies, i.e., by capture on the receptor for one ligand (streptavidin or antibody) and using the other ligand for detection.

Salmonella flagellin induces tumor necrosis factor alpha in a human promonocytic cell line.

During infection of the gastrointestinal tract, salmonellae induce cytokine production and inflammatory responses which are believed to mediate tissue damage in the host. In a previous study, we reported that salmonellae possess the ability to stimulate tumor necrosis factor alpha (TNF-alpha) accumulation in primary human monocytes, as well as in the human promonocytic cell line U38. In this model system, cytokine upregulation is not due to lipopolysaccharide but is mediated by a released protein. In the present study, TnphoA transposon mutagenesis was used to identify the TNF-alpha-inducing factor. A mutant Salmonella strain which lacks the ability to induce TNF-alpha was isolated from a TnphoA library. Genetic analysis of this mutant demonstrated that the hns gene has been interrupted by transposon insertion. The hns gene product is a DNA-binding protein that regulates the expression of a variety of unrelated genes in salmonellae. One of the known targets of histone-like protein H1 is flhDC, the master operon which is absolutely required for flagellar expression. Analysis of other nonflagellated mutant Salmonella strains revealed a correlation between the ability to induce TNF-alpha and the expression of the phase 1 filament subunit protein FliC. Complementation experiments demonstrated that FliC is sufficient to restore the ability of nonflagellated mutant Salmonella strains to upregulate TNF-alpha, whereas the phase 2 protein FljB appears to complement to a lesser extent. In addition, Salmonella FliC can confer the TNF-alpha-inducing phenotype on Escherichia coli, which otherwise lacks the activity. Furthermore, assembly of FliC into complete flagellar structures may not be required for induction of TNF-alpha.

Salmonellae activate tumor necrosis factor alpha production in a human promonocytic cell line via a released polypeptide.

Invasive strains of Salmonella spp. cause both systemic and localized infections in humans. The ability to resist infection and some aspects of the tissue pathology associated with the presence of Salmonella in the gastrointestinal tract have been shown to be mediated in part by the induction of tumor necrosis factor alpha (TNF-alpha), a proinflammatory cytokine produced by activated macrophages and lymphocytes. Recent reports indicate that TNF-alpha is involved in the induction of human immunodeficiency virus replication by Salmonella in the latently infected human promonocytic cell line U1. In the present study, we investigated the effects of Salmonella on TNF-alpha production in U1 cells and a related cell line, U38. Unlike Escherichia coli or Yersinia enterocolitica, salmonellae rapidly induce TNF-alpha expression in these cells through a released factor(s). Time course experiments show that the kinetics of TNF-alpha production by U38 cells stimulated with Salmonella conditioned medium closely resemble those observed in response to live Salmonella. The observation that TNF-alpha levels are elevated by 60 min after exposure to either bacteria or their conditioned medium suggests that the soluble inducer is continuously released or shed by the bacteria and that the signal acts rapidly to increase TNF-alpha production. Furthermore, the ability to produce the TNF-alpha inducer is shared by at least four Salmonella serotypes and does not correlate with the abilities to invade and to survive within phagocytes. Treatment of active conditioned medium with trypsin, but not low pH, high temperature, or urea, significantly inhibits its TNF-alpha-inducing effect on U38 cells, a finding which points to a polypeptide product of Salmonella as the mediator of TNF-alpha production. Gel filtration chromatography of Salmonella conditioned medium reveals two peaks of activity, consistent with molecular masses of approximately 150 and 110 kDa.

Purification and characterization of a Chinese hamster ovary cell elongation factor of Vibrio hollisae.

The halophilic bacterium Vibrio hollisae, isolated from patients with diarrhea, produces an extracellular toxin which elongates Chinese hamster ovary (CHO) cells. We purified this toxin to homogeneity by sequential ammonium sulfate precipitation, gel filtration with Sephacryl S-200, hydrophobic interaction chromatography with phenyl-Sepharose CL-4B, ion-exchange chromatography with DEAE-Sephadex A-50, and affinity chromatography. The toxin is heat labile and sensitive to proteases, with an isoelectric point of about 6.5 and molecular weights of about 83,000 and 80,000, as estimated by gel filtration and sodium dodecyl sulfate-polyacrylamide gel electrophoresis, respectively. The toxin did not react with immunoaffinity-purified antibodies to cholera toxin in a plate enzyme-linked immunosorbent assay and in a Western blot, and its activity could not be neutralized by anti-cholrea toxin serum. Mixed gangliosides and gangliosides GM1, GD1a, GD1b, Gq1b, GT1b, GD2, GD3, GM2, and GM3 failed to block its activity. Elongation of CHO cells induced by the toxin was not accompanied by an increase in the levels of cyclic AMP. The toxin induced intestinal fluid accumulation in suckling mice. These results and the lack of homology between V. hollisae DNA and DNA coding for cholera toxin or the heat-labile toxin of Escherichia coli suggest that the V. hollisae toxin is structurally and functionally different from other CHO cell-elongating toxins.

Regulation of macrophage activation and human immunodeficiency virus production by invasive Salmonella strains.

Salmonellae possess the ability to adhere to and invade macrophages and in so doing trigger a number of intracellular events that are associated with cellular activation. As an initial approach to defining the mechanisms by which invasive salmonellae alter macrophage function, we have explored the impact of Salmonella infection on the production of human immunodeficiency virus (HIV) in U1 cells, a promonocytic cell line latently infected with the virus. Infection of U1 cells with a pathogenic strain of Salmonella enteritidis resulted in a marked induction of macrophage activation and HIV production. The stimulatory effect of salmonellae was mediated by signals other than lipopolysaccharide. Salmonella mutants with specific defects in invasion or intracellular survival were markedly less effective in the induction of HIV production. In contrast to S. enteritidis, strains of Yersinia enterocolitica, Legionella pneumophila, and Escherichia coli did not induce HIV production. However, all of these bacteria induced comparable levels of gene expression mediated by the HIV long terminal repeat. The results of this study are consistent with the notion that invasive salmonellae possess the ability to activate the macrophage by at least one mechanism that is not shared with several other species of gram-negative bacteria. Furthermore, the expression of this unique property is maximal with Salmonella strains that are not only invasive but also capable of prolonged survival within the macrophage. Our results indicate that the U1 cell line may be a very useful model system with which to examine the biochemical pathways by which internalized salmonellae modulate the activation state of the macrophage.

Biochemical and genetic basis for the ETS (enterotoxin sensitivity) phenotype in mice.

Evidence has been accumulating that humans are genetically predisposed to cholera gravis. Using the sealed adult mouse model, we found that certain inbred mice were also hypersensitive to cholera toxin (CT). Such mice were designated ETS+ (enterotoxin sensitive), and the trait was linked to the K end of the mouse H-2 histocompatibility complex. Cells isolated from ETS+ mice bound more CT and accumulated more cyclic adenosine monophosphate (cAMP) after intoxication. Analysis of ETS+ cells showed that they express lesser amounts of the non-GM1 gangliosides that block or compete for relevant CT binding sites in ETS- cells. Conversion of ETS- non-GM1 gangliosides to GM1 with neuraminidase increased CT binding and cAMP responses. Reconstitution of nonreactive ganglioside-deficient cells with ETS+ or ETS- gangliosides caused them to bind CT like the original ETS+ or ETS- cells. Ganglioside expression genes known to map to the same H-2-linked region as the ETS phenotype seem to be involved in controlling murine susceptibility to CT.

Enteropathogenicity of non-toxigenic Vibrio cholerae O1 for adult mice.

The enteropathogenic potential of 32 Vibrio cholerae O1 isolates that do not produce cholera toxin was examined in the orally inoculated, sealed adult mouse model. Live cultures (2 x 10(10) cfu/ml) of 7/16 clinical and 6/16 environmental isolates produced a positive intestinal fluid accumulation (FA) ratio that reached near maximum at approximately 5 h post-inoculation. Colony hybridization did not detect genes for cholera toxin, Escherichia coli heat-labile and heat-stable toxins, or shiga-like toxins. FA activity did not correlate precisely with cytotoxic activities on Chinese hamster ovary (28/32 positive), Vero (29/32) or HeLa (25/32) cells. Certain clinical and environmental isolates of non-toxigenic V. cholerae O1 appear to be enteropathogenic for the mouse, providing evidence that they may have pathogenic potential for humans through an as yet undefined mechanism(s).

Role of Vibrio cholerae neuraminidase in the function of cholera toxin.

Vibrio cholerae neuraminidase (NANase) is hypothesized to act synergistically with cholera toxin (CT) and increase the severity of a secretory response by increasing the binding and penetration of CT to enterocytes. To test this hypothesis, the NANase gene (nanH) from V. cholerae Ogawa 395 was first cloned and sequenced. Isogenic wild-type and NANase- V. cholerae 395 strains were then constructed by using suicide vector-mediated mutagenesis. The influence of NANase on CT binding and penetration was examined in vitro by using culture filtrates from these isogenic strains. Fluorescence due to binding of fluorescein-conjugated CT to C57BL/6 and C3H mouse fibroblasts exposed to NANase+ filtrates increased five- and eightfold, respectively, relative to that with NANase- filtrates. In addition, NANase+ filtrates increased the short-circuit current measured in Ussing chambers 65% relative to that with NANase- filtrates, although this difference decreased as production of CT increased. The role of NANase in V. cholerae pathogenesis was examined in vivo by intragastric inoculation of the isogenic strains into CD1 suckling mice. No difference in fluid accumulation ratios was seen at doses of 10(4) to 10(8) CFU, but NANase+ strains produced 18% higher fluid accumulation ratios at 10(9) CFU than NANase- strains when inoculated into nonfasted suckling mice. It is concluded that NANase plays a subtle but significant role in the binding and uptake of CT by susceptible cells under defined conditions.

Fluid accumulation in infant mice caused by Vibrio hollisae and its extracellular enterotoxin.

Vibrio hollisae, a halophilic bacterium isolated from patients with diarrhea, was examined for virulence factor production. Intragastric administration of 2 X 10(7) CFU per mouse elicited fluid accumulation which peaked at ca. 6 h postchallenge in infant mice. An enterotoxin which elongated Chinese hamster ovary (CHO) cells was detected in extracts of infected-mouse intestines and in culture fluids from various growth media. The yield of the enterotoxin was maximal beginning at the onset of the stationary phase of growth in heart infusion broth supplemented with 0.5% NaCl. A concentrated preparation obtained by ammonium sulfate precipitation of culture supernatant fluids induced intestinal fluid accumulation which peaked at 2 h postchallenge in infant mice. The abilities of the enterotoxin preparation to elongate CHO cells and to elicit fluid accumulation in infant mice were inseparable by gel filtration, isoelectric focusing, and hydrophobic interaction chromatography. The enterotoxin has a molecular weight of ca. 33,000 by gel filtration and an isoelectric point of ca. 4 and is sensitive to heat.

Studies on the genetic and cellular control of sensitivity to enterotoxins in the sealed adult mouse model.

A sealed adult mouse (SAM) model was developed for studies on the effects of cholera enterotoxin (CT). With this system, 38 strains of outbred, inbred, congenic, recombinant, and mutant mice were starved for 24 h, anorectally occluded with cyanoacrylamide ester glue, given CT per os, and sacrificed at 6 h. Fluid accumulation (FA) values were calculated as gut weight to body weight ratios. At a saturating dose of CT (24 micrograms per mouse), FA responses were found to be independent of body weight and gut length. It was found, using recombinant and congenic mice, that mice which possess the H-2k haplotype (homozygous or heterozygous) are 2.5 to 3 times less responsive to CT than animals with the H-2b haplotype. The allele(s) responsible for this affect is located near the K end of the H-2 complex. Inbred and congenic mice given CT intravenously exhibited the same (b = responder, k = nonresponder) pattern in terms of weight loss and death, thus indicating that the H-2 effect is not limited just to the small intestinal epithelium. Mice given sublethal doses of CT intravenously and challenged after conversion to SAM 14 days later showed an immune response inversely related to weight loss (i.e., b haplotypes lost 10 to 15% body weight, recovered, but were not protected against challenge; k haplotypes lost little or no weight but were protected). To examine the possibility of a cellular basis for control of innate responses to CT, responder C57BL/10 (B10) mice were irradiated with 950 rads and immediately reconstituted with bone marrow from (B10 X B10.BR)F1 (nonresponder) mice. The chimeras became nonresponsive to CT when challenged 5 weeks after reconstitution. Reconstituted B10 controls responded normally. Outbred and inbred nude athymic mice also were nonresponsive when compared with normal responder controls. These data demonstrate a genetic basis for resistance to CT and that response and nonresponse is mediated, at least in part, by cells derived from bone marrow.

Virulence mechanisms associated with clinical isolates of non-O1 Vibrio cholerae.

Twenty one isolates of non-O1 V. cholerae from patients with diarrheal illness were examined for the presence of potential virulence mechanisms. The motile strains (90%) produced cell-associated mannose-sensitive hemagglutinins which reacted with human group O, chicken, sheep and rabbit erythrocytes. Motile isolates also attached to embryonic intestinal epithelial cells (ATCC 407), and the adherence was not inhibited by the presence of 1% D-mannose. All vibrio isolates hemolyzed sheep erythrocytes. Three vibrio isolates (14%) harbored two or three plasmids which ranged in size between 1.7 and 5.2 megadaltons. The presence of the plasmid did not correlate with the presence of hemolysin, hemagglutinins, adhesions or antibiotic resistance in any of the isolates. Thus, it appears that multiple factors associated with bacterial cell surfaces influence adhesin and apparently pathogenic potential of the non-O1 vibrio isolates in the host intestine.

Enterotoxigenicity of clinical isolates of non-O1 Vibrio cholerae.

Whole cultures, but not culture supernatant fluids, of 21 isolates of non-O1 V. cholerae from patients with diarrhea were shown to induce positive fluid accumulation in infant mice. CHO cell assays demonstrated the elaboration of heat-labile cytotonic, cytotoxic or both factors from most isolates when grown under optimal culture conditions. These factors were not neutralized by anti-cholera toxin serum. Also genetic studies performed on 9 vibrio isolates using a DNA hybridization probe failed to detect gene sequences homologous with cholera toxin. ELISA assays recognized six isolates which produced a cell-associated substance which immunologically cross-reacted with cholera toxin. Enzymatic profiles of the vibrio isolates did not correlate with the production of any toxic factor. The results indicate that mainly heat-labile and cell-associated cytotonic and cytotoxic factors appear to influence the enterotoxigenic potential of this heterogenous group of non-O1 vibrios.

Reduced bacterial adherence to silicone plastic neurosurgical prosthesis.

Bacteria have been shown to adhere to smooth surfaces, such as shunts, by secreting a complex polysaccharide coat called the glycocalyx. We assume that if bacterial adherence could be reduced to zero, foreign-body-related infections would be essentially eliminated. This study describes a new technique for quantitating bacterial adherence to plastic using radioactive chromium, and demonstrates that presoaking the silicone plastic surgical tubing used for ventriculoperitoneal and ventriculoatrial shunts in bacitracin A solution (50,000 units in 250 ml) reduces the adherence of Staphylococcus epidermidis by 54%. We conclude that pretreatment of a hydrocephalic shunt tubing with an aqueous bacitracin solution before its implantation may help to reduce the postoperative shunt infections due to direct contamination of the shunt at the time it is inserted.

Production and partial characterization of a Vibrio fluvialis cytotoxin.

Conditions are described for the production of an extracellular cytotoxin or CHO cell-killing factor by Vibrio fluvialis, a recently recognized enteric pathogen. The cell-killing factor was ammonium sulfate precipitable, heat labile, and inactivated by proteases, and had an isoelectric point (estimated by sucrose density gradient electrofocusing) and an apparent molecular weight (estimated by gel filtration) of ca. 4.8 and 12,200, respectively. The culture supernatant fluids also possessed hemolytic and phospholipase A2 activities; however, they were separable from cell-killing factor activity by gel filtration. The substance(s) possessing the hemolytic and phospholipase activities coeluted when fractionated by gel filtration with Sephacryl S-200 (apparent molecular weight of ca. 34,500) and had isoelectric points of ca. 4.4 and 4.5, respectively.

Sealed adult mice: new model for enterotoxin evaluation.

Outbred, inbred, and congenic strains of conventional mice which were ano-rectally occluded with cyanoacrylate ester glue and converted to sealed adult mice (SAM) were given, per os, crude cholera enterotoxin (CT) in 10% NaHCO3. At 6 h when the response was maximal, mice were killed, the small intestines were removed, and gut weight/body weight ratios were calculated. Experimental mice gave a linear response after receiving 1.5 to 60 micrograms of CT. Purified heat-stable enterotoxin from Escherichia coli and purified heat-labile enterotoxins from E. coli, Vibrio cholerae, and Clostridium difficile all elicited vigorous fluid outpouring as did culture filtrates from Vibrio fluvialis with cytotoxic activity. Active and passive immunization with crude CT completely or partially neutralized fluid secretion due to CT. Monospecific anti-CT incubated with CT before feeding also eliminated the response. Mice pretreated with penicillin, held in barrier cages, converted to SAM, and fed live vibrios, showed fluid responses similar to those seen with low doses of CT. Each of six different strains of inbred mice fed a half-maximal fluid accumulation response dose of CT gave fluid accumulation ratios which varied fourfold. There was no correlation of fluid accumulation with body weight, gut length, age, or sex. All poor responders were of H-2k haplotype and all good responders were H-2b. BALB congenic mice which differed only in H-2 haplotypes showed the same correlations, and body weights and gut lengths of all haplotypes were not significantly different.

Biological activities of toxins A and B of Clostridium difficile.

Examination of the biological activities of the two known toxins of Clostridium difficile revealed that one of the toxins (toxin A) elicited a hemorrhagic fluid response in rabbit intestinal loops and a positive fluid response in infant mice. The other toxin (toxin B) did not produce a significant fluid response in either model, although the toxin was more lethal in infant mice. Both toxins elicited erythematous and hemorrhagic skin reactions and increased vascular permeability in rabbit skin.

Detection of toxins produced by vibrio fluvialis.

The results of studies with cell-free extracts and culture supernatant fluids of Vibrio fluvialis (a recently recognized, potential enteric pathogen for humans) grown in the absence and presence of lincomycin indicated that the bacterium could produce (i) a factor which causes CHO cell elongation (CEF) similar to that elicited by V. cholerae enterotoxin and by the heat-labile enterotoxin of Escherichia coli, (ii) cytolysin(s) active against erythrocytes, (iii) nonhemolytic, CHO cell-killing factor(s), and (iv) protease(s) active against azocasein. The CEF was heat labile and ammonium sulfate precipitable, and it had an isoelectric point (estimated by sucrose density gradient electrofocusing) and molecular weight (estimated by gel filtration) of about 5.1 and 135,000, respectively.

Adenosine diphosphate-ribosylation of adenylate cyclase catalyzed by heat-labile enterotoxin of Escherichia coli: comparison with cholera toxin.

The heat-labile enterotoxin of Escherichia coli, like cholera toxin, activates adenylate cyclase by catalyzing the transfer of adenosine diphosphate-ribose from HAD+ (oxidized nicotinamide adenine dinucleotide) to the guanyl nucleotide-dependent regulatory component of the cyclase. A preparation of enterotoxin that had been released from E. coli following exposure to polymyxin B and then partially purified was found to contain two enzymatically active peptides, one of about 29,000 and the other of about 24,000 daltons, which correspond in molecular size to the enzymatically active subunit A and fragment A1 of cholera toxin, respectively. As with cholera toxin, the enzymatic activity of E. coli enterotoxin was elevated by incubation with sodium dodecyl sulfate to release active peptides. Treatment with dithiothreitol, however, had no effect. Dithiothreitol activates subunit A of cholera toxin by reducing an internal disulfide bond, but no corresponding bond appears to be present in the partially purified E. coli enterotoxin.