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      Host-Detrimental Role of Esx-1-Mediated Inflammasome Activation in Mycobacterial Infection

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          Abstract

          The Esx-1 (type VII) secretion system is a major virulence determinant of pathogenic mycobacteria, including Mycobacterium marinum. However, the molecular events and host-pathogen interactions underlying Esx-1-mediated virulence in vivo remain unclear. Here we address this problem in a non-lethal mouse model of M. marinum infection that allows detailed quantitative analysis of disease progression. M. marinum established local infection in mouse tails, with Esx-1-dependent formation of caseating granulomas similar to those formed in human tuberculosis, and bone deterioration reminiscent of skeletal tuberculosis. Analysis of tails infected with wild type or Esx-1-deficient bacteria showed that Esx-1 enhanced generation of proinflammatory cytokines, including the secreted form of IL-1β, suggesting that Esx-1 promotes inflammasome activation in vivo. In vitro experiments indicated that Esx-1-dependent inflammasome activation required the host NLRP3 and ASC proteins. Infection of wild type and ASC-deficient mice demonstrated that Esx-1-dependent inflammasome activation exacerbated disease without restricting bacterial growth, indicating a host-detrimental role of this inflammatory pathway in mycobacterial infection. These findings define an immunoregulatory role for Esx-1 in a specific host-pathogen interaction in vivo, and indicate that the Esx-1 secretion system promotes disease and inflammation through its ability to activate the inflammasome.

          Author Summary

          With ∼2 million people dying from tuberculosis every year, Mycobacterium tuberculosis represents the single most important bacterial pathogen globally. We use the closely related Mycobacterium marinum to study fundamental aspects of mycobacterial pathogenesis, likely to extend to human tuberculosis. The Esx-1 (type VII) secretion system is a major virulence determinant of pathogenic mycobacteria, including M. tuberculosis and M. marinum. However, a molecular explanation for Esx-1-mediated virulence in vivo has been lacking. Here we address this problem in a non-lethal mouse model of M. marinum infection that allows quantitative analysis of disease progression. M. marinum established local infection with important features of human tuberculosis, including formation of granulomas with caseating centers. Using a combination of bacterial and host mutants, we show that Esx-1-mediated activation of the host inflammasome increases inflammation without restricting bacterial growth, suggesting that activation of the inflammasome during mycobacterial infection is a manifestation of bacterial virulence rather than a manifestation of host response. These findings define a biological role for Esx-1 in a specific host-pathogen interaction in vivo, and imply that the Esx-1 secretion system has evolved specifically to promote host pathology.

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          Most cited references42

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          The role of the granuloma in expansion and dissemination of early tuberculous infection.

          Granulomas, organized aggregates of immune cells, form in response to persistent stimuli and are hallmarks of tuberculosis. Tuberculous granulomas have long been considered host-protective structures formed to contain infection. However, work in zebrafish infected with Mycobacterium marinum suggests that granulomas contribute to early bacterial growth. Here we use quantitative intravital microscopy to reveal distinct steps of granuloma formation and assess their consequence for infection. Intracellular mycobacteria use the ESX-1/RD1 virulence locus to induce recruitment of new macrophages to, and their rapid movement within, nascent granulomas. This motility enables multiple arriving macrophages to efficiently find and phagocytose infected macrophages undergoing apoptosis, leading to rapid, iterative expansion of infected macrophages and thereby bacterial numbers. The primary granuloma then seeds secondary granulomas via egress of infected macrophages. Our direct observations provide insight into how pathogenic mycobacteria exploit the granuloma during the innate immune phase for local expansion and systemic dissemination.
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            Type VII secretion--mycobacteria show the way.

            Recent evidence shows that mycobacteria have developed novel and specialized secretion systems for the transport of extracellular proteins across their hydrophobic, and highly impermeable, cell wall. Strikingly, mycobacterial genomes encode up to five of these transport systems. Two of these systems, ESX-1 and ESX-5, are involved in virulence - they both affect the cell-to-cell migration of pathogenic mycobacteria. Here, we discuss this novel secretion pathway and consider variants that are present in various Gram-positive bacteria. Given the unique composition of this secretion system, and its general importance, we propose that, in line with the accepted nomenclature, it should be called type VII secretion.
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              Loss of RD1 contributed to the attenuation of the live tuberculosis vaccines Mycobacterium bovis BCG and Mycobacterium microti.

              Although large human populations have been safely immunized against tuberculosis with two live vaccines, Mycobacterium bovis BCG or Mycobacterium microti, the vole bacillus, the molecular basis for the avirulence of these vaccine strains remains unknown. Comparative genomics has identified a series of chromosomal deletions common to both virulent and avirulent species but only a single locus, RD1, that has been deleted from M. bovis BCG and M. microti. Restoration of RD1, by gene knock-in, resulted in a marked change in colonial morphology towards that of virulent tubercle bacilli. Three RD1-encoded proteins were localized in the cell wall, and two of them, the immunodominant T-cell antigens ESAT-6 and CFP-10, were also found in culture supernatants. The BCG::RD1 and M. microti::RD1 knock-ins grew more vigorously than controls in immunodeficient mice, inducing extensive splenomegaly and granuloma formation. Increased persistence and partial reversal of attenuation were observed when immunocompetent mice were infected with the BCG::RD1 knock-in, whereas BCG controls were cleared. Knocking-in five other RD loci did not affect the virulence of BCG. This study describes a genetic lesion that contributes to safety and opens new avenues for vaccine development.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS Pathog
                plos
                plospath
                PLoS Pathogens
                Public Library of Science (San Francisco, USA )
                1553-7366
                1553-7374
                May 2010
                May 2010
                6 May 2010
                : 6
                : 5
                : e1000895
                Affiliations
                [1 ]Department of Microbial Pathogenesis, Genentech Inc., South San Francisco, California, United States of America
                [2 ]Department of Translational Immunology, Genentech Inc., South San Francisco, California, United States of America
                [3 ]Department of Biomedical Imaging, Genentech Inc., South San Francisco, California, United States of America
                [4 ]Department of Pathology, Genentech Inc., South San Francisco, California, United States of America
                University of New Mexico, United States of America
                Author notes
                [¤a]

                Current address: Karolinska Institutet, Department of Microbiology Tumor and Cell Biology, Stockholm, Sweden

                [¤b]

                Current address: Merck Research Laboratories, Department of Biologics Research, West Point, Pennsylvania, United States of America

                Conceived and designed the experiments: FC EJB. Performed the experiments: FC JK CD KHB MS. Analyzed the data: FC CD KHB MS LD EJB. Contributed reagents/materials/analysis tools: FC JK CD KHB RADC MS LD. Wrote the paper: FC EJB.

                Article
                09-PLPA-RA-2048R3
                10.1371/journal.ppat.1000895
                2865529
                20463815
                ac7d7989-c97f-489d-b240-5df2fa247cf3
                Carlsson et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 11 November 2009
                : 5 April 2010
                Page count
                Pages: 12
                Categories
                Research Article
                Immunology/Cellular Microbiology and Pathogenesis
                Immunology/Immune Response
                Immunology/Immunity to Infections
                Immunology/Immunomodulation
                Immunology/Innate Immunity
                Infectious Diseases/Bacterial Infections

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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