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.
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.