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Abu-Ahmad A, Bahouth F, Hershman-Sarafov M, Paz A, Odeh M. Bivalvular Endocarditis Due to Polymicrobial Coinfection with Enterococcus faecalis and Coxiella burnetii: A Case Report and Review of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1122. [PMID: 39064551 PMCID: PMC11279137 DOI: 10.3390/medicina60071122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 06/30/2024] [Accepted: 07/05/2024] [Indexed: 07/28/2024]
Abstract
Polymicrobial endocarditis is uncommon, and polymicrobial endocarditis in combination with Coxiella burnetii is very rare. We herein describe an extremely rare case of polymicrobial bivalvular endocarditis due to coinfection with Enterococcus faecalis and Coxiella burnetii in a 62-year-old male patient, and extensively review the relevant medical literature. To the best of our knowledge, only three similar cases have been previously reported. Q fever is a worldwide endemic bacterial zoonosis, but it and its most common chronic complication, endocarditis, are still underestimated and underdiagnosed worldwide. This situation reflects the paucity of reported cases of polymicrobial endocarditis in combination with Coxiella burnetii. Clinical presentation of Q fever endocarditis is highly nonspecific, and diagnosis may be delayed or missed, leading to severe and potentially fatal disease. Our case and the previously reported similar cases emphasize the need for further evaluation of infective endocarditis due to Coxiella burnetii, in all cases of culture-negative endocarditis, and in prolonged oligo-symptomatic inflammatory syndrome, particularly in the presence of valvular heart disease. This approach should be applied even when typical pathogens are isolated, especially in endemic areas of Q fever, and with atypical presentation.
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Affiliation(s)
- Asala Abu-Ahmad
- Infectious Diseases Unit, Bnai Zion Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3104802, Israel; (A.A.-A.); (M.H.-S.); (A.P.)
| | - Fadel Bahouth
- Department of Cardiology, Bnai Zion Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3104802, Israel;
| | - Mirit Hershman-Sarafov
- Infectious Diseases Unit, Bnai Zion Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3104802, Israel; (A.A.-A.); (M.H.-S.); (A.P.)
| | - Alona Paz
- Infectious Diseases Unit, Bnai Zion Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3104802, Israel; (A.A.-A.); (M.H.-S.); (A.P.)
| | - Majed Odeh
- Department of Internal Medicine A, Bnai Zion Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3104802, Israel
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2
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Bach E, Fitzgerald SF, Williams-MacDonald SE, Mitchell M, Golde WT, Longbottom D, Nisbet AJ, Dinkla A, Sullivan E, Pinapati RS, Tan JC, Joosten LAB, Roest HJ, Østerbye T, Koets AP, Buus S, McNeilly TN. Genome-wide epitope mapping across multiple host species reveals significant diversity in antibody responses to Coxiella burnetii vaccination and infection. Front Immunol 2023; 14:1257722. [PMID: 37954609 PMCID: PMC10637584 DOI: 10.3389/fimmu.2023.1257722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/19/2023] [Indexed: 11/14/2023] Open
Abstract
Coxiella burnetii is an important zoonotic bacterial pathogen of global importance, causing the disease Q fever in a wide range of animal hosts. Ruminant livestock, in particular sheep and goats, are considered the main reservoir of human infection. Vaccination is a key control measure, and two commercial vaccines based on formalin-inactivated C. burnetii bacterins are currently available for use in livestock and humans. However, their deployment is limited due to significant reactogenicity in individuals previously sensitized to C. burnetii antigens. Furthermore, these vaccines interfere with available serodiagnostic tests which are also based on C. burnetii bacterin antigens. Defined subunit antigen vaccines offer significant advantages, as they can be engineered to reduce reactogenicity and co-designed with serodiagnostic tests to allow discrimination between vaccinated and infected individuals. This study aimed to investigate the diversity of antibody responses to C. burnetii vaccination and/or infection in cattle, goats, humans, and sheep through genome-wide linear epitope mapping to identify candidate vaccine and diagnostic antigens within the predicted bacterial proteome. Using high-density peptide microarrays, we analyzed the seroreactivity in 156 serum samples from vaccinated and infected individuals to peptides derived from 2,092 open-reading frames in the C. burnetii genome. We found significant diversity in the antibody responses within and between species and across different types of C. burnetii exposure. Through the implementation of three different vaccine candidate selection methods, we identified 493 candidate protein antigens for protein subunit vaccine design or serodiagnostic evaluation, of which 65 have been previously described. This is the first study to investigate multi-species seroreactivity against the entire C. burnetii proteome presented as overlapping linear peptides and provides the basis for the selection of antigen targets for next-generation Q fever vaccines and diagnostic tests.
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Affiliation(s)
- Emil Bach
- Department of Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark
| | | | | | | | | | | | | | - Annemieke Dinkla
- Department of Bacteriology, Host-Pathogen Interaction and Diagnostic Development, Wageningen Bioveterinary Research, Lelystad, Netherlands
| | - Eric Sullivan
- Nimble Therapeutics, Inc., Madison, WI, United States
| | | | - John C. Tan
- Nimble Therapeutics, Inc., Madison, WI, United States
| | - Leo A. B. Joosten
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Hendrik-Jan Roest
- Department of Bacteriology, Host-Pathogen Interaction and Diagnostic Development, Wageningen Bioveterinary Research, Lelystad, Netherlands
- Ministry of Agriculture, Nature and Food Quality, Den Haag, Netherlands
- Department of Infection and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
| | - Thomas Østerbye
- Department of Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Ad P. Koets
- Department of Bacteriology, Host-Pathogen Interaction and Diagnostic Development, Wageningen Bioveterinary Research, Lelystad, Netherlands
| | - Søren Buus
- Department of Immunology & Microbiology, University of Copenhagen, Copenhagen, Denmark
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Gutierrez-Castañeda LD, Acosta CR, Bustos MA, García DK, Bohada DP, Rodríguez R, Guerrero MI. Single Nucleotide Variants in the TLR1, TLR2 and TLR6 Genes: A Case-Control Study in a Colombian Population. Trop Med Infect Dis 2023; 8:473. [PMID: 37888601 PMCID: PMC10610572 DOI: 10.3390/tropicalmed8100473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Single nucleotide variants in toll-like receptor genes play a crucial role in leprosy susceptibility or resistance. METHODS With an epidemiology case-control study, associations between SNVs rs5743618 in TLR1, rs5743708 in TLR2, and rs5743810 in TLR6 and overall susceptibility for leprosy were estimated in 114 cases and 456 controls. Following that, stratified analysis was performed. DNA was extracted from peripheral blood. Genotyping was performed using predesigned TaqMan probes. RESULTS The A/G genotype of rs5743810 behaved as a protective factor for the development of leprosy in the codominant (OR= 0.37; 95% CI = 016-0.86, p = 0.049) and over-dominant (OR = 0.38; 95% CI = 0.16-0.88, p = 0.019) inheritance models. The A/G and A/A genotypes behaved as a protective factor (OR = 0.39; 95% CI = 0.17-0.87, p = 0.016) in the dominant model. The SNVs rs5743618 and rs5743708 showed no association with any of the models. The CGG haplotype (rs5743618-rs5743708-rs5743810) behaved as a susceptibility factor for developing leprosy (OR = 1.86; 95% CI = 1.11-3.10, p = 0.019). The latter haplotype behaved as a susceptibility factor for leprosy development in women (OR = 2.39; 95% CI = 1.21-4.82, p = 0.013). CONCLUSIONS The identified variants in the genes encoding TLRs, specifically rs5743810 in TLR6 and CGG (rs5743618-rs5743708-rs5743810) haplotypes, may somehow explain leprosy susceptibility in the studied population in a leprosy endemic region in Colombia.
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Affiliation(s)
- Luz D. Gutierrez-Castañeda
- Grupo de Ciencias Básicas en Salud (CBS)-FUCS, Instituto de Investigación, Fundación Universitaria de Ciencias de la Salud-FUCS, Bogotá 111411, Colombia
- Grupo Dermatología General, Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E, Bogotá 111511, Colombia;
| | - Carmen R. Acosta
- Grupo Dermatología Tropical, Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E, Bogotá 111511, Colombia;
| | - Mónica A. Bustos
- Grupo de Investigación en Enfermedades Parasitarias, Tropicales e Infecciosas (GIEPATI) Universidad de Pamplona, Pamplona 543058, Colombia; (M.A.B.); (D.P.B.); (R.R.)
| | - Diana K. García
- Grupo Dermatología General, Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E, Bogotá 111511, Colombia;
| | - Diana P. Bohada
- Grupo de Investigación en Enfermedades Parasitarias, Tropicales e Infecciosas (GIEPATI) Universidad de Pamplona, Pamplona 543058, Colombia; (M.A.B.); (D.P.B.); (R.R.)
| | - Raúl Rodríguez
- Grupo de Investigación en Enfermedades Parasitarias, Tropicales e Infecciosas (GIEPATI) Universidad de Pamplona, Pamplona 543058, Colombia; (M.A.B.); (D.P.B.); (R.R.)
| | - Martha Inirida Guerrero
- Grupo Dermatología Tropical, Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E, Bogotá 111511, Colombia;
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Guzman RM, Howard ZP, Liu Z, Oliveira RD, Massa AT, Omsland A, White SN, Goodman AG. Natural genetic variation in Drosophila melanogaster reveals genes associated with Coxiella burnetii infection. Genetics 2021; 217:6117219. [PMID: 33789347 PMCID: PMC8045698 DOI: 10.1093/genetics/iyab005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/07/2021] [Indexed: 12/16/2022] Open
Abstract
The gram-negative bacterium Coxiella burnetii is the causative agent of Query (Q) fever in humans and coxiellosis in livestock. Host genetics are associated with C. burnetii pathogenesis both in humans and animals; however, it remains unknown if specific genes are associated with severity of infection. We employed the Drosophila Genetics Reference Panel to perform a genome-wide association study to identify host genetic variants that affect host survival to C. burnetii infection. The genome-wide association study identified 64 unique variants (P < 10−5) associated with 25 candidate genes. We examined the role each candidate gene contributes to host survival during C. burnetii infection using flies carrying a null mutation or RNAi knockdown of each candidate. We validated 15 of the 25 candidate genes using at least one method. This is the first report establishing involvement of many of these genes or their homologs with C. burnetii susceptibility in any system. Among the validated genes, FER and tara play roles in the JAK/STAT, JNK, and decapentaplegic/TGF-β signaling pathways which are components of known innate immune responses to C. burnetii infection. CG42673 and DIP-ε play roles in bacterial infection and synaptic signaling but have no previous association with C. burnetii pathogenesis. Furthermore, since the mammalian ortholog of CG13404 (PLGRKT) is an important regulator of macrophage function, CG13404 could play a role in host susceptibility to C. burnetii through hemocyte regulation. These insights provide a foundation for further investigation regarding the genetics of C. burnetii susceptibility across a wide variety of hosts.
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Affiliation(s)
- Rosa M Guzman
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Zachary P Howard
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Ziying Liu
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Ryan D Oliveira
- Department of Veterinary Microbiology and Pathology, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Alisha T Massa
- Department of Veterinary Microbiology and Pathology, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Anders Omsland
- Paul G. Allen School for Global Animal Health, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
| | - Stephen N White
- Department of Veterinary Microbiology and Pathology, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA.,USDA-ARS Animal Disease Research, Pullman, WA 99164, USA.,Center for Reproductive Biology, Washington State University, Pullman, WA 99164, USA
| | - Alan G Goodman
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA.,Paul G. Allen School for Global Animal Health, College of Veterinary Medicine, Washington State University, Pullman, WA 99164, USA
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5
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Delaney MA, Hartigh AD, Carpentier SJ, Birkland TP, Knowles DP, Cookson BT, Frevert CW. Avoidance of the NLRP3 Inflammasome by the Stealth Pathogen, Coxiella burnetii. Vet Pathol 2021; 58:624-642. [PMID: 33357072 DOI: 10.1177/0300985820981369] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Coxiella burnetii, a highly adapted obligate intracellular bacterial pathogen and the cause of the zoonosis Q fever, is a reemerging public health threat. C. burnetii employs a Type IV secretion system (T4SS) to establish and maintain its intracellular niche and modulate host immune responses including the inhibition of apoptosis. Interactions between C. burnetii and caspase-1-mediated inflammasomes are not fully elucidated. This study confirms that C. burnetii does not activate caspase-1 during infection of mouse macrophages in vitro. C. burnetii-infected cells did not develop NLRP3 and ASC foci indicating its ability to avoid cytosolic detection. C. burnetii is unable to inhibit the pyroptosis and IL-1β secretion that is induced by potent inflammasome stimuli but rather enhances these caspase-1-mediated effects. We found that C. burnetii upregulates pro-IL-1β and robustly primes NLRP3 inflammasomes via TLR2 and MyD88 signaling. As for wildtype C. burnetii, T4SS-deficient mutants primed and potentiated NLRP3 inflammasomes. An in vivo model of pulmonary infection in C57BL/6 mice was developed. Mice deficient in NLRP3 or caspase-1 were like wildtype mice in the development and resolution of splenomegaly due to red pulp hyperplasia, and histologic lesions and macrophage kinetics, but had slightly higher pulmonary bacterial burdens at the greatest measured time point. Together these findings indicate that C. burnetii primes but avoids cytosolic detection by NLRP3 inflammasomes, which are not required for the clinical resistance of C57BL/6 mice. Determining mechanisms employed by C. burnetii to avoid cytosolic detection via NLRP3 inflammasomes will be beneficial to the development of preventative and interventional therapies for Q fever.
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Affiliation(s)
- Martha A Delaney
- Departments of Comparative Medicine and Pathology, and the Comparative Pathology Program, 7284University of Washington, Seattle, WA
- Current address: Martha A. Delaney, Zoological Pathology Program, University of Illinois, Brookfield, IL, USA
| | - Andreas den Hartigh
- Departments of Microbiology and Lab Medicine, 7284University of Washington, Seattle, WA
| | - Samuel J Carpentier
- Departments of Microbiology and Lab Medicine, 7284University of Washington, Seattle, WA
| | - Timothy P Birkland
- Departments of Comparative Medicine and Pathology, and the Comparative Pathology Program, 7284University of Washington, Seattle, WA
| | - Donald P Knowles
- Animal Disease Research Unit, Agricultural Research Service, United States Department of Agriculture, Pullman, WA
- Department of Veterinary Microbiology and Pathology, 6760Washington State University, Pullman, WA
| | - Brad T Cookson
- Departments of Microbiology and Lab Medicine, 7284University of Washington, Seattle, WA
| | - Charles W Frevert
- Departments of Comparative Medicine and Pathology, and the Comparative Pathology Program, 7284University of Washington, Seattle, WA
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6
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Sahu R, Rawool DB, Dhaka P, Yadav JP, Mishra SP, Kumar M, Vergis J, Malik SS, Barbuddhe SB. Current perspectives on the occurrence of Q fever: highlighting the need for systematic surveillance for a neglected zoonotic disease in Indian subcontinent. ENVIRONMENTAL MICROBIOLOGY REPORTS 2021; 13:138-158. [PMID: 33314653 DOI: 10.1111/1758-2229.12918] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 06/12/2023]
Abstract
Coxiellosis or Q fever is an important global occupational zoonotic disease caused by one of the most contagious bacterial pathogens - Coxiella burnetii, which ranks one among the 13 global priority zoonoses. The detection of C. burnetii infection is exhibiting an increasing trend in high-risk personnel around the globe. It has increasingly been detected from foods of animal origin (including bulk milk, eggs, and meat) as well as tick vectors in many parts of the world. Coxiellosis is reported to be an important public health threat causing spontaneous abortions in humans and potential reproductive failure, which would result in production losses among livestock. Further, comprehensive coverage of the reports and trends of Q fever in developing countries, where this infection is supposed to be widely prevalent appears scarce. Also, the pathogen remains grossly neglected and underreported. Moreover, policymakers and funding agencies do not view it as a priority problem, especially in the Indian subcontinent, including Sri Lanka, Bhutan, Pakistan, Nepal, Bangladesh and Maldives. Here, we review the occurrence and epidemiology of the disease in a global context with special emphasis on its status in the Indian subcontinent.
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Affiliation(s)
- Radhakrishna Sahu
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Deepak Bhiwa Rawool
- ICAR- National Research Centre on Meat, Hyderabad, Telangana, 500 092, India
| | - Pankaj Dhaka
- School of Public Health and Zoonoses, College of Veterinary Science, GADVASU, Ludhiana, Punjab, 141004, India
| | - Jay Prakash Yadav
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Sidharth Prasad Mishra
- Department of Animal Genetics and Breeding, West Bengal University of Animal and Fishery Sciences, Kolkata, West Bengal, 700037, India
| | - Manesh Kumar
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Jess Vergis
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
| | - Satyaveer Singh Malik
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, 243 122, India
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Fisher JR, Chroust ZD, Onyoni F, Soong L. Pattern Recognition Receptors in Innate Immunity to Obligate Intracellular Bacteria. ZOONOSES (BURLINGTON, MASS.) 2021; 1:10. [PMID: 35282331 PMCID: PMC8909792 DOI: 10.15212/zoonoses-2021-0011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Host pattern recognition receptors (PRRs) are crucial for sensing pathogenic microorganisms, launching innate responses, and shaping pathogen-specific adaptive immunity during infection. Rickettsia spp., Orientia tsutsugamushi, Anaplasma spp., Ehrlichia spp., and Coxiella burnetii are obligate intracellular bacteria, which can only replicate within host cells and must evade immune detection to successfully propagate. These five bacterial species are zoonotic pathogens of clinical or agricultural importance, yet, uncovering how immune recognition occurs has remained challenging. Recent evidence from in-vitro studies and animal models has offered new insights into the types and kinetics of PRR activation during infection with Rickettsia spp., A. phagocytophilum, E. chaffeensis, and C. burnetii, respectively. However, much less is known in these regards for O. tsutsugamushi infection, until the recent discovery for the role of the C-type lectin receptor Mincle during lethal infection in mice and in primary macrophage cultures. This review gives a brief summary for clinical and epidemiologic features of these five bacterial infections, focuses on fundamental biologic facets of infection, and recent advances in host recognition. In addition, we discuss knowledge gaps for innate recognition of these bacteria in the context of disease pathogenesis.
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Affiliation(s)
- James R. Fisher
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Zachary D. Chroust
- School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Florence Onyoni
- Graduate School of Biomedical Sciences, University of Texas Medical Branch, Galveston, Texas, USA
| | - Lynn Soong
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, USA
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, USA
- Corresponding author: Lynn Soong, Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd. MRB 3.142, Galveston, Texas 77555-1070,
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Buijs SB, Jansen AFM, Oosterheert JJ, Schoffelen T, Wever PC, Hoepelman AIM, van de Vosse E, van Deuren M, Bleeker-Rovers CP. Single nucleotide polymorphism (SNP) rs3751143 in P2RX7 is associated with therapy failure in chronic Q fever while rs7125062 in MMP1 is associated with fewer complications. Clin Microbiol Infect 2020; 27:S1198-743X(20)30360-8. [PMID: 32615313 DOI: 10.1016/j.cmi.2020.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Chronic Q fever is a persistent infection with the intracellular bacterium Coxiella burnetii. Development of chronic Q fever is associated with single nucleotide polymorphisms (SNPs) in genes encoding for pattern recognition receptors, for phagolysosomal pathway components and for matrix metalloproteinases (MMPs). We evaluated the association of SNPs in these innate-immunity and MMP genes with clinical outcomes. METHODS SNPs were selected from previous association studies and analysed in a cohort of patients with chronic Q fever. The primary outcome was all-cause mortality; secondary outcomes were therapy failure and chronic Q fever-related complications. Subdistribution hazard ratios (SHR) were calculated. RESULTS Nineteen SNPs were analysed in 134 patients with proven and 29 with probable chronic Q fever. In multivariable analysis, none of the selected SNPs was associated with all-cause mortality. However, SNP rs3751143 located in P2RX7 appeared to be associated with therapy failure (SHR 2.42; 95% confidence interval, 1.16-5.05; p 0.02), which is in line with other reports, showing that a loss of function of the P2X7 receptor leads to inefficient killing of intracellular organisms. In addition, SNP rs7125062 located in MMP1, involved in the cleavage of extracellular matrix, was associated with fewer chronic Q fever-related complications such as acute aneurysms (SHR 0.49; 95% confidence interval, 0.29-0.83; p 0.008). CONCLUSIONS A polymorphism in P2RX7, known to lead to loss of function of the receptor and inefficient killing of intracellular organisms, and a polymorphism in MMP1 were respectively associated with more therapy failures and fewer complications such as acute aneurysms in patients with chronic Q fever.
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Affiliation(s)
- S B Buijs
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
| | - A F M Jansen
- Radboud Expertise Center for Q Fever, Radboud Center for Infectious Diseases, Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - J J Oosterheert
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - T Schoffelen
- Radboud Expertise Center for Q Fever, Radboud Center for Infectious Diseases, Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - P C Wever
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - A I M Hoepelman
- Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - E van de Vosse
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands
| | - M van Deuren
- Radboud Expertise Center for Q Fever, Radboud Center for Infectious Diseases, Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
| | - C P Bleeker-Rovers
- Radboud Expertise Center for Q Fever, Radboud Center for Infectious Diseases, Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
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Lesion size is associated with genetic polymorphisms in TLR1, TLR6, and TIRAP genes in patients with major abscesses and diabetic foot infections. Eur J Clin Microbiol Infect Dis 2019; 39:353-360. [PMID: 31786695 PMCID: PMC7010613 DOI: 10.1007/s10096-019-03732-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 10/02/2019] [Indexed: 11/03/2022]
Abstract
Genetic variation in Toll-like receptors (TLRs) has previously been associated with susceptibility to complicated skin and skin structure infections (cSSSIs). The aim of this study was to investigate associations between the severity of cSSSIs, i.e., major abscesses and diabetic foot infections (DFIs), and a set of genetic polymorphisms in the Toll-like receptor pathway. A total of 121 patients with major abscesses and 132 with DFIs participating in a randomized clinical trial were genotyped for 13 nonsynonymous single-nucleotide polymorphisms (SNPs) in genes coding for TLRs and the signaling adaptor molecule TIRAP. Infection severity was defined by lesion size at clinical presentation for both types of infections. The PEDIS infection score was also used to define severity of DFIs. Linear regression models were used to study factors independently associated with severity. In patients with large abscesses, hetero- or homozygosity for the allelic variant TLR6 (P249S) was associated with significantly smaller lesions while homozygosity for the allelic variant TLR1 (R80T) was associated with significantly larger lesions. PRRs genes were not significantly associated with PEDIS. However, patients with DFI hetero- or homozygous for the allelic variant TLR1 (S248N) had significantly larger lesions. Polymorphisms in TLR1 and TLR6 influence the severity of cSSSIs as assessed by the lesion size of major abscesses and DFIs. ClinicalTrial.gov Identifier: NCT00402727.
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10
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Kohl L, Hayek I, Daniel C, Schulze-Lührmann J, Bodendorfer B, Lührmann A, Lang R. MyD88 Is Required for Efficient Control of Coxiella burnetii Infection and Dissemination. Front Immunol 2019; 10:165. [PMID: 30800124 PMCID: PMC6376249 DOI: 10.3389/fimmu.2019.00165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 01/18/2019] [Indexed: 12/28/2022] Open
Abstract
The intracellular pathogen Coxiella (C.) burnetii causes Q fever, a usually self-limiting respiratory infection that becomes chronic and severe in some patients. Innate immune recognition of C. burnetii and its role in the decision between resolution and chronicity is not understood well. However, TLR2 is important for the response to C. burnetii in mice, and genetic polymorphisms in Myd88 have been associated with chronic Q fever in humans. Here, we have employed MyD88-deficient mice in infection models with the attenuated C. burnetii Nine Mile phase II strain (NMII). Myd88−/− macrophages failed to restrict the growth of NMII in vitro, and to upregulate production of the cytokines TNF, IL-6, and IL-10. Following intraperitoneal infection, NMII bacterial burden was significantly higher on day 5 and 20 in organs of Myd88−/− mice. After infection via the natural route by intratracheal injection, a higher bacterial load in the lung and increased dissemination of NMII to other organs was observed in MyD88-deficient mice. While wild-type mice essentially cleared NMII on day 27 after intratracheal infection, it was still readily detectable on day 42 in multiple organs in the absence of MyD88. Despite the elevated bacterial load, Myd88−/− mice had less granulomatous inflammation and expressed significantly lower levels of chemoattractants, inflammatory cytokines, and of several IFNγ-induced genes relevant for control of intracellular pathogens. Together, our results show that MyD88-dependent signaling is essential for early control of C. burnetii replication and to prevent systemic spreading. The continued presence of NMII in the organs of Myd88−/− mice constitutes a new mouse model to study determinants of chronicity and resolution in Q fever.
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Affiliation(s)
- Lisa Kohl
- Institute of Clinical Microbiology, Immunology and Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Inaya Hayek
- Institute of Clinical Microbiology, Immunology and Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Christoph Daniel
- Department of Nephropathology, Institute of Pathology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Jan Schulze-Lührmann
- Institute of Clinical Microbiology, Immunology and Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Barbara Bodendorfer
- Institute of Clinical Microbiology, Immunology and Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Anja Lührmann
- Institute of Clinical Microbiology, Immunology and Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Roland Lang
- Institute of Clinical Microbiology, Immunology and Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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11
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Genetic variations in innate immunity genes affect response to Coxiella burnetii and are associated with susceptibility to chronic Q fever. Clin Microbiol Infect 2019; 25:631.e11-631.e15. [PMID: 30616015 DOI: 10.1016/j.cmi.2018.08.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/16/2018] [Accepted: 08/11/2018] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Chronic Q fever is a persistent infection, mostly of aortic aneurysms, vascular prostheses or damaged heart valves, caused by the intracellular bacterium Coxiella burnetii. Only a fraction of C. burnetii-infected individuals at risk develop chronic Q fever. In these individuals, a defective innate immune response may contribute to the development of chronic Q fever. We assessed whether genetic variations in genes involved in the killing machinery for C. burnetii by macrophages, contribute to the progression to chronic Q fever. METHODS The prevalence of 66 single nucleotide polymorphisms (SNPs) in 31 genes pivotal in phagolysosomal maturation, bacterial killing and autophagy, was determined in 173 chronic Q fever patients and 184 controls with risk factors for chronic Q fever and serological evidence of a C. burnetii infection. Associations were detected with univariate logistic regression models. To assess the effect of these SNPs on innate responses to C. burnetii, the C. burnetii-induced cytokine production and basal reactive oxygen species production of healthy volunteers was determined. RESULTS RAB7A (rs13081864) and P2RX7 loss-of-function SNP (rs3751143) were more common in chronic Q fever patients than in controls. RAB5A (rs8682), P2RX7 gain-of-function SNP (rs1718119), MAP1LC3A (rs1040747) and ATG5 (rs2245214) were more common in controls. In healthy volunteers, RAB7A (rs13081864) and MAP1LC3A (rs1040747) influenced the C. burnetii-induced cytokine production. RAB7A (rs13081864) modulated basal reactive oxygen species production. CONCLUSIONS RAB7A (rs13081864) and P2RX7 (rs3751143) are associated with the development of chronic Q fever, whereas RAB5A (rs8682), P2RX7 (rs1718119), MAP1LC3A (rs1040747) and ATG5 (rs2245214) may have protective effects.
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12
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Das DP, Malik SVS, Sahu R, Yadav JP, Rawool DB, Barbuddhe SB. Loop-mediated isothermal amplification assay for detection of Coxiella burnetii targeting the com1 gene. J Microbiol Methods 2018; 155:55-58. [PMID: 30445112 DOI: 10.1016/j.mimet.2018.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/02/2018] [Accepted: 11/12/2018] [Indexed: 12/28/2022]
Abstract
We developed the com1 gene based loop-mediated isothermal amplification (LAMP) assay for the detection of Coxiella burnetii and validated it by screening DNA isolated from serum samples collected from animals and humans. The detection of Coxiella by LAMP assay was comparable with the com1 based-PCR.
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Affiliation(s)
- Durga Prasad Das
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - Satya Veer Singh Malik
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - Radhakrishna Sahu
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - Jay Prakash Yadav
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
| | - Deepak B Rawool
- Division of Veterinary Public Health, ICAR- Indian Veterinary Research Institute, Izatnagar 243 122, India
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13
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Ammerdorffer A, Kuley R, Dinkla A, Joosten LAB, Toman R, Roest HJ, Sprong T, Rebel JM. Coxiella burnetii isolates originating from infected cattle induce a more pronounced proinflammatory cytokine response compared to isolates from infected goats and sheep. Pathog Dis 2018; 75:3106324. [PMID: 28387835 DOI: 10.1093/femspd/ftx040] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/05/2017] [Indexed: 12/24/2022] Open
Abstract
Coxiella burnetii is the causative agent of Q fever. Although the prevalence of C. burnetii in cattle is much higher than in goats and sheep, infected cattle are rarely associated with human outbreaks. We investigated whether the immune response of humans differs after contact with C. burnetii isolates from different host origins or with different multilocus variable number of tandem repeat analysis (MLVA) genotypes. Cytokine responses were measured in human peripheral blood mononuclear cells (PBMCs) stimulated with 16 C. burnetii isolates with known MLVA genotype from goats, sheep, cattle, acute and chronic Q fever patients. Coxiella burnetii isolates originating from cattle induce significantly more IL-1β, TNF-α and IL-22 than the isolates from goats, sheep or chronic Q fever patients. Comparing the cytokine induction of the isolates based on their MVLA genotype did not reveal differences in response between the MLVA genotypes. The proinflammatory cytokine response induced in human PBMCs by C. burnetii isolates from cattle may explain the low incidence of human Q fever outbreaks caused by cattle. The cytokine profile of PBMCs stimulated with C. burnetii isolates from chronic Q fever patients resembles isolates from goats. Furthermore, cytokine responses seem to be depending on host origin than on MLVA genotype.
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Affiliation(s)
- Anne Ammerdorffer
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.,Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, 8221 RA Lelystad, The Netherlands
| | - Runa Kuley
- Department of Infection Biology, Wageningen Bioveterinary Research, 8221 RA Lelystad, The Netherlands
| | - Annemieke Dinkla
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, 8221 RA Lelystad, The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Rudolf Toman
- Laboratory for Diagnosis and Prevention of Rickettsial and Chlamydial Infections, Institute of Virology, Slovak Academy of Sciences Bratislava, 811 04 Staré Mesto, Slovakia
| | - Hendrik-Jan Roest
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, 8221 RA Lelystad, The Netherlands
| | - Tom Sprong
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.,Department of Internal Medicine, Canisius-Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands.,Department of Medical Microbiology and Infectious Diseases, Canisius- Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
| | - Johanna M Rebel
- Department of Animal health and Welfare, Livestock Research Wageningen UR, 6708 WD Wageningen, The Netherlands
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14
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Jansen AFM, Schoffelen T, Textoris J, Mege JL, Nabuurs-Franssen M, Raijmakers RPH, Netea MG, Joosten LAB, Bleeker-Rovers CP, van Deuren M. CXCL9, a promising biomarker in the diagnosis of chronic Q fever. BMC Infect Dis 2017; 17:556. [PMID: 28793883 PMCID: PMC5551022 DOI: 10.1186/s12879-017-2656-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 07/31/2017] [Indexed: 12/29/2022] Open
Abstract
Background In the aftermath of the largest Q fever outbreak in the world, diagnosing the potentially lethal complication chronic Q fever remains challenging. PCR, Coxiella burnetii IgG phase I antibodies, CRP and 18F–FDG-PET/CT scan are used for diagnosis and monitoring in clinical practice. We aimed to identify and test biomarkers in order to improve discriminative power of the diagnostic tests and monitoring of chronic Q fever. Methods We performed a transcriptome analysis on C. burnetii stimulated PBMCs of 4 healthy controls and 6 chronic Q fever patients and identified genes that were most differentially expressed. The gene products were determined using Luminex technology in whole blood samples stimulated with heat-killed C. burnetii and serum samples from chronic Q fever patients and control subjects. Results Gene expression of the chemokines CXCL9, CXCL10, CXCL11 and CCL8 was strongly up-regulated in C. burnetii stimulated PBMCs of chronic Q fever patients, in contrast to healthy controls. In whole blood cultures of chronic Q fever patients, production of all four chemokines was increased upon C. burnetii stimulation, but also healthy controls and past Q fever individuals showed increased production of CXCL9, CXCL10 and CCL8. However, CXCL9 and CXCL11 production was significantly higher for chronic Q fever patients compared to past Q fever individuals. In addition, CXCL9 serum concentrations in chronic Q fever patients were higher than in past Q fever individuals. Conclusion CXCL9 protein, measured in serum or as C. burnetii stimulated production, is a promising biomarker for the diagnosis of chronic Q fever. Electronic supplementary material The online version of this article (doi:10.1186/s12879-017-2656-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anne F M Jansen
- Department of Internal Medicine 463, Radboud center for Infectious Diseases (RCI), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. .,Radboud Expert Center for Q fever, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Teske Schoffelen
- Department of Internal Medicine 463, Radboud center for Infectious Diseases (RCI), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.,Radboud Expert Center for Q fever, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Julien Textoris
- Université Claude Bernard Lyon 1, Hospices Civils de Lyon, bioMérieux; EA7426 "Pathophysiology of injury induced immunosuppression (PI3)", Hôpital E. Herriot, Lyon, France
| | | | - Marrigje Nabuurs-Franssen
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Ruud P H Raijmakers
- Department of Internal Medicine 463, Radboud center for Infectious Diseases (RCI), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.,Radboud Expert Center for Q fever, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Mihai G Netea
- Department of Internal Medicine 463, Radboud center for Infectious Diseases (RCI), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.,Radboud Expert Center for Q fever, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine 463, Radboud center for Infectious Diseases (RCI), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.,Radboud Expert Center for Q fever, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Chantal P Bleeker-Rovers
- Department of Internal Medicine 463, Radboud center for Infectious Diseases (RCI), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.,Radboud Expert Center for Q fever, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Marcel van Deuren
- Department of Internal Medicine 463, Radboud center for Infectious Diseases (RCI), Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands. .,Radboud Expert Center for Q fever, Radboud University Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands.
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15
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Jansen AFM, Schoffelen T, Textoris J, Mege JL, Bleeker-Rovers CP, Roest HIJ, Wever PC, Joosten LAB, Netea MG, van de Vosse E, van Deuren M. Involvement of matrix metalloproteinases in chronic Q fever. Clin Microbiol Infect 2017; 23:487.e7-487.e13. [PMID: 28179203 DOI: 10.1016/j.cmi.2017.01.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/20/2017] [Accepted: 01/28/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Chronic Q fever is a persistent infection with the intracellular Gram-negative bacterium Coxiella burnetii, which can lead to complications of infected aneurysms. Matrix metalloproteinases (MMPs) cleave extracellular matrix and are involved in infections as well as aneurysms. We aimed to study the role of MMPs in the pathogenesis of chronic Q fever. METHODS We investigated gene expression of MMPs through microarray analysis and MMP production with ELISA in C. burnetii-stimulated peripheral blood mononuclear cells (PBMCs) of patients with chronic Q fever and healthy controls. Twenty single nucleotide polymorphisms (SNPs) of MMP and tissue inhibitor of MMP genes were genotyped in 139 patients with chronic Q fever and 220 controls with similar cardiovascular co-morbidity. Additionally, circulating MMPs levels in patients with chronic Q fever were compared with those in cardiovascular controls with and without a history of past Q fever. RESULTS In healthy controls, the MMP pathway involving four genes (MMP1, MMP7, MMP10, MMP19) was significantly up-regulated in C. burnetii-stimulated but not in Escherichia coli lipopolysaccharide -stimulated PBMCs. Coxiella burnetii induced MMP-1 and MMP-9 production in PBMCs of healthy individuals (both p<0.001), individuals with past Q fever (p<0.05, p<0.01, respectively) and of patients with chronic Q fever (both p<0.001). SNPs in MMP7 (rs11568810) (p<0.05) and MMP9 (rs17576) (p<0.05) were more common in patients with chronic Q fever. Circulating MMP-7 serum levels were higher in patients with chronic Q fever (median 33.5 ng/mL, interquartile range 22.3-45.7 ng/mL) than controls (20.6 ng/mL, 15.9-33.8 ng/mL). CONCLUSION Coxiella burnetii-induced MMP production may contribute to the development of chronic Q fever.
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Affiliation(s)
- A F M Jansen
- Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands; Radboud Expert Centre for Q fever and Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, The Netherlands.
| | - T Schoffelen
- Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands; Radboud Expert Centre for Q fever and Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, The Netherlands
| | - J Textoris
- Université Claude Bernard Lyon 1, Hospices Civils de Lyon, bioMérieux; "Pathophysiology of Injury Induced Immunosuppression (PI3)", Hôpital E. Herriot, Lyon, France
| | - J L Mege
- URMITE, Aix-Marseille University, Marseille, France
| | - C P Bleeker-Rovers
- Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands; Radboud Expert Centre for Q fever and Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, The Netherlands
| | - H I J Roest
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Lelystad, The Netherlands
| | - P C Wever
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - L A B Joosten
- Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands; Radboud Expert Centre for Q fever and Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, The Netherlands
| | - M G Netea
- Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands; Radboud Expert Centre for Q fever and Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, The Netherlands
| | - E van de Vosse
- Department of Infectious Diseases, Leiden University Medical Centre, Leiden, The Netherlands
| | - M van Deuren
- Department of Internal Medicine, Division of Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands; Radboud Expert Centre for Q fever and Radboud Centre for Infectious Diseases (RCI), Radboud University Medical Centre, The Netherlands
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16
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Battisti JM, Watson LA, Naung MT, Drobish AM, Voronina E, Minnick MF. Analysis of the Caenorhabditis elegans innate immune response to Coxiella burnetii. Innate Immun 2016; 23:111-127. [PMID: 27884946 DOI: 10.1177/1753425916679255] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The nematode Caenorhabditis elegans is well established as a system for characterization and discovery of molecular mechanisms mediating microbe-specific inducible innate immune responses to human pathogens. Coxiella burnetii is an obligate intracellular bacterium that causes a flu-like syndrome in humans (Q fever), as well as abortions in domesticated livestock, worldwide. Initially, when wild type C. elegans (N2 strain) was exposed to mCherry-expressing C. burnetii (CCB) a number of overt pathological manifestations resulted, including intestinal distension, deformed anal region and a decreased lifespan. However, nematodes fed autoclave-killed CCB did not exhibit these symptoms. Although vertebrates detect C. burnetii via TLRs, pathologies in tol-1(-) mutant nematodes were indistinguishable from N2, and indicate nematodes do not employ this orthologue for detection of C. burnetii. sek-1(-) MAP kinase mutant nematodes succumbed to infection faster, suggesting that this signaling pathway plays a role in immune activation, as previously shown for orthologues in vertebrates during a C. burnetii infection. C. elegans daf-2(-) mutants are hyper-immune and exhibited significantly reduced pathological consequences during challenge. Collectively, these results demonstrate the utility of C. elegans for studying the innate immune response against C. burnetii and could lead to discovery of novel methods for prevention and treatment of disease in humans and livestock.
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Affiliation(s)
- James M Battisti
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Lance A Watson
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Myo T Naung
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Adam M Drobish
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Ekaterina Voronina
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
| | - Michael F Minnick
- Program in Cellular, Molecular and Microbial Biology, Division of Biological Sciences, University of Montana, Missoula, MT, USA
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17
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Schoffelen T, Textoris J, Bleeker-Rovers CP, Ben Amara A, van der Meer JWM, Netea MG, Mege JL, van Deuren M, van de Vosse E. Intact interferon-γ response against Coxiella burnetii by peripheral blood mononuclear cells in chronic Q fever. Clin Microbiol Infect 2016; 23:209.e9-209.e15. [PMID: 27876593 DOI: 10.1016/j.cmi.2016.11.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 11/10/2016] [Accepted: 11/11/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Q fever is caused by Coxiella burnetii, an intracellular bacterium that infects phagocytes. The aim of the present study was to investigate whether the C. burnetii-induced IFN-γ response is defective in chronic Q fever patients. METHODS IFN-γ was measured in supernatants of C. burnetii-stimulated peripheral blood mononuclear cells (PBMCs) of 17 chronic Q fever patients and 17 healthy individuals. To assess IFN-γ responses, expression profiles of IFN-γ-induced genes in C. burnetii-stimulated PBMCs were studied in six patients and four healthy individuals. Neopterin was measured in PBMC supernatants (of eight patients and four healthy individuals) and in sera (of 21 patients and 11 healthy individuals). In a genetic association study, polymorphisms in genes involved in the Th1-cytokine response were analysed in a cohort of 139 chronic Q fever patients and a cohort of 220 control individuals with previous exposition to C. burnetii. RESULTS IFN-γ production by C. burnetii-stimulated PBMCs from chronic Q fever patients was significantly higher than in healthy controls. Many IFN-γ response genes were strongly upregulated in PBMCs of patients. Neopterin levels were significantly higher in PBMC supernatants and sera of patients. The IL12B polymorphisms rs3212227 and rs2853694 were associated with chronic Q fever. CONCLUSIONS IFN-γ production, as well as the response to IFN-γ, is intact in chronic Q fever patients, and even higher than in healthy individuals. Polymorphisms in the IL-12p40 gene are associated with chronic Q fever. Thus, a deficiency in IFN-γ responses does not explain the failure to clear the infection. The genetic data suggest, however, that the IL-12/IFN-γ pathway does play a role.
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Affiliation(s)
- T Schoffelen
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - J Textoris
- URMITE, CNRS UMR 7278, IRD 198, INSERM 1095, Aix-Marseille University, Marseille, France
| | - C P Bleeker-Rovers
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Ben Amara
- URMITE, CNRS UMR 7278, IRD 198, INSERM 1095, Aix-Marseille University, Marseille, France
| | - J W M van der Meer
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - M G Netea
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J-L Mege
- URMITE, CNRS UMR 7278, IRD 198, INSERM 1095, Aix-Marseille University, Marseille, France
| | - M van Deuren
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - E van de Vosse
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
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18
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Ammerdorffer A, Stappers MHT, Oosting M, Schoffelen T, Hagenaars JCJP, Bleeker-Rovers CP, Wegdam-Blans MC, Wever PC, Roest HJ, van de Vosse E, Netea MG, Sprong T, Joosten LAB. Genetic variation in TLR10 is not associated with chronic Q fever, despite the inhibitory effect of TLR10 on Coxiella burnetii-induced cytokines in vitro. Cytokine 2015; 77:196-202. [PMID: 26364993 DOI: 10.1016/j.cyto.2015.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/04/2015] [Accepted: 09/04/2015] [Indexed: 10/23/2022]
Abstract
Coxiella burnetii, the causative agent of Q fever, is recognized by TLR2. TLR10 can act as an inhibitory receptor on TLR2-derived immune responses. Therefore, we investigated the role of TLR10 on C. burnetii-induced cytokine production and assessed whether genetic polymorphisms in TLR10 influences the development of chronic Q fever. HEK293 cells, transfected with TLR2, TLR10 or TLR2/TLR10, and human peripheral blood mononuclear cells (PBMCs) in the presence of anti-TLR10, were stimulated with C. burnetii. In both assays, the absence of TLR10 resulted in increased cytokine responses after C. burnetii stimulation. In addition, the effect of single nucleotide polymorphisms (SNPs) in TLR10 was examined in healthy volunteers whose PBMCs were stimulated with C. burnetii Nine Mile or the Dutch outbreak isolate C. burnetii 3262. Individuals bearing SNPs in TLR10 displayed increased cytokine production upon C. burnetii 3262 stimulation. Furthermore, 139 chronic Q fever patients and 220 controls were genotyped for TLR10 N241H, I775V and I369L. None of these polymorphisms were associated with increased susceptibility to chronic Q fever. In conclusion, TLR10 has an inhibitory effect on in vitro cytokine production by C. burnetii, but the presence of TLR10 polymorphisms does not lead to an increased risk of developing chronic Q fever.
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Affiliation(s)
- Anne Ammerdorffer
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; Department of Bacteriology and TSEs, Central Veterinary Institute, 8219 PH Lelystad, The Netherlands
| | - Mark H T Stappers
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; Hasselt University, 3500 Hasselt, Belgium; Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Ziekenhuis, 6532 SZ Nijmegen, The Netherlands
| | - Marije Oosting
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Teske Schoffelen
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Julia C J P Hagenaars
- Department of Surgery, Jeroen Bosch Hospital, 5223 GW 's-Hertogenbosch, The Netherlands
| | - Chantal P Bleeker-Rovers
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Marjolijn C Wegdam-Blans
- Department of Medical Microbiology, Laboratory for Pathology and Medical Microbiology (PAMM), 5504 DL Veldhoven, The Netherlands
| | - Peter C Wever
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 5223 GW 's-Hertogenbosch, The Netherlands
| | - Hendrik-Jan Roest
- Department of Bacteriology and TSEs, Central Veterinary Institute, 8219 PH Lelystad, The Netherlands
| | - Esther van de Vosse
- Department of Infectious Diseases, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Mihai G Netea
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Tom Sprong
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Ziekenhuis, 6532 SZ Nijmegen, The Netherlands; Department of Internal Medicine, Canisius Wilhelmina Ziekenhuis, 6532 SZ Nijmegen, The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
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