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Farmand S, Sender V, Karlsson J, Merkl P, Normark S, Henriques-Normark B. STAT3 Deficiency Alters the Macrophage Activation Pattern and Enhances Matrix Metalloproteinase 9 Expression during Staphylococcal Pneumonia. J Immunol 2024; 212:69-80. [PMID: 37982695 PMCID: PMC10733582 DOI: 10.4049/jimmunol.2300151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 10/19/2023] [Indexed: 11/21/2023]
Abstract
Staphylococcus aureus is a significant cause of morbidity and mortality in pulmonary infections. Patients with autosomal-dominant hyper-IgE syndrome due to STAT3 deficiency are particularly susceptible to acquiring staphylococcal pneumonia associated with lung tissue destruction. Because macrophages are involved in both pathogen defense and inflammation, we investigated the impact of murine myeloid STAT3 deficiency on the macrophage phenotype in vitro and on pathogen clearance and inflammation during murine staphylococcal pneumonia. Murine bone marrow-derived macrophages (BMDM) from STAT3 LysMCre+ knockout or Cre- wild-type littermate controls were challenged with S. aureus, LPS, IL-4, or vehicle control in vitro. Pro- and anti-inflammatory responses as well as polarization and activation markers were analyzed. Mice were infected intratracheally with S. aureus, bronchoalveolar lavage and lungs were harvested, and immunohistofluorescence was performed on lung sections. S. aureus infection of STAT3-deficient BMDM led to an increased proinflammatory cytokine release and to enhanced upregulation of costimulatory MHC class II and CD86. Murine myeloid STAT3 deficiency did not affect pathogen clearance in vitro or in vivo. Matrix metalloproteinase 9 was upregulated in Staphylococcus-treated STAT3-deficient BMDM and in lung tissues of STAT3 knockout mice infected with S. aureus. Moreover, the expression of miR-155 was increased. The enhanced inflammatory responses and upregulation of matrix metalloproteinase 9 and miR-155 expression in murine STAT3-deficient as compared with wild-type macrophages during S. aureus infections may contribute to tissue damage as observed in STAT3-deficient patients during staphylococcal pneumonia.
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Affiliation(s)
- Susan Farmand
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Division of Pediatric Stem Cell Transplantation and Immunology, Clinic of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vicky Sender
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Clinical Microbiology, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Jens Karlsson
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Clinical Microbiology, Karolinska University Hospital Solna, Stockholm, Sweden
| | - Padryk Merkl
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Staffan Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Clinical Microbiology, Karolinska University Hospital Solna, Stockholm, Sweden
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Narciso AR, Henriques-Normark B. Immunization with Attenuated Pneumococcal Strains Provides Protection against Pneumococcal Colonization in Humans. Am J Respir Crit Care Med 2023; 208:832-834. [PMID: 37672662 PMCID: PMC10586242 DOI: 10.1164/rccm.202308-1459ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 09/06/2023] [Indexed: 09/08/2023] Open
Affiliation(s)
- Ana Rita Narciso
- Department of Microbiology, Tumor and Cell Biology Karolinska Institutet, Biomedicum Stockholm, Sweden and Department of Clinical Microbiology Karolinska University Hospital Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology Karolinska Institutet, Biomedicum Stockholm, Sweden and Department of Clinical Microbiology Karolinska University Hospital Stockholm, Sweden
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Shaw D, Abad R, Amin-Chowdhury Z, Bautista A, Bennett D, Broughton K, Cao B, Casanova C, Choi EH, Chu YW, Claus H, Coelho J, Corcoran M, Cottrell S, Cunney R, Cuypers L, Dalby T, Davies H, de Gouveia L, Deghmane AE, Demczuk W, Desmet S, Domenech M, Drew R, du Plessis M, Duarte C, Erlendsdóttir H, Fry NK, Fuursted K, Hale T, Henares D, Henriques-Normark B, Hilty M, Hoffmann S, Humphreys H, Ip M, Jacobsson S, Johnson C, Johnston J, Jolley KA, Kawabata A, Kozakova J, Kristinsson KG, Krizova P, Kuch A, Ladhani S, Lâm TT, León ME, Lindholm L, Litt D, Maiden MCJ, Martin I, Martiny D, Mattheus W, McCarthy ND, Meehan M, Meiring S, Mölling P, Morfeldt E, Morgan J, Mulhall R, Muñoz-Almagro C, Murdoch D, Murphy J, Musilek M, Mzabi A, Novakova L, Oftadeh S, Perez-Argüello A, Pérez-Vázquez M, Perrin M, Perry M, Prevost B, Roberts M, Rokney A, Ron M, Sanabria OM, Scott KJ, Sheppard C, Siira L, Sintchenko V, Skoczyńska A, Sloan M, Slotved HC, Smith AJ, Steens A, Taha MK, Toropainen M, Tzanakaki G, Vainio A, van der Linden MPG, van Sorge NM, Varon E, Vohrnova S, von Gottberg A, Yuste J, Zanella R, Zhou F, Brueggemann AB. Trends in invasive bacterial diseases during the first 2 years of the COVID-19 pandemic: analyses of prospective surveillance data from 30 countries and territories in the IRIS Consortium. Lancet Digit Health 2023; 5:e582-e593. [PMID: 37516557 PMCID: PMC10914672 DOI: 10.1016/s2589-7500(23)00108-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/22/2023] [Accepted: 05/25/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND The Invasive Respiratory Infection Surveillance (IRIS) Consortium was established to assess the impact of the COVID-19 pandemic on invasive diseases caused by Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, and Streptococcus agalactiae. We aimed to analyse the incidence and distribution of these diseases during the first 2 years of the COVID-19 pandemic compared to the 2 years preceding the pandemic. METHODS For this prospective analysis, laboratories in 30 countries and territories representing five continents submitted surveillance data from Jan 1, 2018, to Jan 2, 2022, to private projects within databases in PubMLST. The impact of COVID-19 containment measures on the overall number of cases was analysed, and changes in disease distributions by patient age and serotype or group were examined. Interrupted time-series analyses were done to quantify the impact of pandemic response measures and their relaxation on disease rates, and autoregressive integrated moving average models were used to estimate effect sizes and forecast counterfactual trends by hemisphere. FINDINGS Overall, 116 841 cases were analysed: 76 481 in 2018-19, before the pandemic, and 40 360 in 2020-21, during the pandemic. During the pandemic there was a significant reduction in the risk of disease caused by S pneumoniae (risk ratio 0·47; 95% CI 0·40-0·55), H influenzae (0·51; 0·40-0·66) and N meningitidis (0·26; 0·21-0·31), while no significant changes were observed for S agalactiae (1·02; 0·75-1·40), which is not transmitted via the respiratory route. No major changes in the distribution of cases were observed when stratified by patient age or serotype or group. An estimated 36 289 (95% prediction interval 17 145-55 434) cases of invasive bacterial disease were averted during the first 2 years of the pandemic among IRIS-participating countries and territories. INTERPRETATION COVID-19 containment measures were associated with a sustained decrease in the incidence of invasive disease caused by S pneumoniae, H influenzae, and N meningitidis during the first 2 years of the pandemic, but cases began to increase in some countries towards the end of 2021 as pandemic restrictions were lifted. These IRIS data provide a better understanding of microbial transmission, will inform vaccine development and implementation, and can contribute to health-care service planning and provision of policies. FUNDING Wellcome Trust, NIHR Oxford Biomedical Research Centre, Spanish Ministry of Science and Innovation, Korea Disease Control and Prevention Agency, Torsten Söderberg Foundation, Stockholm County Council, Swedish Research Council, German Federal Ministry of Health, Robert Koch Institute, Pfizer, Merck, and the Greek National Public Health Organization.
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Affiliation(s)
- David Shaw
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK
| | - Raquel Abad
- National Reference Laboratory for Meningococci, National Center of Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Zahin Amin-Chowdhury
- Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
| | | | - Desiree Bennett
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Karen Broughton
- Staphylococcus and Streptococcus Reference Section, AMRHAI, UK Health Security Agency, London, UK
| | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Carlo Casanova
- Swiss National Reference Center for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Eun Hwa Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Yiu-Wai Chu
- Department of Health, Microbiology Division, Public Health Laboratory Services Branch, Centre for Health Protection, Hong Kong Special Administrative Region, China
| | - Heike Claus
- University of Würzburg, Institute for Hygiene and Microbiology, National Reference Centre for Meningococci and Haemophilus influenzae, Würzburg, Germany
| | - Juliana Coelho
- Staphylococcus and Streptococcus Reference Section, AMRHAI, UK Health Security Agency, London, UK
| | - Mary Corcoran
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Robert Cunney
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Lize Cuypers
- National Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Tine Dalby
- Statens Serum Institut, Department of Infectious Disease Epidemiology & Prevention, Copenhagen, Denmark
| | - Heather Davies
- Meningococcal Reference Laboratory, Institute of Environmental Science and Research, Porirua, New Zealand
| | - Linda de Gouveia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Ala-Eddine Deghmane
- Institut Pasteur, Univeristé Paris Cité, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
| | - Walter Demczuk
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Stefanie Desmet
- National Reference Centre for Streptococcus pneumoniae, University Hospitals Leuven, Leuven, Belgium; Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Mirian Domenech
- National Center for Microbiology and CIBER of Respiratory Research, Instituto de Salud Carlos III, Madrid, Spain
| | - Richard Drew
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland; Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland; Clinical Innovation Unit, Rotunda, Dublin, Ireland
| | - Mignon du Plessis
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | | | - Helga Erlendsdóttir
- Department of Clinical Microbiology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Norman K Fry
- Immunisation and Vaccine Preventable Diseases Division and Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | - Kurt Fuursted
- Statens Serum Institut, Department of Bacteria, Parasites & Fungi, Copenhagen, Denmark
| | - Thomas Hale
- Blavatnik School of Government, University of Oxford, Oxford, UK
| | - Desiree Henares
- Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Birgitta Henriques-Normark
- Karolinska Institutet, Karolinska University Hospital, Public Health Agency of Sweden, Stockholm, Sweden
| | - Markus Hilty
- Swiss National Reference Center for Invasive Pneumococci, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Steen Hoffmann
- Statens Serum Institut, Department of Bacteria, Parasites & Fungi, Copenhagen, Denmark
| | - Hilary Humphreys
- Department of Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
| | - Margaret Ip
- Department of Microbiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Susanne Jacobsson
- National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | | | | | | | - Jana Kozakova
- National Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Karl G Kristinsson
- Department of Clinical Microbiology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Pavla Krizova
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Alicja Kuch
- National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | - Shamez Ladhani
- Immunisation and Countermeasures Division, UK Health Security Agency, London, UK
| | - Thiên-Trí Lâm
- University of Würzburg, Institute for Hygiene and Microbiology, National Reference Centre for Meningococci and Haemophilus influenzae, Würzburg, Germany
| | | | - Laura Lindholm
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - David Litt
- Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | | | - Irene Martin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
| | - Delphine Martiny
- National Belgian Reference Centre for Haemophilus influenzae, Laboratoire des Hôpitaux Universitaires de Bruxelles-Universitair Laboratorium van Brussel, Brussels, Belgium; Faculty of Medicine and Pharmacy, University of Mons, Mons, Belgium
| | | | - Noel D McCarthy
- Population Health Medicine, Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - Mary Meehan
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Susan Meiring
- Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Paula Mölling
- National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Julie Morgan
- Streptococcal Reference Laboratory, Institute of Environmental Science and Research Limited, Porirua, New Zealand
| | - Robert Mulhall
- Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland, Dublin, Ireland
| | - Carmen Muñoz-Almagro
- Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain; CIBER of Epidemiology and Public Health, Madrid, Spain; Medicine Department, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | | | - Martin Musilek
- National Reference Laboratory for Meningococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Alexandre Mzabi
- Ministère de la Santé - Direction de la santé, Luxembourg, Luxembourg
| | - Ludmila Novakova
- National Reference Laboratory for Haemophilus Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Shahin Oftadeh
- NSW Pneumococcal Reference Laboratory, Institute of Clinical Pathology and Medical Research - NSW Health Pathology, Sydney, NSW, Australia
| | - Amaresh Perez-Argüello
- Microbiology Department, Institut Recerca Sant Joan de Déu, Hospital Sant Joan de Deu, Barcelona, Spain
| | - Maria Pérez-Vázquez
- Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones Relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Benoit Prevost
- National Belgian Reference Centre for Haemophilus influenzae, Laboratoire des Hôpitaux Universitaires de Bruxelles-Universitair Laboratorium van Brussel, Brussels, Belgium
| | | | - Assaf Rokney
- Public Health Laboratories-Jerusalem, Public Health Services, Ministry of Health, Jerusalem, Israel
| | - Merav Ron
- Public Health Laboratories-Jerusalem, Public Health Services, Ministry of Health, Jerusalem, Israel
| | | | - Kevin J Scott
- Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow Royal Infirmary, Glasgow, UK
| | - Carmen Sheppard
- Respiratory and Vaccine Preventable Bacteria Reference Unit, UK Health Security Agency, London, UK
| | - Lotta Siira
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Vitali Sintchenko
- NSW Pneumococcal Reference Laboratory, Institute of Clinical Pathology and Medical Research - NSW Health Pathology, Sydney, NSW, Australia; Sydney Institute for Infectious Diseases, University of Sydney, NSW, Australia
| | - Anna Skoczyńska
- National Reference Centre for Bacterial Meningitis, Department of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland
| | | | | | - Andrew J Smith
- Bacterial Respiratory Infection Service, Scottish Microbiology Reference Laboratories, Glasgow Royal Infirmary, Glasgow, UK; College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Anneke Steens
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Muhamed-Kheir Taha
- Institut Pasteur, Univeristé Paris Cité, Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France
| | | | - Georgina Tzanakaki
- National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Anni Vainio
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mark P G van der Linden
- Department of Medical Microbiology, German National Reference Centre for Streptococci, University Hospital RWTH Aachen, Aachen, Germany
| | - Nina M van Sorge
- Department of Medical Microbiology and Infection Prevention, and Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Emmanuelle Varon
- Laboratory of Medical Biology and National Reference Centre for Pneumococci, Intercommunal Hospital of Créteil, Créteil, France
| | - Sandra Vohrnova
- National Reference Laboratory for Streptococcal Infections, Centre for Epidemiology and Microbiology, National Institute of Public Health, Prague, Czech Republic
| | - Anne von Gottberg
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
| | - Jose Yuste
- National Center for Microbiology and CIBER of Respiratory Research, Instituto de Salud Carlos III, Madrid, Spain
| | - Rosemeire Zanella
- National Laboratory for Meningitis and Pneumococcal Infections, Center of Bacteriology, Institute Adolfo Lutz, São Paulo, Brazil
| | - Fei Zhou
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Angela B Brueggemann
- Nuffield Department of Population Health, Big Data Institute, University of Oxford, Oxford, UK.
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Garriss G, Wimmercranz Marking U, Nannapaneni P, Henriques-Normark B, Blomqvist K. A case of meningitis caused by Streptococcus pseudopneumoniae in Sweden. Clin Microbiol Infect 2023; 29:944-946. [PMID: 36966987 DOI: 10.1016/j.cmi.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/08/2023] [Accepted: 03/17/2023] [Indexed: 04/03/2023]
Affiliation(s)
- Geneviève Garriss
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden; Division of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
| | | | - Priyanka Nannapaneni
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden; Division of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Blomqvist
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden; Division of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.
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Nakamoto R, Bamyaci S, Blomqvist K, Normark S, Henriques-Normark B, Sham LT. The divisome but not the elongasome organizes capsule synthesis in Streptococcus pneumoniae. Nat Commun 2023; 14:3170. [PMID: 37264013 DOI: 10.1038/s41467-023-38904-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/16/2023] [Indexed: 06/03/2023] Open
Abstract
The bacterial cell envelope consists of multiple layers, including the peptidoglycan cell wall, one or two membranes, and often an external layer composed of capsular polysaccharides (CPS) or other components. How the synthesis of all these layers is precisely coordinated remains unclear. Here, we identify a mechanism that coordinates the synthesis of CPS and peptidoglycan in Streptococcus pneumoniae. We show that CPS synthesis initiates from the division septum and propagates along the long axis of the cell, organized by the tyrosine kinase system CpsCD. CpsC and the rest of the CPS synthesis complex are recruited to the septum by proteins associated with the divisome (a complex involved in septal peptidoglycan synthesis) but not the elongasome (involved in peripheral peptidoglycan synthesis). Assembly of the CPS complex starts with CpsCD, then CpsA and CpsH, the glycosyltransferases, and finally CpsJ. Remarkably, targeting CpsC to the cell pole is sufficient to reposition CPS synthesis, leading to diplococci that lack CPS at the septum. We propose that septal CPS synthesis is important for chain formation and complement evasion, thereby promoting bacterial survival inside the host.
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Affiliation(s)
- Rei Nakamoto
- Infectious Diseases Translational Research Programme and Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117545, Singapore
| | - Sarp Bamyaci
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, SE-17177, Sweden
| | - Karin Blomqvist
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, SE-17177, Sweden
- Clinical Microbiology, Karolinska University Hospital Solna, SE-17176, Stockholm, Sweden
| | - Staffan Normark
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, SE-17177, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, SE-17177, Sweden
- Clinical Microbiology, Karolinska University Hospital Solna, SE-17176, Stockholm, Sweden
| | - Lok-To Sham
- Infectious Diseases Translational Research Programme and Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117545, Singapore.
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Nannapaneni P, Sundh J, Prast-Nielsen S, Rhedin S, Örtqvist Å, Naucler P, Henriques-Normark B. Metatranscriptomics of Nasopharyngeal Microbiota and Host Distinguish between Pneumonia and Health. Am J Respir Crit Care Med 2022; 206:1564-1567. [PMID: 35947760 PMCID: PMC9757092 DOI: 10.1164/rccm.202203-0463le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
| | | | | | - Samuel Rhedin
- Karolinska InstitutetStockholm, Sweden,Sachs Children and Youth HospitalStockholm, Sweden
| | | | | | - Birgitta Henriques-Normark
- Karolinska InstitutetStockholm, Sweden,Karolinska University Hospital, SolnaStockholm, Sweden,Corresponding author (e-mail: )
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Henriques-Normark B, Narciso AR. An Experimental Human Colonization Model with Pneumococcal Serotype 3 has the Potential to be Used for Vaccine Studies. Am J Respir Crit Care Med 2022; 206:1312-1314. [PMID: 35856830 PMCID: PMC9746867 DOI: 10.1164/rccm.202207-1342ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology,Department of Clinical MicrobiologyKarolinska University HospitalStockholm, Sweden
| | - Ana Rita Narciso
- Department of Microbiology, Tumor and Cell Biology,Department of Clinical MicrobiologyKarolinska University HospitalStockholm, Sweden
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Block N, Naucler P, Wagner P, Morfeldt E, Henriques-Normark B. Bacterial meningitis: Aetiology, risk factors, disease trends and severe sequelae during 50 years in Sweden. J Intern Med 2022; 292:350-364. [PMID: 35340067 PMCID: PMC9544249 DOI: 10.1111/joim.13488] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Bacterial meningitis (BM) is a rare but severe infection. Few population-based studies have characterised BM episodes and sequelae over long periods. METHODS This was a population-based observational cohort study with national coverage, using data on aetiological pathogens, sex, premorbid conditions, steroid pretreatment, severe sequelae and birth, death and diagnosis dates collected from 10,339 patients with BM reported to the National Board of Health and Welfare in Sweden between 1964 and 2014. RESULTS During the 50-year study period, the incidence of BM decreased in young children, but not in the elderly. The most common cause of BM was pneumococci (34%), followed by Haemophilus influenzae (26%), and meningococci (18%), mainly community acquired. Premorbid conditions were found in 20%. After the H. influenzae type b vaccine was introduced in 1993, the BM incidence decreased by 36%. Following pneumococcal conjugated vaccine introduction in 2009, the incidence and 30-day mortality from pneumococcal meningitis decreased by 64% and 100%, respectively, in previously healthy children, and the 30-day mortality decreased by 64% among comorbid adults. The BM incidence in immunosuppressed patients increased by 3% annually post vaccine introduction. The 30-day mortality was 3% in children and 14% in adults, and the rate of severe sequelae was 44%. On average, patients lost 11 years of healthy life due to BM. CONCLUSION The introduction of conjugated vaccines into the childhood vaccination program has reduced the incidence of BM in young children, but not in adults. Post vaccine introduction, patients present with more premorbid conditions and other bacterial causes of BM, emphasising the need for a correct diagnosis when treating these infections.
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Affiliation(s)
- Nils Block
- Department of Microbiology, Tumor and Cell biology (MTC), Biomedicum, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Visby County Hospital, Visby, Sweden
| | - Pontus Naucler
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Philippe Wagner
- Centre for Clinical Research Västmanland, Västmanland County Hospital, Uppsala University, Västerås, Sweden
| | | | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell biology (MTC), Biomedicum, Karolinska Institutet, Stockholm, Sweden.,Public Health Agency of Sweden, Solna, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
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9
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Jackmann N, Englund S, Frisk P, Mäkitie O, Utriainen P, Mörtberg A, Henriques-Normark B, Pütsep K, Harila-Saari A. The human cathelicidin hCAP-18 in serum of children with haemato-oncological diseases. Br J Haematol 2022; 198:1023-1031. [PMID: 35849644 PMCID: PMC9543647 DOI: 10.1111/bjh.18360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 11/29/2022]
Abstract
The human cathelicidin hCAP‐18 (pro‐LL‐37) is the pro‐protein of the antimicrobial peptide LL‐37. hCAP‐18 can be produced by many different cell types; bone marrow neutrophil precursors are the main source of hCAP‐18 in the circulation. Neutrophil count is used as a marker for myelopoiesis but does not always reflect neutrophil production in the bone marrow, and thus additional markers are needed. In this study, we established the reference interval of serum hCAP‐18 level in healthy children and compared serum hCAP‐18 levels between different diagnostic groups of children with haemato‐oncological diseases, at diagnosis. We found that children with diseases that impair myelopoiesis, such as acute leukaemia, aplastic anaemia, or myelodysplastic syndrome, presented with low hCAP‐18 levels, whereas patients with non‐haematological malignancies displayed serum hCAP‐18 levels in the same range as healthy children. Children with chronic myeloid leukaemia presented with high circulating levels of hCAP‐18, probably reflecting the high number of all differentiation stages of myeloid cells. We suggest that analysis of serum hCAP‐18 provides additional information regarding myelopoiesis in children with haemato‐oncological diseases, which may have future implications in assessment of myelopoiesis in clinical management.
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Affiliation(s)
- Natalja Jackmann
- Department of Women's and Children's Health, Uppsala University and University Children's Hospital, Uppsala, Sweden
| | - Sofia Englund
- Department of Women's and Children's Health, Uppsala University and University Children's Hospital, Uppsala, Sweden
| | - Per Frisk
- Department of Women's and Children's Health, Uppsala University and University Children's Hospital, Uppsala, Sweden
| | - Outi Mäkitie
- Department of Molecular Medicine and Surgery, Karolinska Institute, and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden.,Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pauliina Utriainen
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anette Mörtberg
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Katrin Pütsep
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Arja Harila-Saari
- Department of Women's and Children's Health, Uppsala University and University Children's Hospital, Uppsala, Sweden
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10
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Oliveira V, Aschtgen MS, van Erp A, Henriques-Normark B, Muschiol S. The Role of Minor Pilins in Assembly and Function of the Competence Pilus of Streptococcus pneumoniae. Front Cell Infect Microbiol 2022; 11:808601. [PMID: 35004361 PMCID: PMC8727766 DOI: 10.3389/fcimb.2021.808601] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 11/30/2021] [Indexed: 12/03/2022] Open
Abstract
The remarkable genomic plasticity of Streptococcus pneumoniae largely depends on its ability to undergo natural genetic transformation. To take up extracellular DNA, S. pneumoniae assembles competence pili composed of the major pilin ComGC. In addition to ComGC, four minor pilins ComGD, E, F, and G are expressed during bacterial competence, but their role in pilus biogenesis and transformation is unknown. Here, using a combination of protein-protein interaction assays we show that all four proteins can directly interact with each other. Pneumococcal ComGG stabilizes the minor pilin ComGD and ComGF and can interact with and stabilize the major pilin ComGC, thus, deletion of ComGG abolishes competence pilus assembly. We further demonstrate that minor pilins are present in sheared pili fractions and find ComGF to be incorporated along the competence pilus by immunofluorescence and electron microscopy. Finally, mutants of the invariant Glu5 residue (E5), ComGDE5A or ComGEE5A, but not ComGFE5A, were severely impaired in pilus formation and function. Together, our results suggest that ComGG, lacking E5, is essential for competence pilus assembly and function, and plays a central role in connecting the pneumococcal minor pilins to ComGC.
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Affiliation(s)
- Vitor Oliveira
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | | | - Anke van Erp
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Muschiol
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
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11
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Hanquet G, Krizova P, Dalby T, Ladhani SN, Nuorti JP, Danis K, Mereckiene J, Knol MJ, Winje BA, Ciruela P, de Miguel S, Portillo ME, MacDonald L, Morfeldt E, Kozakova J, Valentiner-Branth P, Fry NK, Rinta-Kokko H, Varon E, Corcoran M, van der Ende A, Vestrheim DF, Munoz-Almagro C, Sanz JC, Castilla J, Smith A, Henriques-Normark B, Colzani E, Pastore-Celentano L, Savulescu C. Serotype Replacement after Introduction of 10-Valent and 13-Valent Pneumococcal Conjugate Vaccines in 10 Countries, Europe. Emerg Infect Dis 2022; 28:137-138. [PMID: 34932457 PMCID: PMC8714201 DOI: 10.3201/eid2801.210734] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We evaluated invasive pneumococcal disease (IPD) during 8 years of infant pneumococcal conjugate vaccine (PCV) programs using 10-valent (PCV10) and 13-valent (PCV13) vaccines in 10 countries in Europe. IPD incidence declined during 2011-2014 but increased during 2015-2018 in all age groups. From the 7-valent PCV period to 2018, IPD incidence declined by 42% in children <5 years of age, 32% in persons 5-64 years of age, and 7% in persons >65 years of age; non-PCV13 serotype incidence increased by 111%, 63%, and 84%, respectively, for these groups. Trends were similar in countries using PCV13 or PCV10, despite different serotype distribution. In 2018, serotypes in the 15-valent and 20-valent PCVs represented one third of cases in children <5 years of age and two thirds of cases in persons >65 years of age. Non-PCV13 serotype increases reduced the overall effect of childhood PCV10/PCV13 programs on IPD. New vaccines providing broader serotype protection are needed.
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12
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Rodríguez-Baño J, Rossolini GM, Schultsz C, Tacconelli E, Murthy S, Ohmagari N, Holmes A, Bachmann T, Goossens H, Canton R, Roberts AP, Henriques-Normark B, Clancy CJ, Huttner B, Fagerstedt P, Lahiri S, Kaushic C, Hoffman SJ, Warren M, Zoubiane G, Essack S, Laxminarayan R, Plant L. Key considerations on the potential impacts of the COVID-19 pandemic on antimicrobial resistance research and surveillance. Trans R Soc Trop Med Hyg 2021; 115:1122-1129. [PMID: 33772597 PMCID: PMC8083707 DOI: 10.1093/trstmh/trab048] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/23/2021] [Accepted: 03/04/2021] [Indexed: 01/08/2023] Open
Abstract
Antibiotic use in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients during the COVID-19 pandemic has exceeded the incidence of bacterial coinfections and secondary infections, suggesting inappropriate and excessive prescribing. Even in settings with established antimicrobial stewardship (AMS) programmes, there were weaknesses exposed regarding appropriate antibiotic use in the context of the pandemic. Moreover, antimicrobial resistance (AMR) surveillance and AMS have been deprioritised with diversion of health system resources to the pandemic response. This experience highlights deficiencies in AMR containment and mitigation strategies that require urgent attention from clinical and scientific communities. These include the need to implement diagnostic stewardship to assess the global incidence of coinfections and secondary infections in COVID-19 patients, including those by multidrug-resistant pathogens, to identify patients most likely to benefit from antibiotic treatment and identify when antibiotics can be safely withheld, de-escalated or discontinued. Long-term global surveillance of clinical and societal antibiotic use and resistance trends is required to prepare for subsequent changes in AMR epidemiology, while ensuring uninterrupted supply chains and preventing drug shortages and stock outs. These interventions present implementation challenges in resource-constrained settings, making a case for implementation research on AMR. Knowledge and support for these practices will come from internationally coordinated, targeted research on AMR, supporting the preparation for future challenges from emerging AMR in the context of the current COVID-19 pandemic or future pandemics.
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Affiliation(s)
- Jesús Rodríguez-Baño
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, Sevilla, Spain
- Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain
- Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Constance Schultsz
- Department of Global Health - AIGHD Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Srinivas Murthy
- BC Children's Hospital, University of British Columbia, Vancouver, Canada
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Alison Holmes
- Department of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | - Till Bachmann
- The University of Edinburgh, Edinburgh Medical School, Division of Infection and Pathway Medicine, UK
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Rafael Canton
- Servicio de Microbiología. Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
- Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain
| | - Adam P Roberts
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Benedikt Huttner
- Division of Infectious Diseases, Geneva, University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Shawon Lahiri
- JPIAMR Secretariat, Swedish Research Council, Stockholm, Sweden
| | - Charu Kaushic
- Institute of Infection and Immunity, Canadian Institutes of Health Research
- McMaster Immunology Research Center, Dept Pathology and Mol. Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Steven J Hoffman
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, Faculty of Health and Osgoode Hall Law School, York University, Toronto, Canada
| | - Margo Warren
- Access to Medicine Foundation, Amsterdam, the Netherlands
| | - Ghada Zoubiane
- International Centre for Antimicrobial Resistance Solutions (ICARS), Copenhagen, Denmark
| | - Sabiha Essack
- International Centre for Antimicrobial Resistance Solutions (ICARS), Copenhagen, Denmark
- Antimicrobial Research Unit, University of KwaZulu-Natal, Durban, South Africa
| | | | - Laura Plant
- Institute of Infection and Immunity, Canadian Institutes of Health Research
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13
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Naucler P, Galanis I, Petropoulos A, Granath F, Morfeldt E, Örtqvist Å, Henriques-Normark B. Chronic disease and immunosuppression increase the risk for non-vaccine serotype pneumococcal disease - a nationwide population-based study. Clin Infect Dis 2021; 74:1338-1349. [PMID: 34302732 PMCID: PMC9049269 DOI: 10.1093/cid/ciab651] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Indexed: 11/12/2022] Open
Abstract
Background Demography is changing, with people living longer with comorbidities. In this nationwide population-based study, we investigated the serotype-specific invasive pneumococcal disease (IPD) risk in individuals with comorbidities, and effects of the pneumococcal conjugated vaccine (PCV) child immunization program. Methods Cases included 14 096 IPD episodes in Sweden during 2006–2015. Controls (n = 137 289), matched to cases by age, sex, region, and calendar time, were selected from the general population. Comorbidity data was obtained through health registers and grouped as immunocompromising (IC) or chronic medical conditions (CMC). Results The prevalence of CMC and IC among elderly cases was 33.9% and 39.4%. New risks identified for IPD were sarcoidosis, inflammatory polyarthropathies, systemic connective tissue, and neurological diseases. The odds ratio (OR) for IPD caused by non-PCV13 compared with PCV13 serotypes was higher in individuals with CMC/IC. Serotypes associated with the highest risk were 16F, 15C, 35F, 19F, and 23A (OR 3–5 for CMC, >10 for IC). Most comorbidities increased post-vaccination, and absolute increases of IPD caused by non-PCV13, PPV23–non-PCV13, and non-PCV13/non-PPV23 serotypes were higher in individuals with IC/CMC compared with healthy persons. Non-PCV13 serotypes 6C, 9N, 11A, 22F, 23A and 35F increased more in those with comorbidities. Mortality due to non-PCV13 serotypes increased in individuals with IC/CMC, while remaining stable in persons without comorbidities. Conclusions The PCV child immunization program associates with an increased disease burden of non-vaccine serotypes in individuals with comorbidities. These data are important for vaccine design and optimization of current vaccination strategies.
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Affiliation(s)
- Pontus Naucler
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Ilias Galanis
- Public Health Agency of Sweden, SE-171 82 Solna, Sweden
| | - Alexandros Petropoulos
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Fredrik Granath
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Eva Morfeldt
- Public Health Agency of Sweden, SE-171 82 Solna, Sweden
| | - Åke Örtqvist
- Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Sweden
| | - Birgitta Henriques-Normark
- Public Health Agency of Sweden, SE-171 82 Solna, Sweden.,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
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14
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Eichner H, Karlsson J, Spelmink L, Pathak A, Sham LT, Henriques-Normark B, Loh E. RNA thermosensors facilitate Streptococcus pneumoniae and Haemophilus influenzae immune evasion. PLoS Pathog 2021; 17:e1009513. [PMID: 33914847 PMCID: PMC8084184 DOI: 10.1371/journal.ppat.1009513] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/29/2021] [Indexed: 11/18/2022] Open
Abstract
Bacterial meningitis is a major cause of death and disability in children worldwide. Two human restricted respiratory pathogens, Streptococcus pneumoniae and Haemophilus influenzae, are the major causative agents of bacterial meningitis, attributing to 200,000 deaths annually. These pathogens are often part of the nasopharyngeal microflora of healthy carriers. However, what factors elicit them to disseminate and cause invasive diseases, remain unknown. Elevated temperature and fever are hallmarks of inflammation triggered by infections and can act as warning signals to pathogens. Here, we investigate whether these respiratory pathogens can sense environmental temperature to evade host complement-mediated killing. We show that productions of two vital virulence factors and vaccine components, the polysaccharide capsules and factor H binding proteins, are temperature dependent, thus influencing serum/opsonophagocytic killing of the bacteria. We identify and characterise four novel RNA thermosensors in S. pneumoniae and H. influenzae, responsible for capsular biosynthesis and production of factor H binding proteins. Our data suggest that these bacteria might have independently co-evolved thermosensing abilities with different RNA sequences but distinct secondary structures to evade the immune system.
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Affiliation(s)
- Hannes Eichner
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Jens Karlsson
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Laura Spelmink
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Anuj Pathak
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
| | - Lok-To Sham
- Infectious Disease Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
- Clinical Microbiology, Bioclinicum, Karolinska University Hospital, Solna, Sweden
- Lee Kong Chian School of Medicine and Singapore Centre on Environmental Life Sciences Engineering, Nanyang Technological University, Singapore, Singapore
| | - Edmund Loh
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Solna, Sweden
- Clinical Microbiology, Bioclinicum, Karolinska University Hospital, Solna, Sweden
- Lee Kong Chian School of Medicine and Singapore Centre on Environmental Life Sciences Engineering, Nanyang Technological University, Singapore, Singapore
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15
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Iovino F, Henriques-Normark B. Experimental Model for Studies of Pneumococcal Colonization in Older Adults. Am J Respir Crit Care Med 2021; 203:539-540. [PMID: 33075234 PMCID: PMC7924567 DOI: 10.1164/rccm.202009-3681ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Federico Iovino
- Department of Microbiology, Tumor and Cell Biology Karolinska Institute Stockholm, Sweden and
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology Karolinska Institute Stockholm, Sweden and.,Karolinska University Hospital Stockholm, Sweden
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16
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Tabusi M, Thorsdottir S, Lysandrou M, Narciso AR, Minoia M, Srambickal CV, Widengren J, Henriques-Normark B, Iovino F. Neuronal death in pneumococcal meningitis is triggered by pneumolysin and RrgA interactions with β-actin. PLoS Pathog 2021; 17:e1009432. [PMID: 33760879 PMCID: PMC7990213 DOI: 10.1371/journal.ppat.1009432] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/28/2021] [Indexed: 12/14/2022] Open
Abstract
Neuronal damage is a major consequence of bacterial meningitis, but little is known about mechanisms of bacterial interaction with neurons leading to neuronal cell death. Streptococcus pneumoniae (pneumococcus) is a leading cause of bacterial meningitis and many survivors develop neurological sequelae after the acute infection has resolved, possibly due to neuronal damage. Here, we studied mechanisms for pneumococcal interactions with neurons. Using human primary neurons, pull-down experiments and mass spectrometry, we show that pneumococci interact with the cytoskeleton protein β-actin through the pilus-1 adhesin RrgA and the cytotoxin pneumolysin (Ply), thereby promoting adhesion and invasion of neurons, and neuronal death. Using our bacteremia-derived meningitis mouse model, we observe that RrgA- and Ply-expressing pneumococci co-localize with neuronal β-actin. Using purified proteins, we show that Ply, through its cholesterol-binding domain 4, interacts with the neuronal plasma membrane, thereby increasing the exposure on the outer surface of β-actin filaments, leading to more β-actin binding sites available for RrgA binding, and thus enhanced pneumococcal interactions with neurons. Pneumococcal infection promotes neuronal death possibly due to increased intracellular Ca2+ levels depending on presence of Ply, as well as on actin cytoskeleton disassembly. STED super-resolution microscopy showed disruption of β-actin filaments in neurons infected with pneumococci expressing RrgA and Ply. Finally, neuronal death caused by pneumococcal infection could be inhibited using antibodies against β-actin. The generated data potentially helps explaining mechanisms for why pneumococci frequently cause neurological sequelae.
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Affiliation(s)
- Mahebali Tabusi
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, BioClinicum J7:20, Stockholm, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Sigrun Thorsdottir
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, BioClinicum J7:20, Stockholm, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Lysandrou
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, BioClinicum J7:20, Stockholm, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Ana Rita Narciso
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, BioClinicum J7:20, Stockholm, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Melania Minoia
- Department of Molecular Biosciences, The Wenner-Gren Institutet, Stockholm University, Stockholm, Sweden
| | | | - Jerker Widengren
- Department of Applied Physics, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, BioClinicum J7:20, Stockholm, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Federico Iovino
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, BioClinicum J7:20, Stockholm, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
- * E-mail:
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17
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Sender V, Hentrich K, Henriques-Normark B. Virus-Induced Changes of the Respiratory Tract Environment Promote Secondary Infections With Streptococcus pneumoniae. Front Cell Infect Microbiol 2021; 11:643326. [PMID: 33828999 PMCID: PMC8019817 DOI: 10.3389/fcimb.2021.643326] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/01/2021] [Indexed: 01/08/2023] Open
Abstract
Secondary bacterial infections enhance the disease burden of influenza infections substantially. Streptococcus pneumoniae (the pneumococcus) plays a major role in the synergism between bacterial and viral pathogens, which is based on complex interactions between the pathogen and the host immune response. Here, we discuss mechanisms that drive the pathogenesis of a secondary pneumococcal infection after an influenza infection with a focus on how pneumococci senses and adapts to the influenza-modified environment. We briefly summarize what is known regarding secondary bacterial infection in relation to COVID-19 and highlight the need to improve our current strategies to prevent and treat viral bacterial coinfections.
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Affiliation(s)
- Vicky Sender
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Karina Hentrich
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Clinical Microbiology, Karolinska University Hospital, Solna, Sweden
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18
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Rodríguez-Baño J, Rossolini GM, Schultsz C, Tacconelli E, Murthy S, Ohmagari N, Holmes A, Bachmann T, Goossens H, Canton R, Roberts AP, Henriques-Normark B, Clancy CJ, Huttner B, Fagerstedt P, Lahiri S, Kaushic C, Hoffman SJ, Warren M, Zoubiane G, Essack S, Laxminarayan R, Plant L. Antimicrobial resistance research in a post-pandemic world: Insights on antimicrobial resistance research in the COVID-19 pandemic. J Glob Antimicrob Resist 2021; 25:5-7. [PMID: 33662647 PMCID: PMC7919515 DOI: 10.1016/j.jgar.2021.02.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/16/2021] [Indexed: 12/23/2022] Open
Abstract
Antibiotics have been used excessively in hospitalised COVID-19 patients. COVID-19 has caused major disruptions to antimicrobial resistance surveillance and research. Global data on the use of antibiotics during the COVID-19 pandemic are needed. Antimicrobial resistance requires continued public and political engagement.
Antimicrobial resistance must be recognised as a global societal priority - even in the face of the worldwide challenge of the COVID-19 pandemic. COVID-19 has illustrated the vulnerability of our healthcare systems in co-managing multiple infectious disease threats as resources for monitoring and detecting, and conducting research on antimicrobial resistance have been compromised during the pandemic. The increased awareness of the importance of infectious diseases, clinical microbiology and infection control and lessons learnt during the COVID-19 pandemic should be exploited to ensure that emergence of future infectious disease threats, including those related to AMR, are minimised. Harnessing the public understanding of the relevance of infectious diseases towards the long-term pandemic of AMR could have major implications for promoting good practices about the control of AMR transmission.
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Affiliation(s)
- Jesús Rodríguez-Baño
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, Seville, Spain; Departamento de Medicina, Universidad de Sevilla, Seville, Spain; Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III. Madrid, Spain
| | - Gian Maria Rossolini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy
| | - Constance Schultsz
- Department of Global Health-AIGHD Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Srinivas Murthy
- BC Children's Hospital, University of British Columbia, Vancouver, Canada
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Alison Holmes
- Department of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | - Till Bachmann
- The University of Edinburgh, Edinburgh Medical School, Division of Infection and Pathway Medicine, The Chancellor's Building, Edinburgh, UK
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Rafael Canton
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain
| | - Adam P Roberts
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden; Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Cornelius J Clancy
- University of Pittsburgh, 3550 Terrace St., Scaife Hall 867, Pittsburgh, PA, USA
| | - Benedikt Huttner
- Division of Infectious Diseases, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Shawon Lahiri
- JPIAMR Secretariat, Swedish Research Council, Stockholm, Sweden
| | - Charu Kaushic
- Institute of Infection and Immunity, Canadian Institutes of Health Research, Canada; McMaster Immunology Research Center, Department Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Steven J Hoffman
- Global Strategy Lab, Dahdaleh Institute for Global Health Research, School of Global Health and Osgoode Hall Law School, York University, Toronto, Canada
| | - Margo Warren
- Access to Medicine Foundation, Naritaweg 227-A, 1043 CB, Amsterdam, The Netherlands
| | - Ghada Zoubiane
- International Centre for Antimicrobial Resistance Solutions (ICARS), Copenhagen, Denmark
| | - Sabiha Essack
- International Centre for Antimicrobial Resistance Solutions (ICARS), Copenhagen, Denmark; Antimicrobial Research Unit, University of KwaZulu-Natal, Durban, South Africa
| | | | - Laura Plant
- Institute of Infection and Immunity, Canadian Institutes of Health Research, Canada.
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19
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Lindenberg M, Almeida L, Dhillon-LaBrooy A, Siegel E, Henriques-Normark B, Sparwasser T. Clarithromycin impairs tissue-resident memory and Th17 responses to macrolide-resistant Streptococcus pneumoniae infections. J Mol Med (Berl) 2021; 99:817-829. [PMID: 33595670 PMCID: PMC8164591 DOI: 10.1007/s00109-021-02039-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 12/17/2020] [Accepted: 01/12/2021] [Indexed: 01/01/2023]
Abstract
Abstract The increasing prevalence of antimicrobial resistance in pathogens is a growing public health concern, with the potential to compromise the success of infectious disease treatments in the future. Particularly, the number of infections by macrolide antibiotics-resistant Streptococcus pneumoniae is increasing. We show here that Clarithromycin impairs both the frequencies and number of interleukin (IL)-17 producing T helper (Th) 17 cells within the lungs of mice infected with a macrolide-resistant S. pneumoniae serotype 15A strain. Subsequently, the tissue-resident memory CD4+ T cell (Trm) response to a consecutive S. pneumoniae infection was impaired. The number of lung resident IL-17+ CD69+ Trm was diminished upon Clarithromycin treatment during reinfection. Mechanistically, Clarithromycin attenuated phosphorylation of the p90-S6-kinase as part of the ERK pathway in Th17 cells. Moreover, a strong increase in the mitochondrial-mediated maximal respiratory capacity was observed, while mitochondrial protein translation and mTOR sisgnaling were unimpaired. Therefore, treatment with macrolide antibiotics may favor the spread of antimicrobial-resistant pathogens not only by applying a selection pressure but also by decreasing the natural T cell immune response. Clinical administration of macrolide antibiotics as standard therapy procedure during initial hospitalization should be reconsidered accordingly and possibly be withheld until microbial resistance is determined. Key messages • Macrolide-resistant S. pneumoniae infection undergoes immunomodulation by Clarithromycin • Clarithromycin treatment hinders Th17 and tissue-resident memory responses • Macrolide antibiotics impair Th17 differentiation in vitro by ERK-pathway inhibition Supplementary Information The online version contains supplementary material available at 10.1007/s00109-021-02039-5.
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Affiliation(s)
- Marc Lindenberg
- Institute of Infection Immunology, TWINCORE, Centre for Experimental and Clinical Infection Research, Hanover, Germany
- Institute of Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hanover, Germany
- German Centre for Infection Research, partner site Hanover-Brunswick, Hanover, Germany
| | - Luis Almeida
- Institute of Infection Immunology, TWINCORE, Centre for Experimental and Clinical Infection Research, Hanover, Germany
- Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Ayesha Dhillon-LaBrooy
- Institute of Infection Immunology, TWINCORE, Centre for Experimental and Clinical Infection Research, Hanover, Germany
- Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Ekkehard Siegel
- Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, MTC, Karolinska Institutet, Stockholm, Sweden
- Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Tim Sparwasser
- Institute of Infection Immunology, TWINCORE, Centre for Experimental and Clinical Infection Research, Hanover, Germany.
- Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
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20
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Iovino F, Nannapaneni P, Henriques-Normark B, Normark S. The impact of the ancillary pilus-1 protein RrgA of Streptococcus pneumoniae on colonization and disease. Mol Microbiol 2020; 113:650-658. [PMID: 32185835 DOI: 10.1111/mmi.14451] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 12/11/2022]
Abstract
The Gram-positive bacterium Streptococcus pneumoniae, the pneumococcus, is an important commensal resident of the human nasopharynx. Carriage is usually asymptomatic, however, S. pneumoniae can become invasive and spread from the upper respiratory tract to the lungs causing pneumonia, and to other organs to cause severe diseases such as bacteremia and meningitis. Several pneumococcal proteins important for its disease-causing capability have been described and many are expressed on the bacterial surface. The surface located pneumococcal type-1 pilus has been associated with virulence and the inflammatory response, and it is present in 20%-30% of clinical isolates. Its tip protein RrgA has been shown to be a major adhesin to human cells and to promote invasion through the blood-brain barrier. In this review we discuss recent findings of the impact of RrgA on bacterial colonization of the upper respiratory tract and on pneumococcal virulence, and use epidemiological data and genome-mining to suggest trade-off mechanisms potentially explaining the rather low prevalence of pilus-1 expressing pneumococci in humans.
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Affiliation(s)
- Federico Iovino
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Priyanka Nannapaneni
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.,Singapore Centre on Environmental Life Sciences Engineering (SCELSE) and Lee Kong Chian School of Medicine (LKC), Nanyang Technological University (NTU), Singapore, Singapore
| | - Staffan Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Singapore Centre on Environmental Life Sciences Engineering (SCELSE) and Lee Kong Chian School of Medicine (LKC), Nanyang Technological University (NTU), Singapore, Singapore
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21
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Merkl P, Aschtgen MS, Henriques-Normark B, Sotiriou GA. Biofilm interfacial acidity evaluation by pH-Responsive luminescent nanoparticle films. Biosens Bioelectron 2020; 171:112732. [PMID: 33120233 PMCID: PMC7116521 DOI: 10.1016/j.bios.2020.112732] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 12/25/2022]
Abstract
Biofilms are dense bacterial colonies that may adhere to the surfaces of medical devices and are major contributors to infections. These colonies are characterized by a self-produced matrix of extracellular polymeric substances (EPS). Bacterial biofilms are difficult to treat with the commonly used antibiotics partially because of their poor diffusion through the EPS and therefore require new targeted strategies to effectively fight them. Biofilms may produce an acidic microenvironment which can be exploited to design such targeted treatment strategies. However, there is currently a lack of high-throughput ways to determine the acidity of biofilms at their interface with the medical device. Here, a novel all-inorganic pH responsive system is developed from luminescent carbonated hydroxyapatite nanoparticles doped with Eu3+ ions which can determine the biofilm acidity fluorometrically due to carbonate removal in acidic environments that directly affects the nanoparticle luminescence. The pH responsive nanoparticles are in-situ deposited during their production onto substrates on which a variety of clinically-relevant biofilms are grown. The acidity of their interfacial (micro)environment depends on the bacterial species and strain even when differences in biofilm biomass are considered.
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Affiliation(s)
- Padryk Merkl
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Marie-Stephanie Aschtgen
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77, Stockholm, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76, Stockholm, Sweden; Lee Kong Chian School of Medicine (LKC), Singapore Centre on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, 639798, Singapore.
| | - Georgios A Sotiriou
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
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22
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Abstract
Bacterial viruses, or bacteriophages, are major contributors to the evolution, pathogenesis and overall biology of their host bacteria. During their life cycle, temperate bacteriophages form stable associations with their host by integrating into the chromosome, a process called lysogeny. Isolates of the human pathogen Streptococcus pneumoniae are frequently lysogenic, and genomic studies have allowed the classification of these phages into distinct phylogenetic groups. Here, we review the recent advances in the characterization of temperate pneumococcal phages, with a focus on their genetic features and chromosomal integration loci. We also discuss the contribution of phages, and specific phage-encoded features, to colonization and virulence. Finally, we discuss interesting research perspectives in this field.
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Affiliation(s)
- Geneviève Garriss
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77 Stockholm, Sweden
- Clinical Microbiology, Karolinska University Hospital, Bioclinicum, 171 76 Stockholm, Sweden
- Lee Kong Chian School of Medicine (LKC) and Singapore Centre on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore 639798, Singapore
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23
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Subramanian K, Iovino F, Tsikourkitoudi V, Merkl P, Ahmed S, Berry SB, Aschtgen MS, Svensson M, Bergman P, Sotiriou GA, Henriques-Normark B. Mannose receptor-derived peptides neutralize pore-forming toxins and reduce inflammation and development of pneumococcal disease. EMBO Mol Med 2020; 12:e12695. [PMID: 32985105 PMCID: PMC7645366 DOI: 10.15252/emmm.202012695] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/30/2020] [Accepted: 09/02/2020] [Indexed: 12/30/2022] Open
Abstract
Cholesterol‐dependent cytolysins (CDCs) are essential virulence factors for many human pathogens like Streptococcus pneumoniae (pneumolysin, PLY), Streptococcus pyogenes (streptolysin O, SLO), and Listeria monocytogenes (Listeriolysin, LLO) and induce cytolysis and inflammation. Recently, we identified that pneumococcal PLY interacts with the mannose receptor (MRC‐1) on specific immune cells thereby evoking an anti‐inflammatory response at sublytic doses. Here, we identified the interaction sites between MRC‐1 and CDCs using computational docking. We designed peptides from the CTLD4 domain of MRC‐1 that binds to PLY, SLO, and LLO, respectively. In vitro, the peptides blocked CDC‐induced cytolysis and inflammatory cytokine production by human macrophages. Also, they reduced PLY‐induced damage of the epithelial barrier integrity as well as blocked bacterial invasion into the epithelium in a 3D lung tissue model. Pre‐treatment of human DCs with peptides blocked bacterial uptake via MRC‐1 and reduced intracellular bacterial survival by targeting bacteria to autophagosomes. In order to use the peptides for treatment in vivo, we developed calcium phosphate nanoparticles (CaP NPs) as peptide nanocarriers for intranasal delivery of peptides and enhanced bioactivity. Co‐administration of peptide‐loaded CaP NPs during infection improved survival and bacterial clearance in both zebrafish and mice models of pneumococcal infection. We suggest that MRC‐1 peptides can be employed as adjunctive therapeutics with antibiotics to treat bacterial infections by countering the action of CDCs.
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Affiliation(s)
- Karthik Subramanian
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Federico Iovino
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Vasiliki Tsikourkitoudi
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Padryk Merkl
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Sultan Ahmed
- Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Samuel B Berry
- Department of Medicine, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden
| | | | - Mattias Svensson
- Department of Medicine, Center for Infectious Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden
| | - Peter Bergman
- Department of Laboratory Medicine, Karolinska Institutet, Huddinge, Sweden.,The Immunodeficiency Unit, Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Georgios A Sotiriou
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.,Lee Kong Chian School of Medicine (LKC) and Singapore Centre on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore, Singapore
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24
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Iovino F, Merkl P, Spyrogianni A, Henriques-Normark B, Sotiriou GA. Silica-coated phosphorescent nanoprobes for selective cell targeting and dynamic bioimaging of pathogen-host cell interactions. Chem Commun (Camb) 2020; 56:6989-6992. [PMID: 32441283 PMCID: PMC7116283 DOI: 10.1039/d0cc00329h] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Fluorescence in vitro bioimaging suffers from photobleaching of organic dyes, thus, functional probes with superior photostability are urgently needed. Here, we address this challenge by developing novel silica-coated nanophosphors that may serve as superior luminescent nanoprobes compatible with conventional fluorescence microscopes. We specifically explore their suitability for dynamic in vitro bioimaging of interactions between bacterial pathogens and host cells, and further demonstrate the facile surface functionalization of the amorphous silica layer with antibodies for selective cell targeting.
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Affiliation(s)
- Federico Iovino
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-17165 Stockholm, Sweden.
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25
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Tsikourkitoudi V, Karlsson J, Merkl P, Loh E, Henriques-Normark B, Sotiriou GA. Flame-Made Calcium Phosphate Nanoparticles with High Drug Loading for Delivery of Biologics. Molecules 2020; 25:E1747. [PMID: 32290273 PMCID: PMC7181047 DOI: 10.3390/molecules25071747] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 11/18/2022] Open
Abstract
Nanoparticles exhibit potential as drug carriers in biomedicine due to their high surface-to-volume ratio that allows for facile drug loading. Nanosized drug delivery systems have been proposed for the delivery of biologics facilitating their transport across epithelial layers and maintaining their stability against proteolytic degradation. Here, we capitalize on a nanomanufacturing process famous for its scalability and reproducibility, flame spray pyrolysis, and produce calcium phosphate (CaP) nanoparticles with tailored properties. The as-prepared nanoparticles are loaded with bovine serum albumin (model protein) and bradykinin (model peptide) by physisorption and the physicochemical parameters influencing their loading capacity are investigated. Furthermore, we implement the developed protocol by formulating CaP nanoparticles loaded with the LL-37 antimicrobial peptide, which is a biological drug currently involved in clinical trials. High loading values along with high reproducibility are achieved. Moreover, it is shown that CaP nanoparticles protect LL-37 from proteolysis in vitro. We also demonstrate that LL-37 retains its antimicrobial activity against Escherichia coli and Streptococcus pneumoniae when loaded on nanoparticles in vitro. Therefore, we highlight the potential of nanocarriers for optimization of the therapeutic profile of existing and emerging biological drugs.
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Affiliation(s)
- Vasiliki Tsikourkitoudi
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden; (V.T.); (J.K.); (P.M.); (E.L.); (B.H.-N.)
| | - Jens Karlsson
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden; (V.T.); (J.K.); (P.M.); (E.L.); (B.H.-N.)
| | - Padryk Merkl
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden; (V.T.); (J.K.); (P.M.); (E.L.); (B.H.-N.)
| | - Edmund Loh
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden; (V.T.); (J.K.); (P.M.); (E.L.); (B.H.-N.)
- Lee Kong Chian School of Medicine (LKC) and Singapore Centre on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore 639798, Singapore
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden; (V.T.); (J.K.); (P.M.); (E.L.); (B.H.-N.)
- Lee Kong Chian School of Medicine (LKC) and Singapore Centre on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore 639798, Singapore
- Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Georgios A. Sotiriou
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden; (V.T.); (J.K.); (P.M.); (E.L.); (B.H.-N.)
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26
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Hör J, Garriss G, Di Giorgio S, Hack LM, Vanselow JT, Förstner KU, Schlosser A, Henriques-Normark B, Vogel J. Grad-seq in a Gram-positive bacterium reveals exonucleolytic sRNA activation in competence control. EMBO J 2020; 39:e103852. [PMID: 32227509 PMCID: PMC7196914 DOI: 10.15252/embj.2019103852] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/03/2020] [Accepted: 03/06/2020] [Indexed: 12/20/2022] Open
Abstract
RNA–protein interactions are the crucial basis for many steps of bacterial gene expression, including post‐transcriptional control by small regulatory RNAs (sRNAs). In stark contrast to recent progress in the analysis of Gram‐negative bacteria, knowledge about RNA–protein complexes in Gram‐positive species remains scarce. Here, we used the Grad‐seq approach to draft a comprehensive landscape of such complexes in Streptococcus pneumoniae, in total determining the sedimentation profiles of ~ 88% of the transcripts and ~ 62% of the proteins of this important human pathogen. Analysis of in‐gradient distributions and subsequent tag‐based protein capture identified interactions of the exoribonuclease Cbf1/YhaM with sRNAs that control bacterial competence for DNA uptake. Unexpectedly, the nucleolytic activity of Cbf1 stabilizes these sRNAs, thereby promoting their function as repressors of competence. Overall, these results provide the first RNA/protein complexome resource of a Gram‐positive species and illustrate how this can be utilized to identify new molecular factors with functions in RNA‐based regulation of virulence‐relevant pathways.
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Affiliation(s)
- Jens Hör
- Institute of Molecular Infection Biology, University of Würzburg, Würzburg, Germany
| | - Geneviève Garriss
- Department of Microbiology, Tumor & Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Silvia Di Giorgio
- Institute of Molecular Infection Biology, University of Würzburg, Würzburg, Germany.,ZB MED-Information Centre for Life Sciences, Cologne, Germany
| | - Lisa-Marie Hack
- Helmholtz Institute for RNA-based Infection Research (HIRI), Helmholtz Centre for Infection Research (HZI), Würzburg, Germany
| | - Jens T Vanselow
- Rudolf Virchow Center for Experimental Biomedicine, University of Würzburg, Würzburg, Germany
| | - Konrad U Förstner
- ZB MED-Information Centre for Life Sciences, Cologne, Germany.,Faculty of Information Science and Communication Studies, TH Köln, Cologne, Germany
| | - Andreas Schlosser
- Rudolf Virchow Center for Experimental Biomedicine, University of Würzburg, Würzburg, Germany
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor & Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.,SCELSE and LKC, Nanyang Technological University, NTU, Singapore, Singapore
| | - Jörg Vogel
- Institute of Molecular Infection Biology, University of Würzburg, Würzburg, Germany.,Helmholtz Institute for RNA-based Infection Research (HIRI), Helmholtz Centre for Infection Research (HZI), Würzburg, Germany
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27
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Domenech A, Brochado AR, Sender V, Hentrich K, Henriques-Normark B, Typas A, Veening JW. Proton Motive Force Disruptors Block Bacterial Competence and Horizontal Gene Transfer. Cell Host Microbe 2020; 27:544-555.e3. [PMID: 32130952 DOI: 10.1016/j.chom.2020.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/14/2020] [Accepted: 02/03/2020] [Indexed: 12/20/2022]
Abstract
Streptococcus pneumoniae is a commensal of the human nasopharynx that can also cause severe antibiotic-resistant infections. Antibiotics drive the spread of resistance by inducing S. pneumoniae competence, in which bacteria express the transformation machinery that facilitates uptake of exogenous DNA and horizontal gene transfer (HGT). We performed a high-throughput screen and identified potent inhibitors of S. pneumoniae competence, called COM-blockers. COM-blockers limit competence by inhibiting the proton motive force (PMF), thereby disrupting export of a quorum-sensing peptide that regulates the transformation machinery. Known chemical PMF disruptors and alterations in pH homeostasis similarly inhibit competence. COM-blockers limit transformation of clinical multi-drug-resistant strains and HGT in infected mice. At their active concentrations, COM-blockers do not affect growth, compromise antibiotic activity, or elicit detectable resistance. COM-blockers provide an experimental tool to inhibit competence and other PMF-involved processes and could help reduce the spread of virulence factors and antibiotic resistance in bacteria. VIDEO ABSTRACT.
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Affiliation(s)
- Arnau Domenech
- Molecular Genetics Group, Groningen Biomolecular Sciences and Biotechnology Institute, Centre for Synthetic Biology, University of Groningen, Groningen 9747AG, the Netherlands; Department of Fundamental Microbiology, Faculty of Biology and Medicine, University of Lausanne, Biophore Building, Lausanne 1015, Switzerland
| | - Ana Rita Brochado
- European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg 69117, Germany
| | - Vicky Sender
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Karina Hentrich
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm 171 77, Sweden; Department of Clinical Microbiology, Karolinska University Hospital Solna, Stockholm 171 76, Sweden
| | - Athanasios Typas
- European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg 69117, Germany
| | - Jan-Willem Veening
- Molecular Genetics Group, Groningen Biomolecular Sciences and Biotechnology Institute, Centre for Synthetic Biology, University of Groningen, Groningen 9747AG, the Netherlands; Department of Fundamental Microbiology, Faculty of Biology and Medicine, University of Lausanne, Biophore Building, Lausanne 1015, Switzerland.
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28
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Affiliation(s)
- Marie-Stéphanie Aschtgen
- From the, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Lee Kong Chian School of Medicine (LKC), Singapore Centre on Environmental LifeSciences Engineering (SCELSE), Nanyang Technological University, Singapore City, Singapore
| | - Birgitta Henriques-Normark
- From the, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Lee Kong Chian School of Medicine (LKC), Singapore Centre on Environmental LifeSciences Engineering (SCELSE), Nanyang Technological University, Singapore City, Singapore.,Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Staffan Normark
- From the, Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Lee Kong Chian School of Medicine (LKC), Singapore Centre on Environmental LifeSciences Engineering (SCELSE), Nanyang Technological University, Singapore City, Singapore.,Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
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29
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Van Assche D, Reithuber E, Qiu W, Laurell T, Henriques-Normark B, Mellroth P, Ohlsson P, Augustsson P. Gradient acoustic focusing of sub-micron particles for separation of bacteria from blood lysate. Sci Rep 2020; 10:3670. [PMID: 32111864 PMCID: PMC7048738 DOI: 10.1038/s41598-020-60338-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 02/11/2020] [Indexed: 02/08/2023] Open
Abstract
Handling of submicron-sized objects is important in many biochemical and biomedical applications, but few methods today can precisely manipulate this range of particles. We present gradient acoustic focusing that enables flow-through particle separation of submicron particles and cells and we apply it for separation of bacteria from blood lysate to facilitate their detection in whole blood for improved diagnostics. To control suspended objects below the classical 2µm size limit for acoustic focusing, we introduce a co-flowing acoustic impedance gradient to generate a stabilizing acoustic volume force that supresses acoustic streaming. The method is validated theoretically and experimentally using polystyrene particles, Staphylococcus aureus, Streptococcus pneumoniae and Escherichia coli. The applicability of the method is demonstrated by the separation of bacteria from selectively chemically lysed blood. Combined with downstream operations, this new approach opens up for novel methods for sepsis diagnostics.
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Affiliation(s)
- David Van Assche
- Department of Biomedical Engineering, Lund University, Ole Römers väg 3, 22363, Lund, Sweden.,CNRS, Univ. Bordeaux, CRPP, UMR 5031, 115 Avenue Schweitzer, 33600, Pessac, France
| | - Elisabeth Reithuber
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Wei Qiu
- Department of Biomedical Engineering, Lund University, Ole Römers väg 3, 22363, Lund, Sweden
| | - Thomas Laurell
- Department of Biomedical Engineering, Lund University, Ole Römers väg 3, 22363, Lund, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, 17176, Stockholm, Sweden.,Singapore Centre for Environmental Life Sciences Engineering SCELSE and Le Kong Chian School of Medicine LKC, Nanyang Technological University, NTU, 50 Nanyang Ave, 639798, Nanyang, Singapore
| | - Peter Mellroth
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Pelle Ohlsson
- Department of Biomedical Engineering, Lund University, Ole Römers väg 3, 22363, Lund, Sweden.
| | - Per Augustsson
- Department of Biomedical Engineering, Lund University, Ole Römers väg 3, 22363, Lund, Sweden.
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Naucler P, Henriques-Normark B, Hedlund J, Galanis I, Granath F, Örtqvist Å. The changing epidemiology of community-acquired pneumonia: nationwide register-based study in Sweden. J Intern Med 2019; 286:689-701. [PMID: 31278792 DOI: 10.1111/joim.12956] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND There is limited evidence on the impact of pneumococcal conjugate vaccine childhood immunization programmes (PCV-CIP) on community-acquired pneumonia (CAP) in individuals with underlying diseases. METHODS A nationwide cohort study using Swedish health registers to assess the incidence of hospitalization with all-cause (AC-CAP) and pneumococcal or lobar (PL-CAP) CAP between 2005 and 2015, in relation to PCV-CIP introduction in 2007-09. RESULTS In total, 303 691 episodes of AC-CAP occurred, of which 14 225 were PL-CAP. Comparing before (2005-06) with after (2014-15) PCV-CIP, relative incidence reductions were 36% (95% Confidence Interval 32-40), 20% (14-25) and 16% (11-22) of AC-CAP for age groups < 2, 2-4 and 5-17 years, respectively, with similar reductions in young children with and without comorbidities. The reductions were more pronounced for PL-CAP. In the age groups 40-64, 65-74, 75-84 and ≥85 years there were relative increases of 11% (8-14), 18% (15-22), 15% (12-17) and 30% (27-34) of AC-CAP, respectively, but these increases were attenuated after adjustment for admittance practices using four control conditions. In adults with comorbidities, there was an increase in incidence of AC-CAP, and PL-CAP, in contrast to adults without reported underlying diseases where the incidence was stable or diminished for some age groups. Over the study period, there was an increased proportion of pneumonia patients with underlying diseases in all ages. CONCLUSION This emphasizes that direct preventive interventions should be targeted towards individuals with underlying diseases. Future studies should investigate reasons for the observed increased risk in adults with comorbidities, for example due to pneumococcal nonvaccine serotypes, or other pathogens, preferentially affecting subjects with underlying diseases.
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Affiliation(s)
- P Naucler
- From the, Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - B Henriques-Normark
- Public Health Agency of Sweden, Solna, Sweden.,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.,SCELSE and LKC, Nanyang Technological University, NTU, Singapore, Singapore
| | - J Hedlund
- From the, Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - I Galanis
- Public Health Agency of Sweden, Solna, Sweden
| | - F Granath
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Å Örtqvist
- From the, Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Communicable Disease Control and Prevention, Stockholm County Council, Stockholm, Sweden
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Naucler P, Galanis I, Morfeldt E, Darenberg J, Örtqvist Å, Henriques-Normark B. Reply to Theilacker et al. Clin Infect Dis 2019; 66:1642-1643. [PMID: 29272334 DOI: 10.1093/cid/cix1115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Pontus Naucler
- Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm
| | - Ilias Galanis
- Public Health Agency of Sweden, Solna, Singapore, Singapore
| | - Eva Morfeldt
- Public Health Agency of Sweden, Solna, Singapore, Singapore
| | | | - Åke Örtqvist
- Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm.,Department of Communicable Disease Control and Prevention, Stockholm County Council, Singapore, Singapore
| | - Birgitta Henriques-Normark
- Public Health Agency of Sweden, Solna, Singapore, Singapore.,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Singapore, Singapore.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden, Singapore, Singapore.,Singapore Centre on Environmental Life Sciences Engineering (SCELSE) and Lee Kong Chian School of Medicine (LKC), Nanyang Technological University (NTU), Singapore, Singapore
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Iovino F, Thorsdottir S, Henriques-Normark B. Receptor Blockade: A Novel Approach to Protect the Brain From Pneumococcal Invasion. J Infect Dis 2019; 218:476-484. [PMID: 29701809 DOI: 10.1093/infdis/jiy193] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/18/2018] [Indexed: 12/28/2022] Open
Abstract
Background Pneumococci are the major cause of bacterial meningitis globally. To cause meningitis pneumococci interact with the 2 endothelial receptors, polymeric immunoglobulin receptor (pIgR) and platelet endothelial cell adhesion molecule (PECAM-1), to penetrate the blood-brain barrier (BBB) and invade the brain. Methods C57BL/6 mice were infected intravenously with bioluminescent pneumococci, and treated with ceftriaxone (1 hour postinfection) and anti-pIgR and PECAM-1 antibodies (1 or 5 hours postinfection), then monitored for 5 and 10 days. Bacterial brain invasion was analyzed using IVIS imaging and bacterial counts. Results Ceftriaxone, given early after pneumococcal challenge, cleared pneumococci from the blood but not from the brain. After combining ceftriaxone with receptor blockade, using anti-pIgR and PECAM-1 antibodies, we found 100% survival after 5 and 10 days of infection, in contrast to 60% for ceftriaxone alone. Combined antibiotic and antibody treatment resulted in no or few viable bacteria in the brain and no microglia activation. Antibodies remained bound to the receptors during the study period. Receptor blockade did not interfere with antibiotic permeability through the BBB. Conclusions We suggest that adjunct treatment with pIgR and PECAM-1 antibodies to antibiotics may prevent pneumococcal meningitis development and associated brain damages. However, further evaluations are required.
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Affiliation(s)
- Federico Iovino
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Sigrun Thorsdottir
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.,Singapore Centre on Environmental Life Sciences Engineering and Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Subramanian K, Henriques-Normark B, Normark S. Emerging concepts in the pathogenesis of the Streptococcus pneumoniae: From nasopharyngeal colonizer to intracellular pathogen. Cell Microbiol 2019; 21:e13077. [PMID: 31251447 PMCID: PMC6899785 DOI: 10.1111/cmi.13077] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/17/2019] [Accepted: 06/21/2019] [Indexed: 12/19/2022]
Abstract
Streptococcus pneumoniae (the pneumococcus) is a human respiratory tract pathogen and a major cause of morbidity and mortality globally. Although the pneumococcus is a commensal bacterium that colonizes the nasopharynx, it also causes lethal diseases such as meningitis, sepsis, and pneumonia, especially in immunocompromised patients, in the elderly, and in young children. Due to the acquisition of antibiotic resistance and the emergence of nonvaccine serotypes, the pneumococcus has been classified as one of the priority pathogens for which new antibacterials are urgently required by the World Health Organization, 2017. Understanding molecular mechanisms behind the pathogenesis of pneumococcal infections and bacterial interactions within the host is crucial to developing novel therapeutics. Previously considered to be an extracellular pathogen, it is becoming evident that pneumococci may also occasionally establish intracellular niches within the body to escape immune surveillance and spread within the host. Intracellular survival within host cells also enables pneumococci to resist many antibiotics. Within the host cell, the bacteria exist in unique vacuoles, thereby avoiding degradation by the acidic lysosomes, and modulate the expression of its virulence genes to adapt to the intracellular environment. To invade and survive intracellularly, the pneumococcus utilizes a combination of virulence factors such as pneumolysin (PLY), pneumococcal surface protein A (PspA), pneumococcal adhesion and virulence protein B (PavB), the pilus‐1 adhesin RrgA, pyruvate oxidase (SpxB), and metalloprotease (ZmpB). In this review, we discuss recent findings showing the intracellular persistence of Streptococcus pneumoniae and its underlying mechanisms.
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Affiliation(s)
- Karthik Subramanian
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.,Lee Kong Chian School of Medicine (LKC) and Singapore Centre on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore
| | - Staffan Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.,Lee Kong Chian School of Medicine (LKC) and Singapore Centre on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore
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Feldman C, Normark S, Henriques-Normark B, Anderson R. Pathogenesis and prevention of risk of cardiovascular events in patients with pneumococcal community-acquired pneumonia. J Intern Med 2019; 285:635-652. [PMID: 30584680 DOI: 10.1111/joim.12875] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
It is now well recognized that cardiovascular events (CVE) occur quite commonly, both in the acute phase and in the long-term, in patients with community-acquired pneumonia (CAP). CVE have been noted in up to 30% of patients hospitalized with all-cause CAP. One systematic review and meta-analysis of hospitalized patients with all-cause CAP noted that the incidence rates for overall cardiac events were 17.7%, for incident heart failure were 14.1%, for acute coronary syndromes were 5.3% and for incident cardiac arrhythmias were 4.7%. In the case of pneumococcal CAP, almost 20% of patients studied had one or more of these cardiac events. Recent research has provided insights into the pathogenesis of the acute cardiac events occurring in pneumococcal infections. With respect to the former, key involvements of the major pneumococcal protein virulence factor, pneumolysin, are now well documented, whilst systemic platelet-driven neutrophil activation may also contribute. However, events involved in the pathogenesis of the long-term cardiovascular sequelae remain largely unexplored. Emerging evidence suggests that persistent antigenaemia may predispose to the development of a systemic pro-inflammatory/prothrombotic phenotype underpinning the risk of future cardiovascular events. The current manuscript briefly reviews the occurrence of cardiovascular events in patients with all-cause CAP, as well as in pneumococcal and influenza infections. It highlights the close interaction between influenza and pneumococcal pneumonia. It also includes a brief discussion of mechanisms of the acute cardiac events in CAP. However, the primary focus is on the prevalence, pathogenesis and prevention of the longer-term cardiac sequelae of severe pneumococcal disease, particularly in the context of persistent antigenaemia and associated inflammation.
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Affiliation(s)
- C Feldman
- Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - S Normark
- Department of Microbiology, Tumor and Cell biology, Karolinska Institutet, Stockholm, Sweden.,Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.,Lee Kong Chian School of Medicine (LKC), Singapore Centre on Environmental Life Sciences Engineering (SCELCE), Nanyang Technical University, Singapore, Singapore
| | - B Henriques-Normark
- Department of Microbiology, Tumor and Cell biology, Karolinska Institutet, Stockholm, Sweden.,Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.,Lee Kong Chian School of Medicine (LKC), Singapore Centre on Environmental Life Sciences Engineering (SCELCE), Nanyang Technical University, Singapore, Singapore
| | - R Anderson
- Department of Immunology and Institute of Cellular and Molecular Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Sime WT, Aseffa A, Woldeamanuel Y, Brovall S, Morfeldt E, Henriques-Normark B. Serotype and molecular diversity of nasopharyngeal Streptococcus pneumoniae isolates from children before and after vaccination with the ten-valent pneumococcal conjugate vaccine (PCV10) in Ethiopia. BMC Infect Dis 2019; 19:409. [PMID: 31077141 PMCID: PMC6511162 DOI: 10.1186/s12879-019-4024-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/25/2019] [Indexed: 12/01/2022] Open
Abstract
Background Streptococcus pneumoniae is a major human pathogen, and nasopharyngeal colonization is the first step for transmission and pathogenesis of pneumococcal diseases. Ethiopia introduced the 10-valent pneumococcal conjugate vaccine (PCV10) in October 2011. Here we studied nasopharyngeal carriage rates of pneumococci in children and analyzed the serotype and genetic diversity of pneumococcal isolates before first dose and after completion of the vaccine. Method A longitudinal study was conducted from February 2013 to November 2016. Totally 789 infants were enrolled at the age of 6 weeks before first dose of PCV10 vaccination, 206 were re-sampled at the age of 9 months, and 201 at 2 years of age after the final dose of PCV10 at the age of 14 weeks. One hundred sixteen children were followed during all the three sampling periods. A total of 422 nasopharyngeal isolates were serotyped using gel diffusion and the Quellung reaction, 325 were typed with pulsed field gel electrophoresis (PFGE), and 12 were selected for multi locus sequence typing (MLST). Results Pneumococcal carriage rates at the age of 6 weeks, 9 months and 2 years of age were 26.6% (210/789), 56.8% (117/206) and 48.3% (97/201), respectively. Out of 116 children none of them carried the same strain during the three period and the carriage rate at the age of 6 weeks, 9 months and 2 years were 32.7% (38/116), 59.% (69/116) and 49.1% (57/116) respectively. Totally 59 pneumococcal serotypes were identified among 422 isolates. Serotype 6A (5.0%) dominated followed by 34 (4.5%), 10A (4.0%), 11A (4.0%), 19F (3.8%), 15B (3.8%), 23F (3.6%), and 15A (3.6%). The proportion of non-PCV10 serotypes among the isolates recovered at 6 weeks, 9 months and 2 years was 79.4, 88.9 and 89.7% respectively. Molecular typing of 325 isolates collected at 6 weeks and 9 months of age showed a high genetic diversity. Conclusion This study highlights the presence of very diverse serotypes in Ethiopia where non-vaccine serotypes were predominant. Completion of the PCV10 schedule was associated with an approximately 50% reduction of vaccine-type carriage and increase of non-vaccine types. PCV13 would potentially reduce vaccine-type carriage by further 10%. Electronic supplementary material The online version of this article (10.1186/s12879-019-4024-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wondewosen Tsegaye Sime
- Armauer Hansen Research Institute, Jimma Road, 1005, Addis Ababa, Ethiopia. .,Department of Microbiology, Parasitology and Immunology, Saint Paul's Hospital Millennium Medical College, 1271, Addis Ababa, Ethiopia.
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Jimma Road, 1005, Addis Ababa, Ethiopia
| | - Yimtubezenash Woldeamanuel
- Department of Microbiology, Immunology and Parasitology, Addis Ababa University, College of Medicine and Health Science, 9086, Addis Ababa, Ethiopia
| | - Sarah Brovall
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - Eva Morfeldt
- The Public Health Agency of Sweden, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- The Public Health Agency of Sweden, Stockholm, Sweden.,Department of Microbiology, Tumor and Cell Biology, MTC, Karolinska Institutet, 171 77, Stockholm, Sweden.,Clinical Microbiology, Karolinska University Hospital, 171 76, Stockholm, Sweden
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Henning DF, Merkl P, Yun C, Iovino F, Xie L, Mouzourakis E, Moularas C, Deligiannakis Y, Henriques-Normark B, Leifer K, Sotiriou GA. Luminescent CeO 2:Eu 3+ nanocrystals for robust in situ H 2O 2 real-time detection in bacterial cell cultures. Biosens Bioelectron 2019; 132:286-293. [PMID: 30884315 PMCID: PMC6629545 DOI: 10.1016/j.bios.2019.03.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 12/29/2022]
Abstract
Hydrogen peroxide (H2O2) quantification in biomedicine is valuable as inflammation biomarker but also in assays employing enzymes that generate or consume H2O2 linked to a specific biomarker. Optical H2O2 detection is typically performed through peroxidase-coupled reactions utilizing organic dyes that suffer, however, from poor stability/reproducibility and also cannot be employed in situ in dynamic complex cell cultures to monitor H2O2 levels in real-time. Here, we utilize enzyme-mimetic CeO2 nanocrystals that are sensitive to H2O2 and study the effect of H2O2 presence on their electronic and luminescent properties. We produce and dope with Eu3+ these particles in a single-step by flame synthesis and directly deposit them on Si and glass substrates to fabricate nanoparticle layers to monitor in real-time and in situ the H2O2 concentrations generated by Streptococcus pneumoniae clinical isolates. Furthermore, the small CeO2:Eu3+ nanocrystals are combined in a single-step with larger, non-responsive Y2O3:Tb3+ nanoparticles during their double-nozzle flame synthesis to engineer hybrid luminescent nanoaggregates as ratiometric robust biosensors. We demonstrate the functionality of these biosensors by monitoring their response in the presence of a broad range of H2O2 concentrations in vitro from S. pneumoniae, highlighting their potential for facile real-time H2O2 detection in vitro in cell cultures.
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Affiliation(s)
- Dorian F Henning
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden
| | - Padryk Merkl
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden
| | - Changhun Yun
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden
| | - Federico Iovino
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Ling Xie
- Applied Materials Science, Department of Engineering Sciences, Ångström Lab, Uppsala University, SE-752 37 Uppsala, Sweden
| | - Eleftherios Mouzourakis
- Department of Physics, University of Ioannina, Panepistimioupoli, GR-451 10 Ioannina, Greece
| | - Constantinos Moularas
- Department of Physics, University of Ioannina, Panepistimioupoli, GR-451 10 Ioannina, Greece
| | - Yiannis Deligiannakis
- Department of Physics, University of Ioannina, Panepistimioupoli, GR-451 10 Ioannina, Greece
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden; Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Klaus Leifer
- Applied Materials Science, Department of Engineering Sciences, Ångström Lab, Uppsala University, SE-752 37 Uppsala, Sweden
| | - Georgios A Sotiriou
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-1 71 77 Stockholm, Sweden.
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Thorsdottir S, Henriques-Normark B, Iovino F. The Role of Microglia in Bacterial Meningitis: Inflammatory Response, Experimental Models and New Neuroprotective Therapeutic Strategies. Front Microbiol 2019; 10:576. [PMID: 30967852 PMCID: PMC6442515 DOI: 10.3389/fmicb.2019.00576] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/06/2019] [Indexed: 12/11/2022] Open
Abstract
Microglia have a pivotal role in the pathophysiology of bacterial meningitis. The goal of this review is to provide an overview on how microglia respond to bacterial pathogens targeting the brain, how the interplay between microglia and bacteria can be studied experimentally, and possible ways to use gained knowledge to identify novel preventive and therapeutic strategies. We discuss the dual role of microglia in disease development, the beneficial functions crucial for bacterial clearing, and the destructive properties through triggering neuroinflammation, characterized by cytokine and chemokine release which leads to leukocyte trafficking through the brain vascular endothelium and breakdown of the blood-brain barrier integrity. Due to intrinsic complexity of microglia and up until recently lack of specific markers, the study of microglial response to bacterial pathogens is challenging. New experimental models and techniques open up possibilities to accelerate progress in the field. We review existing models and discuss possibilities and limitations. Finally, we summarize recent findings where bacterial virulence factors are identified to be important for the microglial response, and how manipulation of evoked responses could be used for therapeutic or preventive purposes. Among promising approaches are: modulations of microglia phenotype switching toward anti-inflammatory and phagocytic functions, the use of non-bacterolytic antimicrobials, preventing release of bacterial components into the neural milieu and consequential amplification of immune activation, and protection of the blood-brain barrier integrity.
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Affiliation(s)
- Sigrun Thorsdottir
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Bioclinicum, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Bioclinicum, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden.,Singapore Centre for Environmental Life Sciences Engineering (SCELSE) and Lee Kong Chian School of Medicine (LKC), Nanyang Technological University (NTU), Singapore, Singapore
| | - Federico Iovino
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Bioclinicum, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
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Iovino F, Henriques-Normark B. High-Resolution and Super-Resolution Immunofluorescent Microscopy Ex Vivo to Study Pneumococcal Interactions with the Host. Methods Mol Biol 2019; 1968:53-59. [PMID: 30929205 DOI: 10.1007/978-1-4939-9199-0_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In vivo imaging, meaning imaging tissues in living animals, is still a developing technique. However, microscopy imaging ex vivo remains a very important tool that allows for visualization of biological and pathological processes occurring in vivo. As described in Chap. 5, imaging of animal and human tissue postmortem can be performed at high resolution. Recently, imaging of human tissues infected with pneumococci using an even higher resolution, the so-called super-resolution with STED, has been reported.
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Affiliation(s)
- Federico Iovino
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Bioclinicum, Stockholm, SE-17164, Sweden.
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, SE-17176, Sweden.
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Bioclinicum, Stockholm, SE-17164, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, SE-17176, Sweden
- Singapore Centre on Environmental Life Sciences Engineering (SCELSE), Lee Kong Chian School of Medicine (LKC), Nanyang Technological University (NTU), Singapore, Singapore
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Subramanian K, Neill DR, Malak H, Spelmink L, Khandaker S, Marchiori GDL, Dearing E, Kirby A, Yang M, Achour A, Nilvebrant J, Nygren PÅ, Plant L, Kadioglu A, Henriques-Normark B. Pneumolysin binds to the mannose receptor C type 1 (MRC-1) leading to anti-inflammatory responses and enhanced pneumococcal survival. Nat Microbiol 2019; 4:62-70. [PMID: 30420782 PMCID: PMC6298590 DOI: 10.1038/s41564-018-0280-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 10/01/2018] [Indexed: 12/14/2022]
Abstract
Streptococcus pneumoniae (the pneumococcus) is a major cause of mortality and morbidity globally, and the leading cause of death in children under 5 years old. The pneumococcal cytolysin pneumolysin (PLY) is a major virulence determinant known to induce pore-dependent pro-inflammatory responses. These inflammatory responses are driven by PLY-host cell membrane cholesterol interactions, but binding to a host cell receptor has not been previously demonstrated. Here, we discovered a receptor for PLY, whereby pro-inflammatory cytokine responses and Toll-like receptor signalling are inhibited following PLY binding to the mannose receptor C type 1 (MRC-1) in human dendritic cells and mouse alveolar macrophages. The cytokine suppressor SOCS1 is also upregulated. Moreover, PLY-MRC-1 interactions mediate pneumococcal internalization into non-lysosomal compartments and polarize naive T cells into an interferon-γlow, interleukin-4high and FoxP3+ immunoregulatory phenotype. In mice, PLY-expressing pneumococci colocalize with MRC-1 in alveolar macrophages, induce lower pro-inflammatory cytokine responses and reduce neutrophil infiltration compared with a PLY mutant. In vivo, reduced bacterial loads occur in the airways of MRC-1-deficient mice and in mice in which MRC-1 is inhibited using blocking antibodies. In conclusion, we show that pneumococci use PLY-MRC-1 interactions to downregulate inflammation and enhance bacterial survival in the airways. These findings have important implications for future vaccine design.
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Affiliation(s)
- Karthik Subramanian
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Daniel R Neill
- Institute of Infection and Global Health, Ronald Ross Building, 8 West Derby Street, University of Liverpool, Liverpool, UK
| | - Hesham Malak
- Institute of Infection and Global Health, Ronald Ross Building, 8 West Derby Street, University of Liverpool, Liverpool, UK
| | - Laura Spelmink
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Shadia Khandaker
- Institute of Infection and Global Health, Ronald Ross Building, 8 West Derby Street, University of Liverpool, Liverpool, UK
| | | | - Emma Dearing
- Institute of Infection and Global Health, Ronald Ross Building, 8 West Derby Street, University of Liverpool, Liverpool, UK
| | - Alun Kirby
- Centre for Immunology and Infection, Department of Biology and Hull York Medical School, University of York, York, UK
| | - Marie Yang
- Institute of Infection and Global Health, Ronald Ross Building, 8 West Derby Street, University of Liverpool, Liverpool, UK
| | - Adnane Achour
- Science for Life Laboratory, Department of Medicine Solna, Karolinska Institutet, and Department of Infectious Diseases, Karolinska University Hospital, Solna, Stockholm, SE, 17176, Sweden
| | - Johan Nilvebrant
- Division of Protein Technology, School of Biotechnology, Royal Institute of Technology (KTH), SE-106 91 Stockholm, Sweden
| | - Per-Åke Nygren
- Division of Protein Technology, School of Biotechnology, Royal Institute of Technology (KTH), SE-106 91 Stockholm, Sweden
| | - Laura Plant
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Aras Kadioglu
- Institute of Infection and Global Health, University of Liverpool, Liverpool, UK.
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden. .,Clinical Microbiology, Karolinska University Hospital Solna, Stockholm, Sweden. .,Lee Kong Chian School of Medicine (LKC) and Singapore Centre on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore, Singapore.
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40
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Abstract
Animal models are fundamental tools to study the biology of physiological processes and disease pathogenesis. To study invasive pneumococcal disease (IPD), many models using mice in particular have been established and developed during recent years. Thanks to the advances of the research in the pneumococcal field, nowadays, there is the possibility to use defined mouse models to study each disease caused by the pneumococcus. In this chapter mouse models for pneumonia, bacteremia, and meningitis are described. Since pneumococci are commensal pathogens found to a high extent in healthy individuals. Hence, we also describe a mouse model for nasopharyngeal colonization.
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Affiliation(s)
- Federico Iovino
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Bioclinicum, Stockholm, SE-17164, Sweden.
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, SE-17176, Sweden.
| | - Vicky Sender
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Bioclinicum, Stockholm, SE-17164, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Bioclinicum, Stockholm, SE-17164, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, SE-17176, Sweden
- Singapore Centre on Environmental Life Sciences Engineering (SCELSE), and Lee Kong Chian School of Medicine (LCK), Nanyang Technological University (NTU), Singapore, Singapore
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41
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Farmand S, Kremer B, Häffner M, Pütsep K, Bergman P, Sundin M, Ritterbusch H, Seidl M, Follo M, Henneke P, Henriques-Normark B. Eosinophilia and reduced STAT3 signaling affect neutrophil cell death in autosomal-dominant Hyper-IgE syndrome. Eur J Immunol 2018; 48:1975-1988. [PMID: 30315710 PMCID: PMC6587726 DOI: 10.1002/eji.201847650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 08/29/2018] [Accepted: 10/10/2018] [Indexed: 01/15/2023]
Abstract
The autosomal‐dominant hyper‐IgE syndrome (HIES), caused by mutations in STAT3, is a rare primary immunodeficiency that predisposes to mucocutaneous candidiasis and staphylococcal skin and lung infections. This infection phenotype is suggestive of defects in neutrophils, but data on neutrophil functions in HIES are inconsistent. This study was undertaken to functionally characterize neutrophils in STAT3‐deficient HIES patients and to analyze whether the patients` eosinophilia affects the neutrophil phenotype in S. aureus infection. Neutrophil functions and cell death kinetics were studied in eight STAT3‐deficient patients. Moreover, the response of STAT3‐deficient neutrophils to S. aureus and the impact of autologous eosinophils on pathogen‐induced cell death were analyzed. No specific aberrations in neutrophil functions were detected within this cohort. However, the half‐life of STAT3‐deficient neutrophils ex vivo was reduced, which was partially attributable to the presence of eosinophils. Increased S. aureus‐induced cell lysis, dependent on the staphylococcal virulence controlling accessory gene regulator (agr)‐locus, was observed in STAT3‐deficient neutrophils and upon addition of eosinophils. Accelerated neutrophil cell death kinetics may underlie the reported variability in neutrophil function testing in HIES. Increased S. aureus‐induced lysis of STAT3‐deficient neutrophils might affect pathogen control and contribute to tissue destruction during staphylococcal infections in HIES.
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Affiliation(s)
- Susan Farmand
- Department of Clinical Microbiology, Karolinska University Hospital, Solna, Sweden.,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Section of Hematology, Immunology and HSCT, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Bernhard Kremer
- Center for Chronic Immunodeficiency (CCI), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Monika Häffner
- Center for Chronic Immunodeficiency (CCI), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katrin Pütsep
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Peter Bergman
- Department of Clinical Microbiology, Karolinska University Hospital, Solna, Sweden.,Department of Laboratory Medicine, Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden.,Immunodeficiency Unit, Infectious Disease Clinic, Karolinska University Hospital, Huddinge, Sweden
| | - Mikael Sundin
- Section of Hematology, Immunology and HSCT, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Henrike Ritterbusch
- Center for Chronic Immunodeficiency (CCI), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Pediatrics and Adolescent Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maximilian Seidl
- Center for Chronic Immunodeficiency (CCI), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Institute of Pathology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marie Follo
- Lighthouse Core Facility, Department of Medicine I, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Philipp Henneke
- Center for Chronic Immunodeficiency (CCI), Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Pediatrics and Adolescent Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Birgitta Henriques-Normark
- Department of Clinical Microbiology, Karolinska University Hospital, Solna, Sweden.,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
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42
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Hanquet G, Krizova P, Valentiner-Branth P, Ladhani SN, Nuorti JP, Lepoutre A, Mereckiene J, Knol M, Winje BA, Ciruela P, Ordobas M, Guevara M, McDonald E, Morfeldt E, Kozakova J, Slotved HC, Fry NK, Rinta-Kokko H, Varon E, Corcoran M, van der Ende A, Vestrheim DF, Munoz-Almagro C, Latasa P, Castilla J, Smith A, Henriques-Normark B, Whittaker R, Pastore Celentano L, Savulescu C. Effect of childhood pneumococcal conjugate vaccination on invasive disease in older adults of 10 European countries: implications for adult vaccination. Thorax 2018; 74:473-482. [PMID: 30355641 PMCID: PMC6484683 DOI: 10.1136/thoraxjnl-2018-211767] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/31/2018] [Accepted: 08/20/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Pneumococcal conjugate vaccines (PCVs) have the potential to prevent pneumococcal disease through direct and indirect protection. This multicentre European study estimated the indirect effects of 5-year childhood PCV10 and/or PCV13 programmes on invasive pneumococcal disease (IPD) in older adults across 13 sites in 10 European countries, to support decision-making on pneumococcal vaccination policies. METHODS For each site we calculated IPD incidence rate ratios (IRR) in people aged ≥65 years by serotype for each PCV10/13 year (2011-2015) compared with 2009 (pre-PCV10/13). We calculated pooled IRR and 95% CI using random-effects meta-analysis and PCV10/13 effect as (1 - IRR)*100. RESULTS After five PCV10/13 years, the incidence of IPD caused by all types, PCV7 and additional PCV13 serotypes declined 9% (95% CI -4% to 19%), 77% (95% CI 67% to 84%) and 38% (95% CI 19% to 53%), respectively, while the incidence of non-PCV13 serotypes increased 63% (95% CI 39% to 91%). The incidence of serotypes included in PCV13 and not in PCV10 decreased 37% (95% CI 22% to 50%) in six PCV13 sites and increased by 50% (95% CI -8% to 146%) in the four sites using PCV10 (alone or with PCV13). In 2015, PCV13 serotypes represented 20-29% and 32-53% of IPD cases in PCV13 and PCV10 sites, respectively. CONCLUSION Overall IPD incidence in older adults decreased moderately after five childhood PCV10/13 years in 13 European sites. Large declines in PCV10/13 serotype IPD, due to the indirect effect of childhood vaccination, were countered by increases in non-PCV13 IPD, but these declines varied according to the childhood vaccine used. Decision-making on pneumococcal vaccination for older adults must consider the indirect effects of childhood PCV programmes. Sustained monitoring of IPD epidemiology is imperative.
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Affiliation(s)
| | - Pavla Krizova
- National Institute of Public Health, Prague, Czech Republic
| | | | | | - J Pekka Nuorti
- National Institute for Health and Welfare, Helsinki, Finland.,University of Tampere, Tampere, Finland
| | | | | | - Mirjam Knol
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Pilar Ciruela
- Public Health Agency of Catalunya, Barcelona, Spain.,CIBER Epidemiología y Salud Pública, Madrid, Spain
| | | | - Marcela Guevara
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
| | - Eisin McDonald
- Health Protection Scotland, National Services Scotland, Glasgow, UK
| | | | - Jana Kozakova
- National Institute of Public Health, Prague, Czech Republic
| | | | | | | | - Emmanuelle Varon
- National Centre for Pneumococci, European Hospital George Pompidou, Paris, France
| | - Mary Corcoran
- Irish Pneumococcal Reference Laboratory, Temple Street Children's University Hospital, Dublin, Ireland
| | - Arie van der Ende
- Netherlands Reference Laboratory for Bacterial Meningitis, Academic Medical Centre, Amsterdam, The Netherlands
| | | | - Carmen Munoz-Almagro
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,Instituto de Recerca Pediátrica, Hospital Sant Joan de Deu, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Pello Latasa
- General Directorate of Public Health, Madrid, Spain
| | - Jesus Castilla
- CIBER Epidemiología y Salud Pública, Madrid, Spain.,Instituto de Salud Pública de Navarra - IdiSNA, Pamplona, Spain
| | - Andrew Smith
- Scottish Haemophilus, Legionella, Meningococcus and Pneumococcus Reference Laboratory, Glasgow, UK
| | - Birgitta Henriques-Normark
- Public Health Agency of Sweden, Solna, Sweden.,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Robert Whittaker
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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43
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Pathak A, Bergstrand J, Sender V, Spelmink L, Aschtgen MS, Muschiol S, Widengren J, Henriques-Normark B. Factor H binding proteins protect division septa on encapsulated Streptococcus pneumoniae against complement C3b deposition and amplification. Nat Commun 2018; 9:3398. [PMID: 30139996 PMCID: PMC6107515 DOI: 10.1038/s41467-018-05494-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 07/05/2018] [Indexed: 01/20/2023] Open
Abstract
Streptococcus pneumoniae evades C3-mediated opsonization and effector functions by expressing an immuno-protective polysaccharide capsule and Factor H (FH)-binding proteins. Here we use super-resolution microscopy, mutants and functional analysis to show how these two defense mechanisms are functionally and spatially coordinated on the bacterial cell surface. We show that the pneumococcal capsule is less abundant at the cell wall septum, providing C3/C3b entry to underlying nucleophilic targets. Evasion of C3b deposition at division septa and lateral amplification underneath the capsule requires localization of the FH-binding protein PspC at division sites. Most pneumococcal strains have one PspC protein, but successful lineages in colonization and disease may have two, PspC1 and PspC2, that we show affect virulence differently. We find that spatial localization of these FH-recruiting proteins relative to division septa and capsular layer is instrumental for pneumococci to resist complement-mediated opsonophagocytosis, formation of membrane-attack complexes, and for the function as adhesins. Streptococcus pneumoniae evades the action of the complement system by expressing an immuno-protective polysaccharide capsule as well as Factor H-binding proteins. Here, Pathak et al. show that these two defence mechanisms are functionally and spatially coordinated on the bacterial cell surface.
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Affiliation(s)
- Anuj Pathak
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Jan Bergstrand
- Department Applied Physics, Royal Institute of Technology (KTH), Experimental Biomolecular Physics, SE-106 91, Stockholm, Sweden
| | - Vicky Sender
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Laura Spelmink
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Marie-Stephanie Aschtgen
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Sandra Muschiol
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Jerker Widengren
- Department Applied Physics, Royal Institute of Technology (KTH), Experimental Biomolecular Physics, SE-106 91, Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77, Stockholm, Sweden. .,Lee Kong Chian School of Medicine (LKC) and Singapore Centre on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore, 639798, Singapore. .,Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76, Stockholm, Sweden.
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44
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Toepfner N, Herold C, Otto O, Rosendahl P, Jacobi A, Kräter M, Stächele J, Menschner L, Herbig M, Ciuffreda L, Ranford-Cartwright L, Grzybek M, Coskun Ü, Reithuber E, Garriss G, Mellroth P, Henriques-Normark B, Tregay N, Suttorp M, Bornhäuser M, Chilvers ER, Berner R, Guck J. Detection of human disease conditions by single-cell morpho-rheological phenotyping of blood. eLife 2018; 7:e29213. [PMID: 29331015 PMCID: PMC5790376 DOI: 10.7554/elife.29213] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 01/03/2018] [Indexed: 12/27/2022] Open
Abstract
Blood is arguably the most important bodily fluid and its analysis provides crucial health status information. A first routine measure to narrow down diagnosis in clinical practice is the differential blood count, determining the frequency of all major blood cells. What is lacking to advance initial blood diagnostics is an unbiased and quick functional assessment of blood that can narrow down the diagnosis and generate specific hypotheses. To address this need, we introduce the continuous, cell-by-cell morpho-rheological (MORE) analysis of diluted whole blood, without labeling, enrichment or separation, at rates of 1000 cells/sec. In a drop of blood we can identify all major blood cells and characterize their pathological changes in several disease conditions in vitro and in patient samples. This approach takes previous results of mechanical studies on specifically isolated blood cells to the level of application directly in blood and adds a functional dimension to conventional blood analysis.
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Affiliation(s)
- Nicole Toepfner
- Center of Molecular and Cellular Bioengineering, Biotechnology CenterTechnische Universität DresdenDresdenGermany
- Department of MedicineUniversity of CambridgeCambridgeUnited Kingdom
- Department of PediatricsUniversity Clinic Carl Gustav Carus, Technische Universität DresdenDresdenGermany
| | - Christoph Herold
- Center of Molecular and Cellular Bioengineering, Biotechnology CenterTechnische Universität DresdenDresdenGermany
- Zellmechanik Dresden GmbHDresdenGermany
| | - Oliver Otto
- Center of Molecular and Cellular Bioengineering, Biotechnology CenterTechnische Universität DresdenDresdenGermany
- Zellmechanik Dresden GmbHDresdenGermany
- ZIK HIKE, Universität GreifswaldGreifswaldGermany
| | - Philipp Rosendahl
- Center of Molecular and Cellular Bioengineering, Biotechnology CenterTechnische Universität DresdenDresdenGermany
- Zellmechanik Dresden GmbHDresdenGermany
| | - Angela Jacobi
- Center of Molecular and Cellular Bioengineering, Biotechnology CenterTechnische Universität DresdenDresdenGermany
| | - Martin Kräter
- Department of Hematology and OncologyUniversity Clinic Carl Gustav Carus, Technische Universität DresdenDresdenGermany
| | - Julia Stächele
- Department of PediatricsUniversity Clinic Carl Gustav Carus, Technische Universität DresdenDresdenGermany
| | - Leonhard Menschner
- Department of PediatricsUniversity Clinic Carl Gustav Carus, Technische Universität DresdenDresdenGermany
| | - Maik Herbig
- Center of Molecular and Cellular Bioengineering, Biotechnology CenterTechnische Universität DresdenDresdenGermany
| | - Laura Ciuffreda
- Institute of Infection, Immunity and InflammationUniversity of GlasgowGlasgowUnited Kingdom
| | | | - Michal Grzybek
- Paul Langerhans Institute Dresden of the Helmholtz Centre MunichUniversity Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenDresdenGermany
- German Center for Diabetes ResearchNeuherbergGermany
| | - Ünal Coskun
- Paul Langerhans Institute Dresden of the Helmholtz Centre MunichUniversity Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität DresdenDresdenGermany
- German Center for Diabetes ResearchNeuherbergGermany
| | - Elisabeth Reithuber
- Department of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
- Department of Clinical MicrobiologyKarolinska University HospitalStockholmSweden
| | - Geneviève Garriss
- Department of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
- Department of Clinical MicrobiologyKarolinska University HospitalStockholmSweden
| | - Peter Mellroth
- Department of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
- Department of Clinical MicrobiologyKarolinska University HospitalStockholmSweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell BiologyKarolinska InstitutetStockholmSweden
- Department of Clinical MicrobiologyKarolinska University HospitalStockholmSweden
| | - Nicola Tregay
- Department of MedicineUniversity of CambridgeCambridgeUnited Kingdom
| | - Meinolf Suttorp
- Department of PediatricsUniversity Clinic Carl Gustav Carus, Technische Universität DresdenDresdenGermany
| | - Martin Bornhäuser
- Department of Hematology and OncologyUniversity Clinic Carl Gustav Carus, Technische Universität DresdenDresdenGermany
| | - Edwin R Chilvers
- Department of MedicineUniversity of CambridgeCambridgeUnited Kingdom
| | - Reinhard Berner
- Department of PediatricsUniversity Clinic Carl Gustav Carus, Technische Universität DresdenDresdenGermany
| | - Jochen Guck
- Center of Molecular and Cellular Bioengineering, Biotechnology CenterTechnische Universität DresdenDresdenGermany
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45
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Naucler P, Galanis I, Morfeldt E, Darenberg J, Örtqvist Å, Henriques-Normark B. Comparison of the Impact of Pneumococcal Conjugate Vaccine 10 or Pneumococcal Conjugate Vaccine 13 on Invasive Pneumococcal Disease in Equivalent Populations. Clin Infect Dis 2017; 65:1780-1789. [PMID: 29020171 PMCID: PMC5848315 DOI: 10.1093/cid/cix685] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 07/29/2017] [Indexed: 02/06/2023] Open
Abstract
Background Pneumococcal conjugate vaccine 10 (PCV10) and pneumococcal conjugate vaccine 13 (PCV13), are used in childhood immunization programs worldwide, but direct comparisons of impacts against invasive pneumococcal disease (IPD) in equivalent populations have not been performed. We compared the vaccines (prevaccination 2007-2009 vs postvaccination 2013-2016) in Sweden, where the 21 counties use either PCV10 or PCV13 (introduced 2009-2010). Methods All IPD episodes (n = 16992) were recorded in Sweden during 2005-2016. Of 14 186 isolates from 2007-2016, 13 468 (94.9%) were characterized with serotyping and 12 235 (86.2%) with antibiotic susceptibility. Poisson models assessed changes in incidence over time. Results Invasive pneumococcal disease incidences decreased between 2005 and 2016 in vaccinated children (by 68.5%), and in the whole population (by 13.5%), but not among the elderly (increased by 2%) due to a substantial increase in nonvaccine types (NVTs). In 2016, NVTs constituted 72% of IPD cases in the elderly. Serotype 6A declined in PCV10 and PCV13 counties, whereas serotype 19A increased in PCV10 counties. There was no effect against serotype 3. Cross-protection was found between 6B and 6A but not between 19F and 19A. Serotype 6C increased in PCV10 counties, but not in PCV13 counties, suggesting cross-protection with 6A, which is included in PCV13. In the elderly, the increase in NVTs, excluding 6C, was more pronounced in PCV13 counties. Conclusions The overall impact of IPD incidences was not statistically different irrespective of vaccine used. The incidence of serotypes, where the effect of the vaccines differed, will influence the cost-effectiveness of which vaccine to use in immunization programs. The dominance of NVTs suggests a limited effect of current pediatric PCVs against IPD in the elderly.
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Affiliation(s)
- Pontus Naucler
- Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | | | | | - Åke Örtqvist
- Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet
- Department of Communicable Disease Control and Prevention, Stockholm County Council
| | - Birgitta Henriques-Normark
- Public Health Agency of Sweden, Solna, Sweden
- Department of Clinical Microbiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Singapore Centre on Environmental Life Sciences Engineering (SCELSE) and Lee Kong Chian School of Medicine (LKC), Nanyang Technological University (NTU), Singapore
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46
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Muschiol S, Erlendsson S, Aschtgen MS, Oliveira V, Schmieder P, de Lichtenberg C, Teilum K, Boesen T, Akbey U, Henriques-Normark B. Structure of the competence pilus major pilin ComGC in Streptococcus pneumoniae. J Biol Chem 2017; 292:14134-14146. [PMID: 28659339 PMCID: PMC5572924 DOI: 10.1074/jbc.m117.787671] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/14/2017] [Indexed: 01/23/2023] Open
Abstract
Type IV pili are important virulence factors on the surface of many pathogenic bacteria and have been implicated in a wide range of diverse functions, including attachment, twitching motility, biofilm formation, and horizontal gene transfer. The respiratory pathogen Streptococcus pneumoniae deploys type IV pili to take up DNA during transformation. These “competence pili” are composed of the major pilin protein ComGC and exclusively assembled during bacterial competence, but their biogenesis remains unclear. Here, we report the high resolution NMR structure of N-terminal truncated ComGC revealing a highly flexible and structurally divergent type IV pilin. It consists of only three α-helical segments forming a well-defined electronegative cavity and confined electronegative and hydrophobic patches. The structure is particularly flexible between the first and second α-helix with the first helical part exhibiting slightly slower dynamics than the rest of the pilin, suggesting that the first helix is involved in forming the pilus structure core and that parts of helices two and three are primarily surface-exposed. Taken together, our results provide the first structure of a type IV pilin protein involved in the formation of competence-induced pili in Gram-positive bacteria and corroborate the remarkable structural diversity among type IV pilin proteins.
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Affiliation(s)
- Sandra Muschiol
- From the Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77 Stockholm, Sweden,; Department of Clinical Microbiology, Karolinska University Hospital, 171 76 Stockholm, Sweden,.
| | - Simon Erlendsson
- Structural Biology and NMR Laboratory, Linderstrøm-Lang Center for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200 Copenhagen N, Denmark
| | - Marie-Stephanie Aschtgen
- From the Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77 Stockholm, Sweden,; Department of Clinical Microbiology, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Vitor Oliveira
- From the Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77 Stockholm, Sweden,; Department of Clinical Microbiology, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Peter Schmieder
- Leibniz-Institut für Molekulare Pharmakologie FMP, Robert-Rössle-Strasse 10, 13125 Berlin, Germany
| | - Casper de Lichtenberg
- Structural Biology and NMR Laboratory, Linderstrøm-Lang Center for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200 Copenhagen N, Denmark
| | - Kaare Teilum
- Structural Biology and NMR Laboratory, Linderstrøm-Lang Center for Protein Science, Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, 2200 Copenhagen N, Denmark
| | - Thomas Boesen
- Interdisciplinary Nanoscience Center (iNANO), Aarhus University, Gustav Wieds Vej 14, 8000 Aarhus C, Denmark
| | - Umit Akbey
- Interdisciplinary Nanoscience Center (iNANO), Aarhus University, Gustav Wieds Vej 14, 8000 Aarhus C, Denmark,; Aarhus Institute of Advanced Studies (AIAS), Aarhus University, Høegh-Guldbergs Gade 6B, 8000 Aarhus C, Denmark
| | - Birgitta Henriques-Normark
- From the Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, 171 77 Stockholm, Sweden,; Department of Clinical Microbiology, Karolinska University Hospital, 171 76 Stockholm, Sweden,; Singapore Centre on Environmental Life Sciences Engineering (SCELSE) and Lee Kong Chian School of Medicine (LKC), Nanyang Technological University, Singapore 639798, Singapore.
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Iovino F, Engelen-Lee JY, Brouwer M, van de Beek D, van der Ende A, Valls Seron M, Mellroth P, Muschiol S, Bergstrand J, Widengren J, Henriques-Normark B. pIgR and PECAM-1 bind to pneumococcal adhesins RrgA and PspC mediating bacterial brain invasion. J Exp Med 2017; 214:1619-1630. [PMID: 28515075 PMCID: PMC5461002 DOI: 10.1084/jem.20161668] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 02/17/2017] [Accepted: 04/06/2017] [Indexed: 11/28/2022] Open
Abstract
Pneumococci are major causes of bacterial meningitis. Iovino et al. show that pneumococci invade the brain and pass the blood–brain barrier by interacting with the endothelial receptors pIgR and PECAM-1 recognizing the pneumococcal adhesin RrgA and PspC on the bacterial surface. Streptococcus pneumoniae is the main cause of bacterial meningitis, a life-threating disease with a high case fatality rate despite treatment with antibiotics. Pneumococci cause meningitis by invading the blood and penetrating the blood–brain barrier (BBB). Using stimulated emission depletion (STED) super-resolution microscopy of brain biopsies from patients who died of pneumococcal meningitis, we observe that pneumococci colocalize with the two BBB endothelial receptors: polymeric immunoglobulin receptor (pIgR) and platelet endothelial cell adhesion molecule (PECAM-1). We show that the major adhesin of the pneumococcal pilus-1, RrgA, binds both receptors, whereas the choline binding protein PspC binds, but to a lower extent, only pIgR. Using a bacteremia-derived meningitis model and mutant mice, as well as antibodies against the two receptors, we prevent pneumococcal entry into the brain and meningitis development. By adding antibodies to antibiotic (ceftriaxone)-treated mice, we further reduce the bacterial burden in the brain. Our data suggest that inhibition of pIgR and PECAM-1 has the potential to prevent pneumococcal meningitis.
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Affiliation(s)
- Federico Iovino
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Joo-Yeon Engelen-Lee
- Department of Neurology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, 1012 WX Amsterdam, Netherlands
| | - Matthijs Brouwer
- Department of Neurology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, 1012 WX Amsterdam, Netherlands
| | - Diederik van de Beek
- Department of Neurology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, 1012 WX Amsterdam, Netherlands
| | - Arie van der Ende
- Department of Neurology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, 1012 WX Amsterdam, Netherlands
| | - Merche Valls Seron
- Department of Neurology, Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, 1012 WX Amsterdam, Netherlands
| | - Peter Mellroth
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Sandra Muschiol
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden.,Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Jan Bergstrand
- Department of Applied Physics, KTH Royal Institute of Technology, SE-114 28 Stockholm, Sweden
| | - Jerker Widengren
- Department of Applied Physics, KTH Royal Institute of Technology, SE-114 28 Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden .,Department of Clinical Microbiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.,Lee Kong Chian School of Medicine (LKC), Nanyang Technological University, Singapore 639798, Singapore.,Singapore Centre on Environmental Life Sciences Engineering (SCELSE), Nanyang Technological University, Singapore 639798, Singapore
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48
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Zangenah S, Björkhem-Bergman L, Norlin AC, Hansen S, Lindqvist L, Henriques-Normark B, Bergman P. The Pneumocell-study: Vaccination of IgG1- and IgG2-deficient patients with Prevnar13. Vaccine 2017; 35:2654-2660. [PMID: 28410816 DOI: 10.1016/j.vaccine.2017.03.097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/29/2017] [Accepted: 03/31/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Patients with IgG-deficiency often suffer from repeated bacterial infections with S. pneumoniae. Since there is a lack of knowledge regarding whether IgG-deficient patients would benefit from conjugate pneumococcal vaccination, we set out to evaluate the effect of Prevnar13 vaccination in IgG1- and/or IgG2-deficient patients. METHOD We designed a small pilot-study including IgG1- and/or IgG2-deficient patients (n=10) and age- and sex-matched healthy controls (n=10). Serum, plasma and heparin-blood were collected prior to vaccination, as well as 1, 2 and 4weeks post vaccination, and the levels of opsonophagocytic activity (Opa) titers and anti-pneumococcal IgG-antibodies were analyzed. RESULTS Patients generally had lower Opa-titers than controls for most serotypes, but they exhibited an almost normal vaccine response to serotypes 6A and 6B. Notably, 5/10 patients showed vaccine-response to at least one serotype. Most patients reached the presumably protective levels of Opa-titers ≥8 and anti-pneumococcal IgG levels of 0.35µg/ml by 4weeks post-vaccination for a majority of the serotypes. CONCLUSION Our results show that vaccination of IgG-deficient patients with Prevnar13 is likely to have a clinical benefit. Our initial findings will provide a framework for future vaccine-trials in this vulnerable patient group. Registered at www.clinicaltrials.gov as NCT01847781.
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Affiliation(s)
- Salah Zangenah
- Department of Laboratory Medicine, Division of Clinical Microbiology, Sweden
| | | | - Anna-Carin Norlin
- Division of Clinical Immunology, Karolinska Institutet and Karolinska University Hospital Huddinge, SE-141 86 Stockholm, Sweden; Infectious Disease Clinic, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Susanne Hansen
- Infectious Disease Clinic, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Lars Lindqvist
- Infectious Disease Clinic, Karolinska University Hospital, SE-141 86 Stockholm, Sweden
| | - Birgitta Henriques-Normark
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden; Clinical Microbiology, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Peter Bergman
- Department of Laboratory Medicine, Division of Clinical Microbiology, Sweden.
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49
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Subramanian K, Bergman P, Henriques-Normark B. Vitamin D Promotes Pneumococcal Killing and Modulates Inflammatory Responses in Primary Human Neutrophils. J Innate Immun 2017; 9:375-386. [PMID: 28241127 DOI: 10.1159/000455969] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 01/10/2017] [Indexed: 11/19/2022] Open
Abstract
Streptococcus pneumoniae is a major human pathogen and a leading cause of pneumonia, septicemia, and meningitis worldwide. Despite clinical studies linking vitamin D deficiency and pneumonia, molecular mechanisms behind these observations remain unclear. In particular, the effects of vitamin D on neutrophil responses remain unknown. Using pneumococcal strains, primary neutrophils isolated from human blood, and sera from patients with frequent respiratory tract infections (RTIs), we investigated the effects of vitamin D on neutrophil bactericidal and inflammatory responses, including pattern recognition receptors, antimicrobial peptides, and cytokine regulation. We found that vitamin D upregulated pattern recognition receptors, TLR2, and NOD2, and induced the antimicrobial human neutrophil peptides (HNP1-3) and LL-37, resulting in increased killing of pneumococci in a vitamin D receptor-dependent manner. Antibodies targeting HNP1-3 inhibited bacterial killing. Vitamin D supplementation of serum from patients with bacterial RTIs enhanced neutrophil killing. Moreover, vitamin D lowered inflammatory cytokine production by infected neutrophils via IL-4 production and the induction of suppressor of cytokine signaling (SOCS) proteins SOCS-1 and SOCS-3, leading to the suppression of NF-κB signaling. Thus, vitamin D enhances neutrophil killing of S. pneumoniae while dampening excessive inflammatory responses and apoptosis, suggesting that vitamin D could be used alongside antibiotics when treating pneumococcal infections.
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Affiliation(s)
- Karthik Subramanian
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
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Afzal M, Shafeeq S, Manzoor I, Henriques-Normark B, Kuipers OP. N-acetylglucosamine-Mediated Expression of nagA and nagB in Streptococcus pneumoniae. Front Cell Infect Microbiol 2016; 6:158. [PMID: 27900287 PMCID: PMC5110562 DOI: 10.3389/fcimb.2016.00158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 11/02/2016] [Indexed: 11/13/2022] Open
Abstract
In this study, we have explored the transcriptomic response of Streptococcus pneumoniae D39 to N-acetylglucosamine (NAG). Transcriptome comparison of S. pneumoniae D39 wild-type grown in chemically defined medium (CDM) in the presence of 0.5% NAG to that grown in the presence of 0.5% glucose revealed elevated expression of many genes/operons, including nagA, nagB, manLMN, and nanP. We have further confirmed the NAG-dependent expression of nagA, nagB, manLMN, and nanP by β-galactosidase assays. nagA, nagB and glmS are putatively regulated by a transcriptional regulator NagR. We predicted the operator site of NagR (dre site) in PnagA, PnagB, and PglmS, which was further confirmed by mutating the predicted dre site in the respective promoters (nagA, nagB, and glmS). Growth comparison of ΔnagA, ΔnagB, and ΔglmS with the D39 wild-type demonstrates that nagA and nagB are essential for S. pneumoniae D39 to grow in the presence of NAG as a sole carbon source. Furthermore, deletion of ccpA shows that CcpA has no effect on the expression of nagA, nagB, and glmS in the presence of NAG in S. pneumoniae.
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Affiliation(s)
- Muhammad Afzal
- Department of Molecular Genetics, Groningen Biomolecular Sciences and Biotechnology Institute, University of GroningenGroningen, Netherlands; Department of Bioinformatics and Biotechnology, Government College UniversityFaisalabad, Pakistan
| | - Sulman Shafeeq
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet Stockholm, Sweden
| | - Irfan Manzoor
- Department of Molecular Genetics, Groningen Biomolecular Sciences and Biotechnology Institute, University of GroningenGroningen, Netherlands; Department of Bioinformatics and Biotechnology, Government College UniversityFaisalabad, Pakistan
| | | | - Oscar P Kuipers
- Department of Molecular Genetics, Groningen Biomolecular Sciences and Biotechnology Institute, University of Groningen Groningen, Netherlands
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