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Departments of
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Medicine and
Pediatrics, University of California at San Diego, La Jolla, CA 92093
| Abstract |
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| Introduction |
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-defensins that are restricted to small intestinal Paneth cells (4) or
-defensins that are expressed by crypt, villous, and surface epithelial cells throughout the small and large intestine (5), the distribution of cathelicidin in the human intestinal tract is limited to surface epithelial cells in the colon and stomach (6, 7). The murine enteric bacterial pathogen Citrobacter rodentium has important virulence features in common with human enteropathogenic Escherichia coli (EPEC) (8, 9, 10, 11, 12). Within 1 week of oral infection, C. rodentium colonize the murine colon and like EPEC and enterohemorrhagic E. coli (EHEC) in humans, C. rodentium adheres to intestinal epithelial cells where it produces the characteristic attaching and effacing lesion (10, 13, 14). Normally, few if any bacteria invade the mucosa and reach extraintestinal sites (15, 16). At later times, infection results in mucosal erosions, increased epithelial cell proliferation, and crypt hyperplasia (17, 18). Little is known about early innate mucosal defenses against this pathogen, although acquired immunity is needed to control and eliminate C. rodentium (10, 16, 19, 20, 21).
In light of the selective expression of cathelicidin in the human colon, we hypothesized that cathelicidin produced by colon surface epithelial cells may be important in host innate defense against pathogenic enteric bacteria for which lifestyle involves adherence to those cells. Using genetically mutant mice that lack cathelicidin and with C. rodentium as a model murine epithelial adherent pathogen, we have explored the functional importance of cathelicidin in early intestinal innate antimicrobial defense.
| Materials and Methods |
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mCRAMP-deficient (Cnlp/) mice were generated as described (22). Cnlp+/+ littermates were used as controls. Cnlp/ mice were healthy and fertile and did not manifest differences in intestinal mucosal architecture from Cnlp+/+ littermates used as controls. All studies were approved by the University of California at San Diego Animal Welfare Committee.
Bacteria
The following bacteria were used: C. rodentium (21); enteropathogenic E. coli serotype O111:NM, eae+ isolate DEC12f (CDC B170; American Type Culture Collection No. 43887; American Type Culture Collection, Manassas, VA); enterohemorrhagic E. coli O157:H7 strain 86-24 (gift of M. Donnenberg).
To determine total bacterial numbers in the colon and feces of Cnlp+/+ and Cnlp/ mice, colon or feces were homogenized in TS broth. For aerobic culture, samples were plated onto tryptic soy blood agar containing 5% sheep blood and then incubated at 37°C overnight. For anaerobic culture, samples were plated onto Columbia blood agar with 5% sheep blood and then incubated at 37°C for 48 h in anaerobic culture system (Oxide Atmosphere Generation System for Anaerobic Bacteriology and AnaeroGen) after which CFU were determined. Gram staining was performed on 40 colonies from each sample.
Infections
Mice were infected orally with C. rodentium. Bacterial numbers in feces or homogenized colon were determined by plating on MacConkey agar (21). The detection limit of the CFU assay was 103 colonies per g of feces or per colon and <10 colonies per organ in spleen and mesenteric lymph nodes. Identity of representative bacterial colonies was verified by PCR (21).
Histological analysis and immunohistochemistry
Colons processed as Swiss rolls (21) were fixed (1% ZnSO4, 10% formalin) and embedded in paraffin. Sections (5 µm) were treated with 0.3% H2O2 in PBS for 10 min at room temperature. For mCRAMP staining, sections were incubated with goat serum (2%) and BSA (2%) for 1 h at room temperature, followed by incubation overnight at 4°C with 2 µg/ml rabbit anti-mCRAMP IgG (22, 23) or 2 µg/ml preimmune IgG from the same rabbit. HRP-labeled goat anti-rabbit IgG (1/400 dilution; Jackson ImmunoResearch Laboratories) was used as secondary Ab. 3,3'-Diaminobenzidine (Sigma-Aldrich) was used for visualization. Sections were counterstained with hematoxylin. For C. rodentium staining, paraffin-embedded or frozen sections fixed in 4% paraformaldehyde were incubated overnight with rabbit anti-C. rodentium IgG (1/1000; gift of Dr. B. Vallance) or an identical concentration of control rabbit IgG, and stained as above, or with Cy3-labeled goat anti-rabbit IgG (Jackson ImmunoResearch Laboratories) for confocal microscopy. Alexa 488-conjugated phalloidin was used for F-actin staining (Molecular Probes).
RNA extraction and RT-PCR
Total cellular RNA extraction and qualitative and real time RT-PCR were performed as described previously (6, 7) using the primers and conditions indicated in Table I.
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Colon epithelium was isolated as described before (24) and contained surface and crypt epithelium with few, if any, contaminating lamina propria cells. For protein lysates, epithelial cells were homogenized in 100 mM phosphate buffer containing 0.1% Triton X-100 and 0.5% protease inhibitor mixture III (Calbiochem), and centrifuged at 16,000 x g for 20 min. The protein content of the supernatants was measured by Bradford assay (Bio-Rad).
Antimicrobial assays
Aliquots containing 2500 CFU of bacteria were suspended in 25 µl of PBS (pH 7.4) with or without titrated concentrations of synthetic mCRAMP peptide (SynPep), 5 µg/µl epithelial cell lysate from Cnlp+/+ or Cnlp/ mice, or 5 µg/µl BSA. After 2 h at 37°C, bacterial suspensions were plated on Luria-Bertani agar and incubated overnight at 37°C; then CFU were determined. EC50 is the mCRAMP concentration that decreases CFU by 50% relative to the peptide-free control. For inhibition zone assays (25), C. rodentium (107/ml) were added to 1.5% agarose containing tryptone (5 mg/ml) and plated in a 1-mm layer in 10-cm plastic dishes. Colon epithelial cell lysates (10 µl) were added to 3-mm-diameter wells in the agar, plates were incubated overnight at 37°C, and the diameter of the bacteria-free zone was determined.
Statistical analysis
Comparisons between groups used unpaired t tests or rank sum tests.
| Results |
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mCRAMP mRNA was constitutively expressed in the intestinal tract, where it is largely restricted to the colon, with little expression in the small intestine and no expression in the stomach or liver (Fig. 1A). By real time RT-PCR, the colon had >25-fold higher levels of mCRAMP mRNA than the small intestine (not shown). mCRAMP protein was selectively produced by surface colon epithelial cells with little, if any, mCRAMP immunostaining of epithelial cells that line the deeper crypts or cells in the lamina propria (Fig. 1B). No mCRAMP was immunostaining was detected in the small intestine (Fig. 1B). These data show that mCRAMP distribution in murine colon parallels that of the cathelicidin LL-37/hCAP18 in the human colon (6).
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To evaluate in vitro antimicrobial activity of mCRAMP against C. rodentium, bacteria were incubated with synthetic mCRAMP. mCRAMP inhibited C. rodentium growth with an EC50 of 1.8 µM at physiological pH and salt concentrations and was similarly effective against two related human pathogens, EPEC and EHEC (Fig. 2A). To determine the antimicrobial activity of mCRAMP produced by colon epithelial cells, colon epithelial cell extracts from Cnlp+/+ and Cnlp/ mice were assayed for antimicrobial activity against C. rodentium. Extracts from Cnlp+/+ mice had significantly greater antimicrobial activity against C. rodentium than those from Cnlp/ mice (Fig. 2, B and C).
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To determine whether colon epithelial cell mCRAMP decreases colon colonization with C. rodentium, Cnlp+/+ and Cnlp/ mice initially were infected with C. rodentium using an oral inoculum that caused infection in 100% of Cnlp+/+ mice (5 x 108 bacteria/mouse). This resulted in maximal colon colonization with C. rodentium within 1 week. Cnlp/ mice developed significantly higher fecal counts of C. rodentium (
8-fold) than did Cnlp+/+ littermates (Fig. 3A) and, at the peak of colonic colonization, had
10- to 30-fold higher numbers of C. rodentium in the spleen and mesenteric lymph nodes (Fig. 3, B and C). However, by day 14 after infection, significant differences in fecal bacterial counts between Cnlp+/+ and Cnlp/ mice were no longer apparent (Fig. 3A). Infection was cleared by both Cnlp+/+ and Cnlp/ mice when tested at 21 and 28 days after infection with undetectable numbers of C. rodentium in the feces of either Cnlp+/+ or Cnlp/ mice. These data indicate that the presence of mCRAMP is important during early colonization of the colon epithelium.
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We next investigated colonization of colon epithelial cells and mucosal injury over the course of C. rodentium infection. At 7 days after infection of Cnlp+/+ mice (5 x 108 C. rodentium/mouse), bacteria resided in close proximity to mCRAMP-expressing surface epithelial cells, and notably few bacteria were found in association with epithelial cells deeper within the colon crypts (Fig. 6Aa). By comparison, there was no epithelial surface colonization in Cnlp+/+ mice infected with the lower bacterial inoculum (2.5 x 107; Fig. 6Ac). At both inocula, C. rodentium colonization of surface epithelium was significantly greater in Cnlp/ than in Cnlp+/+ mice and at the higher inocula was accompanied by surface epithelial cell damage. Consistent with greater colonization, numerous bacteria were associated with epithelial cells in the upper crypt region of Cnlp/ mice (Fig. 6Ae). The number of upper colon crypts colonized per section were 11.2 ± 2.0, n = 6, in Cnlp+/+ mice and 44.3 ± 12.2, n = 7, in Cnlp/ mice (mean ± SEM, p < 0.05).
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Decreased epithelial mCRAMP expression at later times after infection
Two weeks after infection with C. rodentium (5 x 108 bacteria/mouse), the colon mucosa manifested crypt hyperplasia, a moderate to severe inflammatory cell infiltrate, and surface epithelial erosions. At this time, colon epithelial cells from Cnlp+/+ mice lacked mCRAMP, as assessed by immunostaining (Fig. 7, A and B). Moreover, the extent of colon pathology was similar in infected wild-type and mCRAMP-deficient mice (Figs. 5 and 7A), with the only difference being that scattered cells with characteristics of neutrophils stained for mCRAMP in Cnlp+/+ (Fig. 7C) but not mCRAMP-deficient mice. mCRAMP mRNA transcripts were significantly decreased in isolated epithelial cells from Cnlp+/+ mice (Fig. 7G) whereas expression of the neutrophil chemoattractant MIP-2 was up-regulated in epithelial cells and whole colon tissue of infected compared with uninfected Cnlp+/+ mice (Fig. 7H).
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| Discussion |
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mCRAMP and human LL-37/hCAP18 manifest the same restricted distribution to surface epithelial cells in the colon and have similar killing activities against enteric pathogens in vitro (Ref. 6) and M. Iimura, unpublished data). Taken together, these strongly suggest that the murine model used herein has relevance for human enteric infections. This notion gains support from the observation mCRAMP-deficient mice have decreased resistance to cutaneous infections with group A streptococci (28) and from clinical studies in atopic dermatitis patients that suggest that human cathelicidin is important in preventing skin infections (29).
The concentrations of mCRAMP required for in vitro bacterial killing raise the question as to whether cathelicidin concentrations, or concentrations of other classes of antimicrobial peptides that can mediate antimicrobial activity in vitro, are attained in vivo. Low micromolar concentrations of mCRAMP were required for in vitro killing of C. rodentium, EHEC, and EPEC herein, and up to 2- to 4-fold higher concentrations were required for in vitro killing of several other enteric pathogens by human LL-37/hCAP18 (6, 7) or mCRAMP (M. Imura, unpublished data). In the case of the
-defensins, a different class of antimicrobial peptides that are produced by small intestinal Paneth cells, in vitro killing of several enteric pathogens occurred over a similar concentration range (4). Recent studies indicate that these and higher concentrations of antimicrobial peptides are produced in the intestinal microenvironment in vivo. For example, human cathelicidin in gastric juice of Helicobacter pylori-infected individuals reached concentrations up to 15 µM, yet effectively killed H. pylori in vitro at
10-fold lower concentrations (7), and murine
-defensin concentrations that exceed those required for microbicidal activity in vitro were estimated to be present in the microenvironment of small intestinal crypts (4). Of note, relatively small differences (2- to 4-fold) in the amount of cathelicidin required to kill group B Streptococcus in vitro were paralleled in vivo by a significant difference in the extent of skin ulceration caused by those bacteria (28).
We considered the possibility that a decrease in epithelial mCRAMP might result in increased bacterial numbers in the colon and that, in turn, might decrease the ability of C. rodentium to colonize the colon. However, that was not the case. Nonetheless, we cannot exclude the possibility that there are qualitative differences in the commensal flora of Cnlp+/+ and Cnlp/ mice that might influence the colonization potential of C. rodentium. We favor the notion that differences in the magnitude of surface colonization in Cnlp+/+ and Cnlp/ mice are due to a direct effect of mCRAMP on C. rodentium, although the effects of mCRAMP on other innate functions (30) including those of colon surface epithelial cells may also play a role.
Like its human counterpart LL-37/hCAP18, mCRAMP was produced by colon surface epithelium, but not by epithelial cells that line the small intestinal villi and crypts (6). This firmly establishes a paradigm whereby the distribution of different antimicrobial defense molecules is regionally restricted in the intestine, and within a given region, restricted to cell types that differ in either lineage or differentiation state. Such differences support the notion that different antimicrobial defense molecules are host adapted to have different functional roles in various intestinal sites. Whereas Paneth cell
-defensins may protect adjacent stem cells in the small intestinal crypts from enteric pathogens (4, 31), the selective expression of mCRAMP by surface epithelial cells in the colon could function to effectively protect against colon and epithelial cell colonization with an important class of epithelial adherent foodborne pathogen.
| Disclosures |
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| Footnotes |
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1 This work was supported by National Institutes of Health Grants DK59860, DK35108, and AI56075 and by a grant from the Cystic Fibrosis Foundation. ![]()
2 Current address: Laboratory of Epithelial Immunobiology, RIKEN Research Center for Allergy and Immunology, Yokohama, Japan. ![]()
3 Address correspondence and reprint requests to Dr. Martin F. Kagnoff, Laboratory of Mucosal Immunology, Departments of Medicine and Pediatrics, Mail Code 0623D, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0623. E-mail address: mkagnoff{at}ucsd.edu ![]()
4 Abbreviations used in this paper: mCRAMP, mouse cathelicidin-related antimicrobial peptide; EPEC, enteropathogenic Escherichia coli; EHEC, enterohemorrhagic E. coli. ![]()
Received for publication December 13, 2004. Accepted for publication February 11, 2005.
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