Abstract
Enterococcus faecalis (Ef) accounts for most cases of enterococcal bacteremia, which is one of the principal causes of nosocomial bloodstream infections (BSI). Among several virulence factors associated with the pathogenesis of Ef, an extracellular gelatinase (GelE) has been known to be the most common factor, although its virulence mechanisms, especially in association with human BSI, have yet to be demonstrated. In this study, we describe the complement resistance mechanism of Ef mediated by GelE. Using purified GelE, we determined that it cleaved the C3 occurring in human serum into a C3b-like molecule, which was inactivated rapidly via reaction with water. This C3 convertase-like activity of GelE was shown to result in a consumption of C3 and thus inhibited the activation of the complement system. Also, GelE was confirmed to degrade an iC3b that was deposited on the Ag surfaces without affecting the bound C3b. This proteolytic effect of GelE against the major complement opsonin resulted in a substantial reduction in Ef phagocytosis by human polymorphonuclear leukocytes. In addition, we verified that the action of GelE against C3, which is a central component of the complement cascade, was human specific. Taken together, it was suggested that GelE may represent a promising molecule for targeting human BSI associated with Ef.
The complement system is an essential part of the innate immune system, and performs crucial functions in the recognition and elimination of invading microorganisms in the tissue fluid, as well as the blood of mammals. It is activated by three distinct pathways (the alternative, classical, and lectin pathways), which differ in terms of their modes of activation, but commonly result in the deposition of iC3b (inactive form of C3b) and the formation of the membrane attack complex (C5b-9) (MAC)3 on microbial surfaces via the activity of C3 convertase (C4b2a or C3bBb) (1, 2). In the activation of three complement pathways, C3b is a central component, as it behaves as a recognition protein that attaches covalently to microbial surfaces via its reactive thioester. Bound C3b provides a platform for the generation of more C3 convertase (C3bBb) in the alternative pathway, and C5 convertase (C4b2a3b or C3bBb3b) in all three pathways. The majority of bound C3b is changed to iC3b to prevent the unnecessary consumption of C3 induced by the excessive assembly of C3 convertase on microbial surfaces (3). As the major complement opsonin for phagocytosis by polymorphonuclear leukocytes (PMN), iC3b is generated by protease factor (f) I with the aid of its cofactor, which are fH in serum (4), complement receptor (CR) 1 or membrane cofactor protein (5). CR3 on PMN recognizes iC3b as a ligand displayed on the surfaces of microorganisms (6), and this receptor-ligand interaction is a prerequisite for the complement-mediated clearance of circulating pathogens.
Pathogenic microorganisms have developed a variety of strategies to overcome or evade the complement system. Previous studies concerning complement evasion by microbial virulence factors will have a marked impact on the search for more efficient and specific clinical treatment for infectious disease. In recent years, several complement evasion strategies employed by pathogenic microbes have been elucidated, and many pathogen-encoded proteins that contribute to those strategies have also been identified as novel virulence factors (1, 7, 8). Microbial pathogens utilize two types of strategies for complement system inhibition. One is to resist the deposition of C3b on their surfaces. To do this, 1) they derange the initial recognition steps for complement activation (9, 10), 2) inactivate C3 convertase, thereby preventing further C3b deposition on their surfaces (11), 3) modulate C3 and its split products (C3b and iC3b) (12, 13). The other strategy involves the blockage of the terminal step in the complement cascade, namely the assembly of cytolytic molecules (C5b-9) on the microbial surfaces (14, 15).
Enterococci are the third most common pathogens isolated from human bloodstream infections (BSIs) (16, 17). It has been previously reported that up to 90% of enterococcal infections in human are caused by Enterococcus faecalis (Ef) (18). Whereas the mechanisms of their antibiotic resistance and spread have been extensively studied, virulence mechanisms for enterococcal infections remain largely unknown. In our previous study (19), we purified an extracellular gelatinase (GelE) (GenBank EF105504) of Ef GM (GenBank EF120452), which has been described previously as an important virulence factor of Ef. In addition, we demonstrated that the GelE of Ef GM evidenced an identity of 99% at the nucleotide and amino acid sequence levels with the GelE of Ef V583. It was also shown that proteolytic activity of GelE affected the complement system in human serum, although the mechanisms underlying its anticomplement effect have yet to be elucidated in detail. In the current study, we attempted to uncover the exact mechanism underlying the anticomplement activity of GelE. In particular, we assessed its effects on the complement-mediated phagocytosis of Ef by human PMNs. Furthermore, we also endeavored to determine whether GelE acts specifically on the human complement system.
Materials and Methods
GelE, Abs, and complement components C3, C3b, iC3b, factors B, D, I, and H
GelE was purified from the Ef GM culture media in accordance with the procedures described in our previous study (19). Anti-human C3 Ab was purchased from Sigma-Aldrich (Cat. No. C7761). In the case of the anti-GelE Ab, we utilized an antiserum that had been previously generated via an injection of GelE into a rabbit (19). All human complement components used in this study were commercially obtained from three companies as follows: C3, Sigma-Aldrich C2910; C3b, Calbiochem 204860; iC3b, Calbiochem 204863; fB, Quidel 902985; fD, Sigma-Aldrich C5688; fI, Sigma-Aldrich C5938; fH, Sigma-Aldrich C5813.
Normal human serum and PMNs
Fresh normal human serum (NHS) and PMNs were prepared from blood samples that were collected from three healthy human donors after obtaining informed consent. PMNs were isolated from 15 ml of EDTA-anticoagulated blood via three-step procedures consisting of dextran sedimentation, Ficoll-Hypaque centrifugation, and hypotonic lysis of residual erythrocytes as previously described by Rakita et al. (20). They were then suspended in HBSS containing 1% BSA without Ca2+ and Mg2+ at approximately 6 × 106 cells/ml.
Degradation of C3 in NHS by GelE
Purified C3 was mixed with GelE in the presence of both fH and fI or each of two factors. Alternatively, the same reaction was conducted in the absence of GelE. The reaction volume was 10 μl of PBS and the quantity of each protein used in these tests was adjusted to 1 μg. Each mixture was incubated for 30 min at room temperature and dried down completely via vacuum centrifugation. The sample was then resuspended in 10 μl of SDS-PAGE sample buffer (0.5 M Tris-HCl (pH 6.8), containing 10% (w/v) SDS and 40 mM DTT) and subjected to SDS-PAGE analysis. Duplicate SDS-PAGE gel was employed for immunoblot assay conducted with anti-human C3 Ab. In an effort to detect the proteolytic activity of GelE to C3, fH, fI, fB, or fD, each complement factor was incubated with increasing concentration of GelE under conditions identical to those listed above, then assessed via SDS-PAGE analyses. In addition, C3 (0.5 μg), fB (0.6 μg), and fD (4 ng) were incubated with GelE (0.5 μg) in 10 μl of PBS containing 5 mM MgCl2 for 30 min at room temperature to examine whether the C3b-like molecule generated by GelE is capable of functioning as a component of soluble C3 convertase. For the control assembly of C3 convertase, commercial C3b (0.5 μg) was incubated with fB (0.6 μg) and fD (4 ng) under the same condition as above. The assembly of C3 convertase was verified on SDS-PAGE gel by monitoring a band of fB fragment (Bb) generated via proteolysis by fD. In an effort to assess the activity of soluble C3 convertase against the purified C3, C3 convertase was assembled via the 30-min incubation of C3b (2 μg) with fB (2 μg) and fD (0.4 μg) in 50 μl of PBS containing 5 mM MgCl2 and mixed with 10 μl of PBS containing C3 (10 μg). Alternatively, 50 μl of the assembled C3 convertase was mixed with 10 μl of PBS containing C3 (10 μg), fI (2 μg), and fH (4 μg), then incubated for 30 min at room temperature. In addition, GelE (2 μg) was added to the mixture of fB (2 μg), fD (0.4 μg), fI (2 μg), fH (4 μg), and C3 (10 μg), and then incubated for 30 min at room temperature. Thereafter, 6 μl of each sample was subjected to SDS-PAGE analysis.
To examine the fD cofactor activity of C3b or C3b′, C3b (2 μg) or C3 (2 μg) preincubated for 30 min with GelE, was incubated for 10 min with fB (4 μg) at room temperature. Then, each sample was loaded onto 10% native SDS-PAGE gel. C3 (2 μg) was incubated with fB (4 μg) under the same condition as above and used for control.
Immunofluorescence microscopic observation
Using zymosan (Sigma-Aldrich, Z4025) and C3-deficient human serum (C3-def HS) (Sigma-Aldrich, C8788), we assessed the opsonization of foreign particles by the complement system. Sixty microliters of PBS containing C3 (10 μg) was mixed with 40 μl of Gelatin Veronal Buffer (GVB, Sigma-Aldrich, G6514) containing 50% (v/v) C3-def HS and 100 μg of zymosan. The mixture was then incubated for 1 h at 37°C in a rotary shaker and washed twice in PBS. After centrifugation, the sediment was resuspended in 100 μl of PBS containing 4% (v/v) FITC-labeled C3c complement Ab (GeneTex, 16262), then incubated for an additional 30 min at 37°C in a rotary shaker. The sample was then washed twice in PBS and resuspended in 100 μl of PBS. In brief, 20 μl of sample was removed and observed under the fluorescence microscopy (Leica DMBL). To assess an effect of soluble C3 convertase assembled with C3b (2 μg), fB (2 μg), and fD (0.4 μg) on C3, C3 (10 μg) was incubated in 60 μl of PBS containing C3 convertase for 30 min at room temperature. The sample was then treated sequentially with C3-def HS and zymosan in accordance with the procedure described above, and then subjected to microscopic analysis. Alternatively, C3 was incubated with C3 convertase in the presence of fH (4 μg) and fI (2 μg) under the same condition as above and the sample was subjected to the same microscopic observation procedure. To assess the effects of GelE on C3 opsonization, C3 (10 μg) was incubated for 30 min with GelE (2 μg) in the presence of fH (4 μg) and fI (2 μg) at room temperature. After further incubation in Gelatin Veronal Buffer containing zymosan and C3-def HS, the sample was subjected to microscopic analysis.
PMN-mediated bactericidal assay
One hundred microliters of PMN solution (6 × 106 cells/ml) prepared in HBSS were added to 90 μl of PBS containing 10 μl of NHS. In this experiment, we utilized PBS containing 1 mM CaCl2 and 1 mM MgCl2. This PMN-NHS sample was mixed with log-phase Ef (6 × 105 cells) in 10 μl of PBS. After 30 min of incubation at 37°C in a rotary shaker, 10 μl of the mixture was removed and added to 1.49 ml of distilled water to lyse the PMNs. Then, 10 μl of the sample was plated on tryptic soy agar (Difco). The resultant colonies were counted following overnight incubation at 37°C. For a control, 10 μl of Ef solution (6 × 105 cells) was incubated in buffer mixture (100 μl of HBSS plus 90 μl of PBS) in the absence of NHS and PMNs under the same condition described above. According to the same procedure, bacteria were numerated after overnight incubation. In an effort to assess the effects of GelE on the Ef killing mediated by NHS and PMNs, 100 μl of PMN solution was added to 90 μl of PBS containing various quantities of GelE (0.5, 1, or 2 μM) and 10 μl of NHS and each sample was then subjected to the same procedure as described above. Alternatively, to evaluate the effects of GelE on the killing of pre-opsonized Ef (O-Ef) by PMN, 900 μl of Ef solution (6 × 109 cells/ml) were first incubated with 100 μl of NHS for 15 min at 37°C in a rotary shaker. The reaction was stopped by the addition of 50 mM EDTA solution in PBS, after which the mixture was washed twice in PBS. After a brief centrifugation, the O-Ef sediment was resuspended in 1 ml of PBS. Then, 10 μl of O-Ef (6 × 107 cells/ml) was mixed with 90 μl of PBS containing varying concentration of GelE (0.5, 1 or 2 μM) or no GelE. Following 30 min of incubation at 37°C in a rotary shaker, 100 μl of PMN solution (6 × 106 cells/ml) in HBSS was added to the mixture. After 30 min of incubation, each sample was subjected to the same procedure as described above to count the recovered colonies. For a 100% survival control, O-Ef was incubated under the same conditions in HBSS containing no PMNs.
In addition, we attempted to examine whether GelE affected PMNs and damaged their phagocytic activity against O-Ef. GelE at different concentrations (0.5, 1, or 2 μM) were initially incubated for 30 min with PMNs in HBSS at 37°C. After three times washing in HBSS to remove the remaining GelE, 190 μl of GelE-treated PMN sample (6 × 105 cells) was mixed with 10 μl of PBS containing O-Ef (6 × 105 cells), and incubated for 30 min at 37°C. The survival colonies from each sample were numerated in accordance with the same procedure as described above.
Degradation of iC3b by GelE and microscopic observation for effect of GelE on CR3 (CD11b/CD18) on human PMNs
It has been determined that GelE is capable of degrading purified iC3b and surface-bound iC3b, both of which were generated via the activity of fI in the presence of fH. Purified C3b (2 μg) was incubated for 30 min with GelE (0.5 μg) in 10 μl of PBS containing fI (1 μg) and fH (2 μg) at 37°C. For a control, C3b was treated with an identical amount of fI and fH in PBS without GelE. Each sample was subjected to SDS-PAGE and immunobloting analyses were conducted with anti-C3 Ab. The proteolytic activity of GelE to iC3b was also evaluated using purified iC3b. One microgram of iC3b was incubated with GelE of 2-fold serially diluted concentrations from 0.8 μM for 30 min at 37°C, then subjected to SDS-PAGE analysis. To assess the effect of GelE on surface-bound iC3b, 900 μl of PBS containing 200 μg of zymosan was mixed with 100 μl of NHS and incubated for 20 min at 37°C. After two washings in PBS, zymosan was treated with GelE (2 μg) for 30 min at 37°C. The zymosan sample was then extensively washed in PBS and boiled for 5 min in 50 μl of SDS-sample buffer to elute zymosan-bound proteins. After a brief centrifugation, the supernatant was subjected to SDS-PAGE and duplicate gels were utilized for immunoblot analysis. The protein sample detached from zymosan that was incubated with NHS but not treated with GelE was utilized as a control. Furthermore, zymosan was incubated with NHS for different times, and each sample was treated with GelE. Then, the eluted proteins were also examined by immunobloting analysis. To examine the effect of GelE on CR3, 100 μl of PMNs suspension (2 × 107 cells/ml) in HBSS was mixed with 100 μl of 2 μM GelE in PBS and incubated for 30 min at 37°C. After washing twice with HBSS, PMNs were treated with FITC-conjugated anti-CD11b Ab (sc-52686, Santa Cruz Biotechnology) for 30 min and observed under fluorescence microscopy.
Phagocytosis and flow cytometry analysis
Methanol-fixed Ef was first labeled with FITC (Sigma-Aldrich F7250). FITC-labeled O-Ef was treated with 2 μM GelE for 30 min at 37°C and then incubated for 30 min with PMNs at 37°C. For a control, FITC-labeled O-Ef untreated with 2 μM GelE was incubated with PMNs. According to the same procedure as described above, each sample was then visualized via fluorescence microscopy. To assess the effects of GelE on PMNs, PMN samples were treated with 2 μM GelE for 30 min at 37°C and washed twice in HBSS before incubation with FITC-labeled O-Ef. The phagocytosis of O-Ef by GelE-treated PMNs was then observed in accordance with the same procedures as above. Alternatively, the phagocytosis of FITC-labeled O-Ef by PMNs was assessed via flow cytometry using a FACS flow cytometer (BD Biosciences) with computer-assisted evaluation of data (FACScan software). In these experiments, two times more PMNs (6 × 105 cells) and FITC-labeled O-Ef (1.2 × 106 cells) than those employed in the microscopic experiments were used, and 20,000 PMNs of each sample were analyzed for FACS analyses. Also, before cell counting, the samples were consistently fixed with 4% paraformaldehyde.
Hemolysis assay
Complement activation in sera from human and other animals was assessed by measuring their hemolytic activity against RBC obtained from a rabbit. Human (20 μl), dog (25 μl), chicken (25 μl), mouse (55 μl), or guinea pig (45 μl) sera were mixed with PBS to a total volume of 90 μl. Each serum sample was supplemented with 10 μl of rabbit RBC solution (109 cells/ml) in HBSS, then incubated for 30 min at 37°C. After 3 min centrifugation at 10,000 × g, 50 μl of the supernatant was removed and its OD was measured at 405 nm using a 96-well plate reader (Bio-Tek Instruments ELx 800). Alternatively, each serum sample was treated with 2 μM GelE for 30 min at 37°C before the addition of rabbit RBC, and the hemolysis of each sample was then examined according to the same procedure as described above.
Results
Inactivation of C3 in human serum by GelE
Using purified components of the human complement, the effect of GelE on C3 was assessed via SDS-PAGE and immunoblotting assays. As shown in Fig. 1⇓A, the C3 α-chain vanished from the gel when it was incubated with GelE in the presence of fI and fH. However, without fI or fH in the reaction mixture, C3 was changed into a C3b-like molecule (C3b′) by GelE. In addition, C3 was not affected by fI and fH in the absence of GelE. Therefore, it was concluded that GelE acted on C3 in a manner similar to that of C3 convertase and generated a C3b-like protein which was degraded further by fI in the presence of its cofactor, fH. We also attempted to determine whether this C3b′ can behave like an original C3b as a component of C3 convertase (C3bBb). When it was incubated with fB and fD, it was confirmed that an fB fragment (Bb) was generated via the action of fD with the aid of its cofactor as in the control mixture, to which an original C3b was added (Fig. 1⇓C). This result demonstrated that C3b′ retained an fD cofactor activity for the proteolysis of fB. The proteolytic activity of the assembled C3 convertase (C3b, fB, and fD) against C3 was evaluated in the absence or presence of fI and fH (Fig. 1⇓D). As a result, the C3 α-chain was found to be intact in the mixture containing C3 convertase, fI and fH, thereby indicating that C3 convertase was inactivated by fI and fH (lane 2 in Fig. 1⇓D). In contrast, once C3 was incubated with fB, fD and GelE in the presence of fI and fH, the C3 α-chain disappeared but Bb was detected, thereby suggesting that C3b′ could exert its fD cofactor activity before degradation by fI. In addition, the fD cofactor activity of C3b′ was confirmed via an SDS-PAGE analysis under non-reducing condition (Fig. 1⇓E). When GelE-treated C3 was incubated with fB, the band for C3b′ was shifted to upper position (sixth lane) as did an original C3b incubated with fB (fourth lane), indicating C3b′ was capable of binding to fB and acting as a cofactor of fD. In parallel, it was verified that the assembled C3 convertase did not affect C3 in NHS upon its addition to NHS but that the addition of GelE to NHS resulted in the degradation of the C3 α-chain as had been observed previously (data not shown). From these results, it was concluded that GelE functioned as a soluble C3 convertase which was resistant to proteolysis by fI and fH. Using C3-deficient human serum (C3-def HS) and zymosan, we also determined the effects of GelE on the opsonization of complement on zymosan surfaces (Fig. 2⇓). When C3-def HS was supplemented with C3 that had been preincubated with the assembled C3 convertase, fluorescence resulting from opsonization by C3 fragments, such as C3b and iC3b, was not detected on zymosan surfaces (Fig. 2⇓B). However, C3-def HS supplemented with C3 pre-treated with soluble C3 convertase in the presence of fI and fH evidenced a significant opsonization effect (Fig. 2⇓C) as in the case of the control sample (Fig. 2⇓A). This result indicates that the activity of soluble C3 convertase was abolished by fI and fH, and thus an intact C3 was provided to C3-def HS. In contrast, as expected from the results shown in Fig. 1⇓, C3-def HS supplemented with GelE-treated C3 evidenced no opsonization effects on zymosan (Fig. 2⇓D).
Proteolytic effects of GelE on complement components in the human serum. A, Each reaction mixture was subjected to SDS-PAGE (upper panel) and immunoblotting analysis (lower panel). B, Proteolytic activity of GelE to each purified complement factor. One microgram of each complement factor was treated with GelE at the indicated concentrations for 30 min at room temperature and then subjected to SDS-PAGE. C, The assembly of fluid-phase C3 convertase with fB, fD, and C3b′ generated via GelE action. Validity of C3b′ as a component of C3 convertase was monitored by the appearance of Bb after the incubation of the mixture. Lane 1, human C3b; lane 2, human C3 treated with GelE; lane 3, mixture of C3b, fB, and fD; lane 4, mixture of C3, GelE, fB, and fD. D, Effects of fH and fI on assembled C3 convertase. Lane 1, C3 treated with assembled C3 convertase for control; lane 2, C3 treated with assembled C3 convertase in the presence of fH and fI; lane 3, mixture of C3, GelE, fB, fD, fH, and fI. E, Native SDS-PAGE analysis to examine the fD cofactor activity of C3b and C3b′. Of note, whereas the band for C3 was not changed upon incubation with fB (third lane), those for C3b and C3b′ were moved upward in the presence of fB. In A and E, symbols + and − indicate addition and no addition of corresponding protein into the sample, respectively.
Immunofluorescence analysis for an effect of GelE on C3 opsonization of zymosan. A, Zymosan incubated with C3-def HS supplemented with C3. B, Zymosan incubated with C3-def HS supplemented with C3 treated by C3 convertase. C, Zymosan incubated with C3-def HS supplemented with C3 treated by C3 convertase in the presence of fI and fH. D, Zymosan incubated with C3-def HS supplemented with C3 treated by GelE in the presence of fI and fH. For immunostaining, FITC-labeled anti-C3c Ab was diluted to a concentration of 1/25 in PBS.
Effect of GelE on PMN-mediated bactericidal activity
When Ef was incubated at 5% NHS containing constant quantities of human PMNs and different concentrations of GelE, the rate of Ef survival was enhanced with increasing concentration of GelE in the reaction mixture (Fig. 3⇓A). From this result, it was concluded that GelE inhibited an opsonization by NHS and substantially attenuated PMN-mediated Ef killing. In the following experiments, we also attempted to determine whether this inhibitory effect of GelE could be induced by its action against pre-opsonized Ef (O-Ef) with NHS or against PMNs. Firstly, O-Ef was incubated at varying concentrations of GelE and then the PMN-mediated bactericidal effect was assessed. As a result, the higher the concentration of GelE that was applied to O-Ef, the higher the survival rates of Ef were (Fig. 3⇓B). Secondly, before incubation with O-Ef, PMNs were treated with varying concentrations of GelE. As shown in Fig. 3⇓C, all PMN samples treated with different concentrations of GelE evidenced an equivalent antibacterial activity against O-Ef as was observed with the untreated PMN. Thus, we concluded that GelE affected O-Ef but not PMNs, and thereby damaged the PMN-mediated Ef killing process.
Effects of GelE on PMN-mediated bacterial killing. A, All elements (NHS, PMN, GelE, and Ef) were incubated together in the reaction mixture. B, O-Ef was treated with GelE before incubation with PMN. C, PMN was treated with GelE before incubation with O-Ef. In control sample, Ef bacteria (N-Ef) that were not pre-opsonized by NHS were incubated with PMN, after which the recovered CFU was numerated. In all tests, PMN-mediated Ef killing was expressed as the percent of bacterial survival in each sample as compared with that of the control sample, according to the following equation: [(number of colony forming units (CFU) in test sample/number of CFU in control sample) × 100]. Data were obtained from three independent experiments and expressed as the mean values ± SDs (p < 0.01).
Effects of GelE on C3 fragments bound to zymosan and CR3 on PMN surfaces
As it has been determined that iC3b is a predominant C3 fragment bound to microbial surfaces and performs a pivotal function as a major complement opsonin in phagocytosis by PMNs, we assessed the proteolytic effects of GelE on iC3b. As shown in Fig. 4⇓A, treatment of C3b with fI and fH generated two fragments (62 and 43 kDa) on SDS-PAGE gel. The appearance of two fragments is indicative of the generation of iC3b, which resulted from the removal of the C3f fragment from C3b α-chain. Two fragments of the iC3b α-chain were further degraded upon the addition of GelE into the mixture, a finding which differed from the result that the C3b α-chain was intact against GelE attack. To further verify it, we directly assessed the proteolytic activity of GelE against a purified iC3b. As shown in Fig. 4⇓B, two bands of iC3b corresponding to 62 and 43 kDa vanished from the gel as the concentration of GelE increased in the reaction mixture. In addition, we attempted to evaluate the effects of GelE on C3 fragments bound to the zymosan surface. The protein sample eluted from zymosan pre-opsonized by NHS was subjected to immunoblotting analysis with anti-C3 Ab (Fig. 4⇓C). As a result, iC3b was detected principally as C3 fragments, although some C3b was also detected. However, when opsonized zymosan was treated with GelE, only C3b was shown to have been eluted from zymosan. This result demonstrated that iC3b was stripped off from the zymosan surfaces, as two fragments of the iC3b α-chain were degraded by GelE. Alternatively, GelE was added to the incubation mixture (zymosan and NHS) at different postincubation times (0, 5, and 10 min). After 10 min of further incubation, C3 fragments eluted from the zymosan surfaces were also assessed via an immunoblotting analysis. As a result, both C3b and iC3b were detected in the zymosan samples not treated with GelE. In contrast, only C3b was detected in all samples, to which GelE was added (Fig. 4⇓D). It is worthy of note that the longer zymosan and NHS were incubated before addition of GelE, the more C3b was detected in the sample eluted from zymosan, although iC3b was not detected in any of the GelE-treated samples. According to these results, it was concluded that GelE degraded iC3b, but not C3b bound to the surfaces of foreign particles, and consequently paralyzed an opsonization induced by the complement activation. In addition, the proteolytic effect of GelE against CR3 on the surfaces of human PMNs was examined by fluorescence microscopy (data not shown). Fluorescence resulting from binding of FITC-conjugated anti-CD11b Ab to the PMN surfaces was consistently detected after treatment with GelE, suggesting that CR3 on the PMN surfaces was not affected by Ef GelE.
Proteolysis of human iC3b by GelE. A, Immunoblotting assay for proteolytic activity of GelE against iC3b generated from purified C3b via the action of fI and fH. B, Purified iC3b was treated with varying concentrations of GelE. The sample was then electrophoresed on 10% SDS-PAGE gel and the gel was stained with Coomassie blue. C, Immunoblotting analysis for the proteolytic activity of GelE against C3 fragments bound to the zymosan surfaces. Protein samples were subjected to 8% SDS-PAGE analysis and duplicate gels were used for immunoblotting assay. Lane 1, purified C3b; lane 2, purified iC3b; lane 3, protein sample eluted from zymosan opsonized by NHS; lane 4, proteins eluted from zymosan after the treatment of opsonized-zymosan with 2 μM GelE. D, GelE (2 μM) was added to the reaction mixture at different postincubation times of zymosan and 20% NHS, and protein samples eluted from zymosan were subjected to immunoblotting analysis with anti-C3 Ab as described by Towbin et al. (44 ). In A and D, symbols + and − indicate addition and no addition of corresponding protein into the reaction mixture, respectively.
GelE inhibits complement-mediated phagocytosis of Ef by human PMN
To further assess the functional role of GelE in protecting Ef against the PMN-mediated bactericidal effects, we conducted a series of experiments regarding the phagocytosis of Ef by PMNs under conditions similar to those in the PMN-mediated bactericidal assay. FACS analysis showed that the phagocytosis of Ef was severely disrupted upon the incubation of PMN with NHS containing GelE as compared with the control samples (Fig. 5⇓A). In addition, when O-Ef was treated with GelE and then incubated with PMN, phagocytosis was reduced significantly (Fig. 5⇓B). In contrast, GelE-treated PMN was confirmed to maintain its activity for the phagocytosis of O-Ef (Fig. 5⇓C). Collectively, these results were generally consistent with our previous data obtained from PMN-mediated bactericidal assays (Fig. 3⇑).
Effect of GelE on phagocytosis of Ef by human PMNs. Effects of GelE on phagocytosis of Ef by PMN under different conditions were assessed by FACScan flow cytometry. A, Phagocytosis of Ef by PMNs once FITC-labeled Ef and PMNs were coincubated in 5% NHS containing GelE or no GelE. B, Phagocytosis of O-Ef by PMNs once O-Ef was incubated with PMNs after O-Ef was treated with GelE. C, Phagocytosis by PMNs that were treated with GelE before incubation with O-Ef. In all data, the left ones show the results of the positive controls conducted without the addition of GelE into the sample, and the right ones show the results of the test samples treated with GelE.
Effect of GelE on complement activation in sera from other animals
To get further information about the actual site at which GelE cleaved C3, we tested its activity against sera of animals whose C3 has defined differences in sequence from human C3. Whereas the hemolytic activity of NHS was reduced significantly after GelE treatment, those of sera from four animals against rabbit RBC were not affected by GelE (Fig. 6⇓A). This result suggested that the C3 molecules of four animals were resistant to GelE-mediated proteolysis; consequently, the MAC was assembled successfully on rabbit RBC. Furthermore, the proteolytic effect of GelE on C3 in mouse serum was assessed via an immunoblotting assay conducted with an anti-mouse C3 mAb (CL7503AP: Cedarlane Laboratories) (Fig. 6⇓B). As a result, the band of human C3 was detected at a slightly lower position upon treatment with GelE than was an untreated C3, thereby indicating that C3a was removed from C3 via degradation by GelE. In addition, it was noted that the C3 band was moved to a much lower position when NHS was treated with GelE. This result shows that C3 was changed to C3b′ by GelE, which was subsequently cleaved into iC3b by fI and fH occurring in NHS, and iC3b was degraded further by GelE. In contrast, it was shown that the position of the C3 band in the mouse serum remained unchanged after incubation with GelE.
Sera from human and four other animals were tested for their hemolytic activity against rabbit RBCs and each hemolysis was compared with that of each GelE-treated serum sample (A). Experiments were iterated three times on different days, and the mean values were utilized for the preparation of data (p < 0.01). B, The proteolytic effects of GelE against human and mouse C3 were assessed via immunoblotting analyses. One microgram of purified human C3 (left panel), 10% NHS (center panel), or 10% normal mouse serum (NMS) (right panel) was treated with 2 μM GelE for 30 min at 37°C. Each sample was electrophoresed on 8% SDS-PAGE gels under non-reducing conditions and each duplicate gel was probed with anti-human C3 Ab (left and center) or anti-mouse C3 Ab (right). C, Joining regions of C3a and C3b in C3 molecules from human and other animals. Asterisks (∗) indicate the cleavage sites by C3 convertase and the action site of GelE is indicated on the sequence of human C3 by an arrow. It is worthy of note that, whereas P1 site of human C3 for action of GelE is an Asn, the putative site in other C3 proteins is an acidic amino acid, such as Asp or Glu. Sequences cited were from the database of the National Center for Biotechnology Information (human, AAA85332; chicken, NP_990736; dog, XP_533932; mouse, AAC42013; guinea pig, P12387).
Discussion
BSIs induced by pathogenic bacteria are a principal cause of increasing morbidity and mortality in hospitalized patients. Over the past three decades, worldwide epidemiologic studies with human clinical bacteria have shown that enterococci are one of the predominant pathogens of nosocomial BSIs (17, 18). Among several causes of human BSIs, enterococcal bacteremia has been shown to result in the highest rates of patient mortality (21, 22) although enterococci are known to be intrinsically not as virulent as other Gram-positive cocci or Gram-negative bacilli detected in human BSIs. Enterococcal bacteremia has been considered to evidence features of poly-microbial infection, as enterococci are frequently isolated from poly-microbial flora (21, 23). Accordingly, enterococci have been proposed to perform a critical function in bacterial synergy and the development of diseases caused by other microbes with higher virulence (24). That is to say, it is reasonable to suppose that enterococci may contribute to an evasion of other pathogens from the human immune system, and thus facilitating their survival and proliferation in plasma. Nonetheless, the mechanism underlying the virulence or the immune evasion of enterococci that is associated with human BSIs remains to be clearly elucidated.
GelE is a member of the matrix metalloprotease family, and can hydrolyze a variety of substrates, including collagen, fibrinogen, insulin, and bioactive peptides (25). As for the virulence of GelE, a growing body of evidences has been collected in animal studies (26) and etiological studies conducted with human clinical isolates of Ef (27, 28, 29). In more detail, it has been shown that GelE is crucial for biofilm formation (30, 31), for the pathogenesis of periapical inflammation (18) and for translocation across the human intestine (32). However, the exact mode of action for the virulence of GelE still remains to be explained. Our findings indicated that GelE inhibited the complement cascade by consuming C3 in NHS via an excessive activation of the alternative pathway, or paralyzed the PMN-mediated killing of bacteria by clearing surface-deposited iC3b from the bacterial cells. As has already been established, C3 is a central component of the complement-mediated defense reactions against altered host cells, such as cancer cells, as well as against invading pathogens. It has been reported that neoplasms and pathogenic microbes have developed several strategies to specifically target C3 fragments and C3 convertase that was assembled on their surfaces (33, 34). A variety of neoplasms have been shown to employ C3-cleaving proteases such as matrix metalloprotease (33), serine protease (35), and cysteine proteases (36), which were equipped primarily on their membrane surfaces. As a result of the proteolysis, the deposited C3 fragments were liberated from the cell surface, thereby protecting neoplasms against attack from the host complement system. The elastase of Pseudomonas aeruginosa has been demonstrated as a bacterial protease possessing C3-cleaving activity (37, 38). The protease was demonstrated to degrade the C3 α-chain without affecting the C3 β-chain, which appeared to be similar to the results obtained from our experiment, in which the purified C3 was treated with GelE (Fig. 1⇑B). However, further explanation must be provided as to whether the cleavage of the C3 α-chain by an elastase is associated with complement inactivation and then contributes to the immune evasion activities of P. aeruginosa.
Native C3 in the human plasma is inert, and does not bind to any receptor. Once activated by C3 convertase assembled onto the Ag surfaces, C3 is transformed to C3b (39). During this activation, the protein undergoes a major conformational change, which resulted in the exposure of its internal thioester, which became liable to attack by nucleophiles within its immediate surroundings. Consequently, some C3b bind covalently to nearby molecules on the target surfaces on which complement activation was occurring. However, it was confirmed that this binding of C3b was not efficient: typically, ∼90% of C3b molecules were unable to attach to the target surfaces, and were inactivated rapidly as the result of reaction with water (39). In our previous study (19), we demonstrated that GelE cleaved C3 at a position quite close to the original site for C3 convertase (see in Fig. 6⇑D). In addition, the result of the present study showed that the C3b-like fragment generated by GelE became a component of C3 convertase and was degraded further by fI and fH, as in cases of an original C3b (Fig. 1⇑). Collectively, our results led to the conclusion that GelE acted on C3 in the fluid phase, as if it were a soluble C3 convertase. As a result of the activity of GelE, circulating C3 was transformed continuously into soluble C3b-like molecules, which were then immediately reacted with water and then lost their binding capacity to the target surfaces. Therefore, it was suggested that GelE rendered native C3 inactive, which resulted in the consumption of a central component in all complement activation routes. This activity of GelE against the human complement system was reminiscent of that of cobra venom factor (CVF), which has been well studied as a functional C3b homologue (40, 41). Upon the introduction of CVF into the human serum, it was shown to behave like a C3b molecule in the formation of a C3 convertase with fB in the presence of fD. The resultant CVF-Bb complex could convert native C3 into C3b in the fluid phase. Unlike an original C3 convertase that was very labile, CVF-Bb convertase proved to be rather stable, with a long half-life in the fluid phase (40). Moreover, whereas C3 convertase proved vulnerable to proteolysis by fI and fH, CVF-Bb was confirmed to be completely resistant to them (40). Therefore, as a consequence of its stability, CVF-Bb convertase consumed C3 via the continuous activation of the alternative pathway, and obliterated the functional complement. Similarly, it was evidenced that Ef GelE behaved like a stable C3 convertase in the fluid phase as did CVF-Bb, although it remains to be clarified whether or not GelE was expressed in a serum environment in such amounts that led to complete depletion of C3. In addition, it was interesting to note that CVF-induced C3 convertase activity was detected in the hemolymph of Galleria mellonella (41), from which our bacterium (E. faecalis GM) was isolated (19). We now consider that the C3 convertase activity was probably attributed to the presence of Ef GelE in the G. mellonella hemolymph.
Complement-mediated phagocytosis is accomplished via the specific recognition of bound C3 fragments (C3b and iC3b) by the corresponding receptors (CR1 and CR3) on human PMNs. It has been suggested that CR1 mediates an initial transient adhesion to C3b, and that CR3 mediates the stable interaction between microbes and PMNs via specific binding to iC3b (6). It was verified that the C3b/CR1 interaction did not contribute to the internalization of opsonized-microbes into PMNs, but rather facilitate the conversion of C3b to iC3b on microbial surfaces (42, 43). This conversion progressively increased the proportion of iC3b/CR3 interactions, which further improved the complement-mediated phagocytosis by PMNs. Accordingly, CR1 is considered to function as a cofactor of fI, rather than as a phagocytic receptor to complement opsonin (42). As shown in Fig. 4⇑, GelE degraded iC3b on opsonized Ef without affecting bound C3b. Moreover, it was determined that bound iC3b was stripped off from the Ef surfaces, and this was attributable to the cleavage of 62 kDa fragment containing a thioester binding domain (39) by GelE. In addition, it was observed that the treatment of PMNs with GelE neither disrupted to the phagocytosis of O-Ef by PMNs, nor their capacity for Ef killing. Taken together, our results indicated that GelE impaired an iC3b among the four members participating in opsonin-receptor matches (C3b/CR1 and iC3b/CR3) between O-Ef and PMN. This impairment of iC3b by GelE was sufficient to precipitate a significant reduction in PMN-mediated Ef killing, although it was not clear whether the C3b/CR1 pair was also affected as we have not specifically studied the effect of GelE on PMN surface molecules other than CR3.
At the inception of this work, we surmised that GelE might influence the complement system of other animals in such a way that it acted on the human complement system, as it was previously verified that the cleavage sites in other animals’ C3 molecules by C3 convertase were highly homologous with that of human C3, and GelE cleaved a peptide bond adjacent to the action site of C3 convertase (Fig. 6⇑C). However, our hemolytic assay showed that GelE, at least, did not affect the formation of MAC resulting from complement activation in the sera of the other four animals. Upon consideration of the upstream of the complement cascade, it was likely that the C3b molecules of sera from other animals were sufficiently deposited on the rabbit RBC surfaces, and subsequently afforded the assembly of C3/C5 convertases which resulted in MAC formation. This assumption was bolstered by the fact that the putative sites for the activity of GelE in the C3 of other animals differed from that associated with human C3.
In summary, the results of this study demonstrate that GelE, known as a virulence factor of Ef, paralyzed the human complement system, via a two-stage process (see Fig. 7⇓). Firstly, it functioned as a functional homologue of soluble C3 convertase that converted circulating C3 to C3b, which was instantaneously inactivated via reaction with water. Secondly, GelE degraded two fragments of the α-chain of iC3b, and removed it from the Ef surfaces. Consequently, the iC3b/CR3 match was not made between Ef and PMN, and thus PMN-mediated Ef killing was severely disrupted. Finally, our findings regarding the complement evasion of Ef by GelE make GelE a promising molecule for the targeting of infectious diseases associated with Ef.
Schematic illustration depicting inhibitory effects of GelE on the human complement system. A, Circulating C3 was inactivated via transformation into a C3b-like fragment (C3b′) by GelE and C3b′ was cleaved into iC3b, the α-chain of which was degraded further by GelE. Also, C3b′ bound to fB before degradation by fI, and played a role as an fD cofactor in the generation of Bb. In addition, C3a was degraded by GelE, as reported in our previous work. B, Major complement opsonin (iC3b) was cleaved further by GelE and was released from the Ag surfaces, thereby inhibiting phagocytosis mediated by an interaction between iC3b and CR3 on PMN. AP, CP, and LP denote alternative, classical and lectin pathways, respectively.
Disclosures
The authors have no financial conflict of interest.
Footnotes
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↵1 This work was supported by a grant (2005-015-C00447) from Korea Research Foundation (KRF). S.Y.P. and C.H.K. received a scholarship from the World-Class 2030 Project of Hoseo University. S.J.S. and B.S.K. were supported by a scholarship (or grant) from the BK21 Program, the Ministry of Education and Human Resources Development, Korea.
↵2 Address correspondence and reprint requests to Dr. In Hee Lee, Department of Biotechnology, Hoseo University, 165 Sechuli, Baebangmyun, Asan City, Chungnam, South Korea. E-mail address: leeih{at}hoseo.edu
↵3 Abbreviations used in this paper: MAC, membrane attack complex; PMN, polymorphonuclear leukocyte; f, factor; CR, complement receptor; BSI, bloodstream infection; Ef, Enterococcus faecalis; GelE, gelatinase; NHS, normal human serum; C3-def HS, C3-deficient human serum; O-Ef, pre-opsonized Ef; CVF, cobra venom factor.
- Received March 31, 2008.
- Accepted August 21, 2008.
- Copyright © 2008 by The American Association of Immunologists