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The Role of Bps Polysaccharide in Bordetella Resistance to Host Innate Defenses BY CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL OF ARTS AND SCIENCES in Partial Fulfillment of the Requirements for the Degree of DOCTOR OF PHILOSOPHY Microbiology and Immunology August 2010 Winston-Salem, North Carolina Approved By: Rajendar Deora, Ph.D., Advisor __________________________ Examining Committee: Linda McPhail, Ph.D., Chairman __________________________ Martha Alexander-Miller, Ph.D. __________________________ Griffith Parks, Ph.D. __________________________ Nancy Kock, D.V.M, Ph.D. __________________________

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Page 1: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

The Role of Bps Polysaccharide in Bordetella Resistance to Host Innate

Defenses

BY

CHERATON FABRICE LOVE

A Dissertation Submitted to the Graduate Faculty of

WAKE FOREST UNIVERSITY GRADUATE SCHOOL OF ARTS AND SCIENCES

in Partial Fulfillment of the Requirements

for the Degree of

DOCTOR OF PHILOSOPHY

Microbiology and Immunology

August 2010

Winston-Salem, North Carolina

Approved By:

Rajendar Deora, Ph.D., Advisor __________________________

Examining Committee:

Linda McPhail, Ph.D., Chairman __________________________

Martha Alexander-Miller, Ph.D. __________________________

Griffith Parks, Ph.D. __________________________

Nancy Kock, D.V.M, Ph.D. __________________________

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Table of Contents List of Figures....................................................................................................................iv List of Tables.....................................................................................................................vi List of Abbreviations.......................................................................................................vii Abstract..............................................................................................................................x Chapter One: Introduction...............................................................................................1 The Bordetella genus……………………………………………………………………...1 Bordetella pertussis course of illness…………………………………………………......2 The BvgAS signal transduction system……………………………………………….......6 BvgAS regulation of Bordetella phenotypes......................................................................9 BvgAS regulation of Bordetella virulence factors……………………………………….10

Adhesins………………………………………………………………………….10

Toxins……………………………………………………………………………12

Biofilms………………………………………………………………………………….15

Bordetella biofilms………………………………………………………………………16

Bacterial Exopolysaccharides……………………………………………………………19

Biofilm relevance to human infection……………………………………………………21

Innate immune responses to B. bronchiseptica…………………………………………..22

Antimicrobial peptides…………………………………………………………...22

Neutrophils and macrophages…………………………………………………....24

Cytokines………………………………………………………………………...24

Animal models…………………………………………………………………………...25

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Limitations of studies reported in the literature……..…..……………………………….26

Chapter Two: Materials and Methods...……………………………………………...28

Chapter Three: The Role of Bps in Resistance to Host Innate Defenses….………..35

The Bps polysaccharide protects B. bronchiseptica from killing by polymyxin B...........35

The Bps polysaccharide protects biofilms formed by the Δbps strain from polymyxin B

killing in trans....................................................................................................................41

Overproduction of Bps prevents binding of polymyxin B to B. bronchiseptica

biofilms..............................................................................................................................44

The Bps polysaccharide directly binds polymyxin B........................................................45

The bps locus promotes colonization of B. bronchiseptica in the mouse respiratory tract

during the persistent stage of infection..............................................................................51

The Bps polysaccharide enhances colonization of B. bronchiseptica in the mouse

respiratory tract at 3 days post-inoculation........................................................................51

Neutrophils are an important host factor in the clearance of the Δbps strain in vivo........54

The Bps polysaccharide does not play a role in cellular infiltration following a

B. bronchiseptica infection...............................................................................................64

The Δbps mutant strain does not have increased uptake by neutrophils...........................67

The Δbps strain induces greater cytokine production in mouse lungs at 2 and 3 days post-

inoculation..........................................................................................................................67

Chapter Four: Discussion……………………………………………………………...75

References……………………………………………………………………………..…86

CurriculumVitae………………………………………………………………………..104

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List of Figures

Chapter One

Figure 1: Bacterial load of B. pertussis during classical pertussis illness...........................3

Figure 2: The BvgAS signal transduction system of Bordetella species............................7

Figure 3: Biofilm formation is a multi-step process..........................................................17

Chapter Three

Figure 1: The Bps polysaccharide protects planktonic B. bronchiseptica cells from killing by polymyxin B.......................................................................................36

Figure 2: The Bps polysaccharide protects B. bronchiseptica biofilms from killing by

polymyxin B.......................................................................................................39 Figure 3: The Bps polysaccharide increases resistance of biofilms formed by the Δbps

mutant strain to polymyxin B killing in trans.....................................................42 Figure 4: Overproduction of Bps prevents binding of polymyxin B to B. bronchiseptica

biofilms...............................................................................................................46 Figure 5: The Bps polysaccharide directly binds polymyxin B.........................................49 Figure 6: The bps locus promotes persistent colonization of B. bronchiseptica in the

mouse respiratory tract.......................................................................................52 Figure 7: Kinetics of colonization of the wild-type B. bronchiseptica and isogenic mutant,

Δbps, in the murine respiratory tract..................................................................55 Figure 8: Colonization of the wild-type and Δbps strains in neutropenic and wild-type

C57BL/6 mice at 2 days post-inoculation..........................................................62 Figure 9: Colonization of the wild-type and Δbps strains in neutropenic and wild-type

C57BL/6 mice at 3 days post-inoculation..........................................................65 Figure 10: Cellular infiltration in bronchoalveolar lavage (BAL) fluid of mice infected

with the wild-type B. bronchiseptica or the Δbps strain................................68 Figure 11: Phagocytosis of the wild-type and Δbps strains by neutrophils.......................70

iv

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Figure 12: Cytokine detection in lungs of mice infected with the wild-type and Δbps strains...............................................................................................................73

Chapter Four Figure 1: Model of potential roles of Bps polysaccharide in evasion of host defenses....84

v

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List of Tables

Chapter Three Table 1: Histopathology scores of lungs of mice infected with the wild-type or Δbps strain.................................................................................................................................57 Table 2: Presence of neutrophils in lungs of mice infected with the wild-type or Δbps strain.................................................................................................................................60

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List of Abbreviations

ADP..................................................................................................Adenosine diphosphate ATP..................................................................................................Adenosine triphosphate AMPs.................................................................................................Antimicrobial peptides BAL.................................................................................................Bronchoalveolar lavage BipA.......................................................................Bordetella intermediate phase protein A BMDCs.....................................................................................Bone marrow dendritic cells BG.................................................................................................................Bordet-Gengou Bps...............................................................................................Bordetella polysaccharide Bpshyp...................................................................................................Bps hyper-expressing Δbpsvec.................................................................................................................Δbps vector Bvg................................................................................................Bordetella virulence gene cAMP.................................................................................................................Cyclic AMP CFU.......................................................................................................Colony forming unit CHO..................................................................................................Chinese hamster ovary CPS.................................................................................................Capsular polysaccharide CR3..................................................................................................Complement receptor 3 CSLM...........................................................................Confocal scanning laser microscopy dPNAG...................................................................deacetylated Poly N-acetylglucosamine DNA...................................................................................................Deoxyribonucleic acid DNT......................................................................................................Dermonecrotic toxin DTaP.........................................................................Diphtheria-Tetanus-acellular Pertussis

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ELISA........................................................................Enzyme-linked immunosorbent assay EPS..........................................................................................................Exopolysaccharide FHA............................................................................................Filamentous hemagglutinin Fim...........................................................................................................................Fimbriae H & E................................................................................................Hematoxylin and eosin HBD.....................................................................................................Human beta defensin HNP-1.......................................................................................Human neutrophil peptide-1 HPD.................................................................................Histidine phosphotransfer domain HTE.............................................................................................Hamster tracheal epithelial IFNγ...........................................................................................................Interferon gamma Ig.................................................................................................................Immunoglobulin IL..........................................................................................................................Interleukin IS..............................................................................................................Insertion sequence LPS.........................................................................................................Lipopolysaccharide LRI/ IAP.......................................Leukocyte response integrin/ integrin-associated protein MgSO4.....................................................................................................Magnesium sulfate MIC................................................................................Minimum inhibitory concentration NAD...............................................................................Nicotinamide adenine dinucleotide OD.................................................................................................................Optical density PAMPs....................................................................Pathogen-associated molecular patterns PBS...............................................................................................Phosphate buffered saline PIA.............................................................................Polysaccharide intercellular adhesion PNAG...........................................................................................Poly N-acetylglucosamine

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PRN..........................................................................................................................Pertactin PT...................................................................................................................Pertussis toxin RGD..........................................................................................Arginine-Glycine-Aspartate SEM.......................................................................................Scanning electron microscopy SM....................................................................................................................Streptomycin TAP.......................................................................................Tracheal antimicrobial peptide TCT..........................................................................................................Tracheal cytotoxin TNFα.........................................................................................Tumor necrosis factor alpha TTSS.........................................................................................Type three secretion system WFUHS.................................................................Wake Forest University Health Sciences WT.........................................................................................................................Wild-type

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Abstract

Bacteria face many challenges during infection of the host. Initiation of infection

requires attachment to host surfaces. Bordetella species possess several virulence factors

that mediate binding to the host such as filamentous hemagglutinin and pertactin. A

crucial component of successful colonization is evasion of host defenses. Biofilms have

been proposed to promote bacterial persistence by suppressing the effectiveness of host

responses. A hallmark of mature biofilms is the production of a matrix composed of

extracellular polymers including proteins, DNA and polysaccharides. We have shown

that the bps locus is required for biofilm formation and production of the Bordetella

polysaccharide (Bps), a major constituent of Bordetella biofilms.

Bacterial polysaccharides have been attributed to promote bacterial resistance

to host responses. We chose to explore the role of Bps in resistance to antimicrobial

peptides, a key host factor involved in the first line of defense against microbial infection.

We used polymyxin B, an amphipathic molecule with considerable bactericidal activity,

as a model of antimicrobial peptides. Planktonic cells as well as biofilms formed by the

isogenic Δbps mutant were extremely susceptible to killing by polymyxin B. Addition of

purified Bps to biofilms formed by the Δbps strain in trans significantly increased

survival to polymyxin B treatment. Our findings indicate that Bps mediates resistance to

polymyxin B by binding and sequestering the molecule in the biofilm matrix.

We hypothesized that Bps may be required for long term survival of B.

bronchiseptica in the mouse respiratory tract. At 38 days post-inoculation, the wild-type

strain was recovered in higher numbers than the Δbps strain, suggesting that Bps

contributes to persistence at a late stage of Bordetella infection. Based on these results,

x

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we hypothesized that the bps locus would contribute to the establishment of Bordetella

within the host. We observed that the wild-type strain colonized the murine respiratory

tract more efficiently than the Δbps strain at early stages of Bordetella infection.

Histopathological analysis of mouse lungs led us to investigate the role of neutrophils in

the enhanced clearance of the ∆bps strain. We observed that, in neutropenic mice, the

∆bps mutant strain colonization was restored to similar CFUs as the wild-type strain at 3

days post-inoculation. Bronchoalveolar lavage fluid of mice infected with the wild-type

or the ∆bps strain contained similar absolute numbers of neutrophils. In vitro neutrophil

uptake assays revealed that the ∆bps strain was not more susceptible to phagocytosis.

Thus we conclude that neutrophils play a role in the enhanced clearance of the ∆bps

strain at 3 days post-inoculation by a mechanism independent of rapid influx or

phagocytosis. We have demonstrated that Bps facilitates B. bronchiseptica colonization

in the mouse respiratory tract by successful evasion of host defenses. The Bordetella

polysaccharide is produced by the three classical Bordetella species, B. pertussis, B.

bronchiseptica and B. parapertussis. Our studies highlight the need for therapeutics that

can eliminate bacterial polysaccharide production in vivo to promote an effective host

response and subsequent clearance of the pathogen.

xi

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Chapter One: Introduction

The Bordetella genus

Bordetellae are small, aerobic, Gram-negative bacteria that preferentially bind to

the ciliated epithelium of the respiratory tract of mammals. The Bordetella genus

contains nine species: B. pertussis, B bronchiseptica, B. parapertussishuman(hu), B.

parapertussisovine(ov), B. holmesii, B. hinzii, B. trematum, B. petrii and B. avium (125).

The three classical Bordetella species, B. pertussis, B. bronchiseptica and B.

parapertussis, remain thoroughly studied in the field for their role in pathogenesis.

Bordetella pertussis is a strict human pathogen and the etiological agent of whooping

cough or pertussis (24, 125). Although whooping cough is not life-threatening to

adolescents and adults, it has been proposed that these age groups serve as reservoirs of

transmission to infants and young children in whom the disease is quite serious and often

lethal (37). B. bronchiseptica infects a broad range of animals including cats, dogs and

laboratory animals such as mice and rats. Infection by B. bronchiseptica has been shown

to cause bronchopneumonia in laboratory animals and asymptomatic infection in most

animals (62). Although not often attributed with causing disease in humans, B.

bronchiseptica has been shown to infect immunocompromised individuals (47). B.

parapertussis exists as two genetically distinct strains. B. parapertussisov infection of

sheep leads to a chronic disease in the respiratory tract. B. parapertussishu is a human

adapted strain that causes a milder form of pertussis (9, 15, 47).

The three classical species of Bordetella have been classified as a subspecies

based on their significant DNA sequence similarity. B. bronchiseptica is proposed to be

the evolutionary progenitor of the human adapted strains B. pertussis and B.

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parapertussishu (159). Interestingly, the genomes of B. pertussis and B. parapertussishu

contain approximately one megabase less DNA than B. bronchiseptica. In addition to

gene deletion, the human adapted strains contain several pseudogenes that have been

inactivated by insertion of insertion sequence (IS) elements, and frameshift mutations

(39). Though B. pertussis and B. parapertussishu have evolved from B. bronchiseptica

through genomic decay, they do not lack any genes that have been associated with

pathogenesis.

Bordetella pertussis course of illness

Classic illness caused by infection with B. pertussis lasts up to 12 weeks or longer

and consists of the following stages: catarrhal, paroxysmal and convalescent (Fig 1).

After an incubation period of approximately 7 to 10 days, the infected individual enters

the catarrhal stage with symptoms such as a mild cough and sometimes a slightly

elevated fever. Unfortunately, the symptoms associated with the catarrhal stage resemble

a common cold, making diagnosis of pertussis difficult. Bacterial numbers reach the peak

during the first stage of pertussis illness. The paroxysmal stage begins around the second

week of the illness and lasts up to 8 weeks. A hallmark of the paroxysmal stage is

repeated coughing fits with up to 10 forceful coughs during a single expiration followed

by an inhalation with the characteristic “whoop” sound. Vomiting and weight loss are

common symptoms in infected individuals. Unlike in the catarrhal stage, bacterial

numbers are relatively low during this second stage of pertussis illness. The coughing fits

2

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Fig. 1: Bacterial load of B. pertussis during classical pertussis illness. Following an

incubation period of 7 to 10 days, pertussis illness begins with the catarrhal phase. During

this stage, the infected individual has cold-like symptoms and has a high chance of

transmitting B. pertussis to other individuals due to a large bacterial burden. At the

second week of illness, the paroxysmal stage is characterized by the presence of the

“whooping cough” and a decreased bacterial load. This phase lasts from 2 to 8 weeks. In

the last stage of pertussis illness, the convalescent stage, the infected individual has less

frequent and severe coughing fits. This stage lasts 1 to 2 weeks or sometimes longer.

3

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Stage of pertussis illness

Catarrhal Paroxysmal Convalescent

Time

1 to 2 weeks 2 to 8 weeks 1 to 2 weeks

Bac

teria

l num

bers

Stage of pertussis illness

Catarrhal Paroxysmal Convalescent

Time

1 to 2 weeks 2 to 8 weeks 1 to 2 weeks

Bac

teria

l num

bers

4

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decrease in frequency and severity in the convalescent stage which usually lasts about 1

to 2 weeks but can be longer (125).

It is estimated that there are approximately 48.5 million pertussis cases a year

worldwide with as many as 295,000 deaths (38). The spread of pertussis is limited in

areas of the world with extensive vaccine coverage. The first whole-cell pertussis vaccine

became available in the United States in the 1940s. Due to numerous reports of children

experiencing neurological distress after receiving the whole-cell vaccine, new acellular

vaccines were distributed in the 1990s that consisted of two or more B. pertussis

components (5, 23). The current acellular pertussis vaccine available in the U.S. is

combined with the diphtheria and tetanus toxoids and known as diphtheria-tetanus-

acellular pertussis vaccine (DTaP). B. pertussis virulence factors included in DTaP are

filamentous hemagglutinin (FHA), pertussis toxin (PT), pertactin (PRN) and two distinct

forms of fimbraie (Fim), Fim2 and Fim3. The recommended regimen of DTaP is four

doses at 2, 4, 6 and 15-18 months of age and a booster before the child enters school (20,

21).

As a result of vaccination, incidence of reported pertussis cases shifted from

unvaccinated children between 1 and 9 to vaccinated adolescents and adults (7, 60).

Some reasons for this shift in carriage of B. pertussis include incomplete immunity in

children who have not received all doses of the vaccine as well as the loss of protection in

vaccinated individuals over time due to waning immunity (194). Adolescents and adults

act as carriers of pertussis and serve as reservoirs, transmitting B. pertussis to

unvaccinated infants or children who have not received all doses of the vaccine (8, 41). A

5

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booster vaccine is now available for adults to help prevent spread of pertussis to

susceptible infants and children.

The BvgAS signal transduction system.

Bacteria often use two-component regulatory systems to sense their environment

and subsequently change gene expression. A majority of Bordetella virulence factors

have been shown to be regulated by the BvgAS two-component system. BvgAS is unique

due its His-Asp-His-Asp phosphorelay system (Fig. 2) (183-185). BvgAS consists of the

sensor kinase BvgS and the response regulator BvgA. BvgA contains a receiver domain

and helix-turn-helix domains. BvgS includes a periplasmic domain connected by a linker

region to transmitter, receiver and histidine phosphotransfer domains (HPD). The

environmental stimuli of BvgAS remain unknown although nicotinic acid, sulfate anion

and temperature conditions are used to control activation of BvgAS in laboratory settings

(91, 136)

The periplasmic domain of BvgS recognizes an environmental signal which leads

to autophosphorylation of a histidine on the transmitter domain. This histidine transfers

the phosphoryl group to an aspartate on the BvgS receiver domain. To promote BvgAS-

regulated gene expression, the aspartate then donates its phosphate group to a histidine

located on the histidine phosphotransfer domain which, in turn, phosphorylates an

aspartic acid residue on the receiver domain of BvgA. Once phosphorylated, BvgA

activates transcription by binding to promoter regions of Bordetella genes.

Phosphorylated BvgA also activates the repressor protein BvgR, which represses

transcription of certain Bordetella genes (133-135).

6

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Fig. 2: The BvgAS signal transduction system of Bordetella species. Expression of the

majority of Bordetella virulence factors is regulated by the BvgAS two component

system. BvgS is the transmembrane sensor kinase that exists as dimers of periplasmic

domains, transmitters, receivers and histidine phosphotransferase domains. Detection of

an environmental signal leads to phosphorylation of the transmitter domain. Several

phosphotransfers occur, leading ultimately to the phosphorylation of BvgA, the response

regulator. Phosphorylated BvgA can activate or repress Bordetella genes. When the

BvgAS system is active, Bordetella is in the Bvg+ phase in which several well

characterized virulence factors are expressed such as FHA, pertactin, adenylate cyclase or

pertussis toxin. When the BvgAS system is inactive, Bvg- phase factors such as flagella

and urease are expressed. A third phase, Bvgi, exists in which Bordetella expresses many

unknown factors not observed in the Bvg+ or the Bvg- phases. One factor expressed by

Bordetella during the Bvgi phase is Bordetella intermediate phase protein A (BipA).

MgSO4, nicotinic acid and varying temperatures are modulators used in the laboratory to

regulate the three Bordetella phases controlled by the BvgAS system.

7

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Outer membrane

Inner membrane

BvgS

P P

P P

P PBvgA

Sulfate, Nicotinic acid, Temperature<30oC

Bvg+ Bvg-

Bvgi BipA

MotilityUrease

FHA

Pertactin

CyaA

Outer membrane

Inner membrane

BvgS

Sulfate, Nicotinic acid, Temperature<30oC

PP PP

PP PP

PP PPBvgA

Bvg+ Bvg-

Bvgi BipA

MotilityUrease

FHA

Pertactin

CyaA

8

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BvgAS regulation of Bordetella phenotypes

The BvgAS system controls the three phenotypic stages of Bordetella species (31, 114).

BvgAS is active at 37oC in the absence of magnesium sulfate (MgSO4) or nicotinic acid.

During this phenotypic phase, known as the Bvg+ phase, BvgA activates transcription of

various Bordetella toxins and adhesins such as adenylate cyclase, pertussis toxin,

filamentous hemagglutinin and fimbriae. If the temperature is at or below 25oC or at 37oC

in the presence of millimolar concentrations of MgSO4 or nicotinic acid, BvgAS becomes

inactive and switches to the Bvg- phase in which transcription of Bordetella toxins and

adhesins is repressed. In the Bvg- phase, genes responsible for flagellin are transcribed

for B. bronchiseptica and BvgAS repressed genes of B. pertussis are activated (125).

The BvgAS system does not simply turn on or off in response to environmental

stimuli. A Bvg-intermediate (Bvgi) phase exists in which Bordetella are grown in

concentrations of MgSO4 or nicotinic acid that are less than needed to induce Bvg-

conditions (43, 175). In the Bvgi phase, several adhesins are produced including several

unknown, surface-associated factors. BipA, Bordetella intermediate phase protein A, was

identified as a protein that is maximally expressed during the Bvgi phase. The Bordetella

phenotypic phases are thought to exist for different conditions. The Bvg+ phase is

necessary and required for Bordetella survival during respiratory tract colonization. The

Bvg- phase may allow survival of Bordetella during nutrient starved conditions (32). The

role of the Bvgi phase is less known but it is thought that this phase may be involved in

transmission (58).

9

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BvgAS regulation of Bordetella virulence factors

BvgAS controls the expression of the majority of the genes involved in Bordetella

virulence including adhesins that promote attachment to the host and toxins that modulate

host responses to allow efficient colonization.

Adhesins

Filamentous hemagglutinin (FHA): FHA is expressed in all three Bordetella species.

This highly immunogenic protein has been found to be surface associated as well as

secreted. FHA is considered a dominant Bordetella attachment factor in animal models

and has been shown to contain several binding domains (43, 162). The Arginine-Glycine-

Aspartate (RGD) domain of FHA allows adherence to monocytes and macrophages as

well as other leukocytes by the leukocyte response integrin/ integrin-associated protein

(LRI/ IAP) complex and complement receptor 3 (CR3) (161). The carbohydrate

recognition domain (CRD) mediates attachment of FHA to ciliated respiratory epithelial

cells and macrophages in vitro (158). FHA-mediated hemagglutination and adherence to

nonciliated epithelial cell lines is achieved by the lectin-like activity of FHA that binds to

heparin and other sulfated carbohydrates (132).

Studies suggest that FHA may act as an immunomodulatory molecule for

Bordetella. B. pertussis required FHA to inhibit T cell proliferation to exogenous antigen

(11). Anti-FHA antibodies inhibit phagocytosis of B. pertussis by neutrophils (138). In

addition to its role in immunomodulation, FHA has been found to be crucial for

Bordetella colonization in vivo. FHA of B. bronchiseptica is required for efficient

colonization of the trachea in mice (34). FHA is commonly included as a component in

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acellular pertussis vaccines including the diphtheria-tetanus-acellular pertussis (DTaP)

vaccine (21, 23). Individuals that receive a vaccine containing FHA mount substantial

antibody responses to the protein (49). Acellular vaccines that contain FHA as well as

pertussis toxin (PT) are more effective than vaccines that contain PT alone (177). Thus,

FHA is an essential factor for B. bronchiseptica colonization and immunomodulation of

the host response.

Fimbriae (Fim): All three classical Bordetella species, B. pertussis, B. parapertussis and

B. bronchiseptica, express fimbriae- filamentous, polymeric, cell surface-associated

protein structures. Fimbriae have been shown to mediate Bordetella colonization in vivo.

B. pertussis fimbriae mutants were defective in their ability to multiply in the nose and

trachea of mice (59, 141). In B. bronchiseptica, fimbriae were shown to contribute to the

establishment of tracheal colonization in rats and mice (127). Fim acts as an

immunomodulatory molecule that serves as a T-independent antigen for early IgM

production and induction of a Th2 response in Bordetella (126). The acellular vaccine that

contains the two fimbriae serotypes, Fim2 and Fim3, in addition to pertussis toxin, FHA

and pertactin has higher efficacy than a vaccine that excludes fimbriae (71).

Pertactin (PRN): Pertactin, expressed by all three classical Bordetella species, is a

member of the autotransporter family. PRN is proposed to mediate attachment because it

contains both an RGD motif and proline-leucine motifs that are commonly involved in

promoting protein-protein interactions in eukaryotic cell binding (52). Purified PRN

allows attachment of chinese hamster ovary (CHO) cells to tissue culture wells.

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Expression of PRN in E. coli and Salmonella increased adherence to various mammalian

cell lines (56). Vaccine trials have shown that pertactin antibodies are important for

protection from B. pertussis (42) Anti-pertactin antibodies are required for effective

phagocytosis of B. pertussis by host cells (83). Additionally, diphtheria toxin-acellular

pertussis (DTaP) vaccines that include pertactin have higher efficacy in prevention of B.

pertussis infection (72).

Toxins

Adenylate cyclase (CyaA): CyaA is maximally expressed in the Bvg+ phase. All

Bordetella species capable of infecting mammals secrete CyaA which functions as a

calmodulin-sensitive adenylate cyclase. CD11b serves as the host receptor for secreted

CyaA. When CyaA enters eukaryotic cells, it is activated by calmodulin and catalyzes the

production of supraphysiological amounts of cyclic AMP (cAMP) from ATP to

intoxicate the cell and prevent proper function (16, 25). Secretion of CyaA is required to

cause intoxication of eukaryotic cells (65) CyaA also acts as a hemolysin because of its

ability to lyse sheep red blood cells (85).

CyaA has been demonstrated to have several immunomodulatory functions such

as inhibition of chemotaxis and superoxide production by neutrophils in vitro (155). B.

pertussis CyaA inhibits phagocytosis of Bordetella by human neutrophils (190). CyaA is

responsible for inhibition of CD40 expression and IL-12 production by bone marrow

dendritic cells (BMDCs) of C57BL/6 mice that were infected by B. bronchiseptica (170,

171). In vivo, mutants that lack CyaA are defective in causing lethal infection in infant

mice or growth in the lungs of older mice (63, 67). Due to its ability to alter host

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responses and promote bacterial colonization, CyaA is not present in current DTaP

vaccines.

Dermonecrotic Toxin (DNT): B. pertussis, B. parapertussis and B. bronchiseptica all

express a nearly identical DNT. DNT is a heat-labile toxin that, when injected

intradermally, induces localized necrotic lesions in mice. DNT has been found to be

lethal for mice at low doses intravenously (90, 154). DNT is an A-B toxin with an

unknown receptor although it has been demonstrated to be internalized by dynamin-

dependent endocytosis (123). In vitro, B. bronchiseptica DNT induces morphological

changes and stimulates DNA replication and impairs differentiation of MC 3T3

osteoblasts (87, 88). B. bronchiseptica strains with reduced DNT production cause

decreased turbinate atrophy in infected mice (163). B. pertussis transposon mutants that

do not produce DNT are less virulent in mice (191).

Tracheal cytotoxin (TCT): TCT is a disaccharide-tetrapeptide monomer of

peptidoglycan that Bordetella releases into the environment instead of incorporating into

the cell wall (153, 164). Since TCT is constantly expressed, it is a BvgAS independent

virulence factor. TCT has been shown to cause loss of ciliated cells, cell blebbing and

mitochondrial damage in biopsy samples of human epithelial cells (192). TCT alone can

reproduce the ciliated-cell cytopathogical effects in tracheal tissue explants specific to a

B. pertussis infection (61). Destruction of ciliated cells is proposed to be caused by TCT-

dependent increase in nitric oxide. TCT triggers the production of IL-1α which has been

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demonstrated to increase nitric oxide production in hamster tracheal epithelial (HTE)

cells (81, 82).

Pertussis Toxin (PT): B. pertussis is the only member of the Bordetella species to

synthesize and secrete PT, an ADP-ribosylating toxin. Although B. parapertussis and B.

bronchiseptica contain the loci that codes for PT expression (ptx), the genes have

mutations in the promoter region, rendering the loci transcriptionally silent in these two

species (2, 66, 121). Pertussis toxin is an A-B toxin with six polypeptides named S1

through S5 with S1 acting as the A subunit and S2 through S5 acting as the pentameric B

subunit (116, 143). The A subunit sits on top of the ring-like B structure that binds

eukaryotic cell membranes to increase the efficiency with which S1 can enter the cell

(168, 181). When the B oligomer reaches the host cell cytosol, it intercalates in the

cytoplasmic membrane and binds ATP to release the enzymatic S1 subunit that becomes

active upon reduction of its disulfide bond (102). The S1 subunit transfers an ADP-ribose

from NAD to the alpha subunit of guanine nucleotide-binding proteins as a method of

inactivation of these proteins (10, 102). Observed effects of PT include inhibition of

chemotaxis, oxidative responses and lysosomal enzyme release in neutrophils and

macrophages (12, 14, 107, 130, 131). Although it has been shown to be involved in

immunosuppression, PT is attributed as being the major virulence factor of B. pertussis

and proposed as being responsible for symptoms observed in pertussis-infected children

such as leukocytosis and lymphocytosis (80, 193). PT is included in all available acellular

pertussis vaccines.

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Type III secretion system (TTSS). Type III secretion systems are used by gram-

negative bacteria to inject effector proteins into the cytoplasm of eukaryotic cells (106).

These effector proteins often disturb signaling and other functions that may promote

bacterial clearance (109). The three members of the Bordetella subspecies contain the bsc

locus which contains genes required for the production of the TTSS. However, only B.

bronchiseptica and B. parapertussisov display phenotypes associated with TTSS in vitro

such as inhibition of translocation of NFκB to the nucleus and rapid cell death of

macrophages (195). In vivo, the TTSS of B. bronchiseptica promotes persistent tracheal

colonization in rats and mice (195, 196).

Biofilms

Traditionally, bacteria are grown and studied as planktonic cultures in laboratory

settings. However, it is becoming increasingly evident that bacteria exist predominately

in complex communities called biofilms instead of individual cells (29). Biofilms can be

defined as communities of bacteria attached to a surface and encased in a self-produced

extracellular polymeric matrix. The biofilm matrix can be composed of various materials

including proteins, polysaccharides and nucleic acids (13).

The use of confocal scanning laser microscopy (CSLM) has shown that biofilm

formation is a multi-step process that is illustrated in Fig. 3 (86, 151). Biofilm formation

begins when individual bacteria reversibly attach to a surface. In this first stage of biofilm

formation, the bacteria contain only minute amounts of exopolysaccharide on their

surface and can detach to move to another location (147). The production of extracellular

polymers, such as polysaccharides, promotes the transition of the bacterium from a

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reversible, transient attachment to a permanent, irreversible association. Alginate, an

exopolysaccharide produced by Pseudomonas aeruginosa, is synthesized within fifteen

minutes of attachment. Production of alginate leads to early biofilm formation of P.

aeruginosa in which monolayers of bacteria stack vertically to form microcolonies (40).

An important characteristic of a mature biofilm is the formation of water channels that

allow entry of nutrients and oxygen and diffusion of waste products. Another hallmark of

a mature biofilm is the production of a matrix, composed of various polymers such as

nucleic acids, polysaccharides and proteins, that encases the bacterial cells (26, 176). The

last stage of biofilm formation is detachment in which individual cells or large clumps of

cells are released from the biofilm. The exact mechanism of detachment is not completely

understood. However, some studies reveal that dispersed bacteria are phenotypically

similar to planktonic cells. These detached cells may be released due to physical

deterioration of the biofilm, to find new nutrients or to populate another area to promote

nascent biofilm formation (110, 146, 146, 166).

Bordetella biofilms

We and others have demonstrated that the BvgAS system controls biofilm

formation in Bordetella (91, 136). Wild-type B. bronchiseptica as well as phase-locked

Bvg+ and Bvgi strains were capable of forming biofilms in microtiter wells while the Bvg-

strain was defective in biofilm formation. Chemical modulators that inhibit BvgAS

activity, such as nicotinic acid and sulfate anion, have also been shown to drastically

reduce Bordetella biofilm formation. Scanning electron microscopy (SEM) revealed that

both the wild-type B. bronchiseptica and Bvg- strains could adhere to glass coverslips but

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Fig 3: Biofilm formation is a multi-step process. Biofilm formation includes five

distinct stages: 1) Reversible attachment of bacteria to a surface; 2) Increased production

of extracellular polymers, such as polysaccharides, leading to irreversible attachment;

3) Early biofilm development that contains microcolonies and water channels; 4) Mature

biofilm development in which the biofilm is encased in a matrix composed of various

molecules such as proteins, nucleic acids or polysaccharides; 5) Dispersal of the bacteria

within the biofilm.

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18

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only the wild-type strain developed into a biofilm, indicating that the BvgAS system

regulates biofilm formation after initial attachment. We have observed that B.

parapertussis and B. pertussis are also capable of forming biofilms in vitro and the

BvgAS system regulates biofilms in these Bordetella species (136).

Bordetellae are capable of forming biofilms on biotic surfaces as well. B.

bronchiseptica forms robust biofilms on the nasal septa of C57BL/6 mice at 15 and 38

days post-infection (172). We believe that Bordetella biofilm formation in the nose

allows efficient immune evasion and long-term colonization and promotes transmission

to other individuals.

Bacterial Exopolysaccharides (EPS)

One defining characteristic of mature biofilms is the production of an

extracellular polymeric matrix (13, 136). Pseudomonas aeruginosa has been studied

extensively as a model of biofilm formation due to its frequent colonization of

individuals with cystic fibrosis (13, 64, 142, 160). P. aeruginosa biofilms consist of

numerous polysaccharides including alginate, Pel and Psl (95, 148, 165). Alginate has

been found to contribute to resistance of P. aeruginosa to many host defenses such as

phagocytosis by macrophages and production of reactive oxygen species by phagocytes

in vitro (118, 157).

Two Staphylococcal species, S. epidermidis and S. aureus, produce a linear

polymer of β-1,6- linked N-acetylglucosamine known as polysaccharide intercellular

adhesion (PIA) or poly N-acetylglucosamine (PNAG), respectively. Although PIA/

PNAG were discovered at different times, it was later elucidated that these two

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exopolysaccharides are identical structurally and are both encoded for by the icaADBC

locus. PIA/ PNAG are required for Staphylococcal biofilm formation and structural

integrity (36, 117, 118, 129, 157, 187). PIA/ PNAG have also been demonstrated to play

a role in resistance of Staphylococcus to innate responses. PIA of S. epidermidis is

required for resistance to the antimicrobial peptides LL-37 and HBD-3 and phagocytosis

by neutrophils (187). S. epidermidis biofilms that contained PNAG were shown to be

more resistant to opsonophagocytosis than planktonic cells (22, 165).

The PGA polysaccharide of E. coli, encoded by the pgaABCD locus, is

structurally similar to PIA/ PNAG and cross-reacts with anti-PIA/ PNAG antibodies. The

pgaABCD locus is required for optimal biofilm formation in E. coli (188). Homologues

of the icaADBC and pgaABCD loci have been identified in several other bacterial

genuses such as Actinobacillus actinomycetemcomitans, Yersinia pestis and Bordetella

species (108, 165). The three classical species of Bordetella all produce a β-1,6- linked

N-acetylglucosamine polysaccharide known as Bordetella polysaccharide (Bps) that is

cross-reactive to PNAG antiserum (108, 152). Bps is produced by the proteins encoded

for by the bpsABCD locus. Our laboratory has shown that Bps is required for in vitro

biofilm development following the initial attachment of Bordetella cells to a surface (38).

Additionally, we have demonstrated that Bps is a crucial component of Bordetella

biofilms in vivo. B. bronchiseptica was found to form extensive biofilms in the mouse

nose while the Δbps mutant strain existed as only minute clusters (108, 172) . Thus, Bps

plays a crucial role in Bordetella biofilm formation both in vitro and in vivo.

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Biofilm relevance to human infection

Adherence to a surface is a defining characteristic of biofilms. The use of

microscopy has revealed biofilm formation on medical devices as well as tissues from the

site of chronic infections (27, 30). The formation of biofilms within the human body is a

cause of major concern. Biofilms have been shown to be extremely resistant to antibiotic

treatment compared to planktonic cells (29, 136, 174). One mechanism of resistance is

ineffective penetration of antimicrobials into biofilms. The biofilm matrix has been

shown to retard the diffusion of molecules such as antibiotics, antibodies and reactive

oxygen species (46, 89, 178). Surprisingly, in some instances, when antimicrobial factors

do gain entry into biofilms, they are rendered inactive and unable to kill. Jesiatis et al.

observed that, although neutrophils were able to penetrate a S. aureus biofilm, they were

ineffective at phagocytosis of the bacteria (97).

Bacteria in biofilms have been shown to exhibit a reduced metabolic activity. The

cells in the center of a biofilm may have limited nutrient availability, thus putting them in

a starved state. These bacterial cells that are not actively growing will have decreased

sensitivity to many antimicrobial agents (1, 54, 55). Biofilms formed in the human body

often lead to chronic infection due to the ineffective clearance by antimicrobials.

Antibiotic treatment often continues indefinitely until, in some cases, the biofilm is

surgically removed (27, 30).

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Innate immune responses to B. bronchiseptica

Antimicrobial peptides (AMPs)

Antimicrobial peptides are a major component of the host innate response to

respiratory pathogens. AMPs can be divided into two families- defensins and

cathelicidins- based on structure. Defensins contain a β-sheet and three disulfide bridges.

These peptides can be further classified as α-defensins or β-defensins based on the

location of the disulfide bridges. Human neutrophil peptide-1 (HNP-1) is an α-defensin

produced in azurophilic granules of neutrophils. Human β-defensins (hBDs) are produced

by keratinocytes in the skin as well as by epithelial cells. Cathelicidins are synthesized as

precursor molecules and become active upon cleavage of the cathelin domain on the

amino terminus. Examples of cathelicidins are LL-37 in humans and cathelin-related

antimicrobial peptide (CRAMP) in mice. These peptides are produced by epithelial cells,

neutrophils and skin cells (150, 156).

Most AMPs are cationic in order to bind to the anionic bacterial surface.

Hydrophobic regions located on AMPs are also involved in the binding of these peptides

to bacterial cell wall components (3, 122). The exact mechanistic action of AMPs

remains unclear. AMPs are thought to form pores in the bacterial membrane that leads to

subsequent cell lysis. Three models of pore formation by AMPs are the barrel stave pore

model, the thoroidal model and the carpet model. According to the barrel stave model,

AMPs form multimers after binding the bacterial membrane. The AMP multimers cross

the cell membrane with hydrophobic portions facing the lipid bilayer and hydrophilic

portions facing the inside of the pore. These aggregated peptides form barrel-like

channels that appear similar to staves. The thoroidal model resembles the barrel-stave

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model except that AMP multimers cause the lipid bilayer to form a monolayer in which

the outer and inner lipid bilayers of the bacterial membrane become connected. Lastly, in

the carpet model, AMPs completely cover the bacterial membrane like a carpet. The

result of bound AMPs is disruption of the charge of the membrane bilayer leading to pore

formation at the “carpet” site. Once AMPs are bound to the bacterial membrane, the

pores lead to leakage of the contents of the cell and death (75, 150). In addition to

directly killing bacteria, AMPs can serve as chemotactic factors to induce infiltration of

host cells such as neutrophils and macrophages to the site of infection (3).

Polymyxin B has been used extensively as a model of AMPs due to its

bactericidal activity and amphipathic structure consisting of hydrophobic fatty acids, a

tripeptide side chain and polycationic ring (3, 197). Studies using polymyxin B have

provided insight into the genes that are required by Salmonella enterica to allow

resistance to AMP killing (68, 69). Mathur et al.used polmyxin B as a model AMP to

demonstrate that Vibrio cholerae uses a porin to mediate resistance to AMP killing (122).

Interestingly, polymyxin B is produced by the bacterium Bacillus polymyxa which

emphasizes the important role of AMPs in defense in both eukaryotes as well as

prokaryotes (137).

B. bronchiseptica has evolved mechanisms to overcome the bactericidal

properties of AMPs (51). The type III system of B. bronchiseptica was shown to inhibit

NFκB activity and downregulate tracheal antimicrobial peptide (TAP) mRNA expression

in bovine tracheal epithelial cells (111). LPS protects B. bronchiseptica from killing by

protamine and the β-defensin HNP1. Studies indicate that B. bronchiseptica, which

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naturally colonizes rabbits, is extremely resistant to AMPs produced in rabbit alveolar

macrophages and rabbit peritoneal granulocytes (112, 169). Thus, B. bronchiseptica

utilizes many virulence factors in order to resist killing mechanisms by antimicrobial

peptides.

Neutrophils and macrophages

Phagocytic cells are important in recognition and removal of pathogens from the host.

Inoculation of BALB/c mice with B. bronchiseptica results in the large infiltration of

neutrophils to the lungs. Neutrophils have been shown to be a crucial host component

involved in clearance of B. bronchiseptica. Neutropenic mice succumb to B.

bronchiseptica one to four days post-infection (76). Upon infection with B.

bronchiseptica, macrophages are also recruited to the lungs of mice in fewer numbers. In

vitro cytotoxicity assays revealed that B. bronchiseptica is extremely cytotoxic to J774

cells, a macrophage-like cell line (76).

Cytokines

Cytokines initiate host responses after invasion by pathogens. Microarray analysis

of bone marrow macrophages derived from C57BL/6 mice that were infected with B.

bronchiseptica revealed upregulation of TNFα mRNA. Further in vivo studies showed

that TNFα is required for survival of C57BL/6 mice infected with B. bronchiseptica.

TNFα-/- mice succumbed to a B. bronchiseptica infection as early as three days post-

infection. Neutralization of TNFα with an anti-TNFα antibody within two hours post-

infection resulted in mice developing lethal bordetellosis. These mice were sacrificed to

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prevent suffering due to their severe reaction to B. bronchiseptica infection in the absence

of TNFα (120).

The type III secretion system of B. bronchiseptica causes decreased production of

IFNγ and increased production of IL-10. The use of knockout mice revealed that B.

bronchiseptica has reduced colonization in mice that do not produce IL-10, suggesting a

role for this cytokine in promoting optimal Bordetella persistence in vivo (170).

Animal models

Laboratory animals such as rabbits, rats and mice serve as excellent natural

models of infection for B. bronchiseptica (33, 35, 76, 78, 173, 179, 180). A B.

bronchiseptica strain, RB50, was isolated from the nasal cavity of a naturally infected

New Zealand white rabbit. RB50 has been used extensively in the laboratory to provide

insight into the pathogenesis of B. bronchiseptica in an animal host. The 50% infective

dose of intranasal inoculation of rabbits, rats and mice is less than 200, 25 and 5 colony-

forming units (CFU), respectively (124). The use of knockout mice has facilitated the

understanding of host factors that are crucial in clearance of B. bronchiseptica (76, 78,

103).

B. pertussis and B. parapertussishu have been studied with the use of mouse

models (18, 19, 186, 189). However, unlike B. bronchiseptica, these Bordetella species

are restricted to humans and mice may not serve as appropriate models of infection to

understand pathogenesis. Indeed, often large infectious doses of B. pertussis and B.

parapertussis are required to colonize mice, suggesting that the sensitivity of these

animals is not reflective of infection in humans (124). Nonetheless, intranasal inoculation

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of mice with B. pertussis and B. parapertussis has provided copious amounts of

information concerning virulence factors required for colonization during host-pathogen

interactions. Overall, the use of mice has provided valuable insights into the colonization

of the respiratory tract by all three classical Bordetella species.

Limitations of studies reported in the literature. Although AMP killing has been used

extensively to study resistance by several bacterial species, few studies have been

performed using Bordetella. Elahi et al. demonstrated that B. bronchiseptica is resistant

to porcine and human beta-defensins while B. pertussis was significantly more

susceptible to killing by equivalent concentrations of these molecules. The authors

speculate that, as natural flora found in the respiratory tract of pigs, B. bronchiseptica

may have evolved to become resistant to killing by porcine AMPs. Additionally, the

authors predicted that B. pertussis was killed by AMPs due to direct bactericidal activity

as well as immunomodulatory effects such as recruitment of leukocytes (51). Banemann

et al. suggest that B. bronchiseptica may be more resistant to AMP killing due to its LPS

structure, specifically the presence of the O antigen acts as a protective shield to prevent

AMP killing (4). We hypothesized that Bps may also serve as a barrier to prevent AMP

killing of B. bronchiseptica. Since there were no studies reported that examined the role

of Bps, or any other Bordetella polysaccharide, in Bordetella resistance to AMPs, we

chose to perform AMP killing assays with the wild-type B. bronchiseptica strain as well

as the Δbps isogenic mutant.

We and others have demonstrated that Bps is required for Bordetella biofilm

formation in vitro and in vivo (92, 92, 94, 152, 172, 172). Biofilms are often thought to

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promote bacterial persistence in vivo. However, we predicted that Bps may contribute to

the establishment of B. bronchiseptica in the murine respiratory tract as well. Therefore,

we performed in vivo studies using the wild-type B. bronchiseptica and the Δbps strains

to understand the contribution of Bps to Bordetella colonization during early time points

after infection. We also used these strains at early times post infection to determine the

host components that are required to clear B. bronchiseptica.

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Chapter Two: Materials and Methods

Bacterial strains, media and growth conditions. The wild-type B. bronchiseptica

strain, Δbps isogenic mutant, Bps hyper-expressing (Bpshyp) and Δbps vector (Δbpsvec)

were maintained on Bordet-Gengou (BG) agar (Difco) supplemented with 7.5%

defibrinated sheep’s blood and 50 µg/mL of streptomycin (SM). For animal inoculations

and in vitro experiments, the B. bronchiseptica strains were grown in Stainer-Scholte

broth overnight at 37oC followed by subculture at OD600. The Bpshyp and Δbps vec strains

were grown in media containing chloramphenicol to maintain plasmids (151).

Polymyxin B killing assay. Overnight cultures were subcultured to an OD600 of 0.05 in

fresh medium and 1.5 mL was aliquoted in 12 well plates (Corning). The plates were

incubated at 37o C to allow biofilm formation. After 24 hours, the wells were washed

with water. Fresh media containing increasing concentrations of polymyxin B was added

and the plates were incubated at 37o C for 2 hours. The wells were washed with water

followed by addition of 1.5 ml of sterile PBS. Biofilms were harvested by vigorous

pippeting and serial dilutions were made to enumerate colony forming units (CFUs).

Percent survival was determined by dividing the number of CFUs recovered after

polymyxin B treatment by the number of CFUs recovered from the non-treated controls.

Exogenous addition of the Bps polysaccharide to Δbps cultures and biofilms. Log-

phase Δbps planktonic cells or 24 hour pre-formed biofilms were incubated with the 50

µg/ mL of the Bps or mock preparations for one hour. The bacterial cells were washed

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gently with PBS and incubated with 1% formalin (EMD) for fifteen minutes. After

incubation with 1% formalin, the cells were washed with PBS and resuspended in

Stainer-Scholte media containing varying concentrations of polymyxin B. Percent

survival was determined by dividing the number of CFUs recovered after polymyxin B

treatment by the number of CFUs recovered from the non-treated controls.

Purification of the Bps polysaccharide. The Bpshyp and the Δbps vec strains were spun

down and pellets were resuspended in 0.5M EDTA (Fisher) and boiled for five minutes.

The cells were then treated with 1 mg/mL Pronase at 60oC overnight. The samples were

treated with phenol-chloroform followed by ethanol precipitation. After the pellets were

dried, they were stored in sterile water and treated with .1 mg/mL DNase and RNase

overnight, followed by another phenol-chloroform extraction and ethanol precipitation.

The samples were stored at -20oC or 4oC (151).

Polymyxin B binding assay. 1:2, 1:5 and 1:10 dilutions of 10 mg/ mL of the Bps or the

mock preparations were aliquoted in 10 µL and spotted on a nitrocellulose membrane and

allowed to dry overnight. The blot was blocked in 5% milk for thirty minutes then probed

with 25 µg/mL of polymyxin B (Sigma) for one hour. Anti-polymyxin B IgM primary

antibody (Abcam) was added at a dilution of 1:1000 for one hour followed by three

washes with TBST. The polyclonal IgG+IgM horseradish peroxidase-conjugated

secondary antibody (Abcam) was added at a dilution of 1:5000 for one hour and the blot

was washed three times with TBST and detected by the Amersham Enhanced

Chemiluminescence Western blot system. To detect other Bordetella polysaccharides

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present in the preparations, the Bps or mock preparations were run on a 12% SDS-PAGE

gel followed by transfer to a nitrocellulose membrane. The membrane was treated using

the protocol described above and detected with the Amersham ECL Western blot system.

To perform a competition Western blot, the anti-polymyxin B primary antibody was

incubated with 25 µg/mL of polymyxin B for one hour prior to starting the blot. As a

negative control, the Western blot was performed as above without the addition of

polymyxin B.

Detection of poly-β-1,6-N-acetyl glucosamine. 1:2, 1:5 and 1:10 dilutions of 10 mg/ mL

of the Bps or the mock preparations were aliquoted in 10 µL and spotted on a

nitrocellulose membrane and allowed to dry overnight. The blot was blocked with 5%

milk for thirty minutes and incubated with an antibody raised against S. aureus dPNAG

at a dilution of 1:5000 in 5% milk. After washing three times with TBST, the secondary

horseradish peroxidase-conjugated IgG antibody was used at a dilution of 1:20,000. The

blot was washed three times with TBST and detected with the Amersham Enhanced

Chemiluminescence Western blot system (151).

Titration of polymyxin B in Bordetella biofilms. 24 hour biofilms formed by the wild-

type and Bpshyp strains were treated with 50 µg/ mL of polymyxin B for 2 hours. The

supernatant from these biofilms was transferred to 24 hour pre-formed biofilms formed

by the Δbps and Δbpsvec strains (respectively) for 2 hours. The biofilms were washed

with water and harvested to determine percent survival of the Δbps and Δbpsvec biofilms

30

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determined by dividing the number of CFUs recovered after supernatant treatment by the

number of CFUs recovered from the non-treated controls.

Animal experiments. Six to 8-week old female C57/BL6 mice (Jackson Laboratories)

were lightly sedated with isoflurane and intranasally inoculated with 50 µL of 5 X 105

CFU of the wild-type B. bronchiseptica or the Δbps mutant strain. At designated times

post-inoculation, mice were euthanized and the nasal septum, trachea and lungs were

excised, homogenized in PBS and plated on BG-blood agar plates containing

streptomycin (50 µg/mL) (172). Colonies were enumerated after 2 days of growth at

37oC. All animal experiments were carried out in accordance with institutional guidelines

and approved by the animal care and use committee of WFUHS.

Histopathological examination of the mouse lung. Three of five lobes of the mouse

lung were immediately fixed in 10% formalin following sacrifice for 24 hours. The lungs

were then trimmed, embedded in paraffin, cut at 4 to 6 µm and stained with hematoxylin

and eosin (H & E). Examination of pathology of the lungs was examined using a light

microscope. The lung sections were qualitatively assessed blindly by a board certified

veterinary pathologist, Dr. Nancy Kock, for overall cellularity, vascular changes, edema,

hemorrhage, presence of alveolar and interstitial neutrophils, intrabronchial neutrophils,

perivascular and peribronchiolar lymphocytes, alveolar macrophages and condition of

alveolar walls.

31

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Depletion of neutrophils. Neutrophils were depleted by intraperitoneal injection of 1

mg/mL of the anti-Gr1 antibody 24 hours before bacterial inoculation. Mice were

inoculated with 5 X 105 CFUs of the wild-type or the Δbps strains and sacrificed at 2 or 3

days p.i. to homogenize the nasal septum, trachea and lungs for enumeration of CFUs

(179). Confirmation of neutropenia was determined by IDEXX laboratories by

differential cell counts of blood samples retrieved from cardiac puncture.

Quantification of mouse lung leukocyte infiltration. Following B. bronchiseptica

inoculation and sacrifice (as described above), mice were dissected to expose the trachea

and chest cavity. Tubing was placed in a small incision in the trachea and held with

surgical sutures. The lungs were perfused with 1 mL of sterile PBS two times. The total

number of cells present in the bronchoalveolar lavage (BAL) was quantified by trypan

blue exclusion using a hemacytometer. Cell suspensions were pelleted using Cytospin

centrifugation and stained with Hema 3 Stain. The leukocyte population was determined

by counting four fields of 100 cells with a light microscope (77) .

Neutrophil phagocytosis assay. The wild-type and Δbps mutant strain were grown to

logarithmic phase and opsonized with heat-inactivated mouse serum for 30 minutes at

37oC prior to incubation with human PMNs. The neutrophils and bacteria were incubated

at an MOI of 1 for twenty minutes or one hour in the wells of a 24 well plate (Corning).

After incubation, the supernatant was collected and the adherent neutrophils were washed

two times with sterile PBS. The neutrophils were lysed by vigourous pipetting in water to

harvest the bacterial cells (140). Percent uptake was determined by dividing the number

32

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of bacteria recovered after incubation with neutrophils over the non-treated bacteria that

were recovered at the same time point.

Isolation of human neutrophils. Draw 30 mL of human blood into a heparinized syringe

and overlay over 6mL of Isolymph. Mix blood and Isolymph gently and let settle for

approximately 30 minutes. Transfer the white cell enriched supernatant to a clean 50 mL

tube and centrifuge at 1000 rpm for ten minutes at room temperature. Discard supernatant

and resuspend cell pellet in 1X PBS that is 1/10 the volume of blood drawn. Overlay

resuspended pellet on 3 mL Isolymph and centrifuge at 1350 rpm for 40 minutes at room

temperature. Aspirate the supernatant down to the cell pellet. Perform hypotonic lysis of

cell pellet by adding 5 mL of 0.2% NaCl for 25 seconds on ice then add 5 mL of 1.6%

NaCl and mix. Centrifuge at 1000 rpm for 10 minutes at 4oC. Repeat hypotonic lysis

until all residual red blood cells are removed. Resuspend cells in 3 mL of cold 1X HBSS

and count using hemocytometer. Adjust cell concentration according to experiment.

(Obtained neutrophil isolation assay from McPhail laboratory).

Detection of cytokines in mouse lung homogenates. Lung homogenates of mice

infected with the wild-type and the Δbps mutant strains were stored in -80oC until use for

cytokine assays. To detect cytokines, lung homogenates were thawed and used in ELISA

assays to detect TNFα and IL-10 (BD Biosciences). 96 well plates were coated with anti-

TNFα or anti-IL-10 antibodies at 4oC overnight. The wells were washed three times with

phosphate buffered saline containing 0.05% Tween 20 (PBST) and blocked with 200 µL

of 5% milk for one hour at 37 oC. 100 µL of 1:10 dilution of lung homogenates was

33

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added to the wells and incubated at 37oC for two hours. Wells were washed three times

with PBST and incubated with anti-mouse antibodies conjugated to horseradish

peroxidase. Plates were washed five times with PBST and 3,3’, 5,5’-Tetramethyl

benzidine was added. Absorbance at OD450 was determined using a plate reader.

34

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Chapter Three: The Role of Bps in Resistance to Host Innate Defenses

The Bps polysaccharide protects B. bronchiseptica from killing by polymyxin B.

Exopolysaccharides have been shown to provide resistance to killing by multiple

components of the innate response including antimicrobial peptides (AMPs). PIA

protects S. epidermidis from killing by the antimicrobial peptides human-β-defensin-3

(HBD-3), LL-37 and dermcidin (187). Alginate of P. aeruginosa binds and inhibits

bactericidal activity of the antimicrobial peptides LL-37 and SMAP-29 (84). We sought

to determine if Bps can protect Bordetella bronchiseptica from killing by polymyxin B,

an amphipathic peptide antibiotic that is often used as a model compound representative

of the bactericidal actions of AMPs (17, 182). We first tested the susceptibility of

planktonic cultures of the wild-type and the Δbps strains to polymyxin B. At 25 µg/ mL

of polymyxin B, there was no statistical difference observed in the survival of the wild-

type and the Δbps strain. However, the Δbps strain was recovered in extremely lower

numbers following incubation with 50 and 75 µg/mL of polymyxin B. In contrast, the

wild-type strain had approximately 30% and 10% survival at 50 and 75 µg/mL

polymyxin B, respectively (Fig. 1).

It is becoming increasingly evident that bacteria do not exist as individual, free-

swimming cells that are often studied in the laboratory but rather as biofilms (28, 29, 44).

Biofilms can be defined as a complex community of cells that are attached to a surface

and encased in a matrix that is composed of self-produced polymeric substances (13,

145). We and others have reported the prevalence of B. bronchiseptica in the biofilm

form in which the Bps polysaccharide is a major constituent of the Bordetella biofilm

35

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Fig. 1: The Bps polysaccharide protects planktonic B. bronchiseptica cells from

killing by polymyxin B. Planktonic cells of the wild-type and the Δbps strains were

grown to mid-logarithmic phase and incubated with 25, 50 and 75 µg/ mL of polymyxin

B for 2 hours at 37oC. Results are expressed as percent survival as determined by

dividing the number of CFUs recovered after polymyxin B treatment by the number of

CFUs observed in the mock-treated controls. Bars represent the average of three

independent experiments performed in triplicate with error bars representative of ±

standard deviation.

36

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0

10

20

30

40

50

60

70

25 50 75

Polymyxin B concentration (µg/mL)

% s

urvi

val

WTΔbps

0

10

20

30

40

50

60

70

25 50 75

Polymyxin B concentration (µg/mL)

% s

urvi

val

WTΔbps

37

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matrix (13, 93, 151). Our preliminary results suggest that Bps is expressed at higher

levels in the biofilm state than during planktonic conditions (172). Therefore, we

hypothesized that biofilms formed by the wild-type strain would be resistant to killing by

polymyxin B due to higher levels of Bps. The wild-type B. bronchiseptica and the Δbps

strain were grown as biofilms for 24 hours. The pre-formed biofilms were then incubated

with various concentrations of polymyxin B for two hours at 37oC. As shown in Fig. 2A,

the biofilm formed by the wild-type strain had 100% survival when incubated with 25

µg/mL polymyxin B. At 50 and 75 µg/mL polymyxin B, survival of the biofilm formed

by the wild-type strain remained high averaging at approximately 80-90%. In contrast,

the Δbps mutant strain was susceptible to killing at 25 µg/mL polymyxin B with a

survival of approximately 60%. At 50 and 75 µg/mL polymyxin B, biofilms formed by

the Δbps had approximately 20% survival.

These results suggest that Bps protects B. bronchiseptica from killing by

polymyxin B. To confirm this, we performed polymyxin B killing assays using biofilms

formed by a Bps-hyperexpressing strain (Bpshyp) and a Δbps vector strain (Δbpsvec). The

Bps-hyperexpressing strain contains the entire bps locus complemented on a plasmid in

the Δbps background. The Δbps vector strain is a control that contains only the vector

plasmid in the Δbps strain. When incubated with 25, 50 and 75 µg/mL polymyxin B, the

biofilms formed by the Bpshyp strain had 95% survival (Fig. 2B). Biofilms formed by the

Δbpsvec strain were killed in a dose-dependent manner with 80%, 60% and 50% survival

at 25, 50 and 75 µg/mL polymyxin B, respectively. We concluded that the presence of

the Bps polysaccharide protects B. bronchiseptica biofilms from killing by polymyxin B.

38

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Fig. 2: The Bps polysaccharide protects B. bronchiseptica biofilms from killing by

polymyxin B. The wild-type or the Δbps strains (A) or the Bpshyp or the Δbpsvec control

strains (B) were grown as biofilms for 24 hours in 12 well plates then incubated with 25,

50 and 75 µg/ mL polymyxin B for 2 hours at 37oC. Results are expressed as percent

survival as determined by dividing the number of CFUs recovered after polymyxin B

treatment by the number of CFUs observed in the mock-treated controls. Bars represent

the average of three independent experiments performed in triplicate with error bars

representative of ± standard deviation. Unpaired two-tailed Student t test was used to

determine statistical significance. Asterisk indicates the P value of <0.01.

39

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020406080

100120

25 50 75

Polymyxin B concentration (µg/mL)

% s

urvi

val

WTΔbps

* *

0

20

40

60

80

100

120

25 50 75Polymyxin B concentration (µg/mL)

% s

urvi

val

Bpshyp

* *

A

B

Δbpsvec

020406080

100120

25 50 75

Polymyxin B concentration (µg/mL)

% s

urvi

val

WTΔbps

* *

0

20

40

60

80

100

120

25 50 75Polymyxin B concentration (µg/mL)

% s

urvi

val

Bpshyp

* *

A

B

Δbpsvec

40

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The Bps polysaccharide protects biofilms formed by the Δbps strain from polymyxin

B killing in trans. We next wanted to determine if the addition of exogenous Bps could

increase resistance of the Δbps mutant strain to killing by polymyxin B. This will allow

us to test the hypothesis that purified Bps is able to rescue the Δbps strain from killing by

polymyxin B. To examine this, we purified Bps from the Bpshyp strain by EDTA

extraction to remove the polysaccharide from the bacterial surface followed by pronase,

DNase and RNase treatment to remove all molecules -proteins, DNA and RNA- from the

preparation except polysaccharide. We purified mock samples from the Δbpsvec strain

using the same protocol described above.

Polymyxin B has been shown to bind LPS. It is important to note that the Bps and

mock preparations that were externally added to the Δbps strain contained equivalent

amounts of LPS. We used the mock preparation as a control in this experiment to rule out

any effects that LPS may have on our results. We incubated planktonic Δbps cells with

the Bps or mock preparation for one hour. After the hour incubation, the cells were gently

washed and fixed with 1% formalin to stabilize the interaction between the bacterial cells

and the externally added Bps or mock preparation. We did not observe any effects of 1%

formalin on viability of Δbps cells (data not shown). After Δbps cells were incubated

with 1% formalin, the Δbps cells were incubated with polymyxin B for two hours.

Addition of the Bps preparation to Δbps planktonic cells did not significantly increase

resistance to killing by polymyxin B compared to Δbps planktonic cells treated with the

mock preparation (Fig 3A).

Studies indicate that biofilms are more resistant to killing by antimicrobial agents

than planktonic cells (45, 136, 174). Biofilms have been shown to have different gene

41

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Fig. 3: The Bps polysaccharide increases resistance of biofilms formed by the Δbps

mutant strain to polymyxin B killing in trans. The Bps or mock preparations were

incubated with Δbps planktonic cells (A) or the Δbps strain grown as a biofilm for 24

hours (B) for one hour. The Δbps cells were washed in PBS and incubated with 1%

formalin for 15 minutes followed by treatment with polymyxin B for two hours. Results

are expressed as fold survival (A) or percent survival (B) as determined by dividing the

number of CFUs recovered after polymyxin B treatment by the number of CFUs

observed in the mock-treated controls. Bars represent the average of three independent

experiments performed in triplicate with error bars representative of ± standard deviation.

Unpaired two-tailed Student t test was used to determine statistical significance. Asterisk

indicates the P value of <0.01.

42

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0

10

20

30

40

50

60

Mock Bps

% s

urvi

val

A

B

0

0.5

1

1.5

2

2.5

Mock BpsSurv

ival

(fold

ove

r vec

tor)

**

75 µg/mL Pol B

Pol B0

10

20

30

40

50

60

Mock Bps

% s

urvi

val

A

B

0

0.5

1

1.5

2

2.5

Mock BpsSurv

ival

(fold

ove

r vec

tor)

**

75 µg/mL Pol B

Pol B

43

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expression profiles compared to their planktonic counterparts (176). It is possible that this

distinct gene expression allows better attachment of the purified Bps to the Δbps strain

grown as a biofilm. We sought to determine if Bps could protect 24 hour pre-formed

biofilms formed by the Δbps strain from the bactericidal effects of polymyxin B. The

biofilms formed by the Δbps strain incubated with polymyxin B alone or polymyxin B

and the mock preparation had approximately 10% survival. In contrast, biofilms formed

by the Δbps strain that were incubated with polymyxin B and the Bps preparation had a

significantly increased survival of approximately 50% (Fig. 3B). These results indicate

that the addition of exogenous Bps can protect the biofilms formed by the Δbps strain

from killing by polymyxin B.

Overproduction of Bps prevents binding of polymyxin B to B. bronchiseptica

biofilms. We wanted to determine the mechanism of Bps-mediated resistance of B.

bronchiseptica to polymyxin B killing. Bps may provide resistance by acting as a

physical barrier that shields Bordetella and prevents binding by polymyxin B. We

hypothesized that Bps provides resistance to killing by polymyxin B by sequestering it in

the biofilm matrix. To test this, we incubated polymyxin B with media alone or with a 24

hour biofilm formed by the wild-type strain for 2 hours at 37oC. We then transferred the

supernatant from the polymyxin B alone control or the biofilm formed by the wild-type

strain to a biofilm formed by the Δbps strain for an additional 2 hour incubation. We

predicted that if we first incubated polymyxin B with the biofilm formed by the wild-type

strain, the polymyxin B would be bound by the Bps, resulting in an increase in survival of

the biofilm formed by the Δbps strain. Surprisingly, there was no difference observed in

44

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survival when the biofilm formed by the Δbps strain was treated with supernatant from

the polymyxin B alone control or the biofilm formed by the wild-type strain (Fig. 4A).

We hypothesized that the amount of Bps produced in the matrix of biofilms

formed by the wild-type strain was not sufficient to sequester polymyxin B. We predicted

that the Bpshyp strain that overproduces Bps would adequately sequester polymyxin B in

the matrix, thus leading to increased survival of the biofilm formed by the Δbpsvec strain.

As shown in Fig. 4B, when polymyxin B was incubated with the biofilm formed by the

Bpshyp strain, the biofilm formed by the Δbpsvec strain was protected from killing with

survival of approximately 100%. To ensure that Bps was responsible for the increased

survival of the Δbpsvec strain, we incubated polymyxin B with the biofilm formed by the

Δbpsvec strain for two hours followed by transferring the supernatant to another biofilm

formed by the Δbpsvec strain for an additional two hours. Percent survival did not increase

when polymyxin B was first incubated with a biofilm formed by the strain that does not

produce Bps. We conclude that Bps binds polymyxin B in the biofilm matrix to prevent it

from reaching the bacterial surface.

The Bps polysaccharide directly binds polymyxin B. We predicted that polymyxin B

would bind to purified Bps. Bps and PIA/PNAG of Staphylococcal species produce

antigenically similar polysaccharides consisting of poly-β-1,6-N-acetyl glucosamine. The

homology of Bps to PIA/PNAG has allowed us to use an anti-dPNAG antibody to detect

the Bps polysaccharide in Western blots. To ensure that our Bps preparation contains

poly-β-1,6-N-acetylglucosamine and that our mock preparation lacks this polysaccharide,

we probed the Bps and mock preparations with the anti-dPNAG antibody. Results of the

45

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Fig. 4: Overproduction of Bps prevents binding of polymyxin B to B. bronchiseptica

biofilms. The wild-type or BPShyp strains were grown as biofilms in 12 well plates for 24

hours then incubated with 50 µg/ mL of polymyxin B for two hours at 37oC. The

supernatant from biofilms formed by the wild-type or BPShyp strains was transferred to

the 24 hour pre-formed biofilms formed by the Δbps mutant strain or Δbpsvec strain

(respectively) for two hours at 37oC. Results are expressed as percent survival of the

Δbps strain (A) or the Δbpsvec strain (B) as determined by the number of CFUs recovered

after supernatant treatment by the number of CFUs observed in the mock-treated

controls. Bars represent the average of three independent experiments performed in

triplicate with error bars representative of ± standard deviation. Unpaired two-tailed

Student t test was used to determine statistical significance. The asterisk indicates the P

value of <0.01

46

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01020304050607080

% s

urvi

val o

f the

Δbp

sst

rain

Polymyxin B alone

0

20

40

60

80

100

120

140 *

Polymyxin B alone

Supernatant from Δbpsvec

Supernatant from Bpshyp

A

Supernatant fromwild-type

% s

urvi

val o

f the

Δbp

svec

stra

in

01020304050607080

% s

urvi

val o

f the

Δbp

sst

rain

Polymyxin B alone

0

20

40

60

80

100

120

140 *

Polymyxin B alone

Supernatant from Δbpsvec

Supernatant from Bpshyp

A

Supernatant fromwild-type

% s

urvi

val o

f the

Δbp

svec

stra

in

47

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immunoblot assay revealed that the anti-dPNAG antibody recognizes the Bps preparation

but not the mock preparation (Fig. 5A).

To determine if polymyxin B binds purified Bps, we spotted the Bps and mock

preparations on nitrocellulose and incubated the blot with polymyxin B followed by a

mouse primary antibody raised against polymyxin B and a secondary antibody

conjugated to horseradish peroxidase. We observed that polymyxin B bound the Bps

preparation but not the mock, suggesting that Bps binds polymyxin B (Fig. 5B). A caveat

of these dot blots is that we cannot directly demonstrate that Bps is the only

polysaccharide that is binding to polymyxin B. Therefore, we separated the Bps and

mock preparations on an SDS-PAGE gel and probed with either the anti-dPNAG

antibody or polymyxin B. Our results indicated that polymyxin B recognized the same

band that was detected by the anti-dPNAG antibody, revealing its specificity for Bps and

not other Bordetella polysaccharides (Fig. 5C). Based on these findings, we concluded

that B. bronchiseptica Bps, but not other polysaccharides, binds polymyxin B.

To confirm the specificity of the anti-polymyxin B antibody, we performed a

competition immunoblot in which the antibody was incubated with polymyxin B prior to

its use as the primary antibody in the Western blot. No cross-reactivity was observed,

indicating that the anti-polymyxin B antibody is specific for polymyxin B. To ensure that

polymyxin B does bind the Bps preparation, we performed the Western blot without

addition of polymyxin B. We did not obtain any cross-reactivity when polymyxin B was

not added, indicating that the Bps preparation is only bound by polymyxin B (data not

shown).

48

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Fig. 5: The Bps polysaccharide directly binds polymyxin B. 1:2, 1:5 and 1:10 dilutions

of 10 mg/ mL of the Bps or the mock preparations were aliquoted in 10 µL and spotted

on nitrocellulose and probed with a 1:5000 dilution of anti-dPNAG to detect the presence

of poly-β-1,6-N-acetylglucosamine (A). Equivalent dilutions of the Bps or mock

preparations were spotted on nitrocellulose and incubated with 25 µg/mL polymyxin B

followed by a dilution of 1:1000 of the primary anti-polymyxin B primary and 1:5000

dilution of the secondary antibody conjugated to horseradish peroxidase and detected

with enhanced chemiluminescence. (B). To detect if other Bordetella polysaccharides

present in the preparations are bound by polymyxin B, the Bps or mock preparations

were run on a 12% SDS-PAGE gel followed by transfer to a nitrocellulose membrane.

The blot was incubated with polymyxin B as described above (C). Blots shown are

representative images of at least three independent experiments.

49

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B

Bps

Mock

Polymyxin B αPNAG

BpsMock Bps

Mock

A C

Bps

Mock

B

Bps

Mock

Polymyxin B αPNAG

BpsMock Bps

Mock

A C

Bps

Mock

50

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The bps locus promotes colonization of B. bronchiseptica in the mouse respiratory

tract during the persistent stage of infection. Biofilms have been hypothesized to

promote bacterial persistence in vivo (29, 73, 115). Since Bps is necessary for Bordetella

biofilm formation, we predicted that it would be required for long-term survival of B.

bronchiseptica in the murine respiratory tract. To investigate this, we inoculated mice

intranasally with approximately 5 x 105 CFUs of either the wild-type or the Δbps mutant

strain in 50 µL to sufficiently seed the entire respiratory tract. We chose to sacrifice the

mice at 15 and 38 days post-inoculation as time points indicative of persistent

colonization. At 15 days post-inoculation, the wild-type and Δbps mutant strain colonized

the trachea, nasal septum and lungs of C57BL/6 mice similarly (Fig. 6). However, by 38

days post-inoculation, the wild-type strain was recovered in significantly higher numbers

from both the nasal septum and lungs of mice compared to the Δbps mutant strain. Both

the wild-type and Δbps strains were cleared from the trachea at this late time point. We

concluded that, at a late time in B. bronchiseptica infection, the presence of the Bps

polysaccharide promotes persistent colonization in the mouse respiratory tract.

The Bps polysaccharide enhances colonization of B. bronchiseptica in the mouse

respiratory tract at 3 days post-inoculation. We have shown that Bps promotes

persistent colonization in the murine respiratory tract at 38 days post-inoculation (Fig. 6).

Biofilm matrix polysaccharides have been shown to allow bacterial evasion of the host

immune response. Purified PNAG inhibits opsonization of S. aureus (22). Alginate

protects P. aeruginosa from phagocytosis and hydrogen peroxide production by rat

51

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Fig. 6: The bps locus promotes persistent colonization of B. bronchiseptica in the

mouse respiratory tract. Groups of five C57BL/6 mice were inoculated with

approximately 5 x 105 CFUs of the wild-type or the Δbps mutant strain. At 15 and 38

days post-inoculation, the mice were sacrificed. The trachea, nasal septum and lungs

were removed and homogenized and the resident bacteria were plated to measure

colonization. Horizontal bars represent the numerical mean for each group. The dashed

line represents the lower limit of detection. Unpaired two-tailed Student t test was used to

determine statistical significance. One asterisk indicates the P value of <0.05. Two

asterisks indicate the P value of <0.005.

52

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53

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alveolar macrophages (105). We hypothesized that Bps may allow B. bronchiseptica to

subvert host defenses. We performed a time course to observe colonization of the wild-

type and Δbps strains from as early as three hours up to 14 days post-inoculation. Both

the wild-type and the Δbps mutant strain were recovered in similar numbers in all tissues

at 3, 6 and 24 hours post-inoculation, indicating that Bps is not required for initial

colonization (Fig. 7). The Δbps strain was recovered in lower numbers in the trachea,

nasal septum and lungs at day 3 post-inoculation compared to the wild-type strain.

Colonization of wild-type and the Δbps strains were similar at 9 and 14 days post-

inoculation. We concluded that Bps is not required for initial establishment of B.

bronchiseptica in the murine respiratory tract. However, our data suggest that Bps may

contribute to optimal colonization of B. bronchiseptica at three days post-inoculation.

Neutrophils are an important host factor in the clearance of the Δbps strain in vivo.

B. bronchiseptica infection of mice results in host inflammation and pathology (77). We

sought to determine host cells, such as macrophages and neutrophils, that may be

involved in the response to the wild-type and the Δbps strains. At 6 and 24 hours, 3 and

14 days post-inoculation, the lungs were excised, fixed and stained with hematoxylin and

eosin (H&E). The lungs received qualitative scores based on the pathology parameters

listed in Table 1. Mice infected with the Δbps strain received a higher pathology score at

6 hours although this score was not significantly higher than mouse lungs infected with

the wild-type strain. However, at this time point, mice infected with the Δbps strain were

reported as having exacerbated bronchopneumonia compared to the wild-type strain.

Mice infected with the wild-type and Δbps strains received similar pathology scores at

54

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Fig. 7: Kinetics of colonization of the wild-type B. bronchiseptica and isogenic

mutant, Δbps, in murine respiratory tract. Groups of five C57BL/6 mice were

inoculated with approximately 5 x 105 CFUs of the wild-type strain (diamonds) or the

Δbps mutant strain (squares). At the indicated time point, the mice were sacrificed. The

trachea, nasal septum and lungs were removed and homogenized and resident bacteria

were plated to measure colonization. Each point represents the average of five mice per

group and error bars indicate ± standard deviation. The dashed line represents the lower

limit of detection. Unpaired two-tailed Student t test was used to determine statistical

significance. The asterisk indicates the P value of <0.05.

55

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Trachea

0123456

WT

Δbps

Nasal Septum

0123456

Lungs

012345678

0.125 0.25 1 3 9 14

Time (days)

*

*

*

Log 1

0C

FULo

g 10

CFU

Log 1

0C

FU

Trachea

0123456

Trachea

0123456

WT

Δbps

Nasal Septum

0123456

Nasal Septum

0123456

Lungs

012345678

0.125 0.25 1 3 9 14

Time (days)

Lungs

012345678

0.125 0.25 1 3 9 14

Time (days)

*

*

*

Log 1

0C

FULo

g 10

CFU

Log 1

0C

FU

56

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Table 1: Histopathology scores of the lungs of mice infected with the wild-type or

Δbps strain. Four mice were inoculated with 5 x 105 CFU of the wild-type or Δbps strain

and sacrificed at 6 and 24 hours and 14 days post-inoculation. The right lung was

harvested and processed for H & E staining. The sections were examined blindly by Dr.

Nancy Kock. Results expressed for each pathology parameter are an average score of

four mice with + standard deviations. The total average score for each group represents

the summation of all nine pathology parameters with + standard deviations. No statistical

significance was observed between the wild-type and the Δbps strain at any time point

following use of the unpaired two-tailed student t test.

57

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Pathology parameters WT, 6h Δbps, 6h WT, 24h Δbps, 24h WT, 14d Δbps, 14doverall cellularity 2 ± 0 2.5 ± 0.58 1.25 ± 0.5 2.5 ± 0.58 2.75 ± 0.5 2 ± 0.81 vascular changes(degeneration) 0 ± 0 0.75 ± 0.96 0 ± 0 0 ± 0 0 ± 0 0 ± 0 edema 1.25 ± 0.96 1.5 ± 0.58 1.5 ± 0.58 1.25 ± 0.96 0 ± 0 0 ± 0 hemorrhage 1 ± 0 2 ± 0.8 1.25 ± 0.5 1 ± 0 0 ± 0 0 ± 0 (alveolar/interstitial neutrophils) 1.25 ± 0 2 ± 0.8 1.25 ± 0.5 2.25 ± 0.96 0.5± 0.58 0 ± 0 (intrabronchial neutrophils) 1.75 ± 0.5 1.75 ± 0.96 1 ± 0.5 1.5 ± 1 0.25 ± 0.5 0.25 ± 0.5 (perivascular/peribronchiolar lymphocytes) 0 ± 0 0 ± 0 0 ± 0 0 ± 0 2.25 ± 0.96 2.25 ± 1.3 (alveolar macrophages) 0.25 ± 0.5 0.75 ± 0.5 0.25 ± 0.5 0 ± 0 0 ± 0 0 ± 0 alveolar walls (edema/cellularity) 1.75 ± 0.5 2.75 ± 0.5 1.5 ± 0.58 2.5 ± 0.58 2.5 ± 0.58 1.5 ± 0.58 total average score 9.25 ± 0.78 14 ± 0.90 7.95 ± 0.62 11 ± 1 8.25 ± 1.2 6 ± 0.96

58

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later time points. The histopathology indicated that neutrophils were involved in response

to both the wild-type and Δbps strains (Tables 1 and 2). Neutrophils have been shown to

be a crucial host factor required to control Bordetella infections B (77). Therefore, we

sought to determine the role neutrophils play in the clearance of the Δbps strain by

depleting these cells from the blood of C57BL/6 mice. We rendered mice neutropenic by

intraperitoneal injection of the anti-Gr1 antibody which has been shown to deplete Gr-1

positive cells, including neutrophils, for one to two weeks in mice (104). To confirm

neutropenia in the mice, blood collected from cardiac puncture was analyzed by IDEXX

laboratories for differential leukocyte blood count. It is important to note that the

treatment was effective in depletion of neutrophils but the presence of other host cells,

such as macrophages and lymphocytes, was not altered (data not shown).

We inoculated mice with the wild-type and Δbps mutant strain and sacrificed at 2

and 3 days post-inoculation due to the consistent colonization defect we observed by the

Δbps mutant strain in wild-type C57BL/6 mice. At 2 days post-inoculation, there was

only a slight defect in colonization of the Δbps mutant compared to the wild-type strain in

the nasal septum of wild-type C57BL/6 mice (Fig. 8). Both the wild-type and the Δbps

mutant strain were recovered in similar numbers in the trachea and the lungs of wild-type

C57BL/6 mice. When C57BL/6 mice were rendered neutropenic, colonization of the

wild-type and the Δbps mutant strain was not significantly different than from

colonization observed by these strains in wild-type C57BL/6 mice. These results suggest

that neutrophils do not play a significant role in clearance of B. bronchiseptica from the

mouse respiratory tract at 2 days post-inoculation.

59

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Table 2: Presence of neutrophils in the lungs of mice infected with the wild-type or

Δbps strain at 3 days post-inoculation. Five mice were inoculated with 5 x 105 CFUs

of the wild-type or Δbps strain and sacrificed at 3 days post-inoculation. The right lung

was harvested and processed for H & E staining. The sections were reported and

examined blindly by Dr. Nancy Kock.

60

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Wild-type

(3 days p.i.)

Δbps

3 days p.i.)

Mild neutrophilic

pneumonia

2/5 mice

(40%)

3/5 mice

(60%)

Mild to moderate

neutrophilic

pneumonia

2/5 mice

(40%)

2/5 mice

(40%)

Moderate to

severe

neutrophilic

pneumonia

1/5 mice

(20%)

0/5 mice

(0%)

61

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Fig. 8: Colonization of the wild-type and Δbps strains in neutropenic and wild-type

C57BL/6 mice at 2 days post-inoculation.

Groups of five C57BL/6 mice were rendered neutropenic by intraperitoneal injection of

the anti-Gr1 antibody. One day later the mice were infected with the wild-type (solid red

diamonds) or the Δbps strain (open red diamonds). At two days p.i., the trachea, nasal

septum and lungs were harvested and homogenized. Resident bacteria were plated to

measure colonization. Colonization of neutropenic mice is compared to colonization of

groups of five wild-type C57BL/6 mice infected with wild-type B. bronchiseptica (solid

black diamonds) or the Δbps strain (open black diamonds). Horizontal bars represent the

numerical mean for each group. The dashed line represents the lower limit of detection.

Unpaired two-tailed Student t test was used to determine statistical significance. The

asterisk indicates a P value of < 0.05.

62

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Trachea

0

1

2

3

4

5

6

Log 1

0C

FU

Nasal Septum

01234567

Log 1

0C

FU

Lungs

0123456789

Log 1

0C

FU

Neutropenic mice WT C57BL/6

WT Δbps WT Δbps

*

Trachea

0

1

2

3

4

5

6

Log 1

0C

FU

Nasal Septum

01234567

Log 1

0C

FU

Lungs

0123456789

Log 1

0C

FU

Neutropenic mice WT C57BL/6

WT Δbps WT Δbps

*

63

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Consistently at 3 days post-inoculation, the Δbps mutant strain had significantly

lower colonization in the trachea, nasal septum and lungs compared to the wild-type B.

bronchiseptica strain in C57BL/6 mice (Fig. 9). In neutropenic mice, colonization of the

Δbps mutant strain increased approximately two logs in the trachea compared to

colonization in wild-type C57BL/6 mice. In the nasal septum, both the wild-type and the

Δbps mutant strain increased slightly in colonization in neutropenic mice compared to

colonization in wild-type C57BL/6 mice. Surprisingly, the Δbps mutant strain colonized

approximately five logs higher in the lungs of neutropenic mice compared to colonization

of the Δbps strain in lungs of wild-type C57BL/6 mice. The wild-type strain colonized

similarly in neutropenic or wild-type C57BL/6 mice in the trachea and lungs at this time

point. From these results, we conclude that neutrophils play a crucial role in clearance of

the Δbps mutant strain from the murine respiratory tract at 3 days post-inoculation.

The Bps polysaccharide does not play a role in cellular infiltration following a B.

bronchiseptica infection. Our neutropenic mice data suggest a role for neutrophils in the

clearance of the Δbps strain. We predicted that there will be a more rapid recruitment of

neutrophils to the lungs of mice infected with the Δbps strain. We also hypothesized that

there will be a greater number of neutrophils in the lungs of mice infected with the Δbps

strain. After bacterial inoculation with the wild-type and Δbps strains, we sacrificed mice

at 6, 24 hours and 2, 3 days post-inoculation to perform bronchoalveolar lavage (BAL) in

order to determine cellular infiltration to the lungs. At almost all time points tested, there

was no difference observed in the absolute numbers of neutrophils and macrophages

found in the lungs of mice inoculated with the wild-type or Δbps strain

64

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Fig. 9: Colonization of the wild-type and Δbps strains in neutropenic and wild-type

C57BL/6 mice at 3 days post-inoculation. Mice were rendered neutropenic with

intraperitoneal injection of the anti-Gr1 antibody. One day later the mice were infected

with the wild-type (solid red diamonds) or the Δbps strain (open red diamonds). At three

days post-inoculation., the trachea, nasal septum and lungs were harvested and

homogenized. Resident bacteria were plated to measure colonization. Colonization of

neutropenic mice is compared to colonization of groups of five wild-type C57BL/6 mice

infected with wild-type B. bronchiseptica (solid black diamonds) or the Δbps strain (open

black diamonds). Horizontal bars represent the numerical mean for each group. The

dashed line represents the lower limit of detection. Unpaired two-tailed Student t test was

used to determine statistical significance. One asterisk indicates a P value of < 0.01. Two

asterisks indicates a P value of <0.05.

65

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Trachea

0123

456

Log 1

0C

FU* *

Nasal Septum

0

1

2

3

4

5

6

Log 1

0C

FU

* ****

Lungs

0123456789

Log 1

0C

FU

* **

Neutropenic mice WT C57BL/6

WT Δbps WT Δbps

Trachea

0123

456

Log 1

0C

FU* *

Nasal Septum

0

1

2

3

4

5

6

Log 1

0C

FU

* ****

Lungs

0123456789

Log 1

0C

FU

* **

Neutropenic mice WT C57BL/6

WT Δbps WT Δbps

66

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(Fig. 10). At 24 hours post-inoculation, there were slightly more neutrophils recruited to

the lungs of mice infected with the wild-type strain. It is important to note that there may

be more neutrophils found in the parenchymal lung tissue of mice than in the vessels.

However, there were no significant differences observed in the pathology scores of mice

infected with the wild-type or the Δbps strain of the interstitial or intrabronchial

neutrophils which reflect infiltration in the lung tissue and vessels, respectively. We

conclude that the enhanced clearance of the Δbps strain at 3 days post-inoculation is not

due to a rapid, large influx of neutrophils into the mouse lung.

The Δbps mutant strain does not have increased uptake by neutrophils. We have

observed that the Δbps strain is recovered in significantly higher numbers in the lungs of

neutropenic mice than wild-type C57BL/6, suggesting a role for neutrophils in clearance

of the mutant strain. Biofilm exopolysaccharides have been shown to mediate resistance

to phagocytosis by neutrophils. We hypothesized that, due to the absence of the Bps

polysaccharide, the Δbps mutant strain may be taken up more by neutrophils. We tested

the ability of both the wild-type strain and the Δbps strain to be taken up by neutrophils

after twenty minutes and one hour. At both time points, there was no significant

difference in the percent uptake of the wild-type or Δbps strain after incubation with

neutrophils (Fig. 11). We concluded that the Δbps strain is not more susceptible to

phagocytosis by neutrophils.

The Δbps strain induces greater cytokine production in mouse lungs at 2 and 3 days

post-inoculation. Cytokines play a significant role in the innate response to bacterial

67

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Fig. 10: Cellular infiltration in bronchoalveolar lavage (BAL) fluid of mice infected

with the wild-type B. bronchiseptica or the Δbps strain. Groups of five C57BL/6 mice

were inoculated with 5 x 105 CFUs of the wild-type (black bars) or the Δbps strain (white

bars). Mice were sacrificed at the indicated time point and BAL was harvested by

perfusion of the lungs with sterile PBS. Results are expressed as the absolute numbers of

neutrophils (A) or macrophages (B) determined from differential cell counts of the BAL.

Bars represent the average of five mice and error bars indicate the ± standard deviation.

Unpaired two-tailed Student t test was used to determine statistical significance. The

asterisk indicates the P value of <0.01.

68

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WT

Δbps

0

2000000

4000000

6000000

8000000

10000000

Abs

olut

e N

umbe

rs*

A

Time (days)

0

500000

10000001500000

2000000

2500000

3000000

Abs

olut

e N

umbe

rs

0.25 1 2 3

B

WT

Δbps

0

2000000

4000000

6000000

8000000

10000000

Abs

olut

e N

umbe

rs*

A

0

2000000

4000000

6000000

8000000

10000000

Abs

olut

e N

umbe

rs*

A

Time (days)

0

500000

10000001500000

2000000

2500000

3000000

Abs

olut

e N

umbe

rs

0.25 1 2 3

B

Time (days)

0

500000

10000001500000

2000000

2500000

3000000

Abs

olut

e N

umbe

rs

0.25 1 2 3Time (days)

0

500000

10000001500000

2000000

2500000

3000000

Abs

olut

e N

umbe

rs

0.25 1 2 3

B

69

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Fig. 11: Phagocytosis of the wild-type and Δbps strains by neutrophils. The wild-type

and Δbps strains were opsonized with heat-inactivated Bordetella serum for thirty

minutes at 37oC prior to a one hour incubation with neutrophils. The neutrophils were

lysed in water by vigorous pipetting. Results are expressed as percent uptake determined

by the number of CFUs recovered after incubation with neutrophils divided by the

number of CFUs recovered from mock-treated controls. Bars represent the average of

three independent experiments performed in triplicate. Error bars indicate ± standard

deviation.

70

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012345678

20 60

% u

ptak

eWT

Δbps

Time (min.)

012345678

20 60

% u

ptak

eWT

Δbps

012345678

20 60

% u

ptak

eWT

Δbps

Time (min.)

71

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infection. We performed ELISAs with lung homogenates from mice infected with either

the wild-type or the Δbps strain to observe the production of cytokines in response to

infection. TNFα is required for mice to clear a B. bronchiseptica infection (119).

Therefore, we tested the production of TNFα in lung homogenates at 6 and 24 hours as

well as 2 and 3 days. TNFα production was substantial in mice infected with either strain

at 6 and 24 hours (Fig. 12A). By 2 and 3 days post-inoculation, the lungs of mice infected

with the Δbps strain had significantly more TNFα present than the wild-type strain.

IL-10 has been shown to be involved in the dampening of the immune response.

We hypothesized that the wild-type strain would induce more IL-10 production in the

lungs of mice to prevent clearance. We observed no difference in IL-10 production in

lungs of mice infected with the wild-type or Δbps strain at 6 hours post-inoculation (Fig.

12B). However, mice infected with the wild-type strain did have significantly higher IL-

10 production at 24 hours post-inoculation. By day 2 and 3 post-inoculation, infection

with the Δbps mutant strain produced more IL-10 in the mouse lungs. We conclude that

TNFα and IL-10 are produced in the mouse lung due to infection by B. bronchiseptica

and the Δbps strain induces higher production of these cytokines at days 2 and 3 post-

inoculation.

72

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Fig. 12: Cytokine detection in lungs of mice infected with the wild-type and Δbps

strains. Mice were infected with the wild-type and the Δbps strains and sacrificed at the

indicated time points to harvest and homogenize lungs to measure cytokine production.

ELISA kits were used to detect the presence of TNFα (A) or IL-10 (B) in lung

homogenates. Bars represent the average of five mice and error bars indicate the ±

standard deviation. Unpaired two-tailed Student t test was used to determine statistical

significance. One asterisk indicates the P value of 0.01.

73

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02000400060008000

100001200014000

0.25 1 2 3

TNFα

(pg/

mL)

WT

Δbps

* *

01000200030004000500060007000

0.25 1 2 3

Time (days)

IL-1

0 (p

g/m

L) * * *

A

B

02000400060008000

100001200014000

0.25 1 2 3

TNFα

(pg/

mL)

WT

Δbps

* *

01000200030004000500060007000

0.25 1 2 3

Time (days)

IL-1

0 (p

g/m

L) * * *

A

B

74

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Chapter Four: Discussion

The mammalian host innate response comprises the first line of defense against

invading pathogens. Physical barriers such as the mucociliary escalator strive to prevent

binding of microorganisms to the host epithelial surface. However, when physical

barriers fail to restrict binding of pathogens, the host has a vast arsenal of compounds and

cells to attack microorganisms such as antimicrobial peptides and phagocytic cells such

as neutrophils and macrophages. If these mechanisms are unsuccessful in elimination of a

pathogen, adaptive immunity becomes crucial in clearance of the microbe from the host.

The respiratory tract serves as a prevalent site of infection by various bacteria. B.

bronchiseptica is a respiratory pathogen that often causes asymptomatic infection in

mammals including horses, pigs, companion animals such as dogs and cats as well as

laboratory animals such as rabbits, mice and rats. A major concern of B. bronchiseptica

infection is potential transmission to other animals or zoonotic transfer to

immunocompromised individuals. B. bronchiseptica has been reported to cause illness in

individuals who are infected with the human immunodeficiency virus (HIV) (48).

Investigating host-pathogen interactions provides insight into virulence factors necessary

for efficient colonization by B. bronchiseptica as well as host components required for

clearance of this unique pathogen. We have explored the role of the Bordetella

polysaccharide (Bps) in resistance to antimicrobial peptides (AMPs) in vitro and host

innate components, specifically neutrophils, in vivo.

We chose to examine the interaction of B. bronchiseptica with polymyxin B as a

model of antimicrobial peptides. AMPs, which are abundant in the lung epithelium and

neutrophils, are one of the first host components to respond to a B. bronchiseptica

75

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infection. Most AMPs are both cationic and hydrophobic to allow effective binding to

bacterial surfaces. Although the structure of AMPs is quite diverse, the mechanism of

action is universal. AMPs aggregate to form a pore in the bacterial membrane, leading to

leakage of cellular contents and death (156).

It has been demonstrated that AMPs bind the anionic lipid A portion of Gram-

negative bacteria (53). Bacteria have evolved several mechanisms in order to resist

killing by AMPs. Proteus mirabilis incorporates aminoarabinose into its lipid A to reduce

the negative charge of the outer membrane and prevent AMP binding (128). Salmonella

enterica includes additional fatty acids into the lipid A structure to make the outer

membrane more stable and less prone to permeabilization by AMPs (70). Bacteria have

been shown to use efflux pumps and proteases as additional measures to oppose the

powerful killing capacity of AMPs (149, 156).

Although some bacteria have evolved multiple methods of resistance, most are

still susceptible to AMP killing. Because of this, AMPs can serve as a template for new

antimicrobial agents. Biochemists have synthesized AMPs in the laboratory in order to

study the role of structure in AMP bactericidal activity (6). Cationic peptides are also

being produced for use in clinical applications. Nisin, a cationic peptide made by AMBI,

has successfully passed Phase I clinical trials and is being considered for treating stomach

ulcers caused by Helicobacter pylori. Intrabiotics has synthesized the peptide IB-367 to

begin Phase I clinical trial with the hopes of using this peptide against infections caused

by P. aeruginosa in cystic fibrosis patients in the future (74).

Due to its amphipathic nature and demonstrated bacteriocidal activity, polymyxin

B has been used extensively to study the role of AMPs in bacterial clearance. Use of

76

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polymyxins has demonstrated that several bacteria such as P. aeruginosa, E. coli,

Helicobacter pylori and Yersinia pestis modify lipid A in order to evade AMP killing

(197). In vivo studies performed by Miyajima et al. observed that mice inoculated with

multi-drug resistant (MDR) P. aeruginosa had significantly reduced bacteremia at 6

hours post-inoculation after treatment with polymyxin B (137). Due to the vast use of

polymyxin B in studies involving AMPs, we chose to use this molecule as a model of

AMP interaction with B. bronchiseptica.

Bps allows resistance of B. bronchiseptica to AMPs. The use of a polysaccharide to

sequester AMPs and inhibit killing is a novel mechanism of bacterial resistance. Campos

et al. observed that a capsular polysaccharide (CPS) mutant of Klebsiella pneumoniae

was susceptible to killing by a variety of AMPs including human neutrophil defensin-1

(HNP-1), human β-defensin-1 (hBD-1) and polymyxin B. Moreover, this study

demonstrated that serotypes that produced higher amounts of CPS on their surface had

increased resistance to polymyxin B (17). Encapsulated Neisseria meningitidis had

significantly more survival than an isogenic capsule-deficient mutant following LL-37

treatment (99).

We have shown that Bps binds polymyxin B in order to prevent killing of B.

bronchiseptica biofilms. An obvious consequence of Bps-mediated B. bronchiseptica

resistance to polymyxin B is the reduced effectiveness of AMP killing. It is important to

reiterate that all three classical species, B. bronchiseptica, B. parapertussis and B.

pertussis, produce Bps. Therefore, it is plausible that our findings, indicating that B.

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bronchiseptica Bps promotes resistance to polymyxin B, will be observed in B.

parapertussis and B. pertussis as well.

Dispersal of the biofilm matrix may prove useful as a method to circumvent

bacterial resistance to AMPs. Treatment of alginate with alginate lyase, an enzyme that

cleaves the glycosidic linkages of this polysaccharide, increases diffusion of antibiotics

into alginate. Alginate lyase has been proposed as a potential therapeutic agent capable of

removing alginate from lungs of cystic fibrosis patients (79). Dispersin B (DspB) is an

enzyme produced by Actinobacillus actinomycetemcomitans that specifically cleaves the

glycosidic linkage of poly-β-1,6-N-acetyl glucosamine (100, 101, 151). We have

previously shown that DspB treatment of Bordetella biofilms leads to dissolution of the

extracellular polymeric substances in the biofilm (151). Treatment of Bordetella biofilms

with DspB may serve as a method to increase susceptibility to AMPs in vivo.

Potential roles of Bps in evasion of host immunity to promote efficient colonization

of B. bronchiseptica in the mouse respiratory tract.

We have shown that, at 38 days post-inoculation, Bps promotes persistence of B.

bronchiseptica in the nasal septum and lungs of C57BL/6 mice. Additionally, Bps was

found to be a major component of B. bronchiseptica biofilms formed in the respiratory

tract, suggesting that Bps plays a significant role in biofilm formation in vivo (108, 172).

We hypothesized that Bps may contribute to the establishment of Bordetella colonization

in vivo by acting as an attachment factor or promoting biofilm formation. Inoculation of

C57BL/6 mice revealed no significant differences in colonization of the wild-type or the

Δbps strain except a consistent defect observed by the Δbps strain in the nasal septum,

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trachea and lungs at 3 days post-inoculation. Histopathological analysis of mouse lungs

led us to investigate the role of neutrophils in the enhanced clearance of the Δbps strain at

3 days post-inoculation. The utilization of neutropenic mice revealed that, at 3 days post-

inoculation, the Δbps strain was recovered in significantly higher numbers in the nasal

septum, trachea and lungs compared to colonization of the Δbps strain in wild-type

C57BL/6 mice. These results suggest that neutrophils contribute to the enhanced

clearance of the Δbps strain at 3 days post-inoculation.

It is important to note that both the wild-type and the Δbps strain were recovered

at high numbers in the mouse respiratory tract at 3 and 6 hours post-inoculation.

Therefore, we believe that Bps does not play a role in the initial establishment of B.

bronchiseptica infection in vivo. One possible explanation of the striking defect in

colonization observed by the Δbps strain at 3 days post-inoculation could be its inability

to form biofilms. We have demonstrated that Bps is required for B. bronchiseptica to

form biofilms both in vitro and in vivo (108, 151, 172). We hypothesize that the wild-type

strain may form biofilms as early as 3 days post-inoculation to avoid clearance by the

host response. Jesaitis et al. observed that neutrophils that attempted to phagocytose

biofilms formed by Pseudomonas aeruginosa had impaired killing activity including

reduced degranulation and hydrogen peroxide production (98). Furthermore, biofilms

have been attributed to causing several chronic human infections including periodontitis,

otitis media, and cystic fibrosis pneumonia, indicating their role in evasion of host

immune responses (29, 151). The presence of Bps in a maturing biofilm could further

increase resistance of B. bronchiseptica to host immunity. S. epidermidis biofilms that

contain PNAG had significantly reduced killing by opsonophagocytosis (22).

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In stark contrast to the wild-type, the Δbps strain is incapable of biofilm formation

or production of a protective matrix. Thus, the Δbps strain may be more susceptible to

phagocytosis by neutrophils. Our in vitro neutrophil uptake assay does not demonstrate

increased susceptibility of the Δbps strain to phagocytosis by neutrophils. However, this

assay does not necessarily reflect true conditions in vivo, such as neutrophil activation

signals produced by cytokines. TNFα has been demonstrated to increase neutrophil

antimicrobial activity (57, 139). Although inoculation of mice with either the wild-type or

the Δbps strain resulted in considerable TNFα production, we observed significantly

higher amounts of TNFα produced in the lungs of mice inoculated with the Δbps strain at

2 and 3 days post-inoculation. We believe that the increased production of TNFα allows

the enhanced clearance of the Δbps mutant. Additionally, it is possible that the TNFα-

mediated activation of neutrophils is time-dependent. This hypothesis could explain our

interesting finding that the Δbps mutant has enhanced clearance at 3 days post-

inoculation when high amounts of TNFα have accumulated in the mouse lung. Our

mouse data at 2 days post-inoculation, in which colonization of the Δbps strain is similar

in mice in the presence or absence of neutrophils, could also be due to the fact that a high

amount of TNFα is required for a long duration of time for effective clearance of B.

bronchiseptica by neutrophils. Additionally, in vitro studies suggest that neutrophils are

defective in phagocytosis of bacteria that exist as biofilms. Leid et al. demonstrated that

neutrophils can penetrate biofilms formed by Staphylococcus aureus but do not

internalize bacterial cells (113). In the future, we would like to investigate neutrophil

phagocytosis of biofilms formed by the wild-type and the Δbps strain.

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We believe that neutrophils are a crucial host component involved in the

clearance of the Δbps strain. One important point to note is that we used human

neutrophils in our in vitro phagocytosis assay. We believe that human cells are

appropriate for use with B. bronchiseptica since this pathogen can infect humans as well

as other mammals. However, human neutrophils produce beta-defensins while mouse

neutrophils do not (50). It may be necessary to use purified beta-defensins with both the

wild-type and the Δbps strain to understand the contribution of this molecule in killing B.

bronchiseptica. In the future, we would like to further investigate the role of neutrophils

in killing the Δbps strain. A limitation from our studies is that we conclude that Bps does

not play a role in migration of neutrophils to the lungs. This conclusion was based on

performing differential cell counts of BAL from mice infected with the wild-type or the

Δbps strain in which we saw no differences in absolute numbers of neutrophils in the

lavage fluid. Our assay observes neutrophils that have traveled in the bloodstream but

resident neutrophils in the lungs or other tissues are certainly important as well. One

important assay we would like to perform in the future is to separate neutrophils that

travel to the lungs from the bloodstream from neutrophils that have migrated to the lungs

from other host tissues.

In our in vitro assays, we refer to structures formed by the Δbps strain as

“biofilms” because similar numbers are recovered from 12 well plates for both the wild-

type and the Δbps strain after 24 hours of growth. Therefore, we are confident that our

results reflect the finding that Bps mediates resistance to AMPs. However, it may be a

misnomer to define the structures formed by the Δbps strain as “biofilms” since all of our

published data indicates that the Δbps strain does not form biofilms. Despite the

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nomenclature, our in vitro studies have demonstrated that the Δbps strain is more

susceptible than the wild-type strain to killing by polymyxin B and possibly others

AMPs. One mechanism of killing by neutrophils that we have not explored is AMP

production. AMPs have been shown to be upregulated after bacterial infection (144, 167).

The production of Bps in the biofilm matrix may mask virulence factors on the surface of

the wild-type strain which results in reduced recognition and upregulation of AMPs by

neutrophils as well as other host cells such as epithelial cells. However, since the

virulence factors on the surface of the Δbps strain are not obstructed by the presence of

Bps, we hypothesize that neutrophils recognize PAMPs and thus serve as a predominant

source of AMPs in the mouse lung following infection by the Δbps strain. One future

experiment we propose to explore this hypothesis is infection of mouse neutrophils with

the wild-type and the Δbps strain followed by use of an immunofluorescent antibody to

detect the presence of CRAMP- the homolog of LL-37 produced in mice (96). We predict

that more AMPs would be produced in the neutrophils infected with the Δbps strain.

Isolation of AMPs from neutrophils could reveal if the Δbps strain has increased

susceptibility to AMP killing. In addition to direct bactericidal activity, AMPs also act as

immunomodulatory molecules that increase cytokine production and chemotaxis of

neutrophils and lymphocytes (3). We believe that AMPs produced in the lungs of a

mouse infected with the Δbps strain may not only kill the Δbps mutant but contribute to

the increased production of cytokines observed at 3 days post-inoculation.

It is important to note that Bps is not the only virulence factor of Bordetella that

will allow effective subversion of the host immune response. The B. bronchiseptica type

III secretion system induces increased production of IL-10 to promote persistence in vivo.

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We have observed IL-10 production in the lungs of mice inoculated with the wild-type

and the Δbps strains, which both have an intact type III secretion system. We hypothesize

that the type III secretion system mey be involved in production of IL-10 to promote

persistent colonization of the wild-type and allow increased colonization of the Δbps

mutant after 3 days post-inoculation. Alternatively, the host may produce IL-10 to

alleviate the elevated inflammation due to Bordetella infection. This project has provided

insight into the role of Bps in allowing Bordetella to evade host immune responses. The

study of host-pathogen interactions will further our understanding of the countermeasures

used by bacteria to resist host defenses so that we can create new combative agents to

eliminate bacterial colonization and persistence.

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Fig. 1: Model of potential roles of Bps polysaccharide in evasion of host defenses.

We believe that the presence of Bps promotes biofilm formation by B. bronchiseptica at

early time points post-inoculation. Bps production in the biofilm matrix leads to efficient

colonization of the wild-type strain in the mouse respiratory tract by several possible

mechanisms: 1) Bps sequesters AMPs in the biofilm matrix to prevent killing; 2) Bps

inhibits phagocytosis of the wild-type strain by neutrophils; 3) Bps masks virulence

factors on the surface of the wild-type strain, leading to reduced recognition by host cells

and decreased AMP production.

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wild-type strain

B. bronchiseptica biofilm formation

Bps

Effective phagocytosis by neutrophils

AMP production

AMP killing

wild-type strain

AMP killing

B. bronchiseptica biofilm formation

Bps

B. bronchiseptica biofilm formation

Bps

Effective phagocytosis by neutrophils

AMP production

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Reference List

1. Anwar, H., J. L. Strap, and J. W. Costerton. 1992. Establishment of aging biofilms: possible mechanism of bacterial resistance to antimicrobial therapy. Antimicrob.Agents Chemother. 36:1347-1351.

2. Arico, B. and R. Rappuoli. 1987. Bordetella parapertussis and Bordetella bronchiseptica contain transcriptionally silent pertussis toxin genes. J.Bacteriol. 169:2847-2853.

3. Bals, R. 2000. Epithelial antimicrobial peptides in host defense against infection. Respir.Res. 1:141-150.

4. Banemann, A., H. Deppisch, and R. Gross. 1998. The lipopolysaccharide of Bordetella bronchiseptica acts as a protective shield against antimicrobial peptides. Infect.Immun. 66:5607-5612.

5. Baraff, L. J., R. D. Leake, D. G. Burstyn, T. Payne, C. L. Cody, C. R. Manclark, and G. J. St, Jr. 1984. Immunologic response to early and routine DTP immunization in infants. Pediatrics 73:37-42.

6. Bessalle, R., A. Gorea, I. Shalit, J. W. Metzger, C. Dass, D. M. Desiderio, and M. Fridkin. 1993. Structure-function studies of amphiphilic antibacterial peptides. J.Med.Chem. 36:1203-1209.

7. Birkebaek, N. H., M. Kristiansen, T. Seefeldt, J. Degn, A. Moller, I. Heron, P. L. Andersen, J. K. Moller, and L. Ostergard. 1999. Bordetella pertussis and chronic cough in adults. Clin.Infect.Dis. 29:1239-1242.

8. Bisgard, K. M., P. Rhodes, B. L. Connelly, D. Bi, C. Hahn, S. Patrick, M. P. Glode, and K. R. Ehresmann. 2005. Pertussis vaccine effectiveness among children 6 to 59 months of age in the United States, 1998-2001. Pediatrics 116:e285-e294.

9. Bjornstad, O. N. and E. T. Harvill. 2005. Evolution and emergence of Bordetella in humans. Trends Microbiol. 13:355-359.

10. Bokoch, G. M. and A. G. Gilman. 1984. Inhibition of receptor-mediated release of arachidonic acid by pertussis toxin. Cell 39:301-308.

11. Boschwitz, J. S., J. W. Batanghari, H. Kedem, and D. A. Relman. 1997. Bordetella pertussis infection of human monocytes inhibits antigen-dependent CD4 T cell proliferation. J.Infect.Dis. 176:678-686.

86

Page 98: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

12. Bradford, P. G. and R. P. Rubin. 1985. Pertussis toxin inhibits chemotactic factor-induced phospholipase C stimulation and lysosomal enzyme secretion in rabbit neutrophils. FEBS Lett. 183:317-320.

13. Branda, S. S., A. Vik, L. Friedman, and R. Kolter. 2005. Biofilms: the matrix revisited. Trends in Microbiology 13:20-26.

14. Brandt, S. J., R. W. Dougherty, E. G. Lapetina, and J. E. Niedel. 1985. Pertussis toxin inhibits chemotactic peptide-stimulated generation of inositol phosphates and lysosomal enzyme secretion in human leukemic (HL-60) cells. Proc.Natl.Acad.Sci.U.S.A 82:3277-3280.

15. Brinig, M. M., K. B. Register, M. R. Ackermann, and D. A. Relman. 2006. Genomic features of Bordetella parapertussis clades with distinct host species specificity. Genome Biol. 7:R81.

16. Cahill, E. S., D. T. O'Hagan, L. Illum, and K. Redhead. 1993. Mice are protected against Bordetella pertussis infection by intra-nasal immunization with filamentous haemagglutinin. FEMS Microbiol.Lett. 107:211-216.

17. Campos, M. A., M. A. Vargas, V. Regueiro, C. M. Llompart, S. Alberti, and J. A. Bengoechea. 2004. Capsule polysaccharide mediates bacterial resistance to antimicrobial peptides. Infect.Immun. 72:7107-7114.

18. Carbonetti, N. H., G. V. Artamonova, C. Andreasen, E. Dudley, R. M. Mays, and Z. E. Worthington. 2004. Suppression of serum antibody responses by pertussis toxin after respiratory tract colonization by Bordetella pertussis and identification of an immunodominant lipoprotein. Infect.Immun. 72:3350-3358.

19. Carbonetti, N. H., G. V. Artamonova, R. M. Mays, and Z. E. Worthington. 2003. Pertussis toxin plays an early role in respiratory tract colonization by Bordetella pertussis. Infect.Immun. 71:6358-6366.

20. CDC. Pertussis Vaccination: Use of Acellular Pertussis Vaccines Among Infants and Young Children Recommendations of the Advisory Committee on Immunization Practices (ACIP) . MMWR 46, 1-25. 3-28-1997.

21. CDC. Preventing Tetanus, Diphtheria, and Pertussis Among Adults: Use of

Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine. MMWR 55, 1-33. 12-15-2007.

22. Cerca, N., K. K. Jefferson, R. Oliveira, G. B. Pier, and J. Azeredo. 2006. Comparative antibody-mediated phagocytosis of Staphylococcus epidermidis cells grown in a biofilm or in the planktonic state. Infect.Immun. 74:4849-4855.

87

Page 99: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

23. Cherry, J. D. 2005. Pertussis vaccines for adolescents and adults. Pediatrics 116:755-756.

24. Cherry, J. D. 2006. Epidemiology of pertussis. Pediatr.Infect.Dis.J. 25:361-362.

25. Confer, D. L. and J. W. Eaton. 1982. Phagocyte impotence caused by an invasive bacterial adenylate cyclase. Science 217:948-950.

26. Costerton, J. W. 1995. Overview of microbial biofilms. J.Ind.Microbiol. 15:137-140.

27. Costerton, J. W., Z. Lewandowski, D. E. Caldwell, D. R. Korber, and H. M. Lappin-Scott. 1995. Microbial biofilms. Annu.Rev.Microbiol. 49:711-745.

28. Costerton, J. W., Z. Lewandowski, D. E. Caldwell, D. R. Korber, and H. M. Lappinscott. 1995. Microbial Biofilms. Annual Review of Microbiology 49:711-745.

29. Costerton, J. W., P. S. Stewart, and E. P. Greenberg. 1999. Bacterial biofilms: A common cause of persistent infections. Science 284:1318-1322.

30. Costerton, J. W., P. S. Stewart, and E. P. Greenberg. 1999. Bacterial biofilms: a common cause of persistent infections. Science 284:1318-1322.

31. Cotter, P. A. and A. M. Jones. 2003. Phosphorelay control of virulence gene expression in Bordetella. Trends in Microbiology 11:367-373.

32. Cotter, P. A. and A. M. Jones. 2003. Phosphorelay control of virulence gene expression in Bordetella. Trends in Microbiology 11:367-373.

33. Cotter, P. A. and J. F. Miller. 1994. BvgAS-mediated signal transduction: analysis of phase-locked regulatory mutants of Bordetella bronchiseptica in a rabbit model. Infect.Immun. 62:3381-3390.

34. Cotter, P. A., M. H. Yuk, S. Mattoo, B. J. Akerley, J. Boschwitz, D. A. Relman, and J. F. Miller. 1998. Filamentous hemagglutinin of Bordetella bronchiseptica is required for efficient establishment of tracheal colonization. Infection and Immunity 66:5921-5929.

35. Cotter, P. A., M. H. Yuk, S. Mattoo, B. J. Akerley, J. Boschwitz, D. A. Relman, and J. F. Miller. 1998. Filamentous hemagglutinin of Bordetella bronchiseptica is required for efficient establishment of tracheal colonization. Infect.Immun. 66:5921-5929.

36. Cramton, S. E., C. Gerke, N. F. Schnell, W. W. Nichols, and F. Gotz. 1999. The intercellular adhesion (ica) locus is present in Staphylococcus aureus and is required for biofilm formation. Infection and Immunity 67:5427-5433.

88

Page 100: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

37. Crowcroft, N. S., R. Booy, T. Harrison, L. Spicer, J. Britto, Q. Mok, P. Heath, I. Murdoch, M. Zambon, R. George, and E. Miller. 2003. Severe and unrecognised: pertussis in UK infants. Archives of Disease in Childhood 88:802-806.

38. Crowcroft, N. S. and R. G. Pebody. 2006. Recent developments in pertussis. Lancet 367:1926-1936.

39. Cummings, C. A., M. M. Brinig, P. W. Lepp, S. van de Pas, and D. A. Relman. 2004. Bordetella species are distinguished by patterns of substantial gene loss and host adaptation. Journal of Bacteriology 186:1484-1492.

40. Davies, D. G., M. R. Parsek, J. P. Pearson, B. H. Iglewski, J. W. Costerton, and E. P. Greenberg. 1998. The involvement of cell-to-cell signals in the development of a bacterial biofilm. Science 280:295-298.

41. Deen, J. L., C. A. Mink, J. D. Cherry, P. D. Christenson, E. F. Pineda, K. Lewis, D. A. Blumberg, and L. A. Ross. 1995. Household contact study of Bordetella pertussis infections. Clin.Infect.Dis. 21:1211-1219.

42. Deora, R. 2002. Differential regulation of the Bordetella bipA gene: distinct roles for different BvgA binding sites. J.Bacteriol. 184:6942-6951.

43. Deora, R., H. J. Bootsma, J. F. Miller, and P. A. Cotter. 2001. Diversity in the Bordetella virulence regulon: transcriptional control of a Bvg-intermediate phase gene. Molecular Microbiology 40:669-683.

44. Donlan, R. M. 2002. Biofilms: microbial life on surfaces. Emerg.Infect.Dis. 8:881-890.

45. Donlan, R. M. and J. W. Costerton. 2002. Biofilms: Survival mechanisms of clinically relevant microorganisms. Clinical Microbiology Reviews 15:167-+.

46. Donlan, R. M. and J. W. Costerton. 2002. Biofilms: survival mechanisms of clinically relevant microorganisms. Clin.Microbiol.Rev. 15:167-193.

47. Dworkin, M. S., P. S. Sullivan, S. E. Buskin, R. D. Harrington, J. Olliffe, R. D. MacArthur, and C. E. Lopez. 1999. Bordetella bronchiseptica infection in human immunodeficiency virus-infected patients. Clin.Infect.Dis. 28:1095-1099.

48. Dworkin, M. S., P. S. Sullivan, S. E. Buskin, R. D. Harrington, J. Olliffe, R. D. MacArthur, and C. E. Lopez. 1999. Bordetella bronchiseptica infection in human immunodeficiency virus-infected patients. Clin.Infect.Dis. 28:1095-1099.

89

Page 101: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

49. Edwards, K. M., E. Lawrence, and P. F. Wright. 1986. Diphtheria, tetanus, and pertussis vaccine. A comparison of the immune response and adverse reactions to conventional and acellular pertussis components. Am.J.Dis.Child 140:867-871.

50. Eisenhauer, P. B. and R. I. Lehrer. 1992. Mouse neutrophils lack defensins. Infect.Immun. 60:3446-3447.

51. Elahi, S., R. M. Buchanan, S. Attah-Poku, H. G. Townsend, L. A. Babiuk, and V. Gerdts. 2006. The host defense peptide beta-defensin 1 confers protection against Bordetella pertussis in newborn piglets. Infect.Immun. 74:2338-2352.

52. Emsley, P., I. G. Charles, N. F. Fairweather, and N. W. Isaacs. 1996. Structure of Bordetella pertussis virulence factor P.69 pertactin. Nature 381:90-92.

53. Ernst, R. K., T. Guina, and S. I. Miller. 1999. How intracellular bacteria survive: surface modifications that promote resistance to host innate immune responses. J.Infect.Dis. 179 Suppl 2:S326-S330.

54. Evans, D. J., D. G. Allison, M. R. Brown, and P. Gilbert. 1990. Effect of growth-rate on resistance of gram-negative biofilms to cetrimide. J.Antimicrob.Chemother. 26:473-478.

55. Evans, D. J., D. G. Allison, M. R. Brown, and P. Gilbert. 1991. Susceptibility of Pseudomonas aeruginosa and Escherichia coli biofilms towards ciprofloxacin: effect of specific growth rate. J.Antimicrob.Chemother. 27:177-184.

56. Everest, P., J. Li, G. Douce, I. Charles, J. De Azavedo, S. Chatfield, G. Dougan, and M. Roberts. 1996. Role of the Bordetella pertussis P.69/pertactin protein and the P.69/pertactin RGD motif in the adherence to and invasion of mammalian cells. Microbiology 142 ( Pt 11):3261-3268.

57. Ferrante, A., B. Hauptmann, P. Seckinger, and J. M. Dayer. 1991. Inhibition of tumour necrosis factor alpha (TNF-alpha)-induced neutrophil respiratory burst by a TNF inhibitor. Immunology 72:440-442.

58. Fuchslocher, B., L. L. Millar, and P. A. Cotter. 2003. Comparison of bipA Alleles within and across Bordetella species. Infection and Immunity 71:3043-3052.

59. Geuijen, C. A., R. J. Willems, M. Bongaerts, J. Top, H. Gielen, and F. R. Mooi. 1997. Role of the Bordetella pertussis minor fimbrial subunit, FimD, in colonization of the mouse respiratory tract. Infect.Immun. 65:4222-4228.

90

Page 102: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

60. Gilberg, S., E. Njamkepo, C. Du, I, H. Partouche, P. Gueirard, C. Ghasarossian, M. Schlumberger, and N. Guiso. 2002. Evidence of Bordetella pertussis infection in adults presenting with persistent cough in a french area with very high whole-cell vaccine coverage. J.Infect.Dis. 186:415-418.

61. Goldman, W. E., D. G. Klapper, and J. B. Baseman. 1982. Detection, isolation, and analysis of a released Bordetella pertussis product toxic to cultured tracheal cells. Infect.Immun. 36:782-794.

62. Goodnow, R. A. 1980. Biology of Bordetella-Bronchiseptica. Microbiological Reviews 44:722-738.

63. Goodwin, M. S. and A. A. Weiss. 1990. Adenylate cyclase toxin is critical for colonization and pertussis toxin is critical for lethal infection by Bordetella pertussis in infant mice. Infect.Immun. 58:3445-3447.

64. Govan, J. R. and V. Deretic. 1996. Microbial pathogenesis in cystic fibrosis: mucoid Pseudomonas aeruginosa and Burkholderia cepacia. Microbiol.Rev. 60:539-574.

65. Gray, M. C., G. M. Donato, F. R. Jones, T. Kim, and E. L. Hewlett. 2004. Newly secreted adenylate cyclase toxin is responsible for intoxication of target cells by Bordetella pertussis. Mol.Microbiol. 53:1709-1719.

66. Gross, R., N. H. Carbonetti, R. Rossi, and R. Rappuoli. 1992. Functional analysis of the pertussis toxin promoter. Res.Microbiol. 143:671-681.

67. Gueirard, P. and N. Guiso. 1993. Virulence of Bordetella bronchiseptica: role of adenylate cyclase-hemolysin. Infect.Immun. 61:4072-4078.

68. Gunn, J. S., K. B. Lim, J. Krueger, K. Kim, L. Guo, M. Hackett, and S. I. Miller. 1998. PmrA-PmrB-regulated genes necessary for 4-aminoarabinose lipid A modification and polymyxin resistance. Mol.Microbiol. 27:1171-1182.

69. Gunn, J. S., S. S. Ryan, J. C. Van Velkinburgh, R. K. Ernst, and S. I. Miller. 2000. Genetic and functional analysis of a PmrA-PmrB-regulated locus necessary for lipopolysaccharide modification, antimicrobial peptide resistance, and oral virulence of Salmonella enterica serovar typhimurium. Infect.Immun. 68:6139-6146.

70. Guo, L., K. B. Lim, C. M. Poduje, M. Daniel, J. S. Gunn, M. Hackett, and S. I. Miller. 1998. Lipid A acylation and bacterial resistance against vertebrate antimicrobial peptides. Cell 95:189-198.

71. Gustafsson, L., H. O. Hallander, P. Olin, E. Reizenstein, and J. Storsaeter. 1996. A controlled trial of a two-component acellular, a five-component acellular, and a whole-cell pertussis vaccine. N.Engl.J.Med. 334:349-355.

91

Page 103: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

72. Gustafsson, L., H. O. Hallander, P. Olin, E. Reizenstein, and J. Storsaeter. 1996. A controlled trial of a two-component acellular, a five-component acellular, and a whole-cell pertussis vaccine. N.Engl.J.Med. 334:349-355.

73. Hall-Stoodley, L., F. Z. Hu, A. Gieseke, L. Nistico, D. Nguyen, J. Hayes, M. Forbes, D. P. Greenberg, B. Dice, A. Burrows, P. A. Wackym, P. Stoodley, J. C. Post, G. D. Ehrlich, and J. E. Kerschner. 2006. Direct detection of bacterial biofilms on the middle-ear mucosa of children with chronic otitis media. JAMA 296:202-211.

74. Hancock, R. E. 1999. Host defence (cationic) peptides: what is their future clinical potential? Drugs 57:469-473.

75. Hancock, R. E. and R. Lehrer. 1998. Cationic peptides: a new source of antibiotics. Trends Biotechnol. 16:82-88.

76. Harvill, E. T., P. A. Cotter, and J. F. Miller. 1999. Pregenomic comparative analysis between bordetella bronchiseptica RB50 and Bordetella pertussis tohama I in murine models of respiratory tract infection. Infect.Immun. 67:6109-6118.

77. Harvill, E. T., P. A. Cotter, and J. F. Miller. 1999. Pregenomic comparative analysis between bordetella bronchiseptica RB50 and Bordetella pertussis tohama I in murine models of respiratory tract infection. Infect.Immun. 67:6109-6118.

78. Harvill, E. T., P. A. Cotter, M. H. Yuk, and J. F. Miller. 1999. Probing the function of Bordetella bronchiseptica adenylate cyclase toxin by manipulating host immunity. Infect.Immun. 67:1493-1500.

79. Hatch, R. A. and N. L. Schiller. 1998. Alginate lyase promotes diffusion of aminoglycosides through the extracellular polysaccharide of mucoid Pseudomonas aeruginosa. Antimicrob.Agents Chemother. 42:974-977.

80. Heininger, U., K. Stehr, S. Schmitt-Grohe, C. Lorenz, R. Rost, P. D. Christenson, M. Uberall, and J. D. Cherry. 1994. Clinical characteristics of illness caused by Bordetella parapertussis compared with illness caused by Bordetella pertussis. Pediatr.Infect.Dis.J. 13:306-309.

81. Heiss, L. N., T. A. Flak, J. R. Lancaster, Jr., M. L. McDaniel, and W. E. Goldman. 1993. Nitric oxide mediates Bordetella pertussis tracheal cytotoxin damage to the respiratory epithelium. Infect.Agents Dis. 2:173-177.

82. Heiss, L. N., S. A. Moser, E. R. Unanue, and W. E. Goldman. 1993. Interleukin-1 is linked to the respiratory epithelial cytopathology of pertussis. Infect.Immun. 61:3123-3128.

92

Page 104: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

83. Hellwig, S. M., M. E. Rodriguez, G. A. Berbers, J. G. van de Winkel, and F. R. Mooi. 2003. Crucial role of antibodies to pertactin in Bordetella pertussis immunity. J.Infect.Dis. 188:738-742.

84. Herasimenka, Y., M. Benincasa, M. Mattiuzzo, P. Cescutti, R. Gennaro, and R. Rizzo. 2005. Interaction of antimicrobial peptides with bacterial polysaccharides from lung pathogens. Peptides 26:1127-1132.

85. Hewlett, E. L., V. M. Gordon, J. D. McCaffery, W. M. Sutherland, and M. C. Gray. 1989. Adenylate cyclase toxin from Bordetella pertussis. Identification and purification of the holotoxin molecule. J.Biol.Chem. 264:19379-19384.

86. Heydorn, A., A. T. Nielsen, M. Hentzer, C. Sternberg, M. Givskov, B. K. Ersboll, and S. Molin. 2000. Quantification of biofilm structures by the novel computer program COMSTAT. Microbiology 146 ( Pt 10):2395-2407.

87. Horiguchi, Y., T. Nakai, and K. Kume. 1990. Effects of Bordetella bronchiseptica dermonecrotic toxin on structure and function of osteoblastic clone MC3TC-E1 cells. Jpn.J.Med.Sci.Biol. 43:262-263.

88. Horiguchi, Y., N. Sugimoto, and M. Matsuda. 1993. Stimulation of DNA synthesis in osteoblast-like MC3T3-E1 cells by Bordetella bronchiseptica dermonecrotic toxin. Infect.Immun. 61:3611-3615.

89. Hoyle, B. D., J. Alcantara, and J. W. Costerton. 1992. Pseudomonas aeruginosa biofilm as a diffusion barrier to piperacillin. Antimicrob.Agents Chemother. 36:2054-2056.

90. Iida, T. and T. Okonogi. 1971. Lienotoxicity of Bordetella pertussis in mice. J.Med.Microbiol. 4:51-61.

91. Irie, Y., S. Mattoo, and M. H. Yuk. 2004. The Bvg virulence control system regulates biofilm formation in Bordetella bronchiseptica. Journal of Bacteriology 186:5692-5698.

92. Irie, Y., A. Preston, and M. H. Yuk. 2006. Expression of the primary carbohydrate component of the Bordetella bronchiseptica biofilm matrix is dependent on growth phase but independent of Bvg regulation. J.Bacteriol. 188:6680-6687.

93. Irie, Y., A. Preston, and M. H. Yuk. 2006. Expression of the primary carbohydrate component of the Bordetella bronchiseptica biofilm matrix is dependent on growth phase but independent of Bvg regulation. J.Bacteriol. 188:6680-6687.

94. Irie, Y. and M. H. Yuk. 2007. In vivo colonization profile study of Bordetella bronchiseptica in the nasal cavity. FEMS Microbiol.Lett. 275:191-198.

93

Page 105: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

95. Jackson, K. D., M. Starkey, S. Kremer, M. R. Parsek, and D. J. Wozniak. 2004. Identification of psl, a locus encoding a potential exopolysaccharide that is essential for Pseudomonas aeruginosa PAO1 biofilm formation. J.Bacteriol. 186:4466-4475.

96. Jann, N. J., M. Schmaler, S. A. Kristian, K. A. Radek, R. L. Gallo, V. Nizet, A. Peschel, and R. Landmann. 2009. Neutrophil antimicrobial defense against Staphylococcus aureus is mediated by phagolysosomal but not extracellular trap-associated cathelicidin. J.Leukoc.Biol. 86:1159-1169.

97. Jesaitis, A. J., M. J. Franklin, D. Berglund, M. Sasaki, C. I. Lord, J. B. Bleazard, J. E. Duffy, H. Beyenal, and Z. Lewandowski. 2003. Compromised host defense on Pseudomonas aeruginosa biofilms: characterization of neutrophil and biofilm interactions. J.Immunol. 171:4329-4339.

98. Jesaitis, A. J., M. J. Franklin, D. Berglund, M. Sasaki, C. I. Lord, J. B. Bleazard, J. E. Duffy, H. Beyenal, and Z. Lewandowski. 2003. Compromised host defense on Pseudomonas aeruginosa biofilms: characterization of neutrophil and biofilm interactions. J.Immunol. 171:4329-4339.

99. Jones, A., M. Georg, L. Maudsdotter, and A. B. Jonsson. 2009. Endotoxin, capsule, and bacterial attachment contribute to Neisseria meningitidis resistance to the human antimicrobial peptide LL-37. J.Bacteriol. 191:3861-3868.

100. Kaplan, J. B., C. Ragunath, N. Ramasubbu, and D. H. Fine. 2003. Detachment of Actinobacillus actinomycetemcomitans biofilm cells by an endogenous beta-hexosaminidase activity. J.Bacteriol. 185:4693-4698.

101. Kaplan, J. B., K. Velliyagounder, C. Ragunath, H. Rohde, D. Mack, J. K. Knobloch, and N. Ramasubbu. 2004. Genes involved in the synthesis and degradation of matrix polysaccharide in Actinobacillus actinomycetemcomitans and Actinobacillus pleuropneumoniae biofilms. J.Bacteriol. 186:8213-8220.

102. Kaslow, H. R. and D. L. Burns. 1992. Pertussis toxin and target eukaryotic cells: binding, entry, and activation. FASEB J. 6:2684-2690.

103. Kirimanjeswara, G. S., P. B. Mann, and E. T. Harvill. 2003. Role of antibodies in immunity to Bordetella infections. Infect.Immun. 71:1719-1724.

104. Kirimanjeswara, G. S., P. B. Mann, M. Pilione, M. J. Kennett, and E. T. Harvill. 2005. The complex mechanism of antibody-mediated clearance of Bordetella from the lungs requires TLR4. J.Immunol. 175:7504-7511.

105. Krieg, D. P., R. J. Helmke, V. F. German, and J. A. Mangos. 1988. Resistance of mucoid Pseudomonas aeruginosa to nonopsonic phagocytosis by alveolar macrophages in vitro. Infect.Immun. 56:3173-3179.

94

Page 106: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

106. Kubori, T., Y. Matsushima, D. Nakamura, J. Uralil, M. Lara-Tejero, A. Sukhan, J. E. Galan, and S. I. Aizawa. 1998. Supramolecular structure of the Salmonella typhimurium type III protein secretion system. Science 280:602-605.

107. Lad, P. M., C. V. Olson, and P. A. Smiley. 1985. Association of the N-formyl-Met-Leu-Phe receptor in human neutrophils with a GTP-binding protein sensitive to pertussis toxin. Proc.Natl.Acad.Sci.U.S.A 82:869-873.

108. Lasa, I. 2006. Towards the identification of the common features of bacterial biofilm development. Int.Microbiol. 9:21-28.

109. Lee, C. A. 1997. Type III secretion systems: machines to deliver bacterial proteins into eukaryotic cells? Trends Microbiol. 5:148-156.

110. Lee, S. F., Y. H. Li, and G. H. Bowden. 1996. Detachment of Streptococcus mutans biofilm cells by an endogenous enzymatic activity. Infect.Immun. 64:1035-1038.

111. Legarda, D., M. E. Klein-Patel, S. Yim, M. H. Yuk, and G. Diamond. 2005. Suppression of NF-kappaB-mediated beta-defensin gene expression in the mammalian airway by the Bordetella type III secretion system. Cell Microbiol. 7:489-497.

112. Lehrer, R. I., M. E. Selsted, D. Szklarek, and J. Fleischmann. 1983. Antibacterial activity of microbicidal cationic proteins 1 and 2, natural peptide antibiotics of rabbit lung macrophages. Infect.Immun. 42:10-14.

113. Leid, J. G., M. E. Shirtliff, J. W. Costerton, and P. Stoodley. 2002. Human leukocytes adhere to, penetrate, and respond to Staphylococcus aureus biofilms. Infect.Immun. 70:6339-6345.

114. Leslie P.H. and Gardner A.D. The Phases of Haemophilus pertussis. Journal of Hygiene 31, 423-434. 1931.

115. Lewis, K. 2007. Persister cells, dormancy and infectious disease. Nat.Rev.Microbiol. 5:48-56.

116. Locht, C. and J. M. Keith. 1986. Pertussis toxin gene: nucleotide sequence and genetic organization. Science 232:1258-1264.

117. Mack, D., W. Fischer, A. Krokotsch, K. Leopold, R. Hartmann, H. Egge, and R. Laufs. 1996. The intercellular adhesin involved in biofilm accumulation of Staphylococcus epidermidis is a linear beta-1,6-linked glucosaminoglycan: Purification and structural analysis. Journal of Bacteriology 178:175-183.

95

Page 107: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

118. Mai, G. T., W. K. Seow, G. B. Pier, J. G. McCormack, and Y. H. Thong. 1993. Suppression of lymphocyte and neutrophil functions by Pseudomonas aeruginosa mucoid exopolysaccharide (alginate): reversal by physicochemical, alginase, and specific monoclonal antibody treatments. Infect.Immun. 61:559-564.

119. Mann, P. B., K. D. Elder, M. J. Kennett, and E. T. Harvill. 2004. Toll-like receptor 4-dependent early elicited tumor necrosis factor alpha expression is critical for innate host defense against Bordetella bronchiseptica. Infect.Immun. 72:6650-6658.

120. Mann, P. B., K. D. Elder, M. J. Kennett, and E. T. Harvill. 2004. Toll-like receptor 4-dependent early elicited tumor necrosis factor alpha expression is critical for innate host defense against Bordetella bronchiseptica. Infect.Immun. 72:6650-6658.

121. Marchitto, K. S., S. G. Smith, C. Locht, and J. M. Keith. 1987. Nucleotide sequence homology to pertussis toxin gene in Bordetella bronchiseptica and Bordetella parapertussis. Infect.Immun. 55:497-501.

122. Mathur, J. and M. K. Waldor. 2004. The Vibrio cholerae ToxR-regulated porin OmpU confers resistance to antimicrobial peptides. Infect.Immun. 72:3577-3583.

123. Matsuzawa, T., A. Fukui, T. Kashimoto, K. Nagao, K. Oka, M. Miyake, and Y. Horiguchi. 2004. Bordetella dermonecrotic toxin undergoes proteolytic processing to be translocated from a dynamin-related endosome into the cytoplasm in an acidification-independent manner. J.Biol.Chem. 279:2866-2872.

124. Mattoo, S. and J. D. Cherry. 2005. Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies. Clin.Microbiol.Rev. 18:326-382.

125. Mattoo, S. and J. D. Cherry. 2005. Molecular pathogenesis, epidemiology, and clinical manifestations of respiratory infections due to Bordetella pertussis and other Bordetella subspecies. Clin.Microbiol.Rev. 18:326-382.

126. Mattoo, S., J. F. Miller, and P. A. Cotter. 2000. Role of Bordetella bronchiseptica fimbriae in tracheal colonization and development of a humoral immune response. Infect.Immun. 68:2024-2033.

127. Mattoo, S., J. F. Miller, and P. A. Cotter. 2000. Role of Bordetella bronchiseptica fimbriae in tracheal colonization and development of a humoral immune response. Infection and Immunity 68:2024-2033.

96

Page 108: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

128. McCoy, A. J., H. Liu, T. J. Falla, and J. S. Gunn. 2001. Identification of Proteus mirabilis mutants with increased sensitivity to antimicrobial peptides. Antimicrob.Agents Chemother. 45:2030-2037.

129. McKenney, D., J. Hubner, E. Muller, Y. Wang, D. A. Goldmann, and G. B. Pier. 1998. The ica locus of Staphylococcus epidermidis encodes production of the capsular polysaccharide/adhesin. Infection and Immunity 66:4711-4720.

130. Meade, B. D., P. D. Kind, J. B. Ewell, P. P. McGrath, and C. R. Manclark. 1984. In vitro inhibition of murine macrophage migration by Bordetella pertussis lymphocytosis-promoting factor. Infect.Immun. 45:718-725.

131. Meade, B. D., P. D. Kind, and C. R. Manclark. 1985. Altered mononuclear phagocyte function in mice treated with the lymphocytosis promoting factor of Bordetella pertussis. Dev.Biol.Stand. 61:63-74.

132. Menozzi, F. D., R. Mutombo, G. Renauld, C. Gantiez, J. H. Hannah, E. Leininger, M. J. Brennan, and C. Locht. 1994. Heparin-inhibitable lectin activity of the filamentous hemagglutinin adhesin of Bordetella pertussis. Infect.Immun. 62:769-778.

133. Merkel, T. J., C. Barros, and S. Stibitz. 1998. Characterization of the bvgR locus of Bordetella pertussis. J.Bacteriol. 180:1682-1690.

134. Merkel, T. J., P. E. Boucher, S. Stibitz, and V. K. Grippe. 2003. Analysis of bvgR expression in Bordetella pertussis. J.Bacteriol. 185:6902-6912.

135. Merkel, T. J. and S. Stibitz. 1995. Identification of a locus required for the regulation of bvg-repressed genes in Bordetella pertussis. J.Bacteriol. 177:2727-2736.

136. Mishra, M., G. Parise, K. D. Jackson, D. J. Wozniak, and R. Deora. 2005. The BvgAS signal transduction system regulates biofilm development in Bordetella. Journal of Bacteriology 187:1474-1484.

137. Miyajima, Y., K. Hiramatsu, E. Mizukami, R. Morinaga, H. Ishii, R. Shirai, K. Kishi, I. Tokimatsu, T. Saikawa, and J. Kadota. 2008. In vitro and in vivo potency of polymyxin B against IMP-type metallo-beta-lactamase-producing Pseudomonas aeruginosa. Int.J.Antimicrob.Agents 32:437-440.

138. Mobberley-Schuman, P. S., B. Connelly, and A. A. Weiss. 2003. Phagocytosis of Bordetella pertussis incubated with convalescent serum. J.Infect.Dis. 187:1646-1653.

139. Mobberley-Schuman, P. S. and A. A. Weiss. 2005. Influence of CR3 (CD11b/CD18) expression on phagocytosis of Bordetella pertussis by human neutrophils. Infect.Immun. 73:7317-7323.

97

Page 109: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

140. Mobberley-Schuman, P. S. and A. A. Weiss. 2005. Influence of CR3 (CD11b/CD18) expression on phagocytosis of Bordetella pertussis by human neutrophils. Infect.Immun. 73:7317-7323.

141. Mooi, F. R., W. H. Jansen, H. Brunings, H. Gielen, H. G. van der Heide, H. C. Walvoort, and P. A. Guinee. 1992. Construction and analysis of Bordetella pertussis mutants defective in the production of fimbriae. Microb.Pathog. 12:127-135.

142. Murray, T. S., M. Egan, and B. I. Kazmierczak. 2007. Pseudomonas aeruginosa chronic colonization in cystic fibrosis patients. Curr.Opin.Pediatr. 19:83-88.

143. Nicosia, A., M. Perugini, C. Franzini, M. C. Casagli, M. G. Borri, G. Antoni, M. Almoni, P. Neri, G. Ratti, and R. Rappuoli. 1986. Cloning and sequencing of the pertussis toxin genes: operon structure and gene duplication. Proc.Natl.Acad.Sci.U.S.A 83:4631-4635.

144. Nizet, V., T. Ohtake, X. Lauth, J. Trowbridge, J. Rudisill, R. A. Dorschner, V. Pestonjamasp, J. Piraino, K. Huttner, and R. L. Gallo. 2001. Innate antimicrobial peptide protects the skin from invasive bacterial infection. Nature 414:454-457.

145. O'Toole, G., H. B. Kaplan, and R. Kolter. 2000. Biofilm formation as microbial development. Annual Review of Microbiology 54:49-79.

146. O'Toole, G., H. B. Kaplan, and R. Kolter. 2000. Biofilm formation as microbial development. Annu.Rev.Microbiol. 54:49-79.

147. O'Toole, G. A. and R. Kolter. 1998. Flagellar and twitching motility are necessary for Pseudomonas aeruginosa biofilm development. Mol.Microbiol. 30:295-304.

148. Overhage, J., M. Schemionek, J. S. Webb, and B. H. Rehm. 2005. Expression of the psl operon in Pseudomonas aeruginosa PAO1 biofilms: PslA performs an essential function in biofilm formation. Appl.Environ.Microbiol. 71:4407-4413.

149. Padilla, E., E. Llobet, A. Domenech-Sanchez, L. Martinez-Martinez, J. A. Bengoechea, and S. Alberti. 2010. Klebsiella pneumoniae AcrAB efflux pump contributes to antimicrobial resistance and virulence. Antimicrob.Agents Chemother. 54:177-183.

150. Palffy, R., R. Gardlik, M. Behuliak, L. Kadasi, J. Turna, and P. Celec. 2009. On the physiology and pathophysiology of antimicrobial peptides. Mol.Med. 15:51-59.

98

Page 110: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

151. Parise, G., M. Mishra, Y. Itoh, T. Romeo, and R. Deora. 2007. Role of a putative polysaccharide locus in Bordetella biofilm development. J.Bacteriol. 189:750-760.

152. Parise, G., M. Mishra, Y. Itoh, T. Romeo, and R. Deora. 2007. Role of a putative polysaccharide locus in Bordetella biofilm development. J.Bacteriol. 189:750-760.

153. Parkhill, J., M. Sebaihia, A. Preston, L. D. Murphy, N. Thomson, D. E. Harris, M. T. Holden, C. M. Churcher, S. D. Bentley, K. L. Mungall, A. M. Cerdeno-Tarraga, L. Temple, K. James, B. Harris, M. A. Quail, M. Achtman, R. Atkin, S. Baker, D. Basham, N. Bason, I. Cherevach, T. Chillingworth, M. Collins, A. Cronin, P. Davis, J. Doggett, T. Feltwell, A. Goble, N. Hamlin, H. Hauser, S. Holroyd, K. Jagels, S. Leather, S. Moule, H. Norberczak, S. O'Neil, D. Ormond, C. Price, E. Rabbinowitsch, S. Rutter, M. Sanders, D. Saunders, K. Seeger, S. Sharp, M. Simmonds, J. Skelton, R. Squares, S. Squares, K. Stevens, L. Unwin, S. Whitehead, B. G. Barrell, and D. J. Maskell. 2003. Comparative analysis of the genome sequences of Bordetella pertussis, Bordetella parapertussis and Bordetella bronchiseptica. Nat.Genet. 35:32-40.

154. Parton, R. 1985. Effect of prednisolone on the toxicity of Bordetella pertussis for mice. J.Med.Microbiol. 19:391-400.

155. Pearson, R. D., P. Symes, M. Conboy, A. A. Weiss, and E. L. Hewlett. 1987. Inhibition of monocyte oxidative responses by Bordetella pertussis adenylate cyclase toxin. J.Immunol. 139:2749-2754.

156. Peschel, A. 2002. How do bacteria resist human antimicrobial peptides? Trends Microbiol. 10:179-186.

157. Pier, G. B., F. Coleman, M. Grout, M. Franklin, and D. E. Ohman. 2001. Role of alginate O acetylation in resistance of mucoid Pseudomonas aeruginosa to opsonic phagocytosis. Infect.Immun. 69:1895-1901.

158. Prasad, S. M., Y. Yin, E. Rodzinski, E. I. Tuomanen, and H. R. Masure. 1993. Identification of a carbohydrate recognition domain in filamentous hemagglutinin from Bordetella pertussis. Infect.Immun. 61:2780-2785.

159. Preston, A., J. Parkhill, and D. J. Maskell. 2004. The Bordetellae: Lessons from genomics. Nature Reviews Microbiology 2:379-390.

160. Ramsey, D. M. and D. J. Wozniak. 2005. Understanding the control of Pseudomonas aeruginosa alginate synthesis and the prospects for management of chronic infections in cystic fibrosis. Mol.Microbiol. 56:309-322.

99

Page 111: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

161. Relman, D., E. Tuomanen, S. Falkow, D. T. Golenbock, K. Saukkonen, and S. D. Wright. 1990. Recognition of a bacterial adhesion by an integrin: macrophage CR3 (alpha M beta 2, CD11b/CD18) binds filamentous hemagglutinin of Bordetella pertussis. Cell 61:1375-1382.

162. Relman, D. A., M. Domenighini, E. Tuomanen, R. Rappuoli, and S. Falkow. 1989. Filamentous hemagglutinin of Bordetella pertussis: nucleotide sequence and crucial role in adherence. Proc.Natl.Acad.Sci.U.S A 86:2637-2641.

163. Roop, R. M., H. P. Veit, R. J. Sinsky, S. P. Veit, E. L. Hewlett, and E. T. Kornegay. 1987. Virulence factors of Bordetella bronchiseptica associated with the production of infectious atrophic rhinitis and pneumonia in experimentally infected neonatal swine. Infect.Immun. 55:217-222.

164. Rosenthal, R. S., W. Nogami, B. T. Cookson, W. E. Goldman, and W. J. Folkening. 1987. Major fragment of soluble peptidoglycan released from growing Bordetella pertussis is tracheal cytotoxin. Infect.Immun. 55:2117-2120.

165. Ryder, C., M. Byrd, and D. J. Wozniak. 2007. Role of polysaccharides in Pseudomonas aeruginosa biofilm development. Curr.Opin.Microbiol. 10:644-648.

166. Sauer, K., A. K. Camper, G. D. Ehrlich, J. W. Costerton, and D. G. Davies. 2002. Pseudomonas aeruginosa displays multiple phenotypes during development as a biofilm. J.Bacteriol. 184:1140-1154.

167. Schauber, J., R. A. Dorschner, A. B. Coda, A. S. Buchau, P. T. Liu, D. Kiken, Y. R. Helfrich, S. Kang, H. Z. Elalieh, A. Steinmeyer, U. Zugel, D. D. Bikle, R. L. Modlin, and R. L. Gallo. 2007. Injury enhances TLR2 function and antimicrobial peptide expression through a vitamin D-dependent mechanism. J.Clin.Invest 117:803-811.

168. Sekura, R. D., F. Fish, C. R. Manclark, B. Meade, and Y. L. Zhang. 1983. Pertussis toxin. Affinity purification of a new ADP-ribosyltransferase. J.Biol.Chem. 258:14647-14651.

169. Selsted, M. E., D. Szklarek, and R. I. Lehrer. 1984. Purification and antibacterial activity of antimicrobial peptides of rabbit granulocytes. Infect.Immun. 45:150-154.

170. Skinner, J. A., M. R. Pilione, H. Shen, E. T. Harvill, and M. H. Yuk. 2005. Bordetella type III secretion modulates dendritic cell migration resulting in immunosuppression and bacterial persistence. J.Immunol. 175:4647-4652.

100

Page 112: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

171. Skinner, J. A., A. Reissinger, H. Shen, and M. H. Yuk. 2004. Bordetella type III secretion and adenylate cyclase toxin synergize to drive dendritic cells into a semimature state. J.Immunol. 173:1934-1940.

172. Sloan, G. P., C. F. Love, N. Sukumar, M. Mishra, and R. Deora. 2007. The Bordetella Bps polysaccharide is critical for biofilm development in the mouse respiratory tract. J.Bacteriol. 189:8270-8276.

173. Sloan, G. P., C. F. Love, N. Sukumar, M. Mishra, and R. Deora. 2007. The Bordetella Bps polysaccharide is critical for biofilm development in the mouse respiratory tract. J.Bacteriol. 189:8270-8276.

174. Stewart, P. S. and J. W. Costerton. 2001. Antibiotic resistance of bacteria in biofilms. Lancet 358:135-138.

175. Stockbauer, K. E., B. Fuchslocher, J. F. Miller, and P. A. Cotter. 2001. Identification and characterization of BipA, a Bordetella Bvg-intermediate phase protein. Molecular Microbiology 39:65-78.

176. Stoodley, P., K. Sauer, D. G. Davies, and J. W. Costerton. 2002. Biofilms as complex differentiated communities. Annu.Rev.Microbiol. 56:187-209.

177. Storsaeter, J., H. O. Hallander, L. Gustafsson, and P. Olin. 1998. Levels of anti-pertussis antibodies related to protection after household exposure to Bordetella pertussis. Vaccine 16:1907-1916.

178. Suci, P. A., M. W. Mittelman, F. P. Yu, and G. G. Geesey. 1994. Investigation of ciprofloxacin penetration into Pseudomonas aeruginosa biofilms. Antimicrob.Agents Chemother. 38:2125-2133.

179. Sukumar, N., C. F. Love, M. S. Conover, N. D. Kock, P. Dubey, and R. Deora. 2009. Active and passive immunizations with Bordetella colonization factor A protect mice against respiratory challenge with Bordetella bronchiseptica. Infect.Immun. 77:885-895.

180. Sukumar, N., G. P. Sloan, M. S. Conover, C. F. Love, S. Mattoo, N. D. Kock, and R. Deora. 2010. Cross-species protection mediated by a Bordetella bronchiseptica strain lacking antigenic homologs present in acellular pertussis vaccines. Infect.Immun. 78:2008-2016.

181. Tamura, M., K. Nogimori, S. Murai, M. Yajima, K. Ito, T. Katada, M. Ui, and S. Ishii. 1982. Subunit structure of islet-activating protein, pertussis toxin, in conformity with the A-B model. Biochemistry 21:5516-5522.

182. Tzeng, Y. L., K. D. Ambrose, S. Zughaier, X. Zhou, Y. K. Miller, W. M. Shafer, and D. S. Stephens. 2005. Cationic antimicrobial peptide resistance in Neisseria meningitidis. J.Bacteriol. 187:5387-5396.

101

Page 113: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

183. Uhl, M. A. and J. F. Miller. 1994. Autophosphorylation and Phosphotransfer in the Bordetella-Pertussis Bvgas Signal-Transduction Cascade. Proceedings of the National Academy of Sciences of the United States of America 91:1163-1167.

184. Uhl, M. A. and J. F. Miller. 1996. Central role of the BvgS receiver as a phosphorylated intermediate in a complex two-component phosphorelay. Journal of Biological Chemistry 271:33176-33180.

185. Uhl, M. A. and J. F. Miller. 1996. Integration of multiple domains in a two-component sensor protein: The Bordetella pertussis BVgAS phosphorelay. Embo Journal 15:1028-1036.

186. Vandebriel, R. J., S. M. Hellwig, J. P. Vermeulen, J. H. Hoekman, J. A. Dormans, P. J. Roholl, and F. R. Mooi. 2003. Association of Bordetella pertussis with host immune cells in the mouse lung. Microb.Pathog. 35:19-29.

187. Vuong, C., J. M. Voyich, E. R. Fischer, K. R. Braughton, A. R. Whitney, F. R. DeLeo, and M. Otto. 2004. Polysaccharide intercellular adhesin (PIA) protects Staphylococcus epidermidis against major components of the human innate immune system. Cell Microbiol. 6:269-275.

188. Wang, X., J. F. Preston, and T. Romeo. 2004. The pgaABCD locus of Escherichia coli promotes the synthesis of a polysaccharide adhesin required for biofilm formation. Journal of Bacteriology 186:2724-2734.

189. Watanabe, M. and M. Nagai. 2003. Role of systemic and mucosal immune responses in reciprocal protection against Bordetella pertussis and Bordetella parapertussis in a murine model of respiratory infection. Infect.Immun. 71:733-738.

190. Weingart, C. L., P. S. Mobberley-Schuman, E. L. Hewlett, M. C. Gray, and A. A. Weiss. 2000. Neutralizing antibodies to adenylate cyclase toxin promote phagocytosis of Bordetella pertussis by human neutrophils. Infect.Immun. 68:7152-7155.

191. Weiss, A. A. and M. S. Goodwin. 1989. Lethal infection by Bordetella pertussis mutants in the infant mouse model. Infect.Immun. 57:3757-3764.

192. Wilson, R., R. Read, M. Thomas, A. Rutman, K. Harrison, V. Lund, B. Cookson, W. Goldman, H. Lambert, and P. Cole. 1991. Effects of Bordetella pertussis infection on human respiratory epithelium in vivo and in vitro. Infect.Immun. 59:337-345.

193. Wirsing von Konig, C. H. and H. Finger. 1994. Role of pertussis toxin in causing symptoms of Bordetella parapertussis infection. Eur.J.Clin.Microbiol.Infect.Dis. 13:455-458.

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Page 114: The Role of Bps Polysaccharide in Bordetella Resistance to ...€¦ · CHERATON FABRICE LOVE A Dissertation Submitted to the Graduate Faculty of WAKE FOREST UNIVERSITY GRADUATE SCHOOL

194. Yeh, S. H. 2003. Pertussis: persistent pathogen, imperfect vaccines. Expert Rev.Vaccines 2:113-127.

195. Yuk, M. H., E. T. Harvill, P. A. Cotter, and J. F. Miller. 2000. Modulation of host immune responses, induction of apoptosis and inhibition of NF-kappa B activation by the Bordetella type III secretion system. Molecular Microbiology 35:991-1004.

196. Yuk, M. H., E. T. Harvill, and J. F. Miller. 1998. The BvgAS virulence control system regulates type III secretion in Bordetella bronchiseptica. Molecular Microbiology 28:945-959.

197. Zavascki, A. P., L. Z. Goldani, J. Li, and R. L. Nation. 2007. Polymyxin B for the treatment of multidrug-resistant pathogens: a critical review. J.Antimicrob.Chemother. 60:1206-1215.

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C U R R I C U L U M V I T A E

C H E R A T O N L O V E

ADDRESS 1216 Ebert St., Winston-Salem, NC 27103

Cell: (704) 280-9610

Work: (336) 716-1211

e-mail: [email protected]

EDUCATION 2005- 2010 Wake Forest University Winston-Salem, NC Ph.D., Microbiology and Immunology Advisor: Dr. Rajendar Deora

2001-2005 Winston-Salem State University Winston-Salem, NC B.S., Molecular Biology

RESEARCH SKILLS Immunology: ELISAs, proteome profiling for cytokine production.

Bacteriology: Biofilm assays, killing assays using host immune components and therapeutic agents, cloning, western blots.

Animal Models: Tissue harvesting, bronchoalveolar lavage (BAL), nasal washes, peritoneal exudate washes, intranasal/ intraperitoneal inoculations.

Tissue Culture: Maintenance of cell lines, opsonophagocytosis assays.

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PUBLICATIONS Cheraton F. Love, Rajendar Deora. The Role of Bordetella Bps Polysaccharide in Resito Antimicrobial Peptides. Manuscript in preparation. Neelima Sukumar, Gina Sloan, Matt Conover, Cheraton F. Love, Seema Mattoo, NancyKock, and Rajendar Deora. Cross-species protection mediated by a Bordetella bronchiseptica slacking antigenic homologs present in acellular pertussis vaccines. 2010. Infection and Immunity, 78: 2008-2016. Chelsie E. Armbruster, Wenzhou Hong , Bing Pang, Kristin E. Dew, Richard A. Juneau,Matthew S. Byrd, Cheraton F. Love, Nancy D. Kock, and W. Edward Sword. LuxS promotes biofilm maturation and persistence of nontypeable Haemophilus influenzae in via modulation of lipooligosaccharides on the bacterial surface. 2009. Infection and Immuni77: 4081- 4091. Neelima Sukumar, Cheraton F. Love , Matt Conover, Nancy Kock, Purnima Dubey, Rajendar Deora. Active and Passive Immunization with Bordetella Colonization Factor A(BcfA) Protects Mice Against Respiratory Challenge with Bordetella bronchiseptica. 20Infection and Immunity, 77: 885- 895.

Gina Parise Sloan, Cheraton F. Love, Neelima Sukumar, Meenu Mishra, and Rajendar Deora. The Bordetella Bps Polysaccharide Is Critical for Biofilm Development in the Mouse Respiratory Tract. 2007. Journal of Bacteriology, 189: 8270-8276. Ann-Marie Turner, Cheraton Love, Rebecca Alexander, Pamela Jones. Mutational Analysis of Escherichia coli DEAD-box Protein CsdA. 2007. Journal of Bacteriology, 189: 2769-2776.

TEACHING SKILLS Taught General Biology and General Microbiology at Winston-Salem State

University, 2009-2010. Assisted in teaching Fundamentals of Bacteriology course, 2009.

PROFESSIONAL ACTIVITIES Vice president of Black Graduate Student Association (BGSA), 2008-2009. Assisted graduate school in recruiting at various professional school fairs, 2008. Helped organize Professional and Graduate School Forum, 2006. Member of BGSA, 2005- present.

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AWARDS Student Oral Presentation. FASEB Conference. Microbial polysaccharides of Medical/ Agricultural and Industrial Importance. June 2008.

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