Roland Bücker

Oral and Fecal Campylobacter concisus Strains Perturb Barrier Function by Apoptosis Induction in HT-29/B6 Intestinal Epithelial Cells

Campylobacter concisus infections of the gastrointestinal tract can be accompanied by diarrhea and inflammation, whereas colonization of the human oral cavity might have a commensal nature. We focus on the pathophysiology of C. concisus and the effects of different clinical oral and fecal C. concisus strains on human HT-29/B6 colon cells. Six oral and eight fecal strains of C. concisus were isolated. Mucus-producing HT-29/B6 epithelial monolayers were infected with the C. concisus strains. Transepithelial electrical resistance (Rt) and tracer fluxes of different molecule size were measured in Ussing chambers. Tight junction (TJ) protein expression was determined by Western blotting, and subcellular TJ distribution was analyzed by confocal laser-scanning microscopy. Apoptosis induction was examined by TUNEL-staining and Western blot of caspase-3 activation. All strains invaded confluent HT-29/B6 cells and impaired epithelial barrier function, characterized by a time- and dose-dependent decrease in Rt either after infection from the apical side but even more from the basolateral compartment. TJ protein expression changes were sparse, only in apoptotic areas of infected monolayers TJ proteins were redistributed. Solely the barrier-forming TJ protein claudin-5 showed a reduced expression level to 66±8% (P<0.05), by expression regulation from the gene. Concomitantly, Lactate dehydrogenase release was elevated to 3.1±0.3% versus 0.7±0.1% in control (P<0.001), suggesting cytotoxic effects. Furthermore, oral and fecal C. concisus strains elevated apoptotic events to 5-fold. C. concisus-infected monolayers revealed an increased permeability for 332 Da fluorescein (1.74±0.13 vs. 0.56±0.17 10−6 cm/s in control, P<0.05) but showed no difference in permeability for 4 kDa FITC-dextran (FD-4). The same was true in camptothecin-exposed monolayers, where camptothecin was used for apoptosis induction. In conclusion, epithelial barrier dysfunction by oral and fecal C. concisus strains could mainly be assigned to apoptotic leaks together with moderate TJ changes, demonstrating a leak-flux mechanism that parallels the clinical manifestation of diarrhea.

Arcobacter butzleri Induces Barrier Dysfunction in Intestinal HT-29/B6 Cells

BACKGROUND Arcobacter butzleri causes watery diarrhea and bacteremia. Although, recently, more cases of diarrhea have been caused by Arcobacter species, very little is known about its pathogenesis, the identification of which is the aim of this study. METHODS Human HT-29/B6 colonic epithelial monolayers were apically inoculated with A. butzleri. Transepithelial resistance and macromolecule fluxes were measured in Ussing chambers. Tight junction protein expression was analyzed by Western blotting, and subcellular distribution was analyzed by confocal laser-scanning microscopy. RESULTS Infection of HT-29/B6 caused a decrease in transepithelial resistance to 30% and an increase in paracellular permeability to fluorescein (10.8+/-3.5 10(-6) cm/s vs. 1.8+/-0.6 10(-6) cm/s in control; P<.05) and dextran-4 kDa (0.036+/-0.005 10(-6) cm/s vs. 0.015+/-0.002 10(-6) cm/s in control; P<.01). This effect was time and dose dependent and was also caused by bacterial lysates showing heat and proteinase-K sensitivity. As structural correlate, expression of the tight junctional proteins claudin-1, -5, and -8 was reduced, and claudin-1 and -8 were redistributed off the tight junctional strands forming intracellular aggregates. Furthermore, A. butzleri induced epithelial apoptosis (3-fold). CONCLUSIONS A. butzleri induces epithelial barrier dysfunction by changes in tight junction proteins and induction of epithelial apoptosis, which are mechanisms that are consistent with a leak flux type of diarrhea in A. butzleri infection.

Rapid Loss of Motility of Helicobacter pylori in the Gastric Lumen In Vivo

ABSTRACT The human pathogen Helicobacter pylori has infected more than half of the worlds population. Nevertheless, the first step of infection, the acute colonization of the gastric mucus, is poorly understood. For successful colonization, H. pylori must retain active motility in the gastric lumen until it reaches the safety of the mucus layer. To identify the factors determining the acute colonization, we inserted bacteria into the stomach of anesthetized Mongolian gerbils. We adjusted the gastric juice to defined pH values of between 2.0 and 6.0 by using an autotitrator. Despite the fact that Helicobacter spp. are known to survive low pH values for a certain time in vitro, the length of time that H. pylori persisted under the assay conditions within the gastric juice in vivo was remarkably shorter. In the anesthetized animal we found H. pylori to be irreversibly immotile in less than 1 min at lumen pH values of 2 and 3. At pH 4 motility was lost after 2 min. However, the period of motility increased to more than 15 min at pH 6. Blocking pepsins in the gastric lumen in vivo by using pepstatin significantly increased the period of motility. It was possible to simulate the rapid in vivo immotilization in vitro by adding pepsins. We conclude that pepsin limits the persistence of H. pylori in the gastric chymus to only a few minutes by rapidly inhibiting active motility. It is therefore likely that this short period of resistance in the gastric lumen is one of the most critical phases of Helicobacter infection.

Enterotoxicity of a nonribosomal peptide causes antibiotic-associated colitis

Significance The human gut microbiota is a complex community of microbes with enormous metabolic potential. Recognition of the significance of bacterial metabolites in mediating host interactions and the impact of perturbations of this ecosystem on human health has increased dramatically. Antibiotic therapy eliminates not only pathogens but also some of the commensal enteric microbiota, sometimes leading to inflammation and diarrhea. Understanding how microbial imbalance actually causes disease is challenging. This study reveals how a gut resident is able to cause colitis during penicillin therapy. We show that a pyrrolobenzodiazepine metabolite produced by Klebsiella oxytoca directly damages the intestinal epithelium and disrupts its protective barrier function. The enterotoxicity of tilivalline provides a mechanism for antibiotic-induced colitis. Antibiotic therapy disrupts the human intestinal microbiota. In some patients rapid overgrowth of the enteric bacterium Klebsiella oxytoca results in antibiotic-associated hemorrhagic colitis (AAHC). We isolated and identified a toxin produced by K. oxytoca as the pyrrolobenzodiazepine tilivalline and demonstrated its causative action in the pathogenesis of colitis in an animal model. Tilivalline induced apoptosis in cultured human cells in vitro and disrupted epithelial barrier function, consistent with the mucosal damage associated with colitis observed in human AAHC and the corresponding animal model. Our findings reveal the presence of pyrrolobenzodiazepines in the intestinal microbiota and provide a mechanism for colitis caused by a resident pathobiont. The data link pyrrolobenzodiazepines to human disease and identify tilivalline as a target for diagnosis and neutralizing strategies in prevention and treatment of colitis.

Aerolysin From Aeromonas hydrophila Perturbs Tight Junction Integrity and Cell Lesion Repair in Intestinal Epithelial HT-29/B6 Cells

BACKGROUND Aeromonads cause a variety of infections, including gastroenteritis, sepsis, and wound necrosis. Pathogenesis of Aeromonas hydrophila and its hemolysin has been characterized, but the mechanism of the epithelial barrier dysfunction is currently poorly understood. METHODS Human colon epithelial monolayers HT-29/B6 were apically inoculated with clinical isolates of A. hydrophila or with the secreted pore-forming toxin aerolysin. Epithelial resistance and permeability for several markers were determined in Ussing chambers, using 2-path impedance spectroscopy. The subcellular distribution of tight junction (TJ) and cytoskeleton proteins was analyzed by Western blotting and confocal laser-scanning microscopy. RESULTS A. hydrophila infection induces chloride secretion with a small decrease in transcellular resistance. However, the major effect of A. hydrophila, mediated by its toxin aerolysin, was a sustained reduction of paracellular resistance by retracting sealing TJ proteins from the TJ strands. Aerolysin-treated monolayers showed increased paracellular permeability to FITC-dextran-4000 (0.104 ± 0.014 vs 0.047 ± 0.001 10(-6) cm/s in control; P < .05). Moreover, restitution of epithelial lesions was impaired. The effects were myosin light chain kinase (MLCK) dependent and mediated by intracellular Ca(2+) signaling. CONCLUSIONS During Aeromonas infection, pore formation by aerolysin impairs epithelial integrity by promoting TJ protein redistribution and consequently affecting wound closure. Thus, Aeromonas-induced diarrhea is mediated by 2 mechanisms, transcellular secretion and paracellular leak flux.

Yersinia enterocolitica induces epithelial barrier dysfunction through regional tight junction changes in colonic HT-29/B6 cell monolayers

Yersinia enterocolitica is a common cause of acute gastroenteritis. This study aimed to clarify the mechanisms leading to barrier dysfunction and diarrhea. Exposure of human colonic HT-29/B6 cells to Y. enterocolitica resulted in a decrease in transepithelial resistance from 404±23 to 163±21 Ω cm2 (P<0.001) in parallel with an increase in mannitol (182 Da) and fluorescein (332 Da) permeability, whereas short circuit current did not change. This effect was time dependent, required the presence of living bacteria, could not be triggered by bacterial supernatants and was not due to Yersinia outer proteins. Concomitantly, Y. enterocolitica induced necrosis as indicated by an increase in lactate dehydrogenase-release, whereas epithelial apoptosis was not upregulated. Local changes in conductivity were detected by conductance scanning, indicating ‘leaky regions’ within the epithelium that were visualized by biotinylation and confocal microscopy. In these regions, claudin-3 and -4 and, especially claudin-8, were redistributed off the tight junction (TJ) into the cytoplasm. In addition, the expression of claudin-2, -3, -8, -10 and ZO-1 was diminished as quantified by immunoblotting. Moreover, we found claudin-8 to be regulated by the c-Jun N-terminal kinase, the inhibition of which attenuated the Y. enterocolitica-induced decrease in transepithelial resistance and restored claudin-8 protein level. In conclusion, barrier dysfunction in Y. enterocolitica infection is due to circumscribed epithelial TJ protein changes and necrotic cell loss, as a consequence of which leak flux diarrhea and antigen-uptake provoking extraintestinal arthritis may be triggered.

α-Haemolysin of Escherichia coli in IBD: a potentiator of inflammatory activity in the colon

Objective α-Haemolysin (HlyA) influences host cell ionic homeostasis and causes concentration-dependent cell lysis. As a consequence, HlyA-producing Escherichia coli is capable of inducing ‘focal leaks’ in colon epithelia, through which bacteria and antigens translocate. This study addressed the role of HlyA as a virulence factor in the pathogenesis of colitis according to the ‘leaky gut’ concept. Design To study the action of HlyA in the colon, we performed oral administration of HlyA-expressing E coli-536 and its isogenic α-haemolysin-deficient mutant (HDM) in three mouse models: wild type, interleukin-10 knockout mice (IL-10−/−) and monoassociated mice. Electrophysiological properties of the colonised colon were characterised in Ussing experiments. Inflammation scores were evaluated and focal leaks in the colon were assessed by confocal laser-scanning microscopy. HlyA quantity in human colon biopsies was measured by quantitative PCR. Results All three experimental mouse models infected with HlyA-producing E coli-536 showed an increase in focal leak area compared with HDM. This was associated with a decrease in transepithelial electrical resistance and an increase in macromolecule uptake. As a consequence, inflammatory activity index was increased to a higher degree in inflammation-prone mice. Mucosal samples from human colon were E coli HlyA-positive in 19 of 22 patients with ulcerative colitis, 9 of 9 patients with Crohns disease and 9 of 12 healthy controls. Moreover, focal leaks were found together with 10-fold increased levels of HlyA in active ulcerative colitis. Conclusions E coli HlyA impairs intestinal barrier function via focal leak induction in the epithelium, thereby intensifying antigen uptake and triggering intestinal inflammation in vulnerable mouse models. Therefore, HlyA-expressing E coli strains should be considered as potential cofactors in the pathogenesis of intestinal inflammation.

Helicobacter pylori colonization critically depends on postprandial gastric conditions

The risk of Helicobacter pylori infection is highest in childhood, but the colonization process of the stomach mucosa is poorly understood. We used anesthetized Mongolian gerbils to study the initial stages of H. pylori colonization. Prandial and postprandial gastric conditions characteristic of humans of different ages were simulated. The fraction of bacteria that reached the deep mucus layer varied strongly with the modelled postprandial conditions. Colonization success was weak with fast gastric reacidification typical of adults. The efficiency of deep mucus entry was also low with a slow pH decrease as seen in pH profiles simulating the situation in babies. Initial colonization was most efficient under conditions simulating the postprandial reacidification and pepsin activation profiles in young children. In conclusion, initial H. pylori colonization depends on age-related gastric physiology, providing evidence from an in vivo infection model that suggests an explanation why the bacterium is predominantly acquired in early childhood.

Tracing of gastric reflux into the middle ear in a mongolian gerbil model.

Objectives: The purpose of this study was to trace induced gastric reflux and to examine whether it reaches the middle ear in a Mongolian gerbil model. Background: Otitis media with effusion is the most frequent middle ear disease in childhood. Gastroesophageal reflux is suspected to be a possible factor in its pathogenesis. Methods: Seventeen Mongolian gerbils were assigned to three groups: the control (phosphate-buffered saline application to the lower esophageal sphincter) and two experimental groups (Aquo-Trinitrosan [Merck, Darmstadt, Germany] application to the lower esophageal sphincter, low gastric pressure and Aquo-Trinitrosan application, higher gastric pressure). We injected Chinese ink into the stomach to trace the path of a potential gastroesophageal reflux in all three groups. The traces of ink were investigated by ear and larynx endoscopy and histology. Results: There were no signs of gastroesophageal reflux based on the data obtained from the control group. In animals with traceable laryngeal reflux, the ink was also shown to advance through the eustachian tube and reach the middle ear. In addition, we found that when reflux reaches the middle ear on one side, it also reaches the contralateral middle ear in most cases. Conclusion: Gastroesophageal reflux induced by relaxation of the lower esophageal sphincter was shown to reach the middle ear in our Mongolian gerbil model. These results support recent hypotheses linking gastroesophageal reflux to the development of otitis media with effusion.

Experimental infection of weaned piglets with Campylobacter coli--excretion and translocation in a pig colonisation trial.

Campylobacter (C.) is one of the most common food-borne pathogen causing bacterial enteric infections in humans. Consumption of meat and meat products that have been contaminated with Campylobacter are the major source of infection. Pigs are a natural reservoir of Campylobacter spp. with C. coli as the dominant species. Even though some studies focussed on transmission of C. coli in pig herds and the excretion in faeces, little is known about the colonisation and excretion dynamics of C. coli in a complex gut microbiota present in weaned piglets and the translocation to different tissues. Therefore, an experimental trial was conducted to evaluate the colonisation and translocation ability of the porcine strain C. coli 5981 in weaned pigs. Thus, ten 35 days old piglets were intragastrically inoculated with strain C. coli 5981 (7 × 10(7)CFU/animal) encoding resistances against erythromycin and neomycin. Faecal samples were taken and C. coli levels were enumerated over 28 days. All piglets were naturally colonised with C. coli before experimental inoculation, and excretion levels ranged from 10(4) to 10(7)CFU/g faeces. However, no strain showed resistances against the additional antimicrobials used. Excretion of C. coli 5981 was seen for all piglets seven days after inoculation and highest counts were detectable ten days after inoculation with 10(6)CFU/g faeces. Post-mortem, translocation and subsequent invasion of luminal C. coli was observed for gut tissues of the small intestine and for the gut associated lymphatic tissues, such as jejunal mesenteric lymph nodes and tonsils as well as for spleen and gall bladder. In conclusion, this pig colonisation trial offers the opportunity to study C. coli colonisation in weaned piglets using the porcine strain C. coli 5981 without the need for gnotobiotic or specific pathogen-free animals.