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SWINE TECHNICAL ARTICLES

BORDETELLA BRONCHISEPTICA AND RESPIRATORY DISEASE IN SWINE Samantha J. Hau 1, Susan L. Brockmeier1 1 National Animal Disease Center, ARS, USDA, Ames, IA Corresponding Author ([email protected]) ABSTRACT

Bordetella bronchiseptica is an ubiquitous pathogen of swine Bordetella bronchiseptica is an aerobic, Gram negative, rod- causing respiratory infections including rhinitis, tracheitis, shaped bacterium that is capable of causing respiratory bronchitis, and pneumonia. It spreads quickly between infections in a wide range of mammalian species (1). It is a animals, especially during commingling of naïve animals with member of the class and closely related to subclinical carriers. B. bronchiseptica causes disease through the human pathogen . B. bronchiseptica is the production of virulence factors, such as adhesins and an important cause of respiratory infections in swine, where it toxins, which is coordinated by the BvgAS system. In addition to can cause a range of diseases from asymptomatic colonization causing primary disease, B. bronchiseptica can exacerbate viral to severe pneumonia (2, 3). The prevalence of B. bronchiseptica respiratory infections and predispose animals to other bacterial in swine is high and it is globally distributed within the swine respiratory pathogens, which increases the clinical signifi cance industry (4-10). of B. bronchiseptica colonization. Disease is currently managed with antibiotic treatments and vaccination strategies; however, colonization is diff icult to clear and animals can remain colonized and shed B. bronchiseptica long term, acting as a source of infection for naïve animals within a herd.

5 DISEASES

Bordetella bronchiseptica causes respiratory disease in swine cause more severe atrophy of the turbinates, which can result that can impact both the upper and lower respiratory tracts. in septal deviation (25, 28). Rhinitis presents with clinical Disease has a rapid onset, with clinical signs developing 2-3 signs of sneezing, nasal discharge, and ocular discharge. As days post-exposure (11). B. bronchiseptica is associated with a atrophic rhinitis progresses, atrophy of the turbinates can be high morbidity and low mortality, spreading rapidly within visualized at necropsy and during coinfection with P. multocida, a group of animals but resulting in low death loss (12-14). can lead to brachygnathia, lateral deviation of the snout (Figure Swine diseases caused by B. bronchiseptica include: rhinitis, 1), and/or epistaxis (11). bronchitis, tracheitis, and pneumonia. Bordetella bronchiseptica is also capable of causing inflammation of the airways resulting in tracheitis and Bordetella bronchiseptica is the causal agent of Non bronchitis. Similar to disease associated with the nasal Progressive Atrophic Rhinitis, and it causes tracheitis, mucosa, B. bronchiseptica interacts with the ciliated epithelial bronchitis and pneumonia. cells in the trachea and bronchi causing ciliostasis and epithelial changes (15, 16). This reduces the clearance by the mucociliary Bordetella bronchiseptica is a primary cause of rhinitis in escalator causing accumulation of mucus in the airways, which pigs, which can present as mild rhinitis, nonprogressive may provide a niche for secondary and predispose the atrophic rhinitis, when B. bronchiseptica is the sole animal to pulmonary infection (11). Uncomplicated tracheitis etiologic agent, or progressive atrophic rhinitis, when and bronchitis present with a dry, non-productive cough that B. bronchiseptica infects with toxigenic Pasteurella can be paroxysmal in nature (11). multocida. The interaction of B. bronchiseptica with the nasal mucosa leads to inflammation (rhinitis) and epithelial Pulmonary infection with Bordetella bronchiseptica results changes including squamous metaplasia, ciliostasis, or loss of in suppurative bronchopneumonia (29)(Figure 2). It can ciliated cells (15, 16). Over time, disease progresses to atrophic act as the primary etiologic agent in young pigs and in older rhinitis, in which the boney trabeculae of the turbinates is pigs it generally contributes to the severity of the Porcine replaced with fibrous connective tissue through the action of Respiratory Disease Complex (PRDC) through interaction with the dermonecrotic toxin (DNT) produced by B. bronchiseptica other bacteria and viruses in mixed infections (6, 29-33). The (17-19). With B. bronchiseptica as the sole etiologic agent, necrosis and tissue damage associated with B. bronchiseptica the disease is nonprogressive, affecting predominantly the pneumonia is induced by the action of DNT, without which ventral scrolls and turbinates, which can take weeks to resolve pneumonia does not develop (18, 19). Pneumonia caused by (15, 20-24); however, when B. bronchiseptica interacts with B. bronchiseptica results in red-to-plum areas of cranioventral toxigenic strains of P. multocida, disease is more severe (25-27). consolidation in the lungs that are associated with hemorrhage, The P. multocida toxin (PMT) and DNT act synergistically to necrosis, and neutrophil infiltration (29). Over time, the lesions undergo fibrosis and become grey-to-tan in color and more firm (29). The most prevalent clinical sign of B. bronchiseptica pneumonia is coughing and it can be difficult to discern the cause without further diagnostics.

Figure 1. Fattening pig with lateral deviation of the snout. Source: HIPRA.

6 colonization and disease with other bacterial agents (25, 27, 31). The association between B. bronchiseptica and P. multocida has been well studied as it relates to progressive atrophic rhinitis, where toxigenic P. multocida is better able to colonize and contribute to disease in animals with established B. bronchiseptica infection (25, 27). Additionally, P. multocida is less capable of causing pneumonic lesions as the sole agent or during PRRSV coinfection; however, when P. multocida is associated with PRRSV and B. bronchiseptica, more severe pneumonia develops (37). B. bronchiseptica also predisposes animals to disease with Streptococcus suis, promotes colonization with Haemophilus parasuis, and may contribute to the persistence of Actinobacillus pleuropneumoniae in the respiratory tract (31, 38-40). Coinfection of pigs with B. bronchiseptica and S. suis increases the prevalence of pneumonia as well as increasing the incidence of systemic infection with S. suis (38, 39). Coinfection of B. bronchiseptica and H. parasuis increases the burden of H. parasuis in the nasal cavity (31). Finally, biofi lms produced by B. bronchiseptica may provide a niche for the survival of other in the nasal passageways, as has been seen with A. pleuropneumoniae in vitro (40).

Although Bordetella bronchiseptica is ubiquitous within the Figure 2. Turbinate and lung lesions in a nursery pig aff ected by swine industry, this organism is not a commensal and the Bordetella bronchiseptica. Source: Histology and Anatomical Pathology, B. bronchiseptica Faculty of Veterinary Medicine, University of Murcia. diff erences in severity of disease are associated with the age and immune status of the animal, environmental conditions, coinfections, and variations in B. bronchiseptica Bordetella bronchiseptica is a predisposing factor for other isolates. Younger animals tend to develop more severe nasal diseases. and pulmonary lesions during B. bronchiseptica infection (11, 41). B. bronchiseptica disease is also impacted by immune status Bordetella bronchiseptica is also capable of increasing the and passive immunity, with piglets from vaccinated or naturally severity of respiratory disease caused by viral pathogens infected sows having delayed onset and/or reduced severity of and predisposing pigs to secondary infection with other lesions; however, these animals still become colonized with bacterial pathogens. The impact of B. bronchiseptica on B. bronchiseptica (29, 41, 42). Environmental conditions, such as respiratory disease associated with PRDC has been investigated poor air quality, can exacerbate disease with B. bronchiseptica using coinfection models with several viral agents (12, 32, 34, 35). as well as coinfections with other pathogens, both bacterial and Disease associated with Porcine Reproductive and Respiratory viral. Diff erences in isolate virulence also contribute to diff erences Syndrome Virus (PRRSV), infl uenza A virus (IAV), and Porcine in disease presentation and a broad range of virulence has been Respiratory Corona Virus (PRCV) is exacerbated by coinfection detected (lethal dose 50 variation of 100,000 fold in inbred mice) with B. bronchiseptica (32, 34-37). B. bronchiseptica was found (43, 44). These diff erences have been attributed to variation in to increase lesion severity and prolong disease resolution virulence factor production (43-45); however, even with less when contributing to a viral respiratory infection, which may virulent isolates, B. bronchiseptica predisposes animals to be associated with elevated and sustained cytokine response secondary infections and, when present, B. bronchiseptica during coinfection of viral agents and B. bronchiseptica (12, should not be considered a commensal. 32, 34-36). B. bronchiseptica has also been shown to enhance

7 PATHOGENESIS

Bordetella bronchiseptica infection begins with attachment of mutations prevent the expression of BvgAS and the transition the bacterium to the respiratory epithelium, with preferential of the bacterium to the pathogenic state (11). These Bvg- locked adherence to ciliated cells in the mucosa (15, 46). Through bacteria are readily cleared by the innate immune system and this interaction and toxin production, B. bronchiseptica causes do not establish infections in the swine host (14). ciliostasis and the extrusion of ciliated epithelial cells (15, 16, 29), which contributes to mucus accumulation within the respiratory tract. B. bronchiseptica causes inflammation of the Bordetella bronchiseptica virulence factors epithelium, leading to epithelial metaplasia and necrosis and the infiltration of immune cells (15, 16, 29), which B. bronchiseptica Bordetella bronchiseptica produces a host of virulence factors combats through being cytotoxic to phagocytes (33, 47). This that function in adherence, host tissue damage, and immune allows the bacterium to persist during tissue inflammation and evasion. Adhesion is mediated by a group of adhesins that evade the host immune response. Additionally, while they are work in concert to promote B. bronchiseptica colonization. not the preferred cell type, the interaction of B. bronchiseptica Filamentous hemagglutinin (FHA), fimbrial proteins, and with nonciliated epithelial cells is thought to play a role in pertactin are all thought to contribute to adherence through establishing microcolonies or biofilms, especially within the multiple binding specificities that extend the range of ligands nasal cavity (48). Biofilms are communities of microorganisms (48, 56-61). Toxin production by B. bronchiseptica contributes within a complex matrix that function in adherence, protect the to tissue damage and immune evasion. One prominent toxin organisms from the environment, and contribute to persistent is DNT, which is essential for the bony changes associated infections in bacteria such as B. bronchiseptica (49). with nonprogressive atrophic rhinitis and the necrosis associated with pneumonia (17-19, 62, 63). The production of The pathogenesis of B. bronchiseptica infection is associated DNT is essential for B. bronchiseptica to cause disease in swine with the coordinated implementation of various virulence and many swine isolates of B. bronchiseptica have enhanced factors that are regulated by the BvgAS (Bordetella virulence DNT production due to the presence of mutations in the coding gene) system (50). This system functions as an on/off switch sequence upstream of the gene (64). This genetic change may regulating the virulence genes of B. bronchiseptica and enabling represent host-adaption of swine isolates to causing disease phenotypic modulation that allows the bacterium to succeed in pigs. Another important B. bronchiseptica toxin is tracheal as it cycles between the environment and the host (11, 50, cytotoxin (TCT). TCT is produced by the bacteria during 51). The Bvg+ state is induced by an elevation in temperature cellular proliferation as a breakdown product of during the transition of B. bronchiseptica from the environment remodeling (65). When released from the cell, TCT interacts to infecting a host (50, 51). The virulence factors induced by with lipopolysaccharide in the outer to induce the BvgAS system are generated in two phases: “early” and ciliostasis and extrusion of ciliated epithelial cells from the “late”. Early genes induced by BvgAS function predominantly in mucosa (16, 29, 65). Because TCT is produced during cell wall adherence and aid the bacterium in establishing host infection. remodeling, it is constitutively produced and its production is not Late genes induced by BvgAS include toxins and virulence factors impacted by the BvgAS system. The last major B. bronchiseptica which cause tissue damage and are involved in host evasion. At toxin is (ACT). ACT has adenylate cyclase environmental temperatures in the Bvg- state, B. bronchiseptica activity and induces cellular lysis through pore formation (66, 67). has elevated expression of genes involved in motility and urease ACT can lyse many cell types, but the primary targets of ACT are production, while virulence factors are repressed (52, 53). phagocytes (68). Through its interaction with immune cells, ACT Bvg- B. bronchiseptica also show greater adherence to swine is able to modulate cytokine production and alter the serum and epithelial cells than Bvg+ cells (54, 55), this is thought to assist in secretory antibody response (58, 69, 70). Immune modulation the persistence of Bvg- cells in the respiratory tract until BvgAS and tissue damage are also mediated by effectors of the type can be induced. The BvgAS system can also become locked in 3 secretion system (T3SS) produced by B. bronchiseptica. The the “off” condition through phase variation, in which frameshift T3SS functions in the translocation of effector proteins from

8 the bacterium into the host cell cytosol (71). The effector and the tissue damage associated with rhinitis (76). Second, proteins contribute to immune evasion and tissue necrosis ciliostasis associated with B. bronchiseptica infection inhibits (72-74), and the T3SS is important in the progression and mucociliary clearance leading to the accumulation of mucus persistence of pneumonia (13, 74, 75). within the respiratory tract (16, 29). This provides a niche for secondary bacterial pathogens to adhere and thrive during The presence of B. bronchiseptica in the respiratory tract and B. bronchiseptica infection. Additionally, the epithelial the progression of disease contributes to the development of damage associated with B. bronchiseptica infection leads secondary bacterial infections through several mechanisms. to increased loss of nutrients that can be utilized by First, the interaction of Bordetella bronchiseptica with other bacterial pathogens during colonization. Finally, epithelial cells is mediated through the production of multispecies biofilms can be generated byB. bronchiseptica adhesins, which can be pirated by other bacteria, such as and other bacteria, such as A. pleuropneumoniae, to provide P. multocida, to enable attachment to the nasal epithelium added protection and nutrients within the nasal cavity (40), (11). For the interaction between B. bronchiseptica and thereby increasing the survival and risk of infection with P. multocida, this occurs independently of DNT production both bacterial species.

TRANSMISSION

Bordetella bronchiseptica is highly infectious and spreads also able to persist in the environment with a half-life of 1-2 rapidly throughout a herd to infect most animals (12- hours at ambient temperatures and 75% relative humidity and 14). The bacterium spreads through direct contact between is known to survive weeks in soil or water (77, 79, 80), which infected sows and their piglets as well as between pigs after indicates fomites may also play a role in transmission. Although comingling. B. bronchiseptica can also spread via aerosols there are no documented cases of transmission to swine from between animals without direct contact (12-14, 77), which other animal species, B. bronchiseptica has been isolated from is promoted by the sneezing and coughing associated with wildlife found in close proximity to swine (81) and is a common the progression of disease. After acute disease resolves, cause of disease in other domesticated mammals (1), which B. bronchiseptica colonization persists for several months may allow them to act as a reservoir for B. bronchiseptica and infected animals can serve as a reservoir for newly infection. introduced, naïve animals (78). Bordetella bronchiseptica is

9 DIAGNOSTICS

Bordetella bronchiseptica grows readily on blood agar plates; however, because B. bronchiseptica is a slower-growing organism, it can be difficult to identify without the use of a more restrictive media to prevent overgrowth of contaminating bacteria. Assessing the role of B. bronchiseptica in the disease process can also be difficult due to the mixed nature of many infections. B. bronchiseptica can be detected through isolation and biochemical identification from nasal swabs, or in cases of pneumonia from lung tissue samples or washes from pigs with pneumonia. Additionally, a polymerase chain reaction (PCR) target has been developed that has shown 100% specificity and sensitivity for B. bronchiseptica (82). More recently the use of Figure 3. Routine evaluation of the nasal turbinates in the slaughterhouse oral fluids has compared favorably to the use of nasal swabs and in nursery animals is now the best way of confirming or ruling out Progressive or Non-Progressive AR, respectively. Source: HIPRA. for detecting B. bronchiseptica via PCR at the herd level, improving the ease of sample collection (83, 84). Collection cards that lyse the bacteria and capture and stabilize the DNA for transport and storage at room temperature have also been used successfully to detect B. bronchiseptica in oral fluids (85). Atrophic rhinitis prevention programs can also be assessed using a snout scoring system, in which turbinate atrophy is quantified using a transverse sectioned snout (11) (Figure 3).

10 TREATMENT AND PREVENTION

Control of Bordetella bronchiseptica has been accomplished Vaccination as prevention and control of AR primarily with antibiotic treatments and vaccination to develop protective immunity. B. bronchiseptica tends to Vaccination against Bordetella bronchiseptica in swine be susceptible to chlortetracycline, oxytetracycline, and typically utilizes whole cell bacterins often including enrofloxacin, all antibiotics approved for the treatment of inactivated P. mutocida toxin to provide better control of bacterial agents associated with PRDC, but not specifically progressive atrophic rhinitis. Although vaccination with B. bronchiseptica (86). Resistance to β-lactams, including bacterins does not provide sterilizing immunity, it can ampicillin and ceftiofur, is widespread making them prevent clinical signs, lower bacterial numbers, and limit ineffective in treating B. bronchiseptica (8, 87, 88). While the severity of disease with B. bronchiseptica (89-91). Only antibiotics have been useful in reducing pneumonia and natural infection has been shown to provide total resistance clinical signs associated with B. bronchiseptica infection, to reinfection, probably due to induction of both serum IgG they are not effective in clearing the upper respiratory tract and mucosal IgA, which are important for clearance of the of infection and animals continue to shed B. bronchiseptica lung and upper respiratory tract respectively (92-96). Modified after treatment (11). Atrophic rhinitis control often utilizes live vaccines are not widely available for swine but may be antibiotic treatment using a combination of tetracycline more likely to mimic natural immunity through induction and trimethoprim-sulfonamide of the piglets and/or sow of a mucosal immune response; however, this would be around weaning or farrowing; however, resistance to dependent on the mechanism of attenuation and length of trimethoprim-sulfa antibiotics is becoming more common in persistence in the respiratory tract and thus is strain/vaccine B. bronchiseptica, making this treatment less effective (87). dependent. In addition, attenuated B. bronchiseptica strains In addition, the trend to reduce antibiotic usage in animal colonize the nasal cavity and may still predispose animals to production in general, and more specifically as a disease infection with other respiratory pathogens (76, 97). Systemic prevention measure, may result in a reemergence of overt antibody responses tend to be higher in animals parenterally atrophic rhinitis lesions in herds. vaccinated with bacterins compared to naturally infected animals or animals given intranasally administered attenuated vaccines (89). Thus bacterins are preferred for sow vaccination protocols, which involve vaccinating animals pre-farrow and rely on passively acquired maternal immunity to limit the severity of disease in piglets (98). Reduction of the prevalence of infection, bacterial load, and severity of nasal lesions, as well as increased weight gains have been demonstrated in piglets from B. bronchiseptica bacterin vaccinated sows. As is often the case, active vaccination of piglets can be complicated by the presence of maternal antibodies and vaccination at one and four weeks of age in maternally immune piglets has been employed with mixed results (89, 99). It is reasonable to suggest that vaccination against B. bronchiseptica may also reduce infection or severity of disease with secondary pathogens, nevertheless additional research into the effectiveness of vaccination in preventing enhanced disease with coinfection models using B. bronchiseptica and other respiratory pathogens is needed.

11 CONCLUSION

Bordetella bronchiseptica is a widespread, highly infectious difficult to discern. Vaccination can improve clinical health and cause of respiratory disease in swine. Disease varies from improve performance, but control of B. bronchiseptica can be mild, subclinical infections to severe pneumonia or atrophic challenging due to the difficulty in fully clearing the bacterium rhinitis. The presence of mild and subclinically infected animals using vaccines and antibiotics. Further research should aim to causes B. bronchiseptica to be an underreported contributor to better understand the mechanisms by which B. bronchiseptica respiratory disease in pigs. B. bronchiseptica also exacerbates contributes to enhanced disease with other respiratory viral respiratory infection and enhances colonization and/ pathogens and to determine whether vaccination can improve or disease with other bacterial pathogens, which makes the our ability to control both B. bronchiseptica infection and its full impact of B. bronchiseptica on swine respiratory health contribution to secondary disease.

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