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Fibrinogen Binding Sites P336 and Y338 of Clumping Factor a Are Crucial for Staphylococcus Aureus Virulence

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Fibrinogen Binding Sites P336 and Y338 of Clumping Factor a Are Crucial for Staphylococcus Aureus Virulence Fibrinogen Binding Sites P336 and Y338 of Clumping Factor A Are Crucial for Staphylococcus aureus Virulence Elisabet Josefsson1*, Judy Higgins2, Timothy J. Foster2, Andrej Tarkowski1 1 Department of Rheumatology and Inflammation Research, University of Gothenburg, Go¨teborg, Sweden, 2 Microbiology Department, Moyne Institute of Preventive Medicine, Trinity College, Dublin, Ireland Abstract We have earlier shown that clumping factor A (ClfA), a fibrinogen binding surface protein of Staphylococcus aureus,isan important virulence factor in septic arthritis. When two amino acids in the ClfA molecule, P336 and Y338, were changed to serine and alanine, respectively, the fibrinogen binding property was lost. ClfAP336Y338 mutants have been constructed in two virulent S. aureus strains Newman and LS-1. The aim of this study was to analyze if these two amino acids which are vital for the fibrinogen binding of ClfA are of importance for the ability of S. aureus to generate disease. Septic arthritis or sepsis were induced in mice by intravenous inoculation of bacteria. The clfAP336Y338 mutant induced significantly less arthritis than the wild type strain, both with respect to severity and frequency. The mutant infected mice developed also a much milder systemic inflammation, measured as lower mortality, weight loss, bacterial growth in kidneys and lower IL-6 levels. The data were verified with a second mutant where clfAP336 and Y338 were changed to alanine and serine respectively. When sepsis was induced by a larger bacterial inoculum, the clfAP336Y338 mutants induced significantly less septic death. Importantly, immunization with the recombinant A domain of ClfAP336SY338A mutant but not with recombinant ClfA, protected against septic death. Our data strongly suggest that the fibrinogen binding activity of ClfA is crucial for the ability of S. aureus to provoke disease manifestations, and that the vaccine potential of recombinant ClfA is improved by removing its ability to bind fibrinogen. Citation: Josefsson E, Higgins J, Foster TJ, Tarkowski A (2008) Fibrinogen Binding Sites P336 and Y338 of Clumping Factor A Are Crucial for Staphylococcus aureus Virulence. PLoS ONE 3(5): e2206. doi:10.1371/journal.pone.0002206 Editor: Robin Charles May, University of Birmingham, United Kingdom Received January 25, 2008; Accepted March 20, 2008; Published May 21, 2008 Copyright: ß 2008 Josefsson et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This work was supported by Go¨teborg Medical Society, Go¨teborg Rheumatism Association, King Gustaf V’s 80 Years Foundation, LUA/ALF, Rune and Ulla Amlo¨vs Foundation, Swedish Medical Society, Swedish Research Council, Swedish Rheumatism Association, The Sigurd and Elsa Golje Memorial Foundation, The Family Tho¨le´ns and Kristlers Foundation and Science Foundation Ireland. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: There is a pending patent application on some of the data of this paper. * E-mail: [email protected] Introduction protected against systemic inflammation at the early stages of infection [9]. Clumping factor A (ClfA) is a surface located protein of It is not known how expression of ClfA contributes to the Staphylococcus aureus. ClfA contains a 519 amino acid N-terminal A development of arthritis and sepsis. Especially, the role of the domain, which comprises three separately folded subdomains N1, interaction between ClfA and host fibrinogen in the pathogenesis N2 and N3. The A domain is followed by a serine-aspartate of severe staphylococcal infections is presently unclear. In this dipeptide repeat region and a cell wall- and membrane-spanning study the role of fibrinogen binding of ClfA in promoting the region, which contains the LPDTG-motif for sortase-promoted virulence of S. aureus was investigated in depth. anchoring to the cell wall. ClfA is present in practically all S. aureus A fibrinogen binding-deficient mutant of ClfA was con- strains [1]. It binds to the C-terminus of the c-chain of fibrinogen, structed by exchanging amino acids P336 and Y338 for serine and is thereby able to induce clumping of bacteria in fibrinogen and aspartate, respectively. This mutant protein did not pro- solution [2,3]. mote detectable bacterial adherence to immobilized fibrinogen Expression of ClfA on S. aureus hampers phagocytosis by both or bacterial clumping in a solution of fibrinogen [6]. The macrophages and neutrophils [4,5]. In neutrophils this is due to conformation of single ClfA P336S and ClfAY338A mutants both a fibrinogen-dependent mechanism and to a fibrinogen- were unaltered according to far-UV circular dichroism spectros- independent mechanism. In contrast, platelets are activated by copy [10]. The wild-type chromosomal clfA genes of bacteria expressing ClfA through its interaction with GPIIb/IIIa strains Newman and LS1 were exchanged for the clfA leading to aggregation. This is most efficiently executed when P336SY338A mutant and the strains were tested in well established fibrinogen is present, but there is also a fibrinogen-independent infection models of murine septic arthritis and sepsis [11,12]. In pathway for platelet activation [6,7]. addition a deletion mutant lacking ClfA expression was compared We have earlier shown that ClfA is a virulence factor to the wildtype and non-fibrinogen binding ClfA expressing for induction of septic arthritis in mice [8]. Also, elimination of mutant. Our data strongly suggest that interaction between ClfA ClfA together with another fibrinogen binding protein ClfB and fibrinogen is crucial for infection morbidity and mortality, and PLoS ONE | www.plosone.org 1 May 2008 | Volume 3 | Issue 5 | e2206 ClfA, Fibrinogen and Virulence points out a possibility to create a more efficient approach to vaccination. Results Exchange of two amino acids necessary for ClfA binding to fibrinogen hampers development of septic arthritis and sepsis Two amino acids (P336 and Y338) that are known to be required for fibrinogen binding by ClfA were altered by allelic exchange to create mutants of strains Newman and LS1 that expressed a non-fibrinogen-binding ClfA protein on the cell surface. The level of expression and integrity of the protein was measured by Western blotting. The ability of Newman wild-type and Newman clfA P336S Y338A(clfAPYI) to provoke septic arthritis was investigated. Septic arthritis was induced by intravenous inoculation of 3.56106 to 5.06106 colony-forming units (cfu) and 3.26106 to 6.06106 cfu of Newman wild-type and the clfAPYI mutant, respectively. The development of arthritis was studied clinically for 7 days. The clfAPYI mutant provoked significantly less severe arthritis than the wild-type strain over the entire experimental period (P.0.001, Fig. 1 A). The frequency of arthritis was lower for Newman clfAPYI at all time points (Fig. S1). We reasoned that the new amino acid composition in the ClfAPYI molecule accidentally fits for interaction with a host anti- bacterial defence which could be a possible explanation for our data. To check for this possibility, a new construct was made where different amino acids were substituted for P336 and Y338 (clfA P336AY338S:clfAPYII). Mice that were inoculated with 3.96106 cfu of Newman clfAPYII developed arthritis to the same low extent as the clfAPYI mutant (Fig. 1 A), and with a similar frequency (Fig. S1). This outcome suggests strongly that the loss of fibrinogen binding is responsible for the reduced level of arthritis. It is possible that ClfA is involved in the development of arthritis by mechanisms that do not involve fibrinogen binding. A clfA deletion mutant lacking the ClfA protein was compared to mutants expressing the modified non-fibrinogen binding ClfA protein. However, mice that were infected with 4.36106 to 6 Figure 1. The fibrinogen binding site of ClfA mediates 4.8610 cfu of clfA null mutant developed arthritis in a manner development of septic arthritis and loss of weight. Severity of not different from the clfAPYI and clfAPYII mutant infected mice arthritis (A), measured as arthritic index, and weight loss (B) in mice (Fig. 1 A). The frequency of arthritis was also indistinguishable inoculated with S. aureus strain Newman, and clfAPYI, clfAPYII, and clfA (Fig. S1). null mutants. 3.26106–6.06106 cfu of S. aureus strains were inoculated. Infected joints were also investigated histologically. The Data are represented as medians (squares or center lines), interquartile ranges (boxes), and 80% central ranges (whiskers). Data are from three synovitis in Newman clfAPYI-infected mice was significantly experiments are pooled. N = 27–30, N = 30, N = 10, and milder than in wild-type infected mice in both experiment 1 and Newman clfAPYI clfAPYII NclfA = 16–20. 2(P = 0.02 and 0.001, respectively, Table 1). Bone destruction, a doi:10.1371/journal.pone.0002206.g001 major cause of sequels in human septic arthritis, was almost absent in the Newman clfAPYI-infected samples (Experiment 2, P = 0.001, Table 1). The synovitis and bone destruction induced The serum levels of IL-6, a measure of systemic inflammatory by the Newman clfA null mutant were also less pronounced response, were analyzed at day 7–8 of infection. The pattern of IL- compared to mice infected with Newman wild-type (P = 0.003 and 6 expression was similar to weight changes. Newman wild-type 0.006, respectively, Table 1), but somewhat more severe than in evoked high levels of serum IL-6 (4.8 (2.8, 5.7) ng/ml), the the Newman clfAPYI group, although not significantly so. Newman clfAPYI mutant evoked considerably lower IL-6 (0.2 Next, the metabolic consequences of the clfA mutations for the (0.07, 2.4) ng/ml, P,0.0001) while the Newman clfA null mutant infectious process were analysed.
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