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      Enteroaggregative Escherichia coli Adherence Fimbriae Drive Inflammatory Cell Recruitment via Interactions with Epithelial MUC1

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          ABSTRACT

          Enteroaggregative Escherichia coli (EAEC) causes diarrhea and intestinal inflammation worldwide. EAEC strains are characterized by the presence of aggregative adherence fimbriae (AAF), which play a key role in pathogenesis by mediating attachment to the intestinal mucosa and by triggering host inflammatory responses. Here, we identify the epithelial transmembrane mucin MUC1 as an intestinal host cell receptor for EAEC, demonstrating that AAF-mediated interactions between EAEC and MUC1 facilitate enhanced bacterial adhesion. We further demonstrate that EAEC infection also causes elevated expression of MUC1 in inflamed human intestinal tissues. Moreover, we find that MUC1 facilitates AAF-dependent migration of neutrophils across the epithelium in response to EAEC infection. Thus, we show for the first time a proinflammatory role for MUC1 in the host response to an intestinal pathogen.

          IMPORTANCE

          EAEC is a clinically important intestinal pathogen that triggers intestinal inflammation and diarrheal illness via mechanisms that are not yet fully understood. Our findings provide new insight into how EAEC triggers host inflammation and underscores the pivotal role of AAFs—the principal adhesins of EAEC—in driving EAEC-associated disease. Most importantly, our findings add a new dimension to the signaling properties of the transmembrane mucin MUC1. Mostly studied for its role in various forms of cancer, MUC1 is widely regarded as playing an anti-inflammatory role in response to infection with bacterial pathogens in various tissues. However, the role of MUC1 during intestinal infections has not been previously explored, and our results describe the first report of MUC1 as a proinflammatory factor following intestinal infection.

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          Most cited references54

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          German outbreak of Escherichia coli O104:H4 associated with sprouts.

          A large outbreak of the hemolytic-uremic syndrome caused by Shiga-toxin-producing Escherichia coli O104:H4 occurred in Germany in May 2011. The source of infection was undetermined. We conducted a matched case-control study and a recipe-based restaurant cohort study, along with environmental, trace-back, and trace-forward investigations, to determine the source of infection. The case-control study included 26 case subjects with the hemolytic-uremic syndrome and 81 control subjects. The outbreak of illness was associated with sprout consumption in univariable analysis (matched odds ratio, 5.8; 95% confidence interval [CI], 1.2 to 29) and with sprout and cucumber consumption in multivariable analysis. Among case subjects, 25% reported having eaten sprouts, and 88% reported having eaten cucumbers. The recipe-based study among 10 groups of visitors to restaurant K included 152 persons, among whom bloody diarrhea or diarrhea confirmed to be associated with Shiga-toxin-producing E. coli developed in 31 (20%). Visitors who were served sprouts were significantly more likely to become ill (relative risk, 14.2; 95% CI, 2.6 to ∞). Sprout consumption explained 100% of cases. Trace-back investigation of sprouts from the distributor that supplied restaurant K led to producer A. All 41 case clusters with known trading connections could be explained by producer A. The outbreak strain could not be identified on seeds from the implicated lot. Our investigations identified sprouts as the most likely outbreak vehicle, underlining the need to take into account food items that may be overlooked during subjects' recall of consumption.
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            A complementation analysis of the restriction and modification of DNA in Escherichia coli.

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              MUC1 cell surface mucin is a critical element of the mucosal barrier to infection.

              Cell surface mucin glycoproteins are highly expressed by all mucosal tissues, yet their physiological role is currently unknown. We hypothesized that cell surface mucins protect mucosal cells from infection. A rapid progressive increase in gastrointestinal expression of mucin 1 (Muc1) cell surface mucin followed infection of mice with the bacterial pathogen Campylobacter jejuni. In the first week following oral infection, C. jejuni was detected in the systemic organs of the vast majority of Muc1(-/-) mice but never in Muc1(+/+) mice. Although C. jejuni entered gastrointestinal epithelial cells of both Muc1(-/-) and Muc1(+/+) mice, small intestinal damage as manifested by increased apoptosis and enucleated and shed villous epithelium was more common in Muc1(-/-) mice. Using radiation chimeras, we determined that prevention of systemic infection in wild-type mice was due exclusively to epithelial Muc1 rather than Muc1 on hematopoietic cells. Expression of MUC1-enhanced resistance to C. jejuni cytolethal distending toxin (CDT) in vitro and CDT null C. jejuni showed lower gastric colonization in Muc1(-/-) mice in vivo. We believe this is the first in vivo experimental study to demonstrate that cell surface mucins are a critical component of mucosal defence and that the study provides the foundation for exploration of their contribution to epithelial infectious and inflammatory diseases.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                mBio
                MBio
                mbio
                mbio
                mBio
                mBio
                American Society for Microbiology (1752 N St., N.W., Washington, DC )
                2150-7511
                6 June 2017
                May-Jun 2017
                : 8
                : 3
                : e00717-17
                Affiliations
                [a ]Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, Massachusetts, USA
                [b ]Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, USA
                [c ]Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
                Pasteur Institute
                Author notes
                Address correspondence to Fernando Ruiz-Perez, FR3D@ 123456hscmail.mcc.virginia.edu , or Beth A. McCormick, Beth.mccormick@ 123456umassmed.edu .

                This article is a direct contribution from a Fellow of the American Academy of Microbiology. External solicited reviewers: Andrew Neish, Emory University School of Medicine; Gail Hecht, Loyola University Chicago Health Sciences Division.

                Author information
                http://orcid.org/0000-0001-7536-3453
                Article
                mBio00717-17
                10.1128/mBio.00717-17
                5461410
                28588132
                8af1b4e4-19a2-43a0-bb0e-3cfd44ea4535
                Copyright © 2017 Boll et al.

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license.

                History
                : 16 May 2017
                : 17 May 2017
                Page count
                supplementary-material: 4, Figures: 5, Tables: 1, Equations: 0, References: 64, Pages: 12, Words: 8707
                Funding
                Funded by: Enterics Research Investigational Network
                Award ID: SR00001795
                Award Recipient : Fernando Ruiz-Perez
                Funded by: HHS | National Institutes of Health (NIH) https://doi.org/10.13039/100000002
                Award ID: AI-033096
                Award Recipient : James P. Nataro
                Funded by: HHS | National Institutes of Health (NIH) https://doi.org/10.13039/100000002
                Award ID: DK056754
                Award Recipient : Beth A. McCormick
                Funded by: HHS | National Institutes of Health (NIH) https://doi.org/10.13039/100000002
                Award ID: DK109677
                Award Recipient : Beth A. McCormick
                Funded by: Carlsbergfondet (Carlsberg Foundation) https://doi.org/10.13039/501100002808
                Award ID: 2011_01_0636
                Award Recipient : Erik J. Boll
                Categories
                Research Article
                Custom metadata
                May/June 2017

                Life sciences
                escherichia coli,fimbriae,inflammation,mucin
                Life sciences
                escherichia coli, fimbriae, inflammation, mucin

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