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      Activation of the lectin pathway of complement in experimental human keratitis with Pseudomonas aeruginosa

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          Abstract

          Purpose

          Pseudomonas aeruginosa ( P. aeruginosa) microbial keratitis (MK) is a sight-threatening disease. Previous animal studies have identified an important contribution of the complement system to the clearance of P. aeruginosa infection of the cornea. Mannose-binding lectin (MBL), a pattern recognition receptor of the lectin pathway of complement, has been implicated in the host defense against P. aeruginosa. However, studies addressing the role of the lectin pathway in P. aeruginosa MK are lacking. Hence, we sought to determine the activity of the lectin pathway in human MK caused by P. aeruginosa.

          Methods

          Primary human corneal epithelial cells (HCECs) from cadaveric donors were exposed to two different P. aeruginosa strains. Gene expression of interleukin (IL)-6, IL-8, MBL, and other complement proteins was determined by reverse transcription-polymerase chain reaction (RT–PCR) and MBL synthesis by enzyme-linked immunosorbent assay and intracellular flow cytometry.

          Results

          MBL gene expression was not detected in unchallenged HCECs. Exposure of HCECs to P. aeruginosa resulted in rapid induction of the transcriptional expression of MBL, IL-6, and IL-8. In addition, expression of several complement proteins of the classical and lectin pathways, but not the alternative pathway, were upregulated after 5 h of challenge, including MBL-associated serine protease 1. However, MBL protein secretion was not detectable 18 h after challenge with P. aeruginosa.

          Conclusions

          MK due to P. aeruginosa triggers activation of MBL and the lectin pathway of complement. However, the physiologic relevance of this finding is unclear, as corresponding MBL oligomer production was not observed.

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          Most cited references39

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          The incidence of contact lens-related microbial keratitis in Australia.

          To establish the absolute risk of contact lens (CL)-related microbial keratitis, the incidence of vision loss and risk factors for disease. A prospective, 12-month, population-based surveillance study. New cases of CL-related microbial keratitis presenting in Australia over a 12-month period were identified through surveillance of all ophthalmic practitioners (numerator). Case detection was augmented by records' audits at major ophthalmic centers. The denominator (number of wearers of different CL types in the community) was established using a national telephone survey of 35,914 individuals. Cases and controls were interviewed by telephone to determine subject demographics and CL wear history. Visual outcomes were determined 6 months after the initial event. Annualized incidence and confidence intervals (CI) were estimated for different severities of disease and multivariable analysis was used in risk factor analysis. Annualized incidence (with CI) of disease and vision loss by CL type and wear modality and identification of independent risk factors. We identified 285 eligible cases of CL-related microbial keratitis and 1798 controls. In daily wear rigid gas-permeable CL wearers, the annualized incidence per 10,000 wearers was 1.2 (CI, 1.1-1.5); in daily wear soft CL wearers 1.9 (CI, 1.8-2.0); soft CL wearers (occasional overnight use) 2.2 (CI, 2.0-2.5); daily disposable CL wearers 2.0 (CI, 1.7-2.4); daily disposable CL wearers (occasional overnight use) 4.2 (CI, 3.1-6.6); daily wear silicone hydrogel CL wearers 11.9 (CI, 10.0-14.6); silicone hydrogel CL wearers (occasional overnight use) 5.5 (CI, 4.5-7.2); overnight wear soft CL wearers 19.5 (CI, 14.6-29.5) and in overnight wear of silicone hydrogel 25.4 (CI, 21.2-31.5). Loss of vision occurred in 0.6 per 10,000 wearers. Risk factors included overnight use, poor storage case hygiene, smoking, Internet purchase of CLs, <6 months wear experience, and higher socioeconomic class. Incidence estimates for soft CL use were similar to those previously reported. New lens types have not reduced the incidence of disease. Overnight use of any CL is associated with a higher risk than daily use.
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            Mannose-binding lectin binds to a range of clinically relevant microorganisms and promotes complement deposition.

            Mannose-binding lectin (MBL) is a collagenous serum lectin believed to be of importance in innate immunity. Genetically determined low levels of the protein are known to predispose to infections. In this study the binding of purified MBL to pathogens isolated from immunocompromised children was investigated by flow cytometry. Diverse Candida species, Aspergillus fumigatus, Staphylococcus aureus, and beta-hemolytic group A streptococci exhibited strong binding of MBL, whereas Escherichia coli, Klebsiella species, and Haemophilus influenzae type b were characterized by heterogeneous binding patterns. In contrast, beta-hemolytic group B streptococci, Streptococcus pneumoniae, and Staphylococcus epidermidis showed low levels of binding. Bound MBL was able to promote C4 deposition in a concentration-dependent manner. We conclude that MBL may be of importance in first-line immune defense against several important pathogens.
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              Mannose-binding lectin and its genetic variants.

              Mannose-binding lectin (MBL) is a collagen-like serum protein that mediates activation of the complement system and is of importance for host defence. Common variant alleles situated both in the promoter and structural region of the human MBL gene (MBL2) influence the stability and the serum concentration of the protein. Epidemiological studies have suggested that genetically determined variation in MBL serum concentration influences the susceptibility to and the course of different types of infections, autoimmune, metabolic and cardiovascular diseases, but this is still a subject of debate. The fact that these genetic variations are very frequent indicates a dual role for MBL in host defence. In this survey, we summarize the current molecular understanding of human MBL genetics.
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                Author and article information

                Journal
                Mol Vis
                Mol. Vis
                MV
                Molecular Vision
                Molecular Vision
                1090-0535
                2014
                06 January 2014
                : 20
                : 38-45
                Affiliations
                [1 ]Victorian Infectious Diseases Service, Royal Melbourne Hospital, Parkville VIC, Australia
                [2 ]Department of Medicine, Royal Melbourne Hospital, University of Melbourne, VIC, Australia
                [3 ]Centre for Eye Research Australia, East Melbourne VIC, Australia
                [4 ]Centre for Medicine Use and Safety, Monash University, Parkville VIC, Australia
                Author notes
                Correspondence to: Damon Eisen, Victorian Infectious Diseases Service, Royal Melbourne Hospital, Grattan Street, Parkville VIC 3050, Australia; Phone+61 3 9342 7212; FAX: +61 3 9342 7277; email: Damon.Eisen@ 123456mh.org.au
                Article
                4 2013MOLVIS0691
                3888499
                24426774
                fd2d2383-7ef5-4490-9f74-d0f2fd9294d0
                Copyright © 2014 Molecular Vision.

                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 work is properly cited, used for non-commercial purposes, and is not altered or transformed.

                History
                : 06 November 2013
                : 02 January 2014
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                Vision sciences
                Vision sciences

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