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The probiotic escherichia coli strain Nissle 1917 combats lambdoid bacteriophages stx and lambda
(2018)
Shiga toxin (Stx) producing E. coli (STEC) such as Enterohemorrhagic E. coli (EHEC) are the major cause of foodborne illness in humans. In vitro studies showed the probiotic Escherichia coil strain Nissle 1917 (EcN) to efficiently inhibit the production of Stx. Life threatening EHEC strains as for example the serotype 0104:H4, responsible for the great outbreak in 2011 in Germany, evolutionary developed from certain E. coll strains which got infected by stx2-encoding lambdoid phages turning the E. coil into lysogenic and subsequently Stx producing strains. Since antibiotics induce stx genes and Stx production, EHEC infected persons are not recommended to be treated with antibiotics. Therefore, EcN might be an alternative medication. However, because even commensal E. coli strains might be converted into Stx-producers after becoming host to a stx encoding prophage, we tested EcN for stx-phage genome integration. Our experiments revealed the resistance of EcN toward not only stx-phages but also against lambda-phages. This resistance was not based on the lack of or by mutated phage receptors. Rather it involved the expression of a phage repressor (pr) gene of a defective prophage in EcN which was able to partially protect E. coli K-12 strain MG1655 against stx and lambda phage infection. Furthermore, we observed EcN to inactivate phages and thereby to protect E. coli K-12 strains against infection by stx- as well as lambda-phages. Inactivation of lambda-phages was due to binding of lambda-phages to LamB of EcN whereas inactivation of stx-phages was caused by a thermostable protein of EcN. These properties together with its ability to inhibit Stx production make EcN a good candidate for the prevention of illness caused by EHEC and probably for the treatment of already infected people.
Shiga toxin producing E. coli strains (STEC) are a great concern to human health. Upon an infection with as few as 100 bacteria, humans can develop disease symptoms ranging from watery to bloody diarrhea or even develop the hemolytic uremic syndrome (HUS). The major factor contributing to the disease symptoms is Shiga toxin (Stx) which can bind to the eukaryotic cells in the intestine of the human and induce cell death via apoptosis. Based, among other things, on the microbiota composition, the impact of STEC can vary. Some bacteria of the microbiota can interfere with the colonization of STEC strains in the first place. Others cannot impair the colonization but interfere with the toxin production and there are still others which are even infected by stx encoding phages, being released from STEC strains. Those previously harmless bacteria subsequently contribute to the toxin increase and worsen the disease progression. Since the genetic information of Stx is encoded on a prophage, antibiotic treatment of patients can lead to an increased toxin and stx-phage release and is therefore not recommended. Several STEC epidemics in different countries, which even resulted in the death of some patients, demonstrated that there is an urgent need for alternative treatment strategies.
The E. coli strain Nissle 1917 (EcN) has been used as a probiotic to treat gastrointestinal infections for more than 100 years. It harbors several fitness factors which contribute to the establishment of an intact intestinal barrier in the human gut. Moreover, studies with EcN unraveled that the probiotic E. coli can interfere with the colonization of STEC strains and their toxin production. This study aimed to investigate if EcN could be a possible alternative or supplementary treatment strategy for STEC infected patients, or a preventive treatment for the patient’s close contact persons.
Therefore, EcN was firstly investigated for a possible stx-prophage integration into its’s genome which would eliminate it from being a potential treatment due to the possibility of disease worsening. Despite the presence of the stx-phage surface receptor YaeT, EcN demonstrated a complete resistance towards the lysis and the lysogeny by stx-phages, which was proven by PCR, phage-plaque assays and phage enrichment approaches. Transcriptome data could unravel that a lambdoid prophage in the genome of EcN is involved in the resistance towards the phage infection. Other commensal E. coli tested presented a stx-phage resistance as well and in silico analysis revealed that all of them harbor a complete lambdoid prophage besides the stx-phage susceptible K-12 strain MG1655. We assume that the resistance of EcN towards a stx-phage infection is connected to the presence of an intact lambdoid prophage which interferes with superinfection.
Further experiments regarding the impact of the microcin negative EcN mutant SK22D towards STEC strains depicted that SK22D did not only interfere with the toxin production but also negatively regulated the transcription of the entire stx-prophage in coculture with all STEC strains tested (O157:H7, O26:H11, O145:H25, O103:H2, O111:H- and two O104:H4 isolates from the 2011 outbreak in Germany). This influence on the pathogenic factor production was evinced to be cell contact independent as SK22D could even interfere with the pathogenic factor production when being separated from the STEC strain EDL933 by a Transwell membrane with the pore size of 0.4 µm. From this data we concluded, that factor(s) released by SK22D interfere with the lysis of STEC strains by stabilizing the lysogenic state.
Another positive aspect of EcN towards the pathogenicity of STEC strains was encountered when EcN was incubated with isolated stx-phages. The probiotic strain could reduce the infectivity of the phages towards a MG1655 lysis from ~ 1e7 pfus/ml to 0 after 44 h of incubation. Various approaches to determine the characteristics of the factor(s) of EcN which are involved in the phage inactivation depicted it to be a heat resistant stationary phase protein on the surface of EcN, which could be a component of its biofilm.
Regarding the protective role of EcN we could further evince that SK22D was capable of interfering with the lysogenic K 12 mediated increase of Stx and stx phages. Lysogenic K-12 strains were characterized by a huge increase of Stx and stx-phage production. The presence of SK22D anyhow, could interfere with this K-12 mediated pathogenic factor increase. Transwell and stx phage infection kinetics led to the proposal that SK22D interfered with the stx-phage infection of K-12 strains in the first place rather than disturbing the lysis of lysogenic K 12. The protection from the phage infection could be due to the growth of K 12 strains within the SK22D culture, whereby the phage susceptible strains are masked from phage detection.
Summarizing, this work could underline the beneficial attributes of EcN towards the STEC pathogenicity in vitro. These results should be considered as pioneers for future in vivo studies to enable EcN medication as a supportive STEC infection treatment strategy.
The probiotic Escherichia coli strain Nissle 1917 (EcN) is one of the few probiotics licensed as a medication in several countries. Best documented is its effectiveness in keeping patients suffering from ulcerative colitis (UC) in remission. This might be due to its ability to induce the production of human beta defensin 2 (HBD2) in a flagellin-dependent way in intestinal epithelial cells. In contrast to ulcerative colitis, for Crohn´s disease (CD) convincing evidence is lacking that EcN might be clinically effective, most likely due to the genetically based inability of sufficient defensin production in CD patients. As a first step in the development of an alternative approach for the treatment of CD patients, EcN strains were constructed which were able to produce human alpha-defensin 5 (HD5) or beta-defensin 2 (HBD2). For that purpose codon-optimized defensin genes encoding either the proform with the signal sequence or the mature form of human alpha defensin 5 (HD5) or the gene encoding HBD2 with or without the signal sequence were cloned in an expression vector plasmid under the control of the T7 promoter. Synthesis of the encoded defensins was shown by Western blots after induction of expression and lysis of the recombinant EcN strains. Recombinant mature HBD2 with an N-terminal His-tag could be purified by Ni-column chromatography and showed antimicrobial activity against E. coli, Salmonella enterica serovar Typhimurium and Listeria monocytogenes. In a second approach, that part of the HBD2-gene which encodes mature HBD2 was fused with yebF gene. The resulting fusion protein YebFMHBD2 was secreted from the encoding EcN mutant strain after induction of expression. Presence of YebFMHBD2 in the medium was not the result of leakage from the bacterial cells, as demonstrated in the spent culture supernatant by Western blots specific for ß-galactosidase and maltose-binding protein. The dialyzed and concentrated culture supernatant inhibited the growth of E. coli, Salmonella enterica serovar Typhimurium and Listeria monocytogenes in radial diffusion assays as well as in liquid coculture. This demonstrates EcN to be a suitable probiotic E. coli strain for the production of certain defensins.