Biology Reference
In-Depth Information
Molecular pathogenesis
Mechanism of pathogenicity
Adherence to epithelial cells is probably the most important step in DAEC
infection. This process includes highly specific interaction with the epithelium
to: (i) recognize the infection site; (ii) compete and gain access to gastrointes-
tinal and urinary tract regions that are occupied by the resident microflora; and
(iii) activate signal transduction cascades that are necessary to induce diarrhea
and/or inflammation ( Benz and Schmidt, 1989 ; Bilge et al., 1989 ; Betis et al.,
2003a,b ). Many factors can contribute to DAEC adhesion to the host cells and
some adhesins have been characterized ( Betis et al., 2003a,b ). Two main adhes-
ins have been identified in DA strains, the adhesin involved in diffuse adherence
(AIDA-1) and the F1845 fimbriae ( Benz and Schmidt, 1989 ; Bilge et al., 1989 ).
AIDA-1 is a plasmid-encoded 100 kDa autotransporter protein which was ini-
tially identified in an EPEC strain mediating adherence to HeLa cells and dis-
playing the DA phenotype ( Benz and Schmidt, 1989 ; Maurer et al., 1997 ). The
nucleotide sequence of the F1845 fimbriae has significant homology with the
Afa/Dr family of adhesins, which are virulence determinants in uropathogenic
E. coli strains ( Nowicki et al., 2001 ). Considering that approximately 75% of
DAEC strains produce the F1845 or a related adhesin ( Bilge et al., 1989 ), the
role of Afa/Dr adhesins on the DAEC pathogenesis has been the focus of several
studies.
The Afa/Dr adhesin family contains representatives of fimbrial and non-
fimbrial structures, organized in operons consisting of at least five genes and
belonging to the chaperone-usher family of adhesins. These operons are pres-
ent in both diarrheal and uropathogenic E. coli strains and encode for the Afa/
Dr adhesin, an invasin, and proteins required for the secretion and assembly
of the adhesin at the bacterial cell surface (see Chapter 12) ( Servin, 2005 ; Le
Bouguenec and Servin, 2006 ). Afa/Dr adhesins are also classified on the basis
of the host cell receptors that they bind, such as the Dr(a) blood-group antigen
present on the decay-accelerating factor (DAF, CD55), the extracellular matrix
protein collagen IV and/or carcinoembryonic antigen-related cellular adhesion
molecules (CEACAMs) ( Nowicki et al., 2001 ; Berger et al., 2004 ). All these
receptors play a pivotal role in DEAC adherence to the gastrointestinal and uri-
nary tract.
Adherence
Using polarized epithelial cultured cells it was established that Afa/Dr adhes-
ins interact with DAF or CEACAM receptors (CEACAM6 for F1845) and,
as a result, the receptors accumulate underneath the bacteria ( Goluszko
et al., 1999 ; Le Bouguenec et al., 2001 ). This interaction also triggers sig-
nal transduction cascades that control the growth of long finger-like cellular
projections (lamellipodia) which wrap around the bacteria, promoting tight
attachment of the bacteria to the cell surface ( Cookson and Nataro, 1996 ).
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