Abstract

Young age is a risk factor for prolonged colonization by common pathogens residing in their upper respiratory tract (URT). Why children present with more persistent colonization is unknown and there is relatively little insight into the host-pathogen interactions that contribute to persistent colonization. To identify factors permissive for persistent colonization during infancy, we utilized an infant mouse model of Streptococcus pneumoniae colonization in which clearance from the mucosal surface of the URT requires many weeks to months. Loss of a single bacterial factor, the pore-forming toxin pneumolysin (Ply), and loss of a single host factor, IL-1α, led to more persistent colonization. Exogenous administration of Ply promoted IL-1 responses and clearance, and intranasal treatment with IL-1α was sufficient to reduce colonization density. Major factors known to affect the duration of natural colonization include host age and pneumococcal capsular serotype. qRT-PCR analysis of the uninfected URT mucosa showed reduced baseline expression of genes involved in IL-1 signaling in infant compared to adult mice. In line with this observation, IL-1 signaling was important in initiating clearance in adult mice but had no effect on early colonization of infant mice. In contrast to the effect of age, isogenic constructs of different capsular serotype showed differences in colonization persistence but induced similar IL-1 responses. Altogether, this work underscores the importance of toxin-induced IL-1α responses in determining the outcome of colonization, clearance versus persistence. Our findings about IL-1 signaling as a function of host age may provide an explanation for the increased susceptibility and more prolonged colonization during early childhood.

Highlights

  • Respiratory tract infections remain a leading cause of childhood morbidity and mortality worldwide

  • Opportunistic pathogens are often carried in the upper respiratory tract (URT) for prolonged periods of time

  • We identified that clearance is dictated by bacterial expression of a single pneumococcal toxin, pneumolysin, and by the host response via a single cytokine, IL-1α, that activates IL-1 signaling

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Summary

Introduction

Respiratory tract infections remain a leading cause of childhood morbidity and mortality worldwide. Epidemiological studies have demonstrated young age to be a risk factor for colonization of common respiratory tract pathogens, including Streptococcus pneumoniae (pneumococcus) [2, 3]. Pneumococcal colonization of the URT is prolonged in young children compared to adults [7,8,9]. This increased persistence of S. pneumoniae in young children is suggestive of a more commensal relationship between bacteria and host. Why young children present with more prolonged colonization by bacteria residing on the mucosal surfaces of the URT, like S. pneumoniae, is unknown

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