Abstract

Staphylococcus aureus is the main causative pathogen of subcutaneous, bone, and implant-related infections, forming structures known as staphylococcal abscess communities (SACs) within tissues that also contain immunosuppressive myeloid-derived suppressor cells (MDSCs). Although both SACs and MDSCs are present in chronic S. aureus infections, it remains unknown whether SACs directly trigger MDSC expansion. To investigate this, a previously developed 3D in vitro SAC model was co-cultured with murine and human bone marrow cells. Subsequently, it was shown that SAC-exposed human CD11blow/− myeloid cells or SAC-exposed murine CD11b+ Gr-1+ cells were immunosuppressive mainly by reducing absolute CD4+ and CD8α+ T cell numbers, as shown in T cell proliferation assays and with flow cytometry. Monocytic MDSCs from mice with an S. aureus bone infection also strongly reduced CD4+ and CD8α+ T cell numbers. Using protein biomarker analysis and an immunoassay, we detected in SAC–bone marrow co-cultures high levels of GM-CSF, IL-6, VEGF, IL-1β, TNFα, IL-10, and TGF-β. Furthermore, SAC-exposed neutrophils expressed Arg-1 and SAC-exposed monocytes expressed Arg-1 and iNOS, as shown via immunofluorescent stains. Overall, this study showed that SACs cause MDSC expansion from bone marrow cells and identified possible mediators to target as an additional strategy for treating chronic S. aureus infections.

Highlights

  • Staphylococcus aureus is an opportunistic pathogen that can cause a range of infections, including subcutaneous, bone, and implant-related infections

  • Myeloid-derived suppressor cells (MDSCs) have been associated with chronic S. aureus infections [3,13,14,15,16,17,18], and recently it has been suggested that cells close to staphylococcal abscess communities (SACs) and within abscesses in S. aureus bone infections in mice might be MDSCs [3]

  • SAC model and showed that SAC-exposed human and murine bone marrow cells had immunosuppressive abilities and lowered absolute T cell numbers in a similar manner as monocytic MDSCs isolated from mice with an S. aureus bone infection

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Summary

Introduction

Staphylococcus aureus is an opportunistic pathogen that can cause a range of infections, including subcutaneous, bone, and implant-related infections. A key common feature amongst these infections is biofilm and staphylococcal abscess communities (SACs) [1,2,3,4]. The outer margin of a typical abscess comprises collagen and fibrinogen, which enclose a minority of monocytes and M2 macrophages and many neutrophils, with the fibrinencapsulated SAC at the center [3]. The growth factors granulocyte macrophage colony-stimulating factor (GM-CSF), granulocytecolony-stimulating factor (G-CSF), macrophage-colony-stimulating factor (M-CSF), and vascular endothelial growth factor (VEGF), as well as the cytokine interleukin (IL)-6, are the main drivers of MDSC expansion by activation of the transcription factor STAT3 [7,11,12]

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