Abstract

Polymorphonuclear neutrophils (PMN) are critical for first line innate immune defence against Staphylococcus aureus. Mature circulating PMN maintain a short half-life ending in constitutive apoptotic cell death. This makes them unlikely candidates as a bacterial intracellular niche. However, there is significant evidence to suggest that S. aureus can survive intracellularly within PMN and this contributes to persistence and dissemination during infection. The precise mechanism by which S. aureus parasitizes these cells remains to be established. Herein we propose a novel mechanism by which S. aureus subverts both autophagy and apoptosis in PMN in order to maintain an intracellular survival niche during infection. Intracellular survival of S. aureus within primary human PMN was associated with an accumulation of the autophagic flux markers LC3-II and p62, while inhibition of the autophagy pathway led to a significant reduction in intracellular survival of bacteria. This intracellular survival of S. aureus was coupled with a delay in neutrophil apoptosis as well as increased expression of several anti-apoptotic factors. Importantly, blocking autophagy in infected PMN partially restored levels of apoptosis to that of uninfected PMN, suggesting a connection between the autophagic and apoptotic pathways during intracellular survival. These results provide a novel mechanism for S. aureus intracellular survival and suggest that S. aureus may be subverting crosstalk between the autophagic and apoptosis pathways in order to maintain an intracellular niche within human PMN.

Highlights

  • Staphylococcus aureus is a leading global cause of bloodstream infection and is associated with a higher mortality rate than other bacteraemia, typically 25% [1, 2]

  • In order to determine the ability of S. aureus to survive intracellularly within primary human polymorphonuclear neutrophils (PMN), PMN isolated from the peripheral blood of healthy volunteers were incubated with S. aureus strain PS80 for 1 h before gentamicin treatment to kill any non-phagocytosed extracellular bacteria

  • These results indicate that inhibition of the autophagy pathway impairs the ability of S. aureus to survive intracellularly within human PMN

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Summary

Introduction

Staphylococcus aureus is a leading global cause of bloodstream infection and is associated with a higher mortality rate than other bacteraemia, typically 25% [1, 2]. S. aureus Subverts Autophagy and Apoptosis in PMN relapse of infection has been linked to survival within an intracellular reservoir [4] This ‘Trojan Horse’ theory has been implicated as a contributing factor in recurrent disease, with the indication that S. aureus may be adept at surviving within polymorphonuclear neutrophils (PMN) [5]. We reported that during murine peritoneal infection, S. aureus was found predominantly within PMN disseminated from the peritoneal cavity to the bloodstream [16]. These studies support the notion of intracellular survival in PMN as a possible bacterial virulence mechanism.

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