Abstract

We previously reported that flagellin-expressing Pseudomonas aeruginosa (Pa) provokes NEU1 sialidase-mediated MUC1 ectodomain (MUC1-ED) desialylation and MUC1-ED shedding from murine lungs in vivo. Here, we asked whether Pa in the lungs of patients with ventilator-associated pneumonia might also increase MUC1-ED shedding. The levels of MUC1-ED and Pa-expressed flagellin were dramatically elevated in bronchoalveolar lavage fluid (BALF) harvested from Pa-infected patients, and each flagellin level, in turn, predicted MUC1-ED shedding in the same patient. Desialylated MUC1-ED was only detected in BALF of Pa-infected patients. Clinical Pa strains increased MUC1-ED shedding from cultured human alveolar epithelia, and FlaA and FlaB flagellin-expressing strains provoked comparable levels of MUC1-ED shedding. A flagellin-deficient isogenic mutant generated dramatically reduced MUC1-ED shedding compared with the flagellin-expressing wild-type strain, and purified FlaA and FlaB recapitulated the effect of intact bacteria. Pa:MUC1-ED complexes were detected in the supernatants of alveolar epithelia exposed to wild-type Pa, but not to the flagellin-deficient Pa strain. Finally, human recombinant MUC1-ED dose-dependently disrupted multiple flagellin-driven processes, including Pa motility, Pa biofilm formation, and Pa adhesion to human alveolar epithelia, while enhancing human neutrophil-mediated Pa phagocytosis. Therefore, shed desialylated MUC1-ED functions as a novel flagellin-targeting, Pa-responsive decoy receptor that participates in the host response to Pa at the airway epithelial surface.

Highlights

  • We previously reported that flagellin-expressing Pseudomonas aeruginosa (Pa) provokes NEU1 sialidase-mediated MUC1 ectodomain (MUC1-ED) desialylation and MUC1-ED shedding from murine lungs in vivo

  • We previously reported that Pa increases MUC1-ED shedding using an in vivo mouse model of Pa ­pneumonia[22]

  • Power analysis indicated that this study is 100% powered with these sample sizes to detect different bronchoalveolar lavage fluid (BALF) MUC1-ED levels in Pa-positive (n = 13) vs. Pa-negative (n = 48) patients

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Summary

Introduction

We previously reported that flagellin-expressing Pseudomonas aeruginosa (Pa) provokes NEU1 sialidase-mediated MUC1 ectodomain (MUC1-ED) desialylation and MUC1-ED shedding from murine lungs in vivo. We asked whether Pa in the lungs of patients with ventilator-associated pneumonia might increase MUC1-ED shedding. Ventilator-associated pneumonia (VAP) is defined by the appearance of a new pulmonary infiltrate of infectious origin occurring more than 48 h after endotracheal (ET) i­ntubation[1]. For the diagnosis of VAP, the findings of a new pulmonary infiltrate in the setting of fever, purulent sputum, leukocytosis, and hypoxemia provide a reported sensitivity of 69% and specificity of 75%1. This translates to positive and negative likelihood ratios of 2.5 and 0.06, ­respectively[8]. These bacteria can be introduced into the lower respiratory tract by positive ventilatory ­pressure[10]

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