Abstract

Respiratory infections with Burkholderia cepacia complex (Bcc) bacteria in cystic fibrosis (CF) are associated with a worse prognosis and increased risk of death. In this work, we assessed the virulence potential of three B. cenocepacia clonal isolates obtained from a CF patient between the onset of infection (isolate IST439) and before death with cepacia syndrome 3.5 years later (isolate IST4113 followed by IST4134), based on their ability to invade epithelial cells and compromise epithelial monolayer integrity. The two clonal isolates retrieved during late-stage disease were significantly more virulent than IST439. Proteomic profiling by 2-D DIGE of the last isolate recovered before the patient’s death, IST4134, and clonal isolate IST439, was performed and compared with a prior analysis of IST4113 vs. IST439. The cytoplasmic and membrane-associated enriched fractions were examined and 52 proteins were found to be similarly altered in the two last isolates compared with IST439. These proteins are involved in metabolic functions, nucleotide synthesis, translation and protein folding, cell envelope biogenesis and iron homeostasis. Results are suggestive of the important role played by metabolic reprogramming in the virulence potential and persistence of B. cenocepacia, in particular regarding bacterial adaptation to microaerophilic conditions. Also, the content of the virulence determinant AidA was higher in the last 2 isolates. Significant levels of siderophores were found to be secreted by the three clonal isolates in an iron-depleted environment, but the two late isolates were more tolerant to low iron concentrations than IST439, consistent with the relative abundance of proteins involved in iron uptake.

Highlights

  • Long-term respiratory infections with Burkholderia cepacia complex (Bcc) bacteria in cystic fibrosis (CF) patients generally lead to an accelerated decline in lung function and, in many cases, to a fatal necrotizing pneumonia known as cepacia syndrome [1,2]

  • To compare the virulence potential of the three B. cenocepacia clonal isolates retrieved during chronic infection examined in this study, polarized epithelial monolayers were separately exposed to isolates IST439, IST4113 and IST4134, and epithelial integrity was analysed

  • Isolate IST439 significantly reduced the transepithelial resistance (TER) of 16HBE14o- (CFTR expressing) monolayers after 8 hours (30%), whereas IST4113 and IST4134 both had a similar impact on TER values as early as 4 hours (Figure 1A)

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Summary

Introduction

Long-term respiratory infections with Burkholderia cepacia complex (Bcc) bacteria in cystic fibrosis (CF) patients generally lead to an accelerated decline in lung function and, in many cases, to a fatal necrotizing pneumonia known as cepacia syndrome [1,2]. We have recently contributed to the elucidation of these adaptive mechanisms based on extensive phenotypic, genotypic and genome-wide expression analysis of selected B. cenocepacia clonal variants [7,8,12,13] These are part of an extensive collection comprising over 700 clinical isolates of different Bcc species, gathered during an 18-year long epidemiological survey of Bcc bacteria involved in respiratory infections at the major Portuguese CF Treatment Centre at Santa Maria Hospital in Lisbon [7,14,15]. Three isolates from the set of 11 variants have been scrutinised by genome-wide expression analyses [12,13]: IST439, the first B. cenocepacia isolate recovered, which presumably initiated the infection; IST4113, obtained almost 3 years later after a period of exacerbated infection and intravenous therapy; and IST4134, the last isolate retrieved from the patient immediately before death with cepacia syndrome

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