Abstract

Enterotoxigenic E. coli (ETEC) is a common cause of diarrhea in children in low- and middle-income countries, and in travelers to these countries. ETEC is also an important cause of morbidity and premature mortality in piglets, calves, goat kids and lambs. The major virulence determinants of ETEC are enterotoxins and colonization factors, which enable the pathogen to colonize the small intestine and deliver enterotoxins, such as the heat-stable enterotoxins, STp and STh, to epithelial cells. Because most ETEC strains are host-specific, there are few convenient animal models to investigate the pathogenesis of ETEC infections or to evaluate specific anti-ETEC interventions, such as drugs and vaccines. An exception is ETEC strains bearing F41 pili, which mediate intestinal colonization of various young animals, including neonatal mice, to cause disease and in some cases death. In this study, we used the archetypal F41-producing bovine ETEC strain, B41 (O101:NM; K99, F41, STp) to validate and further explore the contribution of F41 and STp to bacterial virulence. By using targeted gene deletion and trans-complementation studies, augmented by whole genome sequencing, and in vitro and animal studies of virulence, we established that F41 mediates colonization of the mouse intestine and is essential for bacterial virulence. In addition, we showed for the first time that STp is as important as F41 for virulence. Together, these findings validate the use of neonatal mice to study the pathogenesis of F41-bearing ETEC and to investigate possible specific anti-ETEC interventions including vaccines that target heat-stable enterotoxins.

Highlights

  • Enterotoxigenic Escherichia coli (ETEC) is a leading cause of diarrhea in children in low- to middleincome countries and in travelers of all ages to these countries (Qadri et al, 2005; Croxen et al, 2013; Kotloff et al, 2013)

  • Smith and Linggood (1971) showed that both an adhesin (F4/K88) and enterotoxin are required for virulence of Enterotoxigenic E. coli (ETEC) in piglets

  • Their study was facilitated by the facts that (1) both of the virulence factors they investigated were plasmid encoded, making F4- and enterotoxin-negative strains relatively easy to obtain, and (2) piglets are the natural host of F4-positive, enterotoxin-secreting ETEC (Smith and Linggood, 1971)

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Summary

Introduction

Enterotoxigenic Escherichia coli (ETEC) is a leading cause of diarrhea in children in low- to middleincome countries and in travelers of all ages to these countries (Qadri et al, 2005; Croxen et al, 2013; Kotloff et al, 2013). The commonest variety of ST, STa, is highly prevalent in human varieties of ETEC, as well as in strains obtained from newborn domestic animals. It is a weakly antigenic protein comprising 18 (STp) or 19 (STh) amino acids, respectively (Fleckenstein et al, 2010). STh ( known as STIb) is more frequent in ETEC obtained from humans than STp ( known as STIa), these two toxins are structurally similar, have an identical mechanism of action and are antigenically related. 86 kDa) protein containing one A-subunit and five identical B-subunits This toxin resembles cholera toxin structurally, functionally, and antigenically (Kunkel and Robertson, 1979)

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