Abstract

This study investigated the role of the antimicrobial peptide cathelicidin in Escherichia coli O157:H7 infection and subsequent renal damage. Mouse and human cathelicidin, CRAMP and LL-37, respectively, killed E. coli O157:H7 in vitro. Intestines from healthy wild-type (129/SvJ) and cathelicidin-knock-out (Camp−/−) mice were investigated, showing that cathelicidin-deficient mice had a thinner colonic mucus layer compared with wild-type mice. Wild-type (n = 11) and cathelicidin-knock-out (n = 11) mice were inoculated with E. coli O157:H7. Cathelicidin-deficient animals exhibited higher fecal counts of E. coli O157:H7 and bacteria penetrated the mucus forming attaching-and-effacing lesions to a much higher extent than in wild-type animals. Cathelicidin knock-out mice developed symptoms (9/11) as well as anemia, thrombocytopenia and extensive renal tubular damage while all cathelicidin-producing mice remained asymptomatic with normal laboratory findings. When injected with Shiga toxin intraperitoneally, both murine strains developed the same degree of renal tubular damage and clinical disease indicating that differences in sensitivity to infection between the murine strains were related to the initial intestinal response. In conclusion, cathelicidin substantially influenced the antimicrobial barrier in the mouse colon mucosa. Cathelicidin deficiency lead to increased susceptibility to E. coli O157:H7 infection and subsequent renal damage. Administration of cathelicidin or stimulation of endogenous production may prove to be novel treatments for E. coli O157:H7-induced hemolytic uremic syndrome.

Highlights

  • In humans, infection with enterohemorrhagic Escherichia coli (EHEC) often causes diarrhea

  • 1 mM, corresponding to 4.4 mg/ml CRAMP and the minimal inhibitory concentrations (MIC) of the peptide was between 5–10 mM, corresponding to 22–44 mg/ml CRAMP

  • CRAMP-deficient mice have a thinner layer of mucus in the colon

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Summary

Introduction

Infection with enterohemorrhagic Escherichia coli (EHEC) often causes diarrhea. EHEC adheres intimately to the intestinal mucosa and forms attaching and effacing lesions [2]. These lesions are characterized by close contact between the bacteria and epithelial cells and effacement of intestinal microvilli [3]. The intimate attachment and destruction of the intestinal epithelium enable secretion of bacterial virulence factors into the systemic circulation. The toxin secreted in the intestine circulates bound to blood cells (neutrophils, monocytes and platelets) before reaching its target organs [5]. HUS is characterized by nonimmune microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure and is a major cause of acute kidney injury in children [7]

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