Abstract

Mycobacterium tuberculosis (Mtb) has complex and dynamic interactions with the human host, and subpopulations of Mtb that emerge during infection can influence disease outcomes. This study implicates zinc ion (Zn2+) availability as a likely driver of bacterial phenotypic heterogeneity in vivo. Zn2+ sequestration is part of “nutritional immunity”, where the immune system limits micronutrients to control pathogen growth, but this defense mechanism seems to be ineffective in controlling Mtb infection. Nonetheless, Zn2+-limitation is an environmental cue sensed by Mtb, as calprotectin triggers the zinc uptake regulator (Zur) regulon response in vitro and co-localizes with Zn2+-limited Mtb in vivo. Prolonged Zn2+ limitation leads to numerous physiological changes in vitro, including differential expression of certain antigens, alterations in lipid metabolism and distinct cell surface morphology. Furthermore, Mtb enduring limited Zn2+ employ defensive measures to fight oxidative stress, by increasing expression of proteins involved in DNA repair and antioxidant activity, including well described virulence factors KatG and AhpC, along with altered utilization of redox cofactors. Here, we propose a model in which prolonged Zn2+ limitation defines a population of Mtb with anticipatory adaptations against impending immune attack, based on the evidence that Zn2+-limited Mtb are more resistant to oxidative stress and exhibit increased survival and induce more severe pulmonary granulomas in mice. Considering that extracellular Mtb may transit through the Zn2+-limited caseum before infecting naïve immune cells or upon host-to-host transmission, the resulting phenotypic heterogeneity driven by varied Zn2+ availability likely plays a key role during early interactions with host cells.

Highlights

  • The success of Mycobacterium tuberculosis (Mtb) as a human pathogen is enabled by a genetic arsenal that allows it to withstand a myriad of immune defenses, survive in diverse host environments, and establish persistent infection [1]

  • Our results suggest that host-pathogen interactions are influenced by pre-exposure of Mtb to Zn2+ and mycobacteria that transit through a Zn2+-depleted microenvironment are primed to withstand impending oxidative stress upon subsequent contact with immune cells in the same, or a naïve host

  • Considering that the standard mycobacterial media recapitulates a Zn2+-replete environment, the Zn2+-dependent phenotype of the pathogen may confound our fundamental understanding of initial interactions between Mtb and immune cells

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Summary

Introduction

The success of Mycobacterium tuberculosis (Mtb) as a human pathogen is enabled by a genetic arsenal that allows it to withstand a myriad of immune defenses, survive in diverse host environments, and establish persistent infection [1]. Disease outcome is influenced by subpopulations of Mtb arising within heterogeneous microenvironments in vivo, but specific cues from the host leading to their development are mostly unknown [2,3,4,5]. As TB disease progresses, neutrophils infiltrate granulomas, promoting necrosis of unresolved Mtbinfected immune cells [3,10]. Necrotic cells release their contents, including Mtb, into the extracellular milieu, a microenvironment rich in neutrophil-derived Zn2+ and Mn2+-binding protein calprotectin (CP), part of the ‘nutritional immunity’ host response [10]. As with many other bacteria, Mtb has a Zn2+-responsive transcriptional repressor–zinc uptake regulator (Zur) that controls 21 genes with upregulated expression during Zn2+limiting conditions [11]. Since [Zn2+] is tied to specific microenvironments in vivo, it may cue

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