Comparative genomics of ocular Pseudomonas aeruginosa strains from keratitis patients with different clinical outcomes.

The several virulence and drug-resistance mechanisms of Pseudomonas aeruginosa responsible for poor clinical outcomes in keratitis patients remain largely unknown. Here, we investigated the distribution of virulence factors and drug resistance by genes, mutations, efflux-pump systems of P. aeruginosa strains from keratitis patients with different clinical outcomes, included of whole-genome sequenced and annotated our five P. aeruginosa strains. Of the large number of virulence genes detected in all the genomes, MDR/XDR strains carry exoU and non-MDR strains carry exoS exotoxin of the type III secretion system, considered as main contributors of keratitis pathogenesis. However, several strain-specific virulence and resistance genes were detected in keratitis strains with poor outcome. Mainly, the flagellar genes fliC and fliD detected in the exoS carrying strains, reported to alter the host immune response, might impact the clinical outcome. This study may provide new insights into the genome of ocular strains and requires further functional studies.

Mechanisms of Fluoroquinolone and Aminoglycoside Resistance in Keratitis-Associated Pseudomonas aeruginosa.

Global emergence of multidrug resistant (MDR) strains limits therapeutic efficacy in Pseudomonas aeruginosa corneal ulcers. Identifying the primary causal factors of resistance shall improve clinical management. In this study, we sought to identify the underlying mechanisms of fluoroquinolone and aminoglycoside resistance in MDR, non-MDR, and drug susceptible P. aeruginosa (n = 19) strains obtained from keratitis patients. Phenotypic assays were performed to study the bacterial growth kinetics, efflux, permeability, and biofilm formation. Mutational alteration of target genes (DNA sequencing), relative expression of efflux system genes (real time PCR), and detection of aminoglycoside modifying enzyme (AME) genes (PCR) were done by molecular methods. We repeatedly found the mutations in quinolone resistance determining region of fluoroquinolone target genes, gyrA and parC, and the presence of AME genes, aph(3″)-I and aph(6)-I, in all MDR isolates. Furthermore, the MDR isolates were largely characterized by slower growth, cytotoxic type III secretion system genotype, better biofilm-forming ability, and the presence of additional AME genes. The non-MDR isolates were resensitized upon inhibition of active efflux or enhancement of membrane permeability. Altogether this study highlights target gene alteration and enzymatic drug modification as the major mechanisms of quinolone and aminoglycoside resistance in P. aeruginosa keratitis isolates.

Autophagy induced by type III secretion system toxins enhances clearance of Pseudomonas aeruginosa from human corneal epithelial cells.

Corneal ulcers caused by Pseudomonas aeruginosa may lead to severe visual disability due to impaired bacterial clearance from corneal tissues. Our purpose was to study the role of autophagy in the intracellular clearance of P. aeruginosa from human corneal epithelial cells (HCET) and its regulation by the bacterial type III secretion system (T3SS) toxins. Nine different corneal ulcer isolates of P. aeruginosa, PAO1 and T3SS mutants of PAO1 were used to infect HCET cells. Induction of autophagy (Immunofluorescence and Western blot) and pro-inflammatory gene expression (real time PCR) by P. aeruginosa and the role of autophagy in intracellular bacterial clearance were studied in the context of T3SS genotypes. The clinical isolates and PAO1 induced autophagy irrespective of the T3SS genotype, whereas the T3SS mutants were relatively defective in inducing autophagy and becn1 gene expression. External induction of autophagy significantly reduced the intracellular load of P. aeruginosa strains that were associated with worst clinical outcomes. The T3SS negative isolate and PAO1ΔexoST were less sensitive to pharmacological modulation of autophagy and had relatively higher replication potential, suggesting a possible mechanism of bacterial survival in the absence of T3SS toxins. Overall, our results highlight a selective role for autophagy in bacterial clearance from corneal epithelial cells and emphasize the pro-autophagic role of bacterial toxins in the context of corneal ulcers.

Human Corneal MicroRNA Expression Profile in Fungal Keratitis.

PURPOSE: MicroRNAs (miRNAs) are small, stable, noncoding RNA molecules with regulatory function and marked tissue specificity that posttranscriptionally regulate gene expression. However, their role in fungal keratitis remains unknown. The purpose of this study was to identify the miRNA profile and its regulatory role in fungal keratitis. METHODS: Normal donor (n = 3) and fungal keratitis (n = 5) corneas were pooled separately, and small RNA deep sequencing was performed using a sequencing platform. A bioinformatics approach was applied to identify differentially-expressed miRNAs and their targets, and select miRNAs were validated by real-time quantitative PCR (qPCR). The regulatory functions of miRNAs were predicted by combining miRNA target genes and pathway analysis. The mRNA expression levels of select target genes were further analyzed by qPCR. RESULTS: By deep sequencing, 75 miRNAs were identified as differentially expressed with fold change greater than 2 and probability score greater than 0.9 in fungal keratitis corneas. The highly dysregulated miRNAs (miR-511-5p, miR-142-3p, miR-155-5p, and miR-451a) may regulate wound healing as they were predicted to specifically target wound inflammatory genes. Moreover, the increased expression of miR-451a in keratitis correlated with reduced expression of its target, macrophage migration inhibitory factor, suggesting possible regulatory functions. CONCLUSIONS: This is, to our knowledge, the first report on comprehensive human corneal miRNA expression profile in fungal keratitis. Several miRNAs with high expression in fungal keratitis point toward their potential role in regulation of pathogenesis. Further insights in understanding their role in corneal wound inflammation may help design new therapeutic strategies.

Genotypic and phenotypic characterization of Pseudomonas aeruginosa isolates from post-cataract endophthalmitis patients.

Endophthalmitis caused by Pseudomonas aeruginosa is associated with rapid disease progression and poor visual outcome due to high virulence of the organism. Our aim was to characterize the virulence determinants of P. aeruginosa causing post-operative endophthalmitis. Repetitive sequence analysis (ERIC PCR) was done to study the clonal relatedness of the 17 P. aeruginosa isolates. Type 3 secretion system (T3SS) genotypes were determined and the isolates were further classified as invasive or cytotoxic based on gentamicin survival, trypan blue dye exclusion and MTT assays. Phenotypically, the strains were characterized based on bacterial motility patterns, biofilm formation, phospholipase production and antibiotic susceptibility patterns. Most of our ocular isolates were invasive in nature and nearly half of them were multi-drug resistant. 47% of the isolates formed a strong biofilm, whereas the rest formed moderate to weak biofilms, which may account for an increased colonization and antibiotic resistance. Although the T3SS genotypes correlated well with the invasive/cytotoxic nature of the strains, none of the genotypes were associated with any particular phenotypic trait. To the best of our knowledge, this is the first report on the phenotypic characteristics of P. aeruginosa strains causing post-operative endophthalmitis. Our findings demonstrate that these strains have higher invasive potential and an ability to form biofilm which possibly contributes to an increased ocular virulence.

Draft Genome Sequences of Staphylococcus aureus AMRF1 (ST22) and AMRF2 (ST672), Ocular Methicillin-Resistant Isolates.

Sequence type 22 (ST22) and ST672 are the two major emerging clones of community-acquired methicillin-resistant Staphylococcus aureus in India. ST672 strains were found to cause severe ocular infections. We report the draft genome sequences of two emerging strains of methicillin-resistant S. aureus, AMRF1 (ST22) and AMRF2 (ST672), isolated from patients with ocular infections.

Draft Genome Sequence of an Invasive Multidrug-Resistant Strain, Pseudomonas aeruginosa BK1, Isolated from a Keratitis Patient.

Pseudomonas aeruginosa infections are difficult to treat due to the presence of a multitude of virulence factors and antibiotic resistance. Here, we report the draft genome sequence of P. aeruginosa BK1, an invasive and multidrug-resistant strain, isolated from a bacterial keratitis patient in southern India.

Sindbis virus induced phosphorylation of IRF3 in human embryonic kidney cells is not dependent on mTOR.

The mammalian target of rapamycin (mTOR) plays critical roles in immunity. We previously showed that infection of human embryonic kidney (HEK) cells with Sindbis virus (SIN), an enveloped RNA alphavirus, profoundly suppresses Akt/mTOR signaling, and host translation late during infection. To understand how SIN mediated suppression of mTOR affects innate response, we analyzed phosphorylation of interferon regulatory factor 3 (IRF3) and expression of two antiviral genes. Here we show strong phosphorylation of IRF3, and an increase in mRNA levels for antiviral genes interferon stimulated gene (ISG)56 and interferon gamma inducible protein (IP)-10 when intracellular viral RNA levels are high during late infection. The mTOR inhibitors rapamycin and torin1 do not block, but mildly upregulate these responses. Even after prolonged treatment with Ly294002, the PI3K inhibitor only partially blocks SIN induced phosphorylation of IRF3. While Ly294002 treatment downregulated the SIN induced expression of ISG56 mRNA levels, it had no effect on SIN induced upregulation of IP-10 expression. These results point to SIN replication-mediated activation of IRF3, independent of mTOR function, when host protein synthesis is severely suppressed by virus infection.

Lipopolysaccharide inhibits Sindbis virus-induced IP-10 release in human peripheral blood mononuclear cells.

Chemokines play a pivotal role in the innate response to both bacterial and viral infections, and in mixed infections. To determine chemokine responses to Sindbis virus (SIN) in a co-infection model, peripheral blood mononuclear cells (PBMCs) derived from healthy volunteers were exposed to SIN in the presence and absence of lipopolysaccharide (LPS). Culture supernatants recovered at 2, 24, and 72 h post-exposure were evaluated for virus replication and analyzed for chemokines by ELISA. None of the PBMC cultures showed new virus release, GFP reporter expression, or viral RNA synthesis. While SIN had little effect on the induction of IL-8 and RANTES, the chemokines MCP-1, MIP1-α (p < 0.001), and MIP1-ß (p < 0.0004) were drastically upregulated by SIN as well as LPS. Both live and UV-inactivated SIN induced secretion of IP-10 and I-TAC. Although LPS did not induce release of IP-10, it sharply inhibited (p = 0.004) SIN-mediated IP-10 secretion. On the contrary, the release of SLC was blocked by SIN. The adjuvant activity of IP-10, its antiangiogenic function, and antagonism between SIN and LPS for the release of select chemokines may be useful in understanding the pathogenesis of mixed infections, cross-talk between cellular pathways, and may have applications in cancer and sepsis.

Sindbis virus replication, is insensitive to rapamycin and torin1, and suppresses Akt/mTOR pathway late during infection in HEK cells.

Genetically engineered Sindbis viruses (SIN) are excellent oncolytic agents in preclinical models. Several human cancers have aberrant Akt signaling, and kinase inhibitors including rapamycin are currently tested in combination therapies with oncolytic viruses. Therefore, it was of interest to delineate possible cross-regulation between SIN replication and PI3K/Akt/mTOR signaling. Here, using HEK293T cells as host, we report the following key findings: (a) robust SIN replication occurs in the presence of mTOR specific inhibitors, rapamycin and torin1 or Ly294002--a PI3K inhibitor, suggesting a lack of requirement for PI3K/Akt/mTOR signaling; (b) suppression of phosphorylation of Akt, mTOR and its effectors S6, and 4E-BP1 occurs late during SIN infection: a viral function that may be beneficial in counteracting cellular drug resistance to kinase inhibitors; (c) Ly294002 and SIN act additively to suppress PI3K/Akt/mTOR pathway with little effect on virus release; and (d) SIN replication induces host translational shut off, phosphorylation of eIF2α and apoptosis. This first report on the potent inhibition of Akt/mTOR signaling by SIN replication, bolsters further studies on the development and evaluation of engineered SIN genotypes in vitro and in vivo for unique cytolytic functions.