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1.
Sci Rep ; 10(1): 21535, 2020 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-33299023

RESUMO

The zoonotic enterohemorrhagic Escherichia coli (EHEC) O157: H7 bacterium causes diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS) in humans. Cattle are primary reservoirs and EHEC O157: H7; the bacteria predominately inhabit the colon and recto-anal junctions (RAJ). The early innate immune reactions in the infected gut are critical in the pathogenesis of EHEC O157: H7. In this study, calves orally inoculated with EHEC O157: H7 showed infiltration of neutrophils in the lamina propria of ileum and RAJ at 7 and 14 days post-infection. Infected calves had altered mucin layer and mast cell populations across small and large intestines. There were differential transcription expressions of key bovine ß defensins, tracheal antimicrobial peptide (TAP) in the ileum, and lingual antimicrobial peptide (LAP) in RAJ. The main Gram-negative bacterial/LPS signaling Toll-Like receptor 4 (TLR4) was downregulated in RAJ. Intestinal infection with EHEC O157: H7 impacted the gut bacterial communities and influenced the relative abundance of Negativibacillus and Erysipelotrichaceae in mucosa-associated bacteria in the rectum. Thus, innate immunity in the gut of calves showed unique characteristics during infection with EHEC O157: H7, which occurred in the absence of major clinical manifestations but denoted an active immunological niche.


Assuntos
Infecções por Escherichia coli/imunologia , Escherichia coli O157/metabolismo , Microbioma Gastrointestinal/imunologia , Adesinas Bacterianas/imunologia , Animais , Bovinos , Doenças dos Bovinos/imunologia , Diarreia/microbiologia , Escherichia coli O157/patogenicidade , Proteínas de Escherichia coli/imunologia , Síndrome Hemolítico-Urêmica/microbiologia , Íleo/patologia , Reto/microbiologia
2.
Vaccine ; 36(27): 3949-3959, 2018 06 22.
Artigo em Inglês | MEDLINE | ID: mdl-29807709

RESUMO

Escherichia coli O157:H7 is a zoonotic pathogen of global importance and the serotype of Shiga toxin-producing E.coli (STEC) most frequently associated with Hemolytic Uremic Syndrome (HUS) in humans. The main STEC reservoir is cattle. Vaccination of calves with the carboxy-terminal fraction of Intimin γ (IntC280) and EspB can reduce E.coli O157:H7 fecal shedding after experimental challenge. Shiga toxin (Stx) exerts local immunosuppressive effects in the bovine intestine and Stx2B fused to Brucella lumazine synthase (BLS-Stx2B) induces Stx2-neutralizing antibodies. To determine if an immune response against Stx could improve a vaccine's effect on fecal shedding, groups of calves were immunized with EspB + IntC280, with EspB + IntC280 + BLS-Stx2B, or kept as controls. At 24 days post vaccination calves were challenged with E.coli O157:H7. Shedding of E.coli O157:H7 was assessed in recto-anal mucosal swabs by direct plating and enrichment followed by immunomagnetic separation and multiplex PCR. Calves were euthanized 15 days after the challenge and intestinal segments were obtained to assess mucosal antibodies. Vaccination induced a significant increase of IntC280 and EspB specific antibodies in serum and intestinal mucosa in both vaccinated groups. Antibodies against Stx2B were detected in serum and intestinal mucosa of animals vaccinated with 3 antigens. Sera and intestinal homogenates were able to neutralize Stx2 verocytotoxicity compared to the control and the 2-antigens vaccinated group. Both vaccines reduced E.coli O157:H7 shedding compared to the control group. The addition of Stx2B to the vaccine formulation did not result in a superior level of protection compared to the one conferred by IntC280 and EspB alone. It remains to be determined if the inclusion of Stx2B in the vaccine alters E.coli O157:H7 shedding patterns in the long term and after recurrent low dose exposure as occurring in cattle herds.


Assuntos
Adesinas Bacterianas/imunologia , Proteínas da Membrana Bacteriana Externa/imunologia , Infecções por Escherichia coli/veterinária , Escherichia coli O157/imunologia , Proteínas de Escherichia coli/imunologia , Vacinas contra Escherichia coli/administração & dosagem , Síndrome Hemolítico-Urêmica/prevenção & controle , Toxina Shiga II/imunologia , Zoonoses/prevenção & controle , Adesinas Bacterianas/genética , Animais , Anticorpos Antibacterianos/sangue , Anticorpos Neutralizantes/sangue , Proteínas da Membrana Bacteriana Externa/genética , Derrame de Bactérias , Bovinos , Infecções por Escherichia coli/prevenção & controle , Proteínas de Escherichia coli/genética , Vacinas contra Escherichia coli/imunologia , Vacinas contra Escherichia coli/uso terapêutico , Fezes/microbiologia , Humanos , Imunidade Humoral/imunologia , Mucosa Intestinal/imunologia , Masculino , Toxina Shiga II/genética , Vacinação/veterinária , Vacinas Sintéticas/administração & dosagem , Vacinas Sintéticas/imunologia , Vacinas Sintéticas/uso terapêutico
3.
Vaccine ; 36(13): 1728-1735, 2018 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-29483033

RESUMO

E. coli O157:H7 is a foodborne pathogen responsible for bloody diarrhea, hemorrhagic colitis and hemolytic uremic syndrome (HUS). The objective of the present work was to evaluate the ability of colostral IgG obtained from Stx2-immunized cows to prevent against E. coli O157:H7 infection and Stx2 cytotoxicity. Hyperimmune colostrum (HC) was obtained from cows intramuscularly immunized with inactivated Stx2 or vehicle for controls. Colostral IgG was purified by affinity chromatography. Specific IgG antibodies against Stx2 and bovine lactoferrin (bLF) levels in HC and the corresponding IgG (HC-IgG/bLF) were determined by ELISA. The protective effects of HC-IgG/bLF against Stx2 cytotoxicity and adhesion of E. coli O157:H7 and its Stx2-negative mutant were analyzed in HCT-8 cells. HC-IgG/bLF prevention against E. coli O157:H7 was studied in human colon and rat colon loops. Protection against a lethal dose of E. coli O157:H7 was evaluated in a weaned mice model. HC-IgG/bLF showed high anti-Stx2 titers and high bLF levels that were able to neutralize the cytotoxic effects of Stx2 in vitro and in vivo. Furthermore, HC-IgG/bLF avoided the inhibition of water absorption induced by E. coli O157:H7 in human colon and also the pathogenicity of E. coli O157:H7 and E. coli O157:H7Δstx2 in rat colon loops. Finally, HC-IgG/bLF prevented in a 100% the lethality caused by E. coli O157:H7 in a weaned mice model. Our study suggests that HC-IgG/bLF have protective effects against E. coli O157:H7 infection. These beneficial effects may be due to specific anti-Stx2 neutralizing antibodies in combination with high bLF levels. These results allow us to consider HC-IgG/bLF as a nutraceutical tool which could be used in combination with balanced supportive diets to prevent HUS. However further studies are required before recommendations can be made for therapeutic and clinical applications.


Assuntos
Anticorpos Antibacterianos/imunologia , Anticorpos Neutralizantes/imunologia , Doenças dos Bovinos/imunologia , Doenças dos Bovinos/microbiologia , Infecções por Escherichia coli/veterinária , Escherichia coli O157/imunologia , Lactoferrina/biossíntese , Toxina Shiga II/imunologia , Animais , Anticorpos Antibacterianos/biossíntese , Anticorpos Neutralizantes/biossíntese , Especificidade de Anticorpos/imunologia , Bovinos , Linhagem Celular Tumoral , Colo/imunologia , Colo/metabolismo , Colo/microbiologia , Colo/patologia , Escherichia coli O157/patogenicidade , Feminino , Síndrome Hemolítico-Urêmica/veterinária , Humanos , Imunização , Imunoglobulina G/imunologia , Masculino , Camundongos , Testes de Neutralização , Gravidez , Ratos
4.
PLoS One ; 12(1): e0169422, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28046078

RESUMO

Ruminants are the primary reservoir of Shiga-toxin producing Escherichia coli (STEC) O157:H7 and the main source of infection for humans. The aim of this study was to assess the immunogenic properties of a candidate vaccine consisting on the recombinant proteins of E. coli O157:H7 IntiminC280, the carboxy-terminal fraction of Intimin γ, EspB and the fusion protein between the B subunit of Stx2 and Brucella Lumazine Synthase (BLS)(BLS-Stx2B), in Holstein Fresian calves.To accomplish this goal we vaccinated calves with two doses of different vaccine formulations: 2 antigens (IntiminC280, EspB), 3 antigens (IntiminC280, EspB, BLS-Stx2B), BLS-Stx2B alone and a control non-vaccinated group. All antigens were expressed as recombinant proteins in E. coli. Specific IgG titres increased in vaccinated calves and the inclusion of BLS-Stx2B in the formulation seems to have a stimulatory effect on the humoral response to IntiminC280 and EspB after the booster. The neutralizing activity of antibodies against these two antigens was assessed in Red Blood Cell lysis assays and adherence to Hep-2 cells as a correlate of T3SS activity. Both sera from animals vaccinated with 2 or 3 antigens inhibited both virulence properties. Serological response to Stx2 was observed in animals vaccinated only with BLS-Stx2B and with 3 antigens and neutralization of Stx2 cytotoxicity was also observed in both groups. In conclusion, immunization of calves with BLS-Stx2B, IntiminC280 and EspB elicited a potent humoral response able to neutralize Shiga toxin 2 cytotoxity and the T3SS virulence properties in vitro. These results suggest that this formulation is a good candidate vaccine to reduce STEC shedding in cattle and needs to be further assessed in vivo.


Assuntos
Doenças dos Bovinos/imunologia , Bovinos/imunologia , Infecções por Escherichia coli/veterinária , Vacinas contra Escherichia coli/imunologia , Toxina Shiga II/imunologia , Sistemas de Secreção Tipo III , Adesinas Bacterianas/metabolismo , Animais , Anticorpos Antibacterianos/sangue , Proteínas da Membrana Bacteriana Externa/metabolismo , Derrame de Bactérias , Doenças dos Bovinos/microbiologia , Adesão Celular , Chlorocebus aethiops , Eritrócitos/microbiologia , Infecções por Escherichia coli/imunologia , Escherichia coli O157/patogenicidade , Proteínas de Escherichia coli/metabolismo , Imunidade Humoral , Imunoglobulina G/sangue , Masculino , Proteínas Recombinantes/imunologia , Células Vero , Virulência
5.
Int J Med Microbiol ; 303(1): 9-15, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23312797

RESUMO

Many animal and human pathogenic Gram-negative bacteria such as Salmonella, Yersinia, enterohemorrhagic Escherichia coli (EHEC), and enteropathogenic Escherichia coli (EPEC) possess a type III secretion system (TTSS) that is used to deliver virulence proteins directly into the host cell. Recent evidence has suggested that CoilA and CoilB, two synthetic peptides corresponding to coiled-coil domains of the translocator protein EspA, are effective in inhibiting the action of TTSS from EPEC. In the current study, the action of these coiled-coil peptides on the TTSS of EHEC O157:H7 and Citrobacter rodentium was examined. CoilA and CoilB showed to be effective in reducing the red blood cell lysis mediated by EHEC O157:H7 and the in vitro secretion of translocator proteins EspB and EspD by EHEC O157:H7 and EspD by C. rodentium. Treatment of mice with CoilA and CoilB peptides prevented colon damage when the animals were inoculated with C. rodentium. Colon samples of the non-treated group showed areas with loss of superficial epithelium, damaged cells, and endoluminal mononuclear inflammatory infiltrate, consistent with histological lesions induced by C. rodentium, whereas mice treated with the synthetic peptides displayed normal surface epithelium showing a similar structure as the uninfected control group. These encouraging results prompt us to test coiled-coil peptides as treatment or vaccines in other models of bacterial infections in future work.


Assuntos
Proteínas da Membrana Bacteriana Externa/metabolismo , Citrobacter rodentium/efeitos dos fármacos , Infecções por Enterobacteriaceae/tratamento farmacológico , Escherichia coli O157/efeitos dos fármacos , Proteínas de Escherichia coli/metabolismo , Peptídeos/farmacologia , Sequência de Aminoácidos , Animais , Citrobacter rodentium/patogenicidade , Colo/efeitos dos fármacos , Colo/microbiologia , Colo/patologia , Infecções por Enterobacteriaceae/microbiologia , Infecções por Enterobacteriaceae/patologia , Eritrócitos/efeitos dos fármacos , Eritrócitos/microbiologia , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/patologia , Escherichia coli O157/patogenicidade , Proteínas de Escherichia coli/química , Proteínas de Escherichia coli/efeitos dos fármacos , Feminino , Hemólise/efeitos dos fármacos , Humanos , Intestinos/efeitos dos fármacos , Intestinos/microbiologia , Intestinos/patologia , Camundongos , Camundongos Endogâmicos C57BL , Viabilidade Microbiana/efeitos dos fármacos , Dados de Sequência Molecular , Estrutura Terciária de Proteína , Alinhamento de Sequência
6.
Vaccine ; 29(23): 3962-8, 2011 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-21477674

RESUMO

Enterohaemorrhagic Escherichia coli (EHEC) O157:H7 is the most prevalent EHEC serotype that has been recovered from patients with haemolytic uremic syndrome (HUS) worldwide. Vaccination of cattle, the main reservoir of EHEC O157:H7, could be a logical strategy to fight infection in humans. This study evaluated a vaccine based on the carboxyl-terminal fragment of 280 amino acids of γ-intimin (γ-intimin C280) and EspB, two key colonization factors of E. coli O157:H7. Intramuscular immunization elicited significantly high levels of serum IgG antibodies against both proteins. Antigen-specific IgA and IgG were also induced in saliva, but only the IgA response was significant. Following experimental challenge with E. coli O157:H7, a significant reduction in bacterial shedding was observed in vaccinated calves, compared to control group. These promising results suggest that systemic immunization of cattle with intimin and EspB could be a feasible strategy to reduce EHEC O157:H7 faecal shedding in cattle.


Assuntos
Adesinas Bacterianas/imunologia , Proteínas da Membrana Bacteriana Externa/imunologia , Derrame de Bactérias/fisiologia , Doenças dos Bovinos/prevenção & controle , Escherichia coli O157/imunologia , Proteínas de Escherichia coli/imunologia , Vacinas contra Escherichia coli/administração & dosagem , Fezes/microbiologia , Adesinas Bacterianas/administração & dosagem , Adesinas Bacterianas/genética , Animais , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Proteínas da Membrana Bacteriana Externa/administração & dosagem , Proteínas da Membrana Bacteriana Externa/genética , Bovinos , Doenças dos Bovinos/imunologia , Doenças dos Bovinos/microbiologia , Infecções por Escherichia coli/imunologia , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/prevenção & controle , Infecções por Escherichia coli/veterinária , Escherichia coli O157/patogenicidade , Proteínas de Escherichia coli/administração & dosagem , Proteínas de Escherichia coli/genética , Vacinas contra Escherichia coli/genética , Vacinas contra Escherichia coli/imunologia , Injeções Intramusculares , Masculino , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/genética , Proteínas Recombinantes/imunologia , Resultado do Tratamento , Vacinação
7.
J Vet Diagn Invest ; 23(2): 254-9, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21398444

RESUMO

Non-enterotoxin (CPE)-producing Clostridium perfringens type A has been associated with enteritis in calves. Recent evidence has suggested that a novel toxin, named beta2 (CPB2), is implicated in the pathogenesis of this disease, although there is little evidence supporting this. In the current study, the role of C. perfringens type A in an outbreak of enteritis in calves was studied. Two 20-day-old dairy calves exhibiting apathy and reluctance to eat, with paresis of the anterior limbs, were euthanized for postmortem examination. Gross and histological changes compatible with acute enteritis, rumenitis, meningitis, and pneumonia were seen in both calves. Clostridium perfringens type A non-CPE, non-CPB2 was isolated from the abomasum and the small intestine. Escherichia coli ONTH8 (with cdtBIII and f17 virulence genes detected by polymerase chain reaction) was also isolated from the brain, abomasum, and intestine from both calves. All the samples were negative for Salmonella spp. When the C. perfringens strain was inoculated into bovine ligated small and large intestinal loops, cell detachment, erosion, and hemorrhage of the lamina propria were observed, predominantly in the small intestine. The results suggest that non-CPE, non-CPB2 C. perfringens type A is able to induce pathologic changes in the intestine of calves, probably enhanced by other pathogens, such as some pathogenic E. coli strains.


Assuntos
Doenças dos Bovinos/microbiologia , Infecções por Clostridium/veterinária , Clostridium perfringens/isolamento & purificação , Enterite/microbiologia , Enterite/veterinária , Animais , Bovinos , Doenças dos Bovinos/diagnóstico , Doenças dos Bovinos/patologia , Infecções por Clostridium/diagnóstico , Infecções por Clostridium/microbiologia , Infecções por Clostridium/patologia , Clostridium perfringens/genética , Enterite/diagnóstico , Enterite/patologia , Evolução Fatal , Feminino , Laparotomia/veterinária
8.
PLoS One ; 5(2): e9046, 2010 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-20140230

RESUMO

BACKGROUND: Enteropathogenic E. coli (EPEC) and enterohemorrhagic E. coli (EHEC) are two categories of E. coli strains associated with human disease. A major virulence factor of both pathotypes is the expression of a type three secretion system (TTSS), responsible for their ability to adhere to gut mucosa causing a characteristic attaching and effacing lesion (A/E). The TTSS translocates effector proteins directly into the host cell that subvert mammalian cell biochemistry. METHODS/PRINCIPAL FINDINGS: We examined synthetic peptides designed to inhibit the TTSS. CoilA and CoilB peptides, both representing coiled-coil regions of the translocator protein EspA, and CoilD peptide, corresponding to a coiled-coil region of the needle protein EscF, were effective in inhibiting the TTSS dependent hemolysis of red blood cells by the EPEC E2348/69 strain. CoilA and CoilB peptides also reduced the formation of actin pedestals by the same strain in HEp-2 cells and impaired the TTSS-mediated protein translocation into the epithelial cell. Interestingly, CoilA and CoilB were able to block EspA assembly, destabilizing the TTSS and thereby Tir translocation. This blockage of EspA polymerization by CoilA or CoilB peptides, also inhibited the correct delivery of EspB and EspD as detected by immunoblotting. Interestingly, electron microscopy of bacteria incubated with the CoilA peptide showed a reduction of the length of EspA filaments. CONCLUSIONS: Our data indicate that coiled-coil peptides can prevent the assembly and thus the functionality of the TTSS apparatus and suggest that these peptides could provide an attractive tool to block EPEC and EHEC pathogenesis.


Assuntos
Proteínas do Citoesqueleto/metabolismo , Escherichia coli Enteropatogênica/efeitos dos fármacos , Escherichia coli Enteropatogênica/metabolismo , Proteínas de Escherichia coli/metabolismo , Peptídeos/farmacologia , Sequência de Aminoácidos , Animais , Proteínas da Membrana Bacteriana Externa/metabolismo , Western Blotting , Linhagem Celular Tumoral , Proteínas do Citoesqueleto/química , Eritrócitos/efeitos dos fármacos , Eritrócitos/microbiologia , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/química , Proteínas de Escherichia coli/ultraestrutura , Hemólise/efeitos dos fármacos , Humanos , Viabilidade Microbiana/efeitos dos fármacos , Microscopia Imunoeletrônica , Dados de Sequência Molecular , Peptídeos/síntese química , Transporte Proteico/efeitos dos fármacos , Ovinos
9.
Vaccine ; 26(44): 5662-7, 2008 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-18675866

RESUMO

Mucosal vaccine formulations based on purified recombinant C280 gamma-Intimin and EspB (Escherichia coli secreted protein B) from enterohaemorragic E. coli co-administered with a pegylated derivative of the TLR2/6 agonist MALP-2 (macrophage-activating lipopeptide) as adjuvant were evaluated in BALB/c mice. After intranasal vaccination, strong humoral and cellular immune responses were observed against C280 gamma-Intimin and EspB. Sera of immunized mice inhibit bacterial haemolytic activity in vitro. Antigen-specific T-cell proliferation, IL-4, IL-2 and IFN-gamma producing cells, and secretory IgA were mostly detected in animals receiving MALP-2 as adjuvant. These results suggest that C280 gamma-Intimin and EspB are good candidate antigens to be incorporated into mucosal vaccines against this important pathogen.


Assuntos
Adesinas Bacterianas/imunologia , Adjuvantes Imunológicos , Proteínas da Membrana Bacteriana Externa/imunologia , Escherichia coli Êntero-Hemorrágica/imunologia , Proteínas de Escherichia coli/imunologia , Vacinas contra Escherichia coli/administração & dosagem , Lipopeptídeos/imunologia , Administração Intranasal , Animais , Anticorpos Antibacterianos/sangue , Infecções por Escherichia coli/imunologia , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/prevenção & controle , Vacinas contra Escherichia coli/imunologia , Feminino , Ativação Linfocitária/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Linfócitos T/imunologia , Receptor 2 Toll-Like/agonistas , Receptor 6 Toll-Like/agonistas , Vacinação
10.
Clin Vaccine Immunol ; 15(8): 1208-13, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18562563

RESUMO

Enterohemorrhagic Escherichia coli (EHEC) is the main cause of hemolytic-uremic syndrome, an endemic disease in Argentina which had an incidence in 2005 of 13.9 cases per 100,000 children younger than 5 years old. Cattle appear to be a major reservoir of EHEC, and a serological response to EHEC antigens has been demonstrated in natural and experimental infections. In the current study, antibodies against proteins implicated in EHEC's ability to form attaching and effacing lesions, some of which are exported to the host cell via a type three secretion system (TTSS), were identified in bovine colostrum by Western blot analysis. Twenty-seven (77.0%) of the 35 samples examined contained immunoglobulin G (IgG) antibodies against the three proteins assayed in this study: EspA, EspB, and the carboxy-terminal 280 amino acids of gamma-intimin, an intimin subtype associated mainly with O157:H7 and O145:H- serotypes. Every colostrum sample was able to inhibit, in a range between 45.9 and 96.7%, the TTSS-mediated hemolytic activity of attaching and effacing E. coli. The inhibitory effect was partially mediated by IgG and lactoferrin. In conclusion, we found that early colostrum from cows contains antibodies, lactoferrin, and other unidentified substances that impair TTSS function in attaching and effacing E. coli strains. Bovine colostrum might act by reducing EHEC colonization in newborn calves and could be used as a prophylactic measure to protect non-breast-fed children against EHEC infection in an area of endemicity.


Assuntos
Adesinas Bacterianas/imunologia , Proteínas da Membrana Bacteriana Externa/imunologia , Colostro/imunologia , Escherichia coli Êntero-Hemorrágica/patogenicidade , Proteínas de Escherichia coli/imunologia , Imunoglobulina G/imunologia , Adesinas Bacterianas/genética , Adesinas Bacterianas/metabolismo , Animais , Anticorpos Antibacterianos/análise , Anticorpos Antibacterianos/imunologia , Argentina , Proteínas da Membrana Bacteriana Externa/genética , Proteínas da Membrana Bacteriana Externa/metabolismo , Bovinos , Colostro/química , Escherichia coli Êntero-Hemorrágica/genética , Escherichia coli Êntero-Hemorrágica/metabolismo , Escherichia coli O157/genética , Escherichia coli O157/metabolismo , Escherichia coli O157/patogenicidade , Proteínas de Escherichia coli/genética , Proteínas de Escherichia coli/metabolismo , Feminino , Hemólise/imunologia , Humanos , Imunoglobulina G/análise , Lactoferrina/análise , Fatores de Virulência/genética , Fatores de Virulência/imunologia , Fatores de Virulência/metabolismo
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