Yersinia pestis is the causative agent of disease in a variety of mammals, and humans can become infected when human and animal ecologies intersect. This has led to several pandemics of plague in human history, and infection with Y. pestis is currently considered by the WHO as a re-emerging infectious disease because of the increased incidence in a wide number of countries. Bubonic plague is the most common form of disease and the untreated mortality rate is estimated at 40-70%. A number of recent studies from several groups suggest that Y. pestis actively causes immunosuppression early during infection. Furthermore, recent studies have shown that very early events after inoculation are responsible for determining the outcome of infection. One of the first steps in the pathogenesis of bubonic plague is dissemination of the pathogen from the inoculation site (IS) to the draining lymph node (DLN). It has long been believed that the bacteria disseminate to the DLN by trafficking in phagocytic cells. However, there is strikingly little in vivo data demonstrating this. We hypothesize that Y. pestis actively influences these early dissemination events by interacting with key components of the host innate response. Our long-term goal is to understand the mechanism of dissemination of Y. pestis from the IS to the DLN. Using an intradermal route (the route that most closely mimics that of the flea) of inoculation and a dissemination assay we recently developed, we are able to monitor the transit of bacteria to the DLN from the IS, and subsequently to systemic tissues. Here, we will specifically test in vivo (a) the widely held belief that phagocytic cells are important for traffiking Y. pestis from the IS to the DLN, and (b) effects by the Y. pestis virulence factors known to affect interactions with phagocytic cells in vitro for their impact on early dissemination to the DLN.

Public Health Relevance

Yersinia pestis, a highly pathogenic bacterium, is the causative agent of disease in humans with bubonic plague being the most frequent form of the disease. Because of the increase in incidence in a wide number of countries, infection with Y. pestis is currently considered by the WHO as a re-emerging infectious disease. There also is significant concern that Y. pestis may be used as a bioterrorism agent due to its ease of aerosol dissemination and very rapid progression of disease. The very earliest interactions occurring between the host and Y. pestis appear to be the most important in terms of determining outcome for the patient, yet these interactions are the least well understood aspects of Y. pestis pathogenesis. A better understanding of this interplay is essential in order to develop prophylactics and therapeutics.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Exploratory/Developmental Grants (R21)
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Special Emphasis Panel (ZRG1-IDM-A (80))
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Mukhopadhyay, Suman
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University of North Carolina Chapel Hill
Internal Medicine/Medicine
Schools of Medicine
Chapel Hill
United States
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