Control of Neisseria meningitidis and N. gonorrhoeae infections represents a major public health problem around the world due to increased antibiotic resistance and the lack of vaccines for N. meningitidis serogroup B and N. gonorrhoeae. Our long-term goal is to define molecular determinants of Neisserial pathogenicity to enable development of new therapeutics, to permit rapid assessment of bacterial virulence, to identify patients requiring aggressive treatment, and to facilitate vaccine design. Among the recognized Neisserial virulence factors, lipooligosaccharide (LOS) is a major inducer of the proinflammatory cytokine response to the organisms. Our work and that of others has shown that the lipid A (LA) portion of Neisserial LOS engages innate immune receptor toll-like receptor 4 (TLR4) to initiate a signaling cascade leading to cytokine expression by various cell types such as monocytes, neutrophils, and mucosal epithelial cells. The TLR4 pathway is required for an efficient immune response that protects the host from bacterial infection, but its activation can also induce a proinflammatory state leading to septic shock and death. We have shown that native LOS from different Neisserial strains has variability in both acylation and phosphorylation of LA which is correlated with its potency to induce the same inflammatory cytokines in vitro that are found in patients with meningococcal infection. We also have demonstrated that specific phosphoryl and acyl variants of LA from N. meningitidis strain 89I have differential capacities to induce TNF-1 in human monocytes. We recently confirmed that Neisserial LOS activates both MyD88-dependent and TRIF-dependent pathways through NF-:B and IFN regulatory factor 3 (IRF-3) transcription factors, and to our knowledge, will be the first to report that direct activation of NF-:B is positively correlated with a greater number of phosphoryl substituents. We also have found that MIP-11 and MIP-12 were higher in cells treated with LOS containing LA that had the most phosphoryl substitutions. These data support our overall hypotheses that the inflammatory potential of LA increases with increasing number of phosphoryl substituents, and that variation in the LA structure within the LOS of different Neisserial strains is the major determinant of the degree to which the innate immune system responds to Neisserial infection. Based on the key role of TLR4 in the recognition of LOS, it is apparent that inappropriate signaling of TLR4 by LOS could have important consequences during Neisserial infections, leading to exaggerated responses such as meningococcal sepsis and gonococcal pelvic inflammatory disease. Thus, in the studies proposed herein, we seek to define the LA structural elements that determine inflammatory signaling using genetic deletion and variable expression mutants of meningococcal strain 89I to produce LOS with a single invariant LA moiety that differs in the state of phosphorylation and/or acylation.
The Specific Aims are: (1) To determine the molecular mechanisms that regulate the induction of TLR4-dependent innate immune responses to Neisserial LOS in the context of LA structural variation. We will construct genetic variable expression LA mutants and develop a predictive model of LA bioactivity by determining the potential of the mutant LOS to signal through TLR4, to mature dendritic cells and polarize T cells, to induce microRNA, to bind to the TLR4-MD-2 complex, and to induce differences in molecular interactions with TLR4-MD-2 using in silico modeling. (2) To determine the correlation between the predictive model of LA structure and function with the bioactivity and relative abundance of LA expressed by disease-causing and non- pathogenic Neisserial strains. We will correlate the expression by disease-causing and non-pathogenic strains of LA molecules that represent molecular determinants for TLR4 induction with their potential to induce inflammatory cytokines. Our studies are expected to establish the LA structural determinants of inflammatory signaling, to identify new targets for development of antibiotics to treat Neisserial infections, to enable new methods to identify hypervirulent and highly inflammatory strains, and to aid in LOS vaccine design.

Public Health Relevance

Control of infections due to Neisseria meningitidis and N. gonorrhoeae remains problematic due to increased antibiotic resistance and the lack of vaccines for serogroup B N. meningitidis and N. gonorrhoeae. In the U.S., infection caused by serogroup B organisms remains a problem in the military, and group C disease remains a cause of community-acquired meningitis. Following a 74% decline in the reported rate of gonorrhea in the U.S. from 1975 to 1997, the rate increased in 1998 and has remained essentially unchanged to date. The U.S. rate remains the highest of any industrialized nation, with an estimated 700,000 new cases per year. Importantly, epidemiologic studies provide strong evidence that gonococcal infection facilitates the transmission of HIV-1 infection. Given the statistics on the incidence of meningococcal meningitis and gonorrhea in the U.S., a corresponding number of veterans will potentially contract these infections. Thus, our proposed research to understand human immune responses to infection is relevant to the health and patient care missions of the VA.

National Institute of Health (NIH)
Veterans Affairs (VA)
Non-HHS Research Projects (I01)
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Infectious Diseases B (INFB)
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Veterans Affairs Medical Center San Francisco
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United States
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