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2017 ; 13
(8
): e1006582
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Streptococcus pneumoniae in the heart subvert the host response through
biofilm-mediated resident macrophage killing
#MMPMID28841717
Shenoy AT
; Brissac T
; Gilley RP
; Kumar N
; Wang Y
; Gonzalez-Juarbe N
; Hinkle WS
; Daugherty SC
; Shetty AC
; Ott S
; Tallon LJ
; Deshane J
; Tettelin H
; Orihuela CJ
PLoS Pathog
2017[Aug]; 13
(8
): e1006582
PMID28841717
show ga
For over 130 years, invasive pneumococcal disease has been associated with the
presence of extracellular planktonic pneumococci, i.e. diplococci or short chains
in affected tissues. Herein, we show that Streptococcus pneumoniae that invade
the myocardium instead replicate within cellular vesicles and transition into
non-purulent biofilms. Pneumococci within mature cardiac microlesions exhibited
salient biofilm features including intrinsic resistance to antibiotic killing and
the presence of an extracellular matrix. Dual RNA-seq and subsequent principal
component analyses of heart- and blood-isolated pneumococci confirmed the biofilm
phenotype in vivo and revealed stark anatomical site-specific differences in
virulence gene expression; the latter having major implications on future vaccine
antigen selection. Our RNA-seq approach also identified three genomic islands as
exclusively expressed in vivo. Deletion of one such island, Region of Diversity
12, resulted in a biofilm-deficient and highly inflammogenic phenotype within the
heart; indicating a possible link between the biofilm phenotype and a dampened
host-response. We subsequently determined that biofilm pneumococci released
greater amounts of the toxin pneumolysin than did planktonic or RD12 deficient
pneumococci. This allowed heart-invaded wildtype pneumococci to kill resident
cardiac macrophages and subsequently subvert cytokine/chemokine production and
neutrophil infiltration into the myocardium. This is the first report for
pneumococcal biofilm formation in an invasive disease setting. We show that
biofilm pneumococci actively suppress the host response through
pneumolysin-mediated immune cell killing. As such, our findings contradict the
emerging notion that biofilm pneumococci are passively immunoquiescent.