INTRODUCTION
Amyloids represent an evolutionarily conserved fibrillar, cross-β-sheet quaternary structure of certain proteins in which the β-sheets laterally assemble in a noncovalent polymer to form fibers (
1–4). Amyloid aggregates typically form structures with diameters ranging from 6 to 12 nm and share common biophysical properties such as detergent and protease resistance, sensitivity to formic acid dissolution, uptake of amyloidophilic dyes, and birefringent properties when stained with Congo red (CR) (
4,
5). Although amyloids are commonly associated with human diseases related to protein misfolding, functional amyloids are known to play important biological roles across all domains of life (
6). In addition to polysaccharides and extracellular DNA (eDNA), amyloids are increasingly detected as constituents of extracellular biofilm matrices, where they can influence growth at air-water interfaces (
7), serve as a functional sink for quorum sensing molecules (
8), or act as a scaffold to help maintain three-dimensional (3D) architecture, allowing for the formation of channels and wrinkles that determine spatial distribution of species within multispecies biofilms (
1,
3,
9–13). Other functional roles of amyloids include regulation of genes and cell fate, toxicity against other microorganisms and host cells, and immune regulation of host responses (
12). Several bacterial functional amyloids have been described in both Gram-positive and Gram-negative organisms, including the curli proteins from
Escherichia coli and
Salmonella spp.,
Bacillus subtilis TasA,
Pseudomonas aeruginosa FapBC,
Staphylococcus aureus Bap and phenol-soluble modulins (PSM),
Enterococcus faecalis Esp, and
Streptococcus mutans P1 (also known as SpaP or antigen I/II), WapA, and SMU_63c (
12,
14–19). Multiple factors, including pH, salt concentration, and surface hydrophobicity, have been reported to influence the propensity of proteins to form amyloids within bacterial biofilms (
1,
10,
15,
20,
21).
A resident of the dental biofilm,
S. mutans is a keystone pathogen in dental caries. The cariogenic potential of
S. mutans can be largely attributed to several characteristics that are hallmarks of its successful coevolution with humans. First,
S. mutans genomes encode a number of glucosyltransferase enzymes that convert sucrose into large glucan polymers, which compose the bulk of the extracellular polymeric matrix and are critical for the establishment and maintenance of the dental biofilm (
22). In addition,
S. mutans thrives in carbohydrate-rich environments, as it can metabolize a wide range of carbohydrates, generating acids (acidogenicity) and surviving and continuing to undergo glycolysis even at pHs below 5.0 (aciduricity) (
23,
24).
In addition to the sucrose-dependent colonization mechanism that is based on glucan polymer synthesis,
S. mutans also possesses sucrose-independent colonization mechanisms whereby cell surface-associated adhesins such as P1 and WapA mediate attachment to the salivary pellicle that coats the tooth enamel (
25,
26). Of note, P1 and WapA also mediate binding to collagen-rich surfaces (
27). More recently, genes encoding two closely related surface-associated collagen-binding proteins (CBPs),
cnm and
cbm, were identified in approximately 20% of
S. mutans strains (
28–30). Cnm was shown to mediate invasion of epithelial and oral cell lines and binding to collagenous and laminin-rich substrates present in oral (dentin, cementum, and roots) and extraoral environments (heart valves) (
27,
31–33). Cnm and Cbm were shown to be important virulence factors implicated in systemic infections such as infective endocarditis, cerebral microbleeds, and hemorrhagic stroke (
34–38). Moreover, clinical studies have linked oral infection with CBP
+ S. mutans strains with increased caries risk and poor caries outcomes (
23,
27,
39,
40).
While Cnm has a predicted molecular mass of 54 kDa, it migrates at approximately 120 kDa when separated by SDS-PAGE. Recently, we discovered that this aberrant migration was, in great part, a result of Cnm posttranslational modification through glycosylation. Specifically, we identified a novel protein glycosylation machinery
pgf (
protein
glycosyltrans
ferase) in
S. mutans (
41) that was cotranscribed with
cnm and responsible for its glycosylation in the serotype
f OMZ175 strain (
42). Inactivation of
pgf genes resulted in a Cnm protein that migrated at approximately 90 kDa and that is highly susceptible to proteolysis, indicating a critical role for glycosylation in Cnm function and stability (
41,
42).
In silico analysis revealed that the threonine-rich repeat domain located in the Cnm C terminus is subjected to glycosylation, while the β-sheet-rich N terminus where the conserved collagen-binding domain (CBD) resides is not modified by the Pgf glycosylation machinery (
42). In addition, the Pgf system was shown to also modify WapA, whose N-terminal truncation product antigen A (AgA) was shown to have amyloidogenic properties (
41). Interestingly, homology models revealed a high similarity between the tertiary structures of the Cnm CBD with that of AgA (
27). Based on the similarity between AgA and the Cnm CBD, we hypothesized that Cnm may also self-assemble into amyloid fibers. In the present study, we confirmed this prediction by using a panel of wild-type and mutant strains and different variant forms of purified Cnm (native glycosylated, recombinant nonglycosylated, and recombinant CBD). We show that Cnm is a major amyloidogenic protein in the Cnm
+ S. mutans strain OMZ175, with its CBD being sufficient for amyloidogenesis but possibly requiring the threonine-rich repeat for maintenance of stability, especially in acidic environments. We also demonstrate that when in monomeric form, the main function of Cnm is collagen binding. However, when Cnm self-assembles into amyloids, its ability to competitively inhibit binding of
S. mutans cells to collagenous substrates is lost. Hence, amyloid formation by Cnm might act as a negative regulatory mechanism to modulate collagen-binding activity within
S. mutans biofilms.
DISCUSSION
Microbial amyloids have been a focus of increased attention due to their wide array of biofilm-associated functions, which include organization of biofilm structure, modulation of biofilm hydrophobicity and mechanical properties, control of quorum sensing, regulation of genes, toxicity, and modulation of host response (
1,
8–13,
52). Functional amyloids have been discovered in pathogenic and nonpathogenic bacteria, and their formation is generally associated with growth in biofilms (
1,
10,
45). The discovery of multiple functional amyloids in
S. mutans (WapA, P1, and SMU_63c) made us wonder if Cnm, a surface protein that is also rich in β-sheet structure, could be part of this group. Here, we suggest that Cnm function might be modulated by its aggregation status.
An amyloid is a noncovalent oligomer of extended intermolecularly hydrogen-bonded β-sheets that self-assemble to form fibers. Regardless of the origin, amyloids share several properties, which include a fibrillar structure when viewed by electron microscopy, enhanced birefringence on binding to Congo red, and a cross-β-sheet structure in which the β-strands run perpendicular to the fiber axis, resulting in a characteristic X-ray fiber diffraction pattern (
53). Our
in silico analyses suggested that the CBD portion of Cnm assembles into amyloid aggregates, whereas the glycosylated threonine-rich repeat likely does not contribute to the amyloid fibril assembly. During oligomerization, the β-sheet structures of the monomeric units interact, with the glycosylated threonine-rich domains protruding outward. This model is consistent with our
in vivo and
ex vivo collagen-binding competitive inhibition assays, in which we observed that purified rCBD monomers competed with intact cells of
S. mutans for binding to collagen-rich surfaces, while rCBD-derived amyloid did not. In other words, the loss of the collagen-binding function of Cnm following amyloid aggregation suggests that the same β-sheet-rich region that mediates collagen binding also functions as the elongation point for fibril formation, thus rendering it unavailable for its primary adhesive function. Depending on the protein, formation of amyloids can result in a loss or a gain of function of the aggregating polypeptide (
4). Hence, amyloid aggregation represents a potential mechanism to regulate protein function as needed in different environments (
54,
55). The oligomerization of Cnm into amyloids does not seem to be dependent upon glycosylation by the Pgf machinery since native glycosylated and nonglycosylated recombinant proteins both activated ThT fluorescence and displayed visible amyloid fibers when visualized by microscopy. The contribution of glycosylation to protein amyloidogenesis is still a relatively unexplored field, although the effect of glycosylation of the amyloid precursor protein of Aβ in Alzheimer’s disease has gained attention due to its regulatory role in the protein’s proteolytic processing (
56,
57). Bacterial amyloids derived from glycoproteins have now been reported as components of the structural extracellular matrix of biofilms rich in ammonia-oxidizing bacteria and nitrite-oxidizing bacteria grown in aerobic and granular sludge (
58). Further characterization of glycoprotein-derived amyloids is warranted, as these may demonstrate common features in different domains of life.
In addition to its correlation with increased caries risk,
S. mutans Cnm has also been shown to contribute to increased acid tolerance (
59). Therefore, it was relevant to investigate if the newfound amyloidogenic properties of Cnm are modulated by acidic pH. Based on ThT assays of Cnm, rCnm, and rCBD stirred in neutral compared to acidic pH, we found that in contrast to glycosylated Cnm and rCnm, the rCBD variant forms fewer amyloid fibrils at pH 5.5 than at pH 7.4. We speculate that the threonine-rich domain might contribute to fiber integrity of full-length Cnm at acidic pH. This effect may be related to the presence of an external layer of acidic threonines to accept protons, thus protecting the β-sheet core from unfolding by charge repulsion (
60). This observation strengthens the notion that, although the threonine-rich domain is not related to the collagen-binding activity of Cnm, it supports that activity by contributing to the stability of the Cnm monomer. For instance, a previous study from our group demonstrated that glycosylation of the threonine-rich domain by the Pgf machinery protects Cnm against the proteolytic activity of proteinase K (
41). Also, the effect of acidity in promoting amyloidogenesis has been well characterized for Aβ oligomers related to Alzheimer’s disease as a key factor for pathogenicity (
61,
62). In
S. mutans, neutral pH was shown to favor amyloid formation by WapA and P1, while the secreted amyloidogenic protein Smu_63c, which appears to be a negative regulator of biofilm cell density and genetic competence, is triggered to assemble into amyloid by acidic pH (
15). Of note, formation of
S. aureus Bap amyloids is also favored at acidic pH (
15,
63).
TEM visualization of amyloid material induced by mechanical agitation of purified proteins, followed by treatment with proteinase K, revealed a mat-like structure for glycosylated Cnm but a fibrillar morphology for nonglycosylated Cnm and CBD. Mat-like aggregates have been proposed as a more biologically germane form of
S. mutans amyloids that represents a supramolecular structure composed of amyloid fibers, monomers, and oligomer intermediates (
48) where pure fibers, achieved by proteolytic digestion of
S. mutans amyloid-containing mats, are likely only seen in laboratory settings. It has also been shown that the addition of monomeric protein to purified fibrils shifts the morphology of fibrils back to mats (
48). Amyloid mats derived from purified
S. mutans C123 (the amyloid-forming truncation derivative of P1), AgA (the amyloid-forming truncation product of WapA), and Smu_63c, as well as purified fibers produced by protease treatment of the mats, all demonstrated classical X-ray fiber diffraction patterns with distinct intensities at 4.8 Å in the meridional direction corresponding to the separation of strands in a β-sheet and distinct equatorial intensities at 10 Å corresponding to the distance between stacked β-sheets (
48). Our current results revealed that proteinase K treatment of aggregated native glycosylated Cnm did not disrupt the amyloid mats, confirming our previous finding that glycosylation of Cnm confers resistance to proteinase K degradation of monomers (
41). In contrast, protease-treated aggregates of nonglycosylated rCnm and rCBD were more fibrillar in nature. The visualization of amyloid mats and fiber morphologies, in conjunction with ThT uptake assays, provides direct evidence of amyloid formation by
S. mutans Cnm.
To confirm Cnm amyloidogenic properties
in vivo, Congo red-induced birefringence was evaluated for mature biofilms of the wild-type, Δ
cnm, and Δ
srtA strains. Of note,
S. mutans harbors only one sortase-encoding gene, and inactivation of
srtA results in a complete lack of LPXTG motif-containing proteins on the cell surface (
64), including the amyloidogenic proteins P1, WapA, and Cnm. While not every sortase substrate is amyloidogenic (
15), most amyloid-forming proteins identified in other bacteria are anchored to the cell surface (
17,
63,
65). In
S. mutans, elimination of
srtA negatively impacted biofilm-associated amyloid formation, suggesting that cell surface protein anchoring contributes to this process (
16). Organized amyloid-containing birefringent aggregates were visualized in 5-day-old
S. mutans OMZ175 biofilms, and surprisingly, the OMZ175Δ
cnm mutant showed similarly diminished birefringent properties as the OMZ175Δ
srtA mutant compared to the parent OMZ175 strain. This indicates that Cnm is one of the most abundant amyloidogenic proteins of strain OMZ175 and is present in amyloid form within mature biofilms, likely as a component of the biofilm matrix. Notably, while
spaP (encoding P1) is present in the OMZ175 genome, the expression of P1 appears to be downregulated in Cnm
+ strains (
66)—hence, the pronounced impact of
cnm deletion on detection of biofilm-associated amyloids.
A shift in function between monomeric and fibrillar forms of an amyloidogenic protein was previously observed for
S. aureus PSMs (
19). Monomeric (soluble) and amyloid fibers (insoluble) of PSMα peptides were assessed for their ability to modulate the antibiotic tolerance to ciprofloxacin in
S. aureus cultures. The presence of PSMα monomers led to a reduction in the number of persister cells tolerant to ciprofloxacin, while the presence of PSMα amyloid fibrils did not alter the persister cell phenotype under the same conditions. It was proposed that the PSMα fibrils might act as reservoirs of the active form of this virulence factor that could be later mobilized if needed during changes in environmental conditions, such as pH fluctuation, a factor known to influence fiber formation, and dissociation of certain amyloids (
61,
67). Another functional shift was also described between monomeric and fibrillar forms of PSM whereby several PSM monomers (PSMα, PSMβ, and δ-toxin), known to contribute to biofilm detachment (
68), displayed the opposite behavior of promoting biofilm integrity when sequestered into amyloids (
18). Based on our collagen-binding competition assays, we observed that Cnm also undergoes a functional shift when in amyloid form. In biofilms of common laboratory strains of
S. mutans that lack Cnm, amyloid material is more readily detected as the biofilm matures, usually after 60 h of growth (
48). Whether this represents time and concentration-dependent amyloid nucleation leading to polymerization and elongation (
69) or depends on other changing environmental conditions within the aging biofilm is not yet understood. The loss of Cnm collagen-binding activity as the protein transitions to amyloid form might suggest that it serves as a mechanism to regulate this property once adhesion and colonization have occurred and the biofilm is established. It is possible that Cnm amyloid fibrils present with other macromolecules such as eDNA and polysaccharides in mature biofilms might serve a scaffolding function to integrate biofilm cells and provide a substrate for attachment of other members of the biofilm community. Alternatively, accumulation of amyloid material in the matrix could result in consolidation and detachment of mature biofilms, as surface-anchored monomers would stop interacting with the collagenous substrates and interact instead with other monomers to form amyloid fibers within the biofilm. Studies are under way to evaluate the possible contribution of Cnm and other amyloids to the three-dimensional architecture and adhesion/detachment of bacteria during progression of
S. mutans biofilm development. It will be important to establish whether the amyloid form of Cnm alters other functions already described for this virulence factor, including oral colonization, and epithelial and endothelial cell invasion (
27,
34). Our results provide the foundation to address these questions in future studies. Our findings also may shed some light on an emerging paradigm of Gram-positive multifunctional proteins and their structural transitions from monomer to amyloid forms as an energy-effective strategy for biofilm modulation (
17,
63,
70). Such new aspects of Cnm organization status (monomers and amyloid fibers) will inform future studies not only in
S. mutans but also in a myriad of other organisms implicated in biofilm-related disease processes.