INTRODUCTION
Streptococcus intermedius is a facultatively anaerobic member of the normal flora of the human oral cavity and the upper respiratory, gastrointestinal, and female urogenital tracts.
S. intermedius belongs to the Anginosus group of streptococci (AGS), which also includes
Streptococcus anginosus and
Streptococcus constellatus (
1,
2). AGS tend to form local suppurative infections, and these organisms are the most common pathogens associated with bacterial intracerebral abscesses (
1–6).
S. intermedius is the most pathogenic species of AGS and a leading cause of deep-seated, serious purulent infections, including brain and liver abscesses (
1,
2). This pathogen secretes a human-specific cytolysin, intermedilysin (ILY), which was originally identified in studies using an
S. intermedius strain, UNS46, isolated from a human liver abscess (
7). ILY is a member of the cholesterol-dependent cytolysin (CDC) family and is considered the major virulence factor for infectivity and cytotoxicity toward human cells by
S. intermedius (
8–11). Therefore, investigation of the mechanisms that regulate
ily expression could help elucidate how
S. intermedius mediates its pathogenicity by controlling the amount of ILY secreted. To date, two factors have been reported to control the expression of
ily. The first is autoinducer 2 (AI-2) (a LuxS product used by several bacteria in quorum-sensing signaling), which is reported to be an exponential-growth-phase-specific activator of
ily transcription (
12). In addition, we recently revealed that
ily expression and the growth rate of the bacteria are modulated through catabolite control protein A (CcpA), which is a LacI/GalR-type repressor that monitors the extracellular glucose/utilizable carbohydrate concentration (
13).
Oral bacteria can metabolize several sugars found in foods and drinks regularly consumed by humans. Lactose, a disaccharide formed from galactose and glucose, is most notably found in milk and other dairy products. This sugar plays an important role in oral microbial ecology and can contribute to the development of dental caries in both adults and young children. The metabolism of lactose and galactose in Gram-positive bacteria has been well characterized using Gram-positive cocci as models (
14–17). It has been reported that these sugars are rapidly fermented by both the tagatose-6-phosphate (
lac) and Leloir (
gal) pathways in
Streptococcus mutans strain UA159 (
17). The tagatose-6-phosphate pathway, known to be the most efficient route for lactose and galactose fermentation, is found almost exclusively in Gram-positive bacteria. Lactose and galactose fermentation can occur through these pathways. Lactose is first internalized by the phosphoenolpyruvate (PEP)-dependent lactose phosphotransferase (PTS) system (lactose-PTS permease, LacFE), yielding lactose-6-phosphate (Lac-6-P). Lac-6-P is then hydrolyzed to glucose and Gal-6-P by a cytoplasmic phospho-β-galactosidase (LacG). Galactose is internalized by the glucose- and lactose-PTS permeases, yielding Gal-6-P. The Gal-6-P generated from these sugars can then be catabolized to glycerone phosphate and
d-glyceraldehyde-3-phosphate by enzymes in the tagatose-6-phosphate pathway (LacA to LacD). It has been reported that these enzymes are encoded by the
lac operon in some Gram-positive cocci (
14–17). The lactose phosphotransferase system repressor (LacR) is a member of the GntR family of transcriptional regulators (
18). It has been shown that LacR can repress transcription of the
lac operon by binding the LacR recognition element, which consists of direct repeats of the sequence TGTTTNWTTT (where N is any base and W is A or T) on the
lac promoter under lactose- or galactose-limited conditions (
18,
19). It is believed that tagatose-6-phospate, a catabolite of galactose, can bind LacR and inhibit the interaction between LacR and the
lac promoter. This allows RNA polymerase to bind to the promoter and initiate transcription of the
lac operon under conditions where lactose or galactose is abundant (
17,
18).
AI-2 and CcpA have been reported to regulate ily expression. However, the action of these two factors cannot explain the difference between strains with constitutively high production of ILY, which seem to be more highly pathogenic, and strains with low production of ILY. Therefore, we screened for additional factors that could regulate ily expression by employing random gene disruption in a low-ILY-producing strain from human dental plaque.
MATERIALS AND METHODS
Bacterial strains, plasmids, and growth conditions.
The bacterial strains and plasmids used in this study are listed in
Tables 1 and
2.
Streptococcus intermedius was cultured at 37°C or 42°C under anaerobic conditions. Brain heart infusion (BHI) broth (Becton, Dickinson, Palo Alto, CA, USA) was used as the culture medium. Accumulation of lactate acidifies the culture medium and causes a loss of ILY activity in the culture supernatant (
13). Therefore, we used 3-(
N-morpholino)propanesulfonic acid (MOPS)-buffered BHI (MOPS-BHI) medium for culture to monitor the amount of ILY secreted. The MOPS-BHI medium contained 100 mM MOPS buffer (pH 7.4) and either 18.5 g/liter BHI broth or 17.5 g/liter BHI broth without dextrose (United States Biological, Swampscott, MA, USA). MOPS-BHI medium was supplemented with glucose or other sugars at specified concentrations.
Escherichia coli cells were grown in Luria-Bertani (LB) medium at 37°C under aerobic conditions. The following antibiotics were added at the following concentrations: ampicillin, 100 μg/ml for
E. coli; chloramphenicol (Cm), 20 μg/ml for
E. coli and 2 μg/ml for
S. intermedius; and erythromycin (Em), 100 μg/ml for
E. coli and 1 μg/ml for
S. intermedius.
Random gene disruption of low-ILY-producing strain PC574.
pGh9:IS
S1 (
Table 1) was transformed into
S. intermedius PC574 cells that had been treated with competence-stimulating peptide (CSP) (DSRIRMGFDFSKLFGK), which were then cultured on BHI agar with Em for plasmid selection at 42°C. Around 5,000 colonies were transferred with toothpicks to human erythrocyte agar. Three independent high-ILY-producing strains (PC574 IS
S1 1 to 3), which could generate larger beta-hemolysis zones than strain PC574 on human erythrocyte agar, were used for plasmid rescue experiments.
Plasmid rescue method.
Sequences flanking the pGh9:IS
S1 insertion site were obtained using a sequence rescue strategy, as described previously (
21). Briefly, the chromosomal DNA of
S. intermedius PC574 IS
S1 1 was purified and digested with EcoRI. The digested DNA was self-ligated and then introduced into
E. coli TG1 (der) cells. The recombinant plasmids were purified, and the chromosomal DNA regions corresponding to these plasmids were amplified by PCR and sequenced using the primers pGh
+9#02 and 5′IS
S1(rev) (rev stands for reverse) (
21). Alignment of the PCR product sequences bridging the transposition site and the
S. intermedius NCDO2227 genome sequence (GenBank accession no. AP010969) helped identify the chromosomal sequence flanking the transposition site.
Databases and sequence alignment.
Nucleotide and protein sequences were obtained from the Microbes genomic BLAST databases by an Entrez cross-database search at the National Center for Biotechnology Information (NCBI) (National Institutes of Health, USA). The degree of homology between the lac operon from S. intermedius NCDO2227 and the consensus sequences of the LacR recognition element was determined using the software program GENETYX-MAC version 17. Sequence alignments between LacR sequences from the type strain NCDO2227 and the strains isolated from clinical specimens or dental plaques were performed using the NCBI BLAST Needleman-Wunsch Global Sequence Alignment Tool.
Generation of lacR knockout mutant in strain PC574.
A
lacR knockout mutant (Δ
lacR mutant) was produced by homologous recombination. Briefly, the 5′ region of the
lacR DNA fragment (533 bp) was amplified using primer lacR F (F stands for forward) and internal primer lacR BamHI R (R stands for reverse) (
Table 3) and then digested with BamHI. The 3′ region of the latter (560-bp) DNA fragment was amplified using the internal primers lacR SalI F and lacR R (
Table 3) and then digested with SalI. The Em resistance cassette was amplified from the genomic DNA of
ily knockout mutant UNS38 B3 (
11) using primers erm BamHI F and erm SalI R (
Table 3). The BamHI- and SalI-digested erythromycin cassette was ligated to the BamHI-digested 5′ region and SalI-digested 3′ region, and the ligated fragment was then amplified by PCR with primers lacR F and lacR R (
Table 3). The amplified fragment was used to construct the Δ
lacR mutant. The Δ
lacR mutant was produced by transformation of CSP-treated
S. intermedius PC574 cells with the PCR amplicon. Colonies were selected on BHI agar containing 1 μg/ml Em. Disruption of
lacR was confirmed by PCR, as well as by immunoblotting using anti-LacR rabbit antiserum (
Fig. 1B).
Complementation of S. intermedius PC574 ΔlacR mutant.
Streptococcus-E. coli shuttle vector pSETN1 (
13,
22) was used for complementation of the
S. intermedius PC574 Δ
lacR mutant.
lacR fragments containing the putative native promoter were amplified by PCR using the primers lacR EcoRI F and lacR PstI R (
Table 3) from
S. intermedius type strain NCDO2227 and genomic DNA from the clinically isolated strains A4676a, UNS46, UNS38, UNS35, UNS32, UNS45, JICC 33616, HW7, and P22 (
Table 2). The amplified fragments were digested with EcoRI and PstI, cloned into the corresponding sites in pSETN1, and transformed into
E. coli DH5αZ1 (
Table 1). Each resultant plasmid (
Table 1) was transformed into a CSP-treated PC574 Δ
lacR mutant. Transformants were selected and isolated on BHI agar containing 2 μg/ml Cm and then confirmed by immunoblotting using anti-LacR rabbit antiserum, PCR, and reverse transcription (RT)-PCR (data not shown). Hemolysis assays were used to monitor the ability of these plasmids to complement the Δ
lacR mutant.
qRT-PCR analysis.
S. intermedius cells were grown in the MOPS-BHI medium at 37°C for 16 h under anaerobic conditions, and the cells were subsequently separated by centrifugation (5,000 ×
g). Isolation of total RNA from cells and quantitative RT-PCR (qRT-PCR) analysis was performed as previously described (
13). Real-time PCR was performed in 96-well plates using an ABI PRISM 7900HT instrument with
Power SYBR green master mix (Applied Biosystems, Warrington, United Kingdom). The primer set of qRT-
ily F and qRT-
ily R (
13) was used for quantification of
ily mRNA. The primer set of qRT-
gyrB F and qRT-
gyrB R (
13) was used as an internal control to normalize the amount of total RNA in each sample. To plot calibration curves for the primer set, cDNA from the
S. intermedius PC574 Δ
lacR mutant was used as the template in a 5-step dilution process (corresponding to 100, 50, 25, 12.5, and 6.25 ng of input RNA). Thermal cycling conditions were as follows: initial denaturation at 95°C for 10 min, followed by 40 cycles, with 1 cycle consisting of 15 s at 95°C and 1 min at 60°C. The amounts of target RNAs were calculated from the calibration curves.
Nucleotide sequences of lacR from S. intermedius clinical isolates.
lacR fragments containing the putative native promoter were amplified by PCR and sequenced using either primer set lacR seq. F and lacR seq. R or primer set lacR seq. F1 and lacR seq. R2. DNA sequencing was performed by an industrial sequence commission (Hokkaido System Science, Sapporo, Japan).
Infection assay.
S. intermedius cells were grown in BHI broth at 37°C for 20 h under anaerobic conditions. The infection assays were performed as previously described with minor modifications (
11,
24). HepG2 cells in 350 μl of Dulbecco's modified Eagle's medium (DMEM) containing 10% fetal bovine serum (FBS) without antibiotics were dispensed into 48-multiwell tissue culture plates (1 × 10
5 cells/well) and cultured overnight at 37°C in the presence of 5% CO
2. For cell infection, bacterial cultures were centrifuged at 13,000 ×
g for 1 min, and the cells were resuspended at a density of 1 × 10
6 cells in 350 μl of DMEM in the absence of antibiotics containing 5% FBS and 0.1% heat-inactivated human plasma from a healthy Japanese volunteer. The bacterial suspension was added to the HepG2 cells, and infection was allowed to proceed for 3 h in the 48-multiwell tissue culture plates. The supernatant was then completely removed, and cells were washed three times with PBS. Infected cells were cultured in 350 μl of fresh medium containing 5% FBS and 0.1% human plasma. A portion of the culture medium (200 μl) was replaced with fresh medium every 12 h to avoid accumulation of ILY. The viability of infected cells was determined using the neutral red (NR) method (
25). After infection, the medium was removed at the indicated time point, and the cells were incubated with 350 μl of NR solution (50 μg/ml) in DMEM for 3 h at 37°C. The cells were subsequently washed three times with PBS and then fixed with 200 μl formaldehyde solution (1.0%, vol/vol) containing 1 mM HEPES-KOH (pH 7.3), 0.85% NaCl, and 1.0% CaCl
2. To extract the dye taken into viable cells, the fixed cells were lysed with 1% acetic acid in 50% (vol/vol) ethanol. The absorbance was then measured at 540 nm (
A540). The control for 0% viability consisted of cells exposed to 1.0 M HCl, while the control for 100% viability consisted of cells incubated in bacterium-free DMEM. The level of cytotoxicity was calculated as follows: viability (expressed as a percentage) = [(
A540 of the extract from infected cells −
A540 of the extract from the control for 0% viability)/(
A540 of the extract from the control with 100% viability −
A540 of the extract from the control for 0% viability)] × 100.
Human erythrocyte agar plating.
Hemolysis induced by the bacterial cells was examined on human erythrocyte agar incubated at 37°C for 1 day under anaerobic conditions. Human blood samples were obtained from healthy Japanese volunteers and stored in an equal volume of sterilized Alsever's solution at 4°C. Before use, the human blood cells (5 ml) in Alsever's solution (5 ml) were washed three times with phosphate-buffered saline (PBS), centrifuged (1,000 × g), and resuspended in 5 ml of PBS. Human erythrocytes suspended in PBS were added to BHI medium containing 1% (wt/vol) agar at a final concentration of 10% (vol/vol).
Hemolysis assay.
S. intermedius cells were grown in MOPS-BHI medium containing 1% (wt/vol) glucose, galactose, or lactose at 37°C for 48 h under anaerobic conditions. The culture supernatant was obtained by centrifugation (5,000 ×
g) and standardized by dilution with PBS for an optical density at 600 nm (OD
600) of 0.25 to 0.5 for the assay. Hemolysis was assayed as previously described (
7) with minor modifications. Human erythrocytes stored in sterilized Alsever's solution were washed three times with PBS at 4°C by centrifugation (1,000 ×
g) before use. Chilled PBS containing 5 × 10
7 erythrocytes/ml and the dilution series (25- to 1,600-fold) of the culture supernatant with PBS were mixed in microcentrifuge tubes (total volume of 0.5 ml). Incubation was at 37°C for 1 h. After the reaction, nonlysed erythrocytes were removed by centrifugation (1,000 ×
g) at 4°C for 5 min. The
A540 of 200 μl of the supernatant was measured in a microplate reader (model 550; Bio-Rad, Hercules, CA, USA). The percent hemolysis was calculated as follows: percent hemolysis = [(
A540 of the supernatant from the sample containing diluted culture supernatant −
A540 of the supernatant from the sample containing no diluted culture supernatant)/(
A540 of the supernatant from the sample completely hemolyzed by hypotonic processing −
A540 of the supernatant from the sample containing no diluted culture supernatant)] × 100. The relative hemolytic activity was calculated as follows: relative hemolytic activity (as a percentage) = (dilution rate of culture supernatant sample giving 50% of hemolysis/dilution rate of culture supernatant of
S. intermedius UNS38 or PC574 Δ
lacR mutant giving 50% of hemolysis) × 100.
Preparation of His-tagged recombinant LacR.
lacR was amplified from the chromosomal DNA of
S. intermedius type strain NCDO2227 by using the primers lacR BamHI F and lacR PstI R (
Table 3). The amplified fragment was digested with BamHI and PstI and cloned into pUHE212-1 (
26). The resultant plasmid (pN-his
lacR) was transformed into
E. coli DH5αZ1. Hyperexpression of the recombinant protein was induced by adding 1 mM isopropyl-β-
d-thiogalactopyranoside to
E. coli cells in the mid-log phase and by continuing incubation at 37°C for 2 h. The cells were then harvested by centrifugation (5,000 ×
g) and resuspended in buffer A (20 mM Tris-HCl buffer [pH 8.0] containing 300 mM NaCl, 20 mM imidazole, and 6 M urea). The suspension was sonicated using an Astrason ultrasonic processor (model XL2020; Misonix Inc., Farmingdale, NY, USA) and then incubated at 30°C for 1 h to denature the proteins. The resultant cell extract was centrifuged at 10,000 ×
g for 20 min to remove unbroken cells. The supernatant was loaded onto a nickel-nitrilotriacetic acid (Ni-NTA) agarose column (Qiagen, Valencia, CA, USA), and the column was washed with buffer A. Proteins bound to the column were eluted with a linear gradient of 20 to 500 mM imidazole in 20 mM Tris-HCl (pH 8.0) containing 300 mM NaCl and 6 M urea. Peak fractions were dialyzed with 20 mM Tris-HCl buffer (pH 8.0) containing 100 mM NaCl, 1 mM EDTA, and 10% glycerol. The renatured and precipitated LacR was frozen at −80°C until use.
Anti-LacR rabbit antiserum.
To obtain anti-LacR rabbit antiserum, 150 μg of purified His-tagged recombinant LacR in 1.5 ml of PBS was emulsified with an equal volume of Freund's complete adjuvant and administered to rabbits (intramuscular injection). Three booster shots of 150 μg of the antigen were administered using Freund's incomplete adjuvant (subcutaneous injection) at 3-week intervals. Ten milliliters of blood was drawn 2 weeks after the final booster shot was administered, and antiserum was collected for immunoblotting.
Biotinylated DNA probe pulldown assay.
Biotinylated DNA probe pulldown assay was performed as previously described with minor modifications (
27). Biotinylated DNA fragments were generated by PCR using 5′ biotinylated primers (Eurofins MWG Operon, Huntsville, AL, USA) listed in
Table 3 and
S. intermedius NCDO2227 genomic DNA. The
ily promoter region (213 bp) was amplified using primers Bio-Pily F (Bio stands for biotinylated, and Pily stands for promoter of the
ily gene) and Pily R. The
lacD promoter region (168 bp) was amplified using primers Bio-PlacD F and PlacD R, and the
lacA promoter region (164 bp) was amplified using primers Bio-PlacA F and PlacA R, respectively. A nonspecific DNA fragment (181 bp) with no LacR recognition element was amplified using primers Bio-lacF F and lacF R. Unincorporated primers were removed using a QIAquick PCR purification kit (Qiagen, Valencia, CA, USA). A 100-μl aliquot of a solution of NeutrAvidin (deglycosylated avidin with far less nonspecific binding than biotin) agarose resins (Thermo Scientific, Rockford, IL, USA) was then coated with 1 μg of biotinylated DNA per the manufacturer's instructions. Whole soluble protein from the cell extract was produced as follows.
S. intermedius PC574 cells were grown for 16 h in 40 ml of BHI medium. The cells were harvested by centrifugation (6,000 ×
g, 5 min, 4°C), and the cell pellet was washed twice with 5 ml of lysis buffer containing 10 mM Tris-HCl (pH 7.5) and 50 mM NaCl, and then resuspended in 1 ml of lysis buffer containing protease inhibitor cocktail (EDTA free) (Nacalai Tesque, Tokyo, Japan). The resuspended cells were then disrupted three times using lysing matrix B (Qbiogene Inc., Carlsbad, CA, USA) tubes in a FastPrep cell disruptor (Savant Instruments, Holbrook, NY, USA) at a setting of 6.0 for 20 s each time, with cooling. Debris and undisrupted cells were removed by centrifugation (14,000 ×
g, 5 min, 4°C), and the total protein concentration of the cleared supernatant was determined using Bradford assay reagent (Bio-Rad, Hercules, CA, USA). The protein concentration was adjusted to 2.0 mg/ml, glycerol was added to a final concentration of 20%, and the solution was stored at −80°C until use.
For the pulldown, an aliquot of DNA-coated resins was mixed with the protein extract (1 mg), and binding buffer containing 10 mM Tris-HCl (pH 8.0), 100 mM KCl, 3 mM MgCl2, 20 mM EDTA, 5% glycerol, 40 μg/ml sonicated salmon sperm DNA, and 10 μg/ml bovine serum albumin was added to make a total volume of 1 ml. Following a 30-min incubation at room temperature with gentle mixing, the resin was collected by centrifugation (500 × g, 1 min, 4°C), washed four times with 500 μl of binding buffer, and then suspended in 50 μl of sodium dodecyl sulfate (SDS) sample buffer for sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). A similar method was used for the pulldown assay using the His-tagged recombinant LacR (5 μg) instead of the whole soluble protein, except for the addition of 0.2% Nonidet P-40 in binding buffer to reduce nonspecific binding of recombinant LacR. LacR precipitated by the resins was visualized by Coomassie brilliant blue staining or by immunoblotting analysis using anti-LacR rabbit serum.
Gel electrophoresis and immunoblotting.
S. intermedius cells were grown in BHI or MOPS-BHI medium at 37°C under anaerobic conditions. The culture supernatant and cells were separated by centrifugation (5,000 ×
g). The cells were washed three times with PBS and resuspended in 0.5 ml of 20 mM Tris-HCl buffer (pH 8.0) containing 100 mM NaCl, 1 mM EDTA, and 10% glycerol. Samples were then added to lysing matrix B (Qbiogene Inc., Carlsbad, CA, USA) tubes and lysed in a FastPrep cell disruptor (Savant Instruments, Holbrook, NY, USA). To obtain the soluble protein fraction, samples were centrifuged at 17,400 ×
g for 30 min, and the supernatant was retained. Total protein (5 or 10 μg) and LacR, which precipitated along with the biotinylated DNA probe, were subjected to 12.0% SDS-PAGE by the method of Laemmli (
28). For immunoblotting analysis, the gel-resolved proteins were transferred to a poly(vinylidene difluoride) membrane (Millipore, Bedford, MA, USA). Blots were incubated with anti-LacR or anti-ILY rabbit serum (
9) developed with 5-bromo-4-chloro-3′-indolylphosphate (BCIP)–nitroblue tetrazolium chloride (NBT) by using alkaline phosphatase-conjugated anti-rabbit or anti-mouse immunoglobulin G as the secondary antibody.
Statistics.
Data are presented as the mean ± standard deviation (SD) values.
DISCUSSION
It had been reported that the genes involved in basic metabolic processes, including the catabolism of complex carbohydrates, are crucial to the pathogenicity of many streptococci (
29–32). It is known that CcpA is a major regulator of the expression of carbohydrate catabolism genes and in addition can control the expression of many streptococcal virulence factors (e.g., ILY of
S. intermedius, streptolysin S, the multiple virulence gene regulator of group A streptococci [GAS], and fructan hydrolase of
Streptococcus mutans) by CCR (
13,
31–35). Therefore, transcriptional control of carbohydrate catabolism genes by CcpA is thought to have an important role in regulating the pathogenicity of streptococci. In this study, we demonstrated by random insertional mutagenesis that another negative transcriptional regulator, LacR, could also control
ily expression, observed by measuring the enlargement of the zone of hemolysis on human erythrocyte agar as an index. Subsequently, a biotinylated DNA probe pulldown assay showed that LacR could interact with P
ily even in the absence of any region of homology with the LacR recognition element (
Fig. 3B and
C). These unprecedented results suggest that
S. intermedius LacR might recognize not only this reported consensus sequence but also another unidentified sequence that is localized in P
ily. Further studies are required to identify this new recognition sequence, which will further our understanding of how LacR controls the expression of
ily and other genes in
S. intermedius.
It is well-known that
cdc genes are found in many Gram-positive pathogens. Nevertheless, to date, CcpA or LacR regulation of
cdc genes such as
ily has not been reported, and the mechanisms regulating
ily expression seem to have evolved specifically in
S. intermedius. This poses the question as to why this pathogen has evolved this regulation mechanism? The specific binding of ILY to the glycosylphosphatidylinositol-linked membrane protein, human CD59 (huCD59), a regulator of the terminal pathway of complement in humans (
36), suggests that
S. intermedius is primarily adapted to be a human pathogen. It follows then that this bacterium requires horizontal and vertical (mother-to-child) human transmission for successful proliferation within the host population. Our results suggest that
S. intermedius with a functional LacR has two modes: a less-virulent (low-ILY-producing) mode under conditions when glucose is abundant (
13) and a highly virulent (high-ILY-producing) mode under conditions of galactose excess (
Fig. 4). In the presence of lactose-abundant foods, such as milk or foods derived from milk, this bacterium might transiently increase its pathogenicity, thereby increasing the chances of successful transmission/colonization as a result of horizontal transmission. Maternal milk contains large amounts of lactose which, in this context might help to promote vertical transmission of this bacterium.
We found that high-ILY-producing strains isolated from severe clinical cases have a substitution of an amino acid(s) and/or an insertion mutation in LacR (
Table 2). However, the levels of ILY secreted from 50 clinically isolated strains covered a wide range (
Table 2), and 3 high-ILY-producing strains (JICC 33405, UNS40, and F600) had functional LacR (
Table 3 and
Fig. 6), indicating that
ily is also regulated by a factor other than LacR. It has been reported that compared to other AGS, infection with
S. intermedius can cause brain or liver abscesses with high frequency (
1,
2). Indeed, 21 of the 50 clinical isolates were derived from these abscesses. We found that 7 strains isolated from liver abscesses secreted elevated levels of ILY, ranging from 15.3% (UNS27s) to 187.0% (UNS46) relative to the high-ILY-producing strain UNS38 (
Table 2). Therefore, the increase in ILY production induced by mutation of LacR or some other factor seems to be important for abscess development. However, the levels of ILY secreted from 14 strains derived from brain abscesses were more widely distributed, ranging from <0.1% (2Q) to 329.9% (A4676a) relative to strain UNS38. The processes in the development of a liver abscess by
S. intermedius (invasion of the human host, survival in neutrophils, and migration into the liver) might require constitutive and higher induction of ILY than that required for the development of brain abscesses. Although, at present, it is unknown whether wild-type strains can benefit from the enhanced production of intermedilysin and resultant increased cell damage by
lacR mutants, our data showing that the
S. intermedius PC574 strain and Δ
lacR mutant have similar growth rates indicate that both could coexist in the same niche. Therefore, in order to further our knowledge of
S. intermedius pathogenicity, it is important to investigate possible synergistic partnerships between wild-type and
lacR mutant strain populations in the human oral cavity (e.g., during tissue invasion). However, as ILY is specific to humans, animal models of
S. intermedius infection are precluded, and alternative strategies, such as the development of human CD59-transgenic mice, will be required in order to study cooperation between these strains.
It has been shown that mutations in the
covRS (
csrRS), which encodes a two-component regulatory system, are important in the transition of M1T1 serotype strains from the noninvasive phenotype to the invasive phenotype of
Streptococcus pyogenes (
37). These mutations result in the transcriptional upregulation of multiple virulence-associated genes, including the NAD-glycohydrolase operon for synthesis of the hyaluronic acid capsule and streptolysin O (SLO), streptococcal inhibitor of complement (SIC), and downregulation of the streptococcal pyogenic exotoxin B (SpeB). It was recently reported that 57.3% of
S. pyogenes strains isolated from group A streptococcal toxic shock syndrome (STSS) contained mutations in
covRS and/or
rgg (
ropB) (
38). Rgg is also a known repressor of the virulence-associated NAD-glycohydrolase operon, including the gene encoding SLO, and mutation of
rgg results in the transcriptional upregulation of this operon and downregulation of SpeB, as with
covR or
covS mutations (
39,
40). SLO is also a member of the CDC family and a known major virulence factor for
S. pyogenes. Previous studies using a mouse model showed that strains with upregulated SLO induced by
covR or
covS mutation could induce necrosis of neutrophils and prompt the escape of mutated strains, resulting in increased lethality (
41). Thus, in addition to the upregulation of
ily expression and ILY secretion, mutations in LacR could also affect the regulation of other genes/operons associated with virulence of
S. intermedius. Further studies on the transcriptional control mechanism for
ily will help us to understand further the mechanisms underlying gene expression and pathogenic phenotype in
S. intermedius. It had been believed that deep-seated abscesses caused by AGS, including
S. intermedius, are uncommon in healthy individuals without any identifiable risk factors such as immunocompromised states caused by diabetes, cirrhosis, and cancer (
42–44). However, some reports have shown that
S. intermedius can form deep-seated abscesses in the brain, lung, and spleen in healthy humans (
45–47). It is important to analyze whether clinical isolates from such cases show high-ILY-producing phenotypes associated with
lacR mutation.