Enterotoxigenic
Escherichia coli (ETEC) infections are a major cause of diarrhea in developing countries, especially among young children (
6). ETEC also causes traveler's diarrhea. Infecting bacteria adhere to and colonize the intestinal epithelium and cause diarrhea primarily by the production of heat-labile and/or heat-stable enterotoxin. Adherence is mediated by colonization factors (CFs), which usually are fimbrial structures present on the surface of the bacteria that have affinity for receptors exposed on the luminal surface of epithelial cells. Although more than 20 serologically distinct CFs have been identified, the first to be characterized was colonization factor antigen (CFA/I), which remains one of those most commonly associated with ETEC infection (
8,
11). CFA/I belongs to a group of eight ETEC fimbriae with genetic and biochemical similarities (reference
1 and references therein). Other members of this group are coli surface antigen 1 (CS1), CS2, CS4, CS14, CS17, CS19, and PCF071.
Expression of four genes (
cfaABCE) in the CFA/I operon is required for assembly of CFA/I fimbriae (
17). The same is true for CS1 (
cooBACD) and CS2 (
cotBACD) (
30).
cfaB encodes the major pilin subunit (corresponding to
cooA and
cotA in CS1 and CS2, respectively), whereas
cfaE (
cooD and
cotD) encodes a minor tip protein. The
cfaA (
cooB and
cotB) gene product is a chaperone-like protein, and
cfaC (
cooC and
cotC) encodes a protein involved in transport of fimbriae across the outer membrane.
The adhesion of fimbriated bacteria to host epithelium may be mediated by the major fimbrial subunit as in K99 fimbriae (
16) or the minor tip protein as in P fimbriae (
21). In the case of CFA/I, it has been proposed that adhesion is via the major subunit (
7). However, a point mutation in the tip protein CfaE abolished fimbrially induced hemagglutination (
31). A similar result was obtained with CS1 when the corresponding tip protein, CooD, was mutated in the same manner. Furthermore, Fab fragments directed against the N-terminal region of the minor tip protein inhibited both hemagglutination induced by bacteria expressing CFA/I and their ability to bind to Caco-2 cells (
1). These results suggest that the minor tip proteins of these fimbriae are involved in adhesion.
Although the genetics and architecture of CFA/I and related fimbriae have been extensively studied, far less is known about their target cell receptors. In the present study, the ability of CFA/I fimbriae, with and without the minor tip protein, to bind to glycosphingolipids from various sources was investigated. Specific interactions could be demonstrated between CFA/I-fimbriated bacteria or purified CFA/I fimbriae and a number of nonacid glycosphingolipids. Interestingly, there appeared to be no difference in binding between CFA/I with or without the minor tip protein, demonstrating that these activities reside with the major CfaB subunit.
DISCUSSION
In the present study, carbohydrate recognition by CFA/I fimbriae was investigated by testing the binding of either radiolabeled fimbriated bacteria or purified fimbriae to glycosphingolipids separated on thin-layer chromatograms. The binding patterns obtained both with bacteria and with the purified fimbriae had several features in common with those of previously described lactosylceramide-binding bacteria (
19), with binding to lactosylceramide with hydroxy fatty acids and/or phytosphingosine, isoglobotriaosylceramide, neolactotetraosylceramide, gangliotriaosylceramide, and gangliotetraosylceramide. However, binding to compounds that are not recognized by lactosylceramide-binding bacteria was also observed. These included glucosylceramide, the H5 type 2 pentaglycosylceramide, and glycosphingolipids with terminal Le
a, Le
x, and Le
y determinants. Previous studies had suggested that sialylated glycoconjugates, such as the GM2 ganglioside (
9) or sialoglycoproteins, may act as CFA/I receptors (
4,
26,
35). In the present study, however, no binding of CFA/I to gangliosides was observed.
Requirement of a certain ceramide species for binding to occur, like the requirement of hydroxy fatty acids and/or phytosphingosine for CFA/I binding to lactosylceramide, has been reported for antibodies, bacterial toxins, and K99-fimbriated
E. coli, as well as other lactosylceramide-binding bacteria, including
H. pylori (reference
2 and references therein). In the case of lactosylceramide recognition, it has been proposed that the selectivity is due to binding of a conformation of lactosylceramide in which the oxygen of the fatty acid hydroxyl group forms a hydrogen bond with the hydroxymethyl group of the glucose (
2). Unlike other lactosylceramide-recognizing bacteria, CFA/I-fimbriated
E. coli binds to glucosylceramide. However, the glucosylceramide binding is relatively weak, indicating that although the binding epitope includes parts of the internal glucose, addition of terminal β4-linked galactose, yielding lactosylceramide, results in a more optimal binding epitope.
In order to investigate which fimbrial proteins were associated with the carbohydrate-binding properties observed in these experiments, a mutant was generated in which the
cfaE gene encoding the minor tip protein was deleted. Despite a dramatic reduction in CFA/I expression in this strain, fimbriae could be detected by inhibition enzyme-linked immunosorbent assay, observed by electron microscopy, and purified sufficiently for use in binding assays. In agreement with previous findings in which a point mutation in the tip protein was able to compromise the hemagglutination capacity of CFA/I fimbriae (
1), the recombinant bacteria expressing the tipless fimbriae were no longer able to agglutinate human erythrocytes. However, the bacteria expressing these tipless fimbriae still bound to the glycosphingolipids recognized by native fimbriae, demonstrating that the glycosphingolipid-binding site(s) resides within the major CfaB subunit. It thus seems that CFA/I fimbriae have multiple binding sites. Glycosphingolipid binding is mediated by the major CfaB subunit, whereas interaction with unidentified receptors on human erythrocytes and Caco-2 cells is mediated by CfaE, the minor tip protein (
1). Indeed, previous findings do support a binding capacity residing with CfaB, since monoclonal antibodies directed against this protein could inhibit the binding of CFA/I-expressing cells to human jejunal cells and prevent fluid accumulation induced by CFA/I-positive bacteria in rabbit intestinal loops (
29).
An interesting parallel to our observations is found in the S fimbriae of meningitis-associated
E. coli. The minor tip protein SfaS interacts with NeuAcα3Gal-carrying glycoproteins (
23,
24), whereas the major subunit SfaA binds to sulfatide, seminolipid, galactosylceramide, and lactosylceramide (
27). Hemagglutination induced by S-fimbriated
E. coli is abolished when the
sfaS gene is deleted (
12), but these bacteria still adhere to human endothelial cells (
25). Also, the well-characterized Galα4Gal-binding P fimbriae of uropathogenic
E. coli seems to have multiple binding capacities, since it interacts with fibronectin in a manner that is independent of Galα4Gal-binding tip protein PapG (
36).
The broader carbohydrate recognition pattern of CFA/I fimbriae compared to lactosylceramide-binding bacteria suggests either that the binding site is more permissive or that there is more than one binding site within the protein. However, the binding of lactosylceramide, isoglobotriaosylceramide, neolactotetraosylceramide, and the Lea pentaglycosylceramide could all be inhibited by incubating the CFA/I fimbriae with lactose or Lea pentasaccharide, suggesting that these compounds are accommodated in the same carbohydrate binding. Final resolution of this issue must, however, await cocrystallization of CfaB with binding-active saccharides.
The relevance of the glycosphingolipid-binding capacities shown in this study to the CFA/I-mediated adhesion of ETEC to host cells during colonization has yet to be determined. However, experiments with glycosphingolipid fractions isolated from human small intestine demonstrated that CFA/I bound in the mono-, di-, and triglycosylceramide regions in the nonacid fractions from the three individuals tested. In two of these individuals, binding to a compound comigrating with the Le
a pentaglycosylceramide was observed. In the epithelial cells of human small intestine monohexosylceramides (galactosylceramide and glucosylceramide), blood group ABH (type 1 chain) and Lewis glycolipids with five to seven sugar residues are the major glycolipid constituents and the expression of major blood groups glycosphingolipids is in agreement with the ABO, Lewis, and secretor phenotype of the individuals (
5). There are also trace amounts of Le
x- and Le
y-terminated glycosphingolipids. In addition, Le
x, Le
y, and H type 2 determinants are found on glycoproteins of human small intestinal epithelial cells (
10). Several of the CFA/I-binding compounds such as glucosylceramide-, Le
a-, Le
x-, Le
y-, and H type 2-terminated glycoconjugates may thus feasibly act as targets for CFA/I-mediated adherence. Isoglobotriaosylceramide, on the other hand, has been found in, e.g., dog intestine (
14) but not in humans, while gangliotriaosylceramide and gangliotetraosylceramide have not been chemically identified in peripheral human tissues.
In conclusion, we have demonstrated that the major CfaB subunit of CFA/I fimbriae is a carbohydrate-binding protein which specifically interacts with a number of carbohydrate sequences that are present in human small intestinal glycosphingolipids and glycoproteins in substantial quantities. Our findings suggest that the carbohydrate-binding activity contributes to the attachment of CFA/I-fimbriated E. coli to host intestinal epithelium and may be a basis for the rational design of receptor saccharide analogues for inhibition of the adhesion of CFA/I-expressing ETEC and also ETEC carrying CFA/I-related fimbriae.