INTRODUCTION
Human monocytic ehrlichiosis (HME), discovered in 1986 (
27), is one of the most prevalent life-threatening tick-borne zoonoses in North America (
31). HME is an acute febrile illness characterized by headache, malaise, nausea, myalgia and/or arthralgia and is frequently accompanied by leukopenia, thrombocytopenia, anemia, and elevation of hepatic transaminase levels (
38). HME patients may develop a fulminant toxic or septic shock-like syndrome, particularly individuals with HIV infection or who are otherwise immunocompromised (
39). The small numbers of bacteria detected in the blood and tissues of patients suggest that the clinical disease is mediated largely by proinflammatory cytokines (
41).
HME is caused by
Ehrlichia chaffeensis, a monocyte-tropic obligatory intracellular bacterium (
9). Previously, we demonstrated that the Wakulla strain is more virulent than the type strain Arkansas in mice with severe combined immunodeficiency (SCID mice) (
33). The Wakulla strain of
E. chaffeensis causes a fatal illness in SCID mice; the mice develop fulminant hepatitis and show upregulation of tumor necrosis factor alpha (TNF-α) and interleukin-1β (IL-1β), several chemokines, including CXCL2 (Mip2, a mouse homolog of human IL-8), and chemokine receptors in the inflammatory liver (
32). The Arkansas strain of
E. chaffeensis induces expression of IL-1β, IL-8, and IL-10 mRNA and proteins in the human monocytic leukemia cell line THP-1 at 2 and 24 h postexposure, respectively (
23). Transcriptome analysis also determined induction of IL-1β, IL-8, and TNF-α in
E. chaffeensis Arkansas-infected THP-1 cells (
56). These studies demonstrate that
E. chaffeensis can induce inflammatory cytokines and chemokines upon interaction with mammalian host cells.
It is well known that pathogen-associated molecular patterns (PAMPs) such as lipopolysaccharide (LPS), flagella, and peptidoglycan are able to induce cytokines/chemokines by innate immune cells (
14,
37,
45). Although
E. chaffeensis is a Gram-negative bacterium, these PAMPs are not encoded in the
E. chaffeensis genome (
10,
25). This suggests that the cytokine and chemokine induction by
E. chaffeensis is dependent on other types of PAMPs or the signaling pathway. For example, ehrlichial ankyrin repeat-containing protein p200 binds to the promoter region of 456 host genes, including TNF-α, and it was suggested that this leads to transcriptional activation of TNF-α (
58). PAMPs are recognized by the pattern-recognition receptors (PRRs) such as Toll-like receptors (TLRs), retinoic acid-inducible gene I-like receptors, and nucleotide-binding oligomerization domain-like receptors (
20). Other than a single report describing a prolonged infection by
E. chaffeensis of C3H/HeJ mice deficient in TLR4 function (
46), the role of PRRs in
E. chaffeensis pathogenesis and immunity is unknown.
To investigate the E. chaffeensis cytokine induction pathways, in the present study we determined cytokine induction in bone marrow-derived macrophages (BMDMs) from various mouse strains deficient in TLRs or adaptor molecules as well as in THP-1 cells in response to E. chaffeensis Wakulla. To further analyze the signaling for IL-8 induction, we developed a luciferase reporter assay system using HEK293 cells that can be infected with E. chaffeensis. We present here potentially new cytokine induction pathways activated by E. chaffeensis Wakulla.
DISCUSSION
In this study, we showed that
E. chaffeensis induces cytokines and a chemokine in BMDMs through MyD88, but independently of TRIF. MyD88 is also a key signaling adaptor molecule for IL-1R and IL-18R, but we found that neither IL-1R nor IL-18R is required for induction of cytokines and a chemokine in response to
E. chaffeensis. Recently Koh et al. reported MyD88-dependent clearance of
Ehrlichia muris in mice (
18).
E. muris induced IL-12 p40 in mouse bone marrow-derived dendritic cells (DCs), but not in macrophages, and this is also MyD88 dependent (
18). In the same study, caspase-1-deficient DCs did not show any differences in IL-12 p40 induction and
E. muris infection compared to wild-type DCs. Taken together, MyD88, but not TRIF or the IL-1R/IL-18R family, plays a critical role in
Ehrlichia sp. recognition by innate immune cells. This is in stark contrast to gamma interferon (IFN-γ) secretion by natural killer T (NKT) cells in response to
E. muris infection, which is a CD1d-dependent but MyD88-independent process, and during which an endogenous glycolipid may be an
E. muris PAMP for NKT cell stimulation (
29).
In agreement with previous observations of cytokine/chemokine induction in SCID mice (
32), significantly higher levels of proinflammatory cytokines were induced in THP-1 cells in response to strain Wakulla than to the same number of cells of strain Arkansas. Thus, strain Wakulla can provide a convenient
in vitro model to study proinflammatory cytokine induction by
E. chaffeensis. TLR2 and TLR4 did not mediate cytokine and chemokine induction by
E. chaffeensis Wakulla. Because TLR1 and TLR6 function as a heterodimer with TLR2 (
45), the result also may imply lack of TLR1 and TLR6 involvement in induction of IL-1β, CXCL2, and TNF-α by Wakulla. Although TLR5, TLR11, and TLR13 also recruit MyD88 for their downstream signaling (
20,
43), TLR5 is so far not known to recognize any PAMPs other than flagella, which the
E. chaffeensis genome does not encode (
10). Furthermore, although bacterial ligands of TLR11, TLR12, and TLR13 have not been identified, none of these receptors is encoded in the human genome (
45). Therefore, we can exclude involvement of TLR11, -12, and -13 because
E. chaffeensis is nevertheless able to induce cytokines in human cells. TLR8 is a human counterpart of mouse TLR7, and the mouse
tlr10 gene is disrupted by insertion of an endogenous retrovirus (
37,
45). DNase or RNase treatment of freeze-thawed
E. chaffeensis Wakulla did not reduce cytokine induction (data not shown). Bacterial DNA needs to be processed in the acidic endosome to be recognized by TLR9 (
2). It is possible that TLR9 is not present in
E. chaffeensis inclusions or that
E. chaffeensis DNA cannot be processed properly, since bacterial inclusion does not fuse with lysosomes. Therefore, it appears that none of these TLRs (TLR1, -2, -3, -4, -5, -6, -7, -9, -11, -12, or -13) mediates proinflammatory cytokine induction by
E. chaffeensis. This is corroborated by the fact that HEK cells, which do not express TLRs, could be induced to express proinflammatory cytokines and a chemokine in response to
E. chaffeensis stimulation. Combined with the report that IL-12 p40 secretion by mouse bone marrow-derived DCs in response to
E. muris occurs independently of TLR1, -2, -3, -4, -5, -6, -7, -9, and -11 (
18), these observations support an emerging concept of TLR-independent activation of innate immune cells by
Ehrlichia spp.
There are several recent reports about TLR-independent cytokine induction by bacteria or bacterial components. For example,
Burkholderia pseudomallei can induce IL-8 via NF-κB and MAPK pathways, aided by the Bsa type III secretion system (T3SS), without involving TLRs (
16). VP1680, a T3SS effector protein of
Vibrio parahaemolyticus, is responsible for IL-8 induction in Caco-2 cells, which is mediated by activation of both the ERK signaling pathway and NF-κB (
44). Phosphoglycolipids from thermophilic bacteria such as
Meiothermus taiwanensis induce IL-1 in human monocytes through a mechanism involving PKC-α, MEK1/2, and JNK, but independently of TLRs (
53). In all of these cases, cytokine induction is independent of MyD88 or MyD88 dependency is unknown.
E. chaffeensis recombinant TRP120 (2 tandem repeats) was reported to induce strong chemokine responses (IL-8, MCP-1, MIP-1β) (
57). While cytokine induction was not reported with another tandem repeat protein, p47 of
E. chaffeensis, it can interact with a number of host cytoplasmic signaling proteins (
47). It is possible that p47 or other
E. chaffeensis proteins may directly activate the ERK signaling pathway and NF-κB in a MyD88-dependent manner. While p47 sequences are more than 99% identical between Wakulla and Arkansas (
33), proteins of variable amino acid sequences or expression amounts between Wakulla and Arkansas strains (
33) may be responsible for strain-variable cytokine induction. We previously reported that the
E. chaffeensis Arkansas strain induces IL-1β, IL-8, and IL-10 in THP-1 cells (
23). Because viable
E. chaffeensis organisms are not required for induction of IL-1β, IL-8, or IL-10 (
23,
57), and freeze-thawed Wakulla induces strong proinflammatory cytokine induction (data not shown), bacterial infection does not seem to be required for this early response.
NF-κB is thought to be a key transcription factor in regulating inflammatory cytokine expression, including IL-8 (
22). Indeed, both our previous study with the less-virulent
E. chaffeensis Arkansas strain (
23) and the present study using the virulent Wakulla strain showed a critical role for NF-κB in induction of cytokines and chemokines by
E. chaffeensis. In addition, the present study revealed that the ERK pathway is also required for induction of these cytokines. It has been reported that LPS induces cytokines/chemokines (IL-1β, TNF-α, IL-8, etc.) through the TLR4-dependent MAPK pathway and activation of NF-κB (
14,
17).
M. tuberculosis induces TNF-α through TLR2 and PKCζ-mediated ERK activation in human monocytes/macrophages (
52).
Chlamydia trachomatis, an obligatory intracellular Gram-negative bacterium, induces IL-8 in infected epithelial cells through the ERK pathway (
6).
C. trachomatis LPS is associated with cytokine induction through TLR4/CD14- and NF-κB-dependent signaling (
15). In contrast to those reports, the present study showed that the IL-8 gene and NF-κB were activated in HEK293 cells by
E. chaffeensis Wakulla without transfection of any TLR genes, despite other reports that HEK293 cells require transfection with one or two specific TLR genes, such as the TLR2/6, TLR4, and TLR8 genes, to activate NF-κB or cytokine genes (
21,
30,
36). Taken together, our results indicate that
E. chaffeensis does not require any TLRs to activate ERK and NF-κB. Elucidation of
E. chaffeensis PRRs awaits further investigation.
Ras is a GTPase that is inactive when GDP-bound and becomes activated when a nucleotide exchange factor (GEF) stimulates GDP dissociation allowing rapid replacement by the more abundant GTP. To date, 5 families of GEF molecules have been identified: SOS, RasGRF, RasGRP, CNRasGEF, and PLCε (
7). Among them, the SOS family is ubiquitously expressed to signal downstream of receptor tyrosine kinases. In addition, THP-1 cells seem to have RasGRP2 and PLCε, according to results of a transcriptome analysis (GEO data set number GSE4110) (
13). HEK293 cells appear to express RasGRF1, RasGRP1, and RasGRP2 (GEO data set number GDS686) (
55). Human monocytes seem to have RasGRF2, RasGRP1, RasGRP2, RasGRP4, and PLCε (GEO data set number GSE6054). These findings imply that SOS and/or RasGRP2 may be commonly involved in the Ras-Raf-MEK-ERK pathway to induce cytokines by
E. chaffeensis in these cells.
C. trachomatis induces IL-8 expression at a markedly later time (15 h p.i.), which is dependent on bacterial intracellular growth and protein synthesis. IL-8 induction occurs only within inclusion-containing cells and is independent of exogenous factors in the supernatant, indicating a requirement for chlamydial products within the host cell (
5). In contrast, because
E. chaffeensis induces cytokines within 2 h p.i., this indicates that preformed bacterial factors can induce inflammation independent of infection.
We cannot rule out involvement of additional signaling pathways in E. chaffeensis cytokine/chemokine induction. However, taken altogether, the present study shows that LPS- and peptidoglycan-deficient E. chaffeensis cells induce monocyte inflammatory responses through MyD88, ERK, and NF-κB, but not via TLRs, suggesting involvement of previously unrecognized PAMPs and cognate PRRs.