In this study, we addressed the issue of the mode of action on DNA and resulting genotoxicity in the host cell of the natural colibactins produced by
pks+ enterobacteria. As natural active colibactins resist isolation, we used live bacteria with an intact colibactin synthesis pathway, under culture conditions that allowed production of the genotoxic metabolites as demonstrated by the genotoxicity for the infected epithelial cells. In summary, we observed that addition of exogenous bacterial or mammalian DNA during the infection of epithelial cells by
pks+ E. coli protected the cells from colibactin genotoxicity. The DNA directly exposed to colibactin-producing bacteria did not exhibit strand breaks but did exhibit cross-linking of the DNA strands. The
in vitro cross-linking activity of
pks+ E. coli was also observed on naked DNA in the absence of epithelial cells. This DNA cross-linking was similar to that induced by MMC and cisplatin (a natural cytotoxin and a synthetic antineoplastic drug, respectively), which are bifunctional DNA alkylators generating ICLs. All
pks+ enterobacterial species (including clinical
E. coli,
C. koseri, and
K. pneumoniae isolates) exerted the same phenotype. Mutagenesis of genes inactivating (pre)colibactin synthesis or inactivating the deacylation step that maturates precolibactins into genotoxic colibactins resulted in a complete loss of the cross-linking activity. These
in vitro results strongly argue for a direct interaction of the natural colibactins with double-stranded DNA and for covalent cross-linking of the two complementary strands, resulting in DNA ICLs. Such a mode of action is in good agreement with the structural features that were recently predicted or identified in candidate nongenotoxic precolibactins: a thiazoline-thiazole tail and a spirocyclic cyclopropane ring (
48,
49). Thiazole rings have been shown to allow DNA intercalation of DNA-targeting natural products such as the bleomycins, thus supporting the idea of a direct interaction of colibactins with DNA. Cyclopropane “warheads” are found in potent DNA-damaging natural products such as illudins, CC-1065, yatakemycin, and duocarmycins, which alkylate DNA through nucleophilic cyclopropane ring openings. An isolated candidate precolibactin (purified from a nongenotoxic
clbP mutant) bearing the cyclopropane showed weak cross-linking activity when added in millimolar amounts to plasmid DNA and incubated for 20 h (
32). In addition, synthetic compounds bearing a cyclopropane ring system similar to that detected in precolibactin candidates from
clbP mutants were recently shown to alkylate plasmid DNA, resulting in extensive DNA cleavage (but not cross-linking) (
33). The NRPS ClbH incorporates the cyclopropane during synthesis of (pre)colibactins, and we observed that
clbH gene inactivation fully abrogated the DNA damage in infected cells and the cross-linking of plasmid DNA
in vitro. In addition, both the DNA cross-linking and genotoxicity of
pks+ E. coli were inhibited by addition of purified self-resistance protein ClbS, which was recently shown to convert the cyclopropane into inactive products by hydrolysis (
27). Altogether, these data support a model where the natural colibactins directly damage double-stranded DNA, with a key role for the electrophilic cyclopropane in the alkylation of one DNA strand, formation of a second electrophilic site, and alkylation of the cDNA strand, resulting in an ICL.
Denaturing gel electrophoresis of DNA from epithelial cells infected with
pks+ E. coli indicated that ICLs are rapidly (as soon as the end of the 4-h infection) generated within host cell genomic DNA. Thus, colibactins produced by
pks+ E. coli not only directly damage and cross-link naked DNA
in vitro but also can traffic in the infected epithelial cell, reach the nucleus, and cross-link DNA that is packaged into chromatin. DNA ICLs are recognized by the cellular DNA damage response mainly during DNA replication, halting the replication machinery and generating patches of single-stranded DNA (
50,
51). ATR is activated in response to this replication stress signaled by the patches of single-stranded DNA directly bound by RPA (
39). A previously published observation that
pks+ E. coli-exposed cells lagged 48 h in the S phase before accumulating in the G
2 phase whereas control cells proceeded through S-G
2-M phases in 12 h (
1) is consistent with the occurrence of replication stress. The recruitment of RPA in subnuclear foci and the activation/phosphorylation of ATR and its downstream substrate CHK1 also indicate the induction of replication stress in cells exposed to
pks+ E. coli. Moreover, ATR activation was central in orchestrating the cellular response to colibactin-induced damage, since its pharmacological inhibition abrogated the DNA damage response and resulted in mitotic catastrophe and cell death. Activated ATR allowed the recruitment of the Fanconi anemia DNA cross-link repair pathway, evidenced by the activation of FANCD2 and its recruitment in subnuclear foci together with p-H2AX. As for ATR, FANCD2 was required for cell survival of colibactin-induced damage, as shown by the decreased level clonogeny upon FANCD2 depletion. Thus, induction of early genomic DNA ICLs by colibactins resulted in replication stress and activation of the ATR and Fanconi anemia repair pathways. Concurrently, DNA DSBs were formed, evidenced by ATM phosphorylation and the recruitment of p-H2AX and 53BP1 in subnuclear repair foci. Colibactin-induced ICLs are thus converted into DNA DSBs during the repair process, when DNA lesions are excised by the host repair nucleases (
52,
53). Additionally, extended replication stalling and fork collapse can result in aberrant DNA structures and DSBs (
54). The DNA-colibactin adducts might also degrade, as observed
in vitro with synthetic colibactins mimics (
33), or under oxidative conditions, colibactins could form reactive peroxides, leading to further DNA damage (
27). We also cannot exclude the possibility that other types of DNA insults might be inflicted by different forms of colibactins, leading to DSBs by distinct mechanisms.
In conclusion, to our knowledge, this represents the first report of a direct induction of DNA ICLs in the mammalian genome by a bacterial infection. Such lesions induce replication stress and favor DSBs, and it has been shown that their accumulation over time contributes to aging in tissue and to genomic instability, a hallmark of precancerous cells. ICL is also an extremely lethal form of DNA damage, as it poses an unsurpassable block to replication and suppresses other fundamental DNA processes such as transcription and maintenance. Thus, these findings delineate a role of colibactins in tumorigenesis that might be more complex than previously thought.