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RESEARCHARTICLE Suppression of Propionibacterium acnes Infection and the Associated Inflammatory Response by the Antimicrobial Peptide P5 in Mice SunhyoRyu1,HyoMiHan1,PeterI.Song2,CherylA.Armstrong2☯*,YoonkyungPark1,3☯* 1 DepartmentofBiomedicalScience,ChosunUniversity,Gwangju,Korea,2 DepartmentofDermatology, UniversityofColoradoDenverAnschutzMedicalCampus,Aurora,Colorado,UnitedStatesofAmerica, a11111 3 ResearchCenterforProteineousMaterials,ChosunUniversity,Gwangju,Korea ☯Theseauthorscontributedequallytothiswork. * [email protected](YP); [email protected](CA) Abstract OPENACCESS Thecutaneousinflammationassociatedwithacnevulgarisiscausedbytheanaerobicbac- Citation:RyuS,HanHM,SongPI,ArmstrongCA, ParkY(2015)SuppressionofPropionibacterium teriumPropionibacteriumacnesthroughactivationoftheinnateimmunesystemintheskin. acnesInfectionandtheAssociatedInflammatory Currentstandardtreatmentsforacnehavelimitationsthatincludeadverseeffectsandpoor ResponsebytheAntimicrobialPeptideP5inMice. efficacyinmanypatients,makingdevelopmentofamoreeffectivetherapyhighlydesirable. PLoSONE10(7):e0132619.doi:10.1371/journal. Inthepresentstudy,wedemonstratetheprotectiveeffectsofanovelcustomizedα-helical pone.0132619 cationicpeptide,P5,againstP.acnes-inducedinflammatoryresponsesinvitroandinvivo. Editor:MauroPicardo,SanGallicanoDermatologic ApplicationofP5significantlyreducedexpressionoftwoinflammatorycytokinesIL-8and Institute,ITALY TNF-αinP.acnes-treatedprimaryhumankeratinocytes,whereP5appearedtoactinpart Received:March3,2015 bybindingtobacteriallipoteichoicacid,therebysuppressingTLR2-to-NF-κBsignaling.In Accepted:June16,2015 addition,inamousemodelofacnevulgaris,P5exertedbothanti-inflammatoryandantimi- Published:July21,2015 crobialeffectsagainstP.acnes,butexertednocytotoxiceffectsagainstskincells.These resultsdemonstratethatP5,andperhapsothercationicantimicrobialpeptides,offerthe Copyright:©2015Ryuetal.Thisisanopenaccess articledistributedunderthetermsoftheCreative uniqueabilitytoreducenumbersP.acnescellsintheskinandtoinhibittheinflammation CommonsAttributionLicense,whichpermits theytrigger.Thissuggeststhesepeptidescouldpotentiallybeusedtoeffectivelytreatacne unrestricteduse,distribution,andreproductioninany withoutadverselyaffectingtheskin. medium,providedtheoriginalauthorandsourceare credited. DataAvailabilityStatement:Allrelevantdataare withinthepaperanditsSupportingInformationfiles. Funding:ThisworkwassupportedbyaNational ResearchFoundationofKorea(NRF)grantfunded Introduction bytheKoreanGovernment(MEST;No.2011- Acnevulgarisisamultifactorialinflammatorydisease,thesymptomsofwhichincludecome- 0017532)andGlobalResearchLaboratory(GRL) dones,papules,pustules,nodules,cystsandpilosebaceousinflammation,oftenleadingtosig- Grant(NRF-2014K1A1A2064460).Thefundershad noroleinstudydesign,datacollectionandanalysis, nificantscaringanddisfigurementofthefaceanduppertrunk[1].Propionibacteriumacnes(P. decisiontopublish,orpreparationofthemanuscript. acnes)playsakeyroleinthepathogenesisofacne.Thisubiquitousgram-positivebacteriumis partofthenormalskinmicroflora,butispresentinabnormallyhighnumberswithinpilose- CompetingInterests:Theauthorshavedeclared thatnocompetinginterestsexist. baceousfolliclesinpatientswithacne[2].Itiswidelyacceptedthatinflammatoryacnereflects PLOSONE|DOI:10.1371/journal.pone.0132619 July21,2015 1/18 InflammatoryResponsebytheAntimicrobialPeptideP5 theimmuneresponseofthehosttoP.acnes,whichcanstimulatetheproductionofproinflam- matorycytokinesandchemokines(e.g.,IL-8andTNF-α)byimmunesystemcells,therebytrig- geringthegranulomatousreactionsofinflammatoryskindisease[3].Consistentwiththatidea, P.acnesreleaseschemoactivefactorsthatattractneutrophils,monocytesandlymphocytes[4], andactsviathetoll-likereceptor(TLR)2-to-NF-κBsignalingpathwaytostimulateproduction ofpro-inflammatorycytokines,chemokinesandadhesionmolecules[5,6]. ReductionofthenumbersofP.acnesintheskinbyacnemedicationscorrelateswithclinical improvement[2].However,treatmentofacnevulgariswithcommonlyusedantibiotics, includingoraltetracyclineandtopicalerythromycinandclindamycin,hasincreasedtheresis- tanceofP.acnestoantibioticsandincreasedthelikelihoodoftherapeuticfailure[7].Benzoyl peroxide(BPO),alipophilicnon-antibioticantibacterialagent,isalsohighlyeffectiveagainst P.acnes;however,ithasahighminimalinhibitoryconcentration(MIC:150μg/ml)[8,9].Oral isotretinoin,apotentoralretinoidreservedforthetreatmentofsevereacne,iseffective,butits useislimitedbyitsmanyseveresideeffects[10].Recently,a5%dapsonegel(asyntheticsul- fone)wasshowntohavesomeefficacyinthetreatmentofacnevulgaris[11],butpotential hematologictoxicitylimitsitsclinicalutility[12].Itisthusclearthatdevelopmentofasafe therapeuticreagentthathasnosideeffectsbutstrongantibacterialactivitywouldhighlydesir- ableforthetreatmentofacne.Onepromisingapproachistheuseofantimicrobialpeptides (AMPs),whichefficientlykillmicrobialpathogensandmodulatehostimmuneresponses[13]. CAisa37-aminoacidcationicAMPisolatedfromthecaterpillarofthececropiamoth (Hyalaphoracecropia)[14],whileMAisa23-aminoacidcationicAMPfromtheskinofthe Africanclawedfrog(Xenopuslaevis)[15].BothCAandMAexertstrongantibacterialeffects withlittleornocytotoxicityaffectingmammaliancells[14,15].Aprimarytargetforthesepep- tidesisthelipidbilayerofthebacterialcytoplasmicmembrane,towhichtheybindandinduce membranepermeabilization[16].WerecentlyreportedasyntheticCA-MAhybridanalogue, P5,whichwasdesignedtoincreasethenetpositivechargeandhydrophobicityofthepeptide [17,18].P5showedgreatlyincreasedantibacterialactivityagainstbothGram-positiveand Gram-negativebacteria,actingviaamembranolyticmechanism,butnohemolyticorcytotoxic activityinmammaliancells.Notably,P5hasstrongerantibacterialandantifungalactivities thanCA-MAagainstavarietyofaerobicmicrobes,buthaslittleornohemolyticorcytotoxic activityagainstnormaleukaryoticcells[17–20].Moreover,ithasnotyetbeendemonstrated whetherP5hastheabilitytoeffectivelypreventortreatinflammatoryskindiseasessuchas acne.Inthepresentstudy,therefore,ouraimwastoassessthepotentialutilityofP5asathera- peuticagentforthetreatmentofinflammatoryacnevulgarisbasedonitspotentantibacterial effectsanditsabilitytosuppressdevelopmentoftheinflammatoryresponsestriggeredbyP. acnes.Todothat,wetestedtheeffectsofP5oninflammatorycytokineproductioninlivingP. acnes-infectedhumankeratinocytes(HKs)invitro,andinvestigatedthemolecularmechanism oftheanti-inflammatoryeffectsofP5inamousemodelofP.acnes-inducedinflammatory acne. MaterialsandMethods EthicsStatement ThisstudywascarriedoutinstrictaccordancewiththerecommendationsintheGuideforthe CareandUseofLaboratoryAnimalsoftheNationalInstitutesofHealth.Theprotocolwas approvedbytheCommitteeontheEthicsofAnimalExperimentsoftheUniversityofArkan- sasforMedicalSciences(PermitNumber:A3063-01).Allsurgerywasperformedunder sodiumpentobarbitalanesthesia,andalleffortsweremadetominimizesuffering. PLOSONE|DOI:10.1371/journal.pone.0132619 July21,2015 2/18 InflammatoryResponsebytheAntimicrobialPeptideP5 Experimentalanimalprotocol WeutilizedfemalewildtypeInstituteofCancerResearch(ICR)mice(6–8weeks-old;Harlan, Indianapolis,IN)inthisstudyasameansofassessingtheabilityofthenewlydesignedsyn- theticantimicrobialpeptideP5tominimizeaPropionibacteriumacnes(P.acnes)infection, andmodulatetheinnateinflammatoryresponseofthehostasdescribedindetailpreviously [21].Birefly,P5(1.6μM,20μl),orPBS(20μl)wasinjectedintradermallyintotherightearsof ICRmice24hoursafterP.acnes(1x108CFUper20μlinPBS)inoculationatthesamesite.P. acneswasquantifiedbyplatingserialdilutionsofthehomogenateonagarplatesandincubat- ingunderanaerobicconditionsfor48hours.Earthicknesswasmeasuredusingamicrocaliper (Mitutoyo547-400S;MSIVikingGage,Charleston,SC)priortoinjectionandat24,48,72and 96hoursafterinjection.Forallinvivoexperiments,n=10animals/treatmentgroup/time pointwereusedunlessotherwisespecified.Experimentalcomparisonsweremadebya repeatedmeasuresANOVAmodelusingSASProcmixedsoftware(SASInstitute,Inc.,Cary, NC). Preparationofsyntheticpeptides SyntheticAMPsCA-MA(KWKLFKKIGIGKFLHSAKKF-NH2),P5(KWKKLLKKPLLKKLLK KL-NH2),andP4(KWKKKKKKPKFL-NH2)weresynthesizedasdescribedpreviously[17]. Thestocksolutionwasmadeataconcentrationof1mMinsterilizeddistilledwaterandfil- teredthrougha0.22-μmporefilter.Thefilteredsolutionwasstoredat-20°Cuntiluse. Bacterialculture P.acnes(ATCC11828andATCC6919)(AmericanTypeCultureCollection,Manassas,VA) wasculturedinReinforcedClostridialMedium(BD:FranklinLakes,NJ)underanaerobiccon- ditionsusingGas-Pakat37°Casdescribedindetailpreviously[21].Staphylococcusepidermidis (S.epidermidis)(ATCC12228)wasculturedinNutrientbroth(BD)underaerobicconditions at37°C.Forstimulationofnormalhumankeratinocytes(HKs),bacterialcellswereharvested bycentrifugationat3,000xgfor10minat4°C.Thebacteriawerethenwashedthreetimes withPBSandresuspendedinstarvationmediumlackinghydrocortisoneandbovinepituitary extract(BPE)orinPBSat1x108colony-formingunits(CFU)/ml. Invitroantibacterialassays Minimumbactericidalconcentrations(MBCs)ofthepeptidesagainstanaerobicandaerobic microorganismsweredeterminedinduplicateintwoindependentexperimentsusingmicrodi- lutionmethodswith96-wellmicrotitrecellcultureplates.Thepeptideswerefilteredthrough 0.22μmfiltersanddilutedstepwiseinappropriatebrothmediatoconcentrationsrangingfrom 100μMto0.39μM.The2-foldseriallydilutedsolutionsofeachpeptide(100μl)weremixed with100μlofbacterialsuspensiontoadensityof2x106CFU/ml.Theplateswerethenincu- batedfor16hat37°Cunderanaerobicoraerobicconditions.Afterincubation,thereaction mixturesweredilutedandplatedontoappropriateagarplatesforcountingtheCFUs.The MBCwasdefinedasthelowestpeptideconcentrationthatresultedinnovisiblemicroorganism growthontheagarplate. Keratinocyteculture Humanepidermalkeratinocytes(HKs)fromforeskinwerepurchasedfromPromoCell(Hei- delberg,Germany)andculturedinkeratinocytegrowthmedium(KGM;Clonetics,San Diego,CA)asdescribedindetailpreviously[21].Briefly,HKcellswereculturedinKGMat PLOSONE|DOI:10.1371/journal.pone.0132619 July21,2015 3/18 InflammatoryResponsebytheAntimicrobialPeptideP5 37°Cinahumidifiedatmospherecontaining5%CO .Cellculturemediawaschangedevery 2 2to3daysandcellswereharvestedafterpassage3to4.HKcellswereseededataconcentra- tionof104to105cellsperwellinto6/12/96wellcultureplatesandchamberslides.Thecells wereallowedtogrowuptoabout70%confluence.Intherequiredexperimentalconditions, HKcellswereculturedinKGMstarvingmedia,whichisfreeofsupplementandgrowthfac- tors(BPE,hEGF,insulin,hydrocortisone,epinephrine,transferrinandgentamicin/ampho- tericin-B). Scanningelectronmicroscopy(SEM) SEMwasperformedasdescribedpreviously[18].Allsampleswerevisualizedusingafield emission-scanningelectronmicroscope(FE-SEM,JSM-7100F,Jeol,Japan)at20,000xmagnifi- cation(15.0kV). TreatmentofP.acnesand/orpeptidesinHKs AfterculturedHKswerepre-infectedwithP.acnes(1x108CFU/ml)for24hours,asynthetic peptide(CA-MA,P5orP4)wasaddedtoeachwelltoaconcentrationof0.8μM,1.6μMor 3.2μM.Then,thecellswereincubatedforvariousperiodsasindicatedintheresults.Cultured HKcellsinstarvationmediumonlyservedasanegativecontrol.Thecellswerethenharvested forRNAextraction.Thesupernatantscollectedbycentrifugationat14,000xgfor10minat 4°Cwerealiquotedandstoredat-70°CuntilusedinIL-8andTNF-αassay. QuantitativeRT-PCR TargetgenemRNAexpressionwasanalyzedbyreal-timeRT-PCRasdescribedinthemanu- facturer’sprotocol(ABI7500real-timePCRsystemusingSYBRGreenmastermix;Applied Biosystems,FosterCity,CA)asdescribedindetailpreviously[21].Theprimersequenceswere asfollows:forIL-8,5'-GCAGTTTTGCCAAGGAGTGCT-3'(sense)and5'-TTTCTGTGTTG GCGCAGTGTG-3'(antisense);forTNF-α,5’-ATAGCTCCCAGAAAAGCAAGC-3’(sense) and5’-CACCCCGAAGTTCAGTAGACA-3’(antisense);forTLR2,5’-TGTCTTGTGACCGCA ATGGT-3’(sense)and5’-GTTGGACAGGTCAAGGCTTT-3’(antisense);andfor18SrRNA, 5'-CGGCTACATCCAAGGAA-3'(sense)and5'-GCTGGAATTACCGCGGCT-3'(anti- sense).Quantificationoftargetgeneexpressionwasnormalizedusinganinternalcontrolgene, 18SrRNA[22].Alltheexperimentswereperformedintriplicate. Enzyme-LinkedImmunosorbentAssay(ELISA) TheIL-8andTNF-αlevelsincollectedculturesupernatantsweredeterminedusinghuman TNF-αandIL-8immunoassaykits(R&DSystems,Minneapolis,MN)accordingtothemanu- facturer’sinstructions.TheopticaldensityofthewellswasmeasuredusinganELISAreaderset to450nmwithawavelengthcorrectionsetto540nm.Alltheexperimentswereperformedin triplicate. ImmunofluorescentstainingforNF-κBnucleartranslocationandTLR2 cellularlocalization ImmunofluorescenceanalysisofNF-κBandTLR2localizationwasperformedaspreviously described[23].Briefly,HKsweretreatedwithP.acnes(1x108CFU/ml)for30minforNF-κB or24hforTLR2inthepresenceorabsenceof1.6μMP5orP4.Thecellswerethenfirstincu- batedwithrabbitpolyclonalanti-humanNF-κBp65antibody(RelA)orrabbitanti-human TLR2antibody(Rockland,Gilbertsville,PA),diluted1:3000inblockingbuffer(ImmPRESS PLOSONE|DOI:10.1371/journal.pone.0132619 July21,2015 4/18 InflammatoryResponsebytheAntimicrobialPeptideP5 kit;VectorLaboratories,Burlingame,CA).Theywerethenincubatedfor1hwithFITC-conju- gatedaffinity-purifiedgoatanti-rabbitIgG(1:300dilution;H+L;JacksonImmunoResearch Laboratories,Inc.,WestGrove,GA)atroomtemperatureinthedark.Finally,thecellswere visualizedunderamicroscope(OlympusEX51;CenterValley,PA),andimageswereacquired usingaQICAMfast1394camera(Westmont,IL). MTTassay AstandardcolorimetricassayforassessingcellviabilitybasedontheactivityofMTT(yellow tetrazoliumsalt:3-(4,5-dimethuylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide)reducing enzymeswasperformedaccordingtothemanufacturer’sinstructions(MolecularProbes,Inc., Eugene,OR)usingHKcells(5x103per200μlculturemedia)inthepresenceandabsenceof P5orP4atconcentrationsrangingfrom1.6to6.4μM.Dataarepresentedasthepercentageof viableHKcellscomparedtothepercentageofviablecellsaftertreatmentwith2%TritonX- 100,whichservedasthepositivecontrolforcellcytotoxicity. Circulardichroism(CD)analysisofP5bindingtolipoteichoicacid(LTA) CDspectrawererecordedat25°ConaJasco810spectropolarimeter(Jasco,Tokyo,Japan) equippedwithatemperaturecontrolunitusingaquartzcellwitha0.1-cmpathlength.The CDspectrafor50μMpeptidedissolvedinPBS(pH7.2)werescannedinthepresenceor absenceof0.1%LTAdissolvedinPBS.Atleastfourscansofthe250–190nmwavelengthrange wereconducted,afterwhichtheaverageblankspectraweresubtractedfromtheaverageofthe samplespectra. AnalysisofintracellularCa2+mobilizationinkeratinocytes MobilizationofintracellularCa2+wasevaluatedtoassessthefunctionalresponseofHKstoP. acnes-infectioninthepresenceandabsenceofsyntheticpeptidesasdescribedindetailprevi- ously[21].Briefly,culturedHKsoncoverslipswereincubatedfor45minat37°CinPBScon- taining2μMfura-2/AM(Invitrogen,Carlsbad,CA),themembranepermeantformofthe fluorescentCa2+probefura-2.Afterthreewashes,thecellswerepretreatedwithorwithout 1.6μMP5orP4,afterwhichP.acneswasaddedduringtheactivemonitoringofintracellular Ca2+mobilization.FluorescencewasmeasuredusinganInCytBasicIMFluorescenceImaging System(IntracellularImagingInc.,Cincinnati,OH)accordingtothemanufacturer’sinstruc- tions.TheintracellularfreeCa2+concentrationwasdeterminedbymeasuringtheratioofthe 510nmemissionselicitedbyexcitationat340and380nm. DeterminationofP.acnesabundanceandP.acnes-induced inflammationinvivo P5(1.6μM,20μl)orPBS(20μl)wasintradermallyinjectedintotherightearsofICRmice (Harlan,Indianapolis,IN)24hafterP.acnes(1x108CFUper20μlinPBS)inoculationatthe samesite.Leftearsofthesamemicewereinjectedwith20μlofPBS.InnegativecontrolICR mice,therightearsremaineduntreated,whiletheleftearsreceivedintradermalinjectionsof PBS.Tenmgoftissuefrom8mmpunchbiopsiestakenfromtheears24hoursafterpeptide injectionwerehomogenizedin250μlofsterilePBSusingatissuegrinder.P.acneswasquanti- fiedbyplatingserialdilutionsofthehomogenateonagarplatesandincubatingthemfor48h underanaerobicconditions.Earthicknesswasmeasuredusingamicrocaliper(Mitutoyo547- 400S;MSIVikingGage,Charleston,SC)priortopeptideinjectionandat24,48and72hours afterinjection. PLOSONE|DOI:10.1371/journal.pone.0132619 July21,2015 5/18 InflammatoryResponsebytheAntimicrobialPeptideP5 Statisticalanalysis Resultsareexpressedasmeans±SD.ANOVAwithprobabilitieswasperformedforbothover- allsignificanceandpairwisecomparison.P<0.05wasconsideredtobestatisticallysignificant. Results AntibacterialeffectsofCA-MA,P5andBPOagainstskinbacteria WecomparedtheantibacterialactivitiesofCA-MA,itsnewlydesignedanalogueP5,andBPO againsttheskinbacteriaP.acnesATCC11828,P.acnesATCC6919andS.epidermidisATCC 12228bydeterminingtheMBCofeachstrainusingthemicrodilutionmethod.Thethree strainswereculturedinthepresenceofvariousconcentrationseachagentfor48,72and24 hours,respectively.Bacterialgrowthwasthenevaluatedbymeasuringtheabsorbanceat600 nm,afterwhichthebacteriaweredilutedandspottedonagarplatestocounttheCFUs (Table1).Eachsyntheticpeptide,CA-MA(parentalpeptide),P5andanegativecontrolpeptide (P4),wastestedatconcentrationsrangingfrom0.1to12.8μMusingtwofoldserialdilutions. BPO,whichisatraditionalcompoundusedtotreatmildtomoderateacne,wastestedatcon- centrationsrangingfrom7.8to250μM,with5%(vv-1)DMSOservingasthecontrol.The MBCvaluesofP5andCA-MAwere0.2and0.4μM,respectively(Table1).TheMBCforP5 was300timeslowerthanthatforBPO(62.5μM)and64timeslowerthanforP4(>12.8μM), itsnegativecontrolpeptide.ThepotentantibacterialactivityofP5againstanaerobicP.acnesis similartothatofclindamycin(MBC<0.2μM),acommontopicaltreatmentforacnevulgaris. Theseresultsdemonstratethatincreasingthepositivechargeandthehydrophobicityofthe newlydesignedAMPP5ledtoadistinctincreaseinitsbactericidalactivity. CytotoxicityofP5againstHKs TodeterminethecytotoxiceffectsofP5onHKs,weusedMTTassaystomeasureHKviability inserum-freemediumwithorwithoutP5for24hat37°C.HKviabilitywasdeterminedafter 24hoftreatmentatconcentrationsrangingfrom0.5to5μM.WefoundthatHKswere100% viableafter24hoftreatmentwithP5oritscontrol,P4(S1Table).Theseresultsdemonstrate thatP5hasnosignificantcytotoxiceffectonHKs,evenatconcentrationsseveraltimeshigher thannecessaryforantibacterialactivityagainstP.acnes. P5inducesmorphologicaldisruptionofP.acnesthatsuggestsa bactericidaleffect CationicAMPskillbacteriaprimarilythroughmembranepermeabilizationandsubsequent structuraldisruption.UsingSEM,wewereabletodirectlyobservecellmorphologyand Table1. MBCsofSyntheticAMPsandConventionalAgentsagainstAcne-InducingPropionibacteriumacnes. Antimicrobialpeptides(AMPs) MBC(μM)ofthefollowingbacteria P.acnes(ATCC11828) P.acnes(ATCC6919) P.acnes(ATCC12228) CA-MA 0.4 0.4 0.4 P5 0.2 0.2 0.2 P4 >12.8 >12.8 >12.8 Clindamycin <0.2 <0.2 <0.2 BPO(benzoylperoxide) 62.5 >62.5 >62.5 MBC(minimalbactericidalconcentration)wasdefinedasthelowestpeptideconcentration(μM)thatprevented100%ofbacterialgrowthonagarplates. doi:10.1371/journal.pone.0132619.t001 PLOSONE|DOI:10.1371/journal.pone.0132619 July21,2015 6/18 InflammatoryResponsebytheAntimicrobialPeptideP5 Fig1.MorphologicalperturbationsandblebsinducedinP.acnesbyP5.ShownareP.acnescellsafter incubationfor20minintheabsence(A)andpresenceofCA-MA(B),P5(C)andP4(D)ataconcentrationof 1/2MBC.Arrowspointtomorphologicalperturbationsandblebs,whichwereclearlyvisiblefollowing treatmentwithP5. doi:10.1371/journal.pone.0132619.g001 integrityafterpeptidetreatment.WeobservedthatP5inducedmorphologicalperturbations andblebsintheP.acnescellwallataconcentrationof0.1μM(Fig1C),whereasCA-MA(Fig 1B)andP4(Fig1D)inducedlittlemorphologicchangestothecellsurfaceatthesameconcen- tration.TheseresultsindicatethattheantimicrobialeffectofP5againstP.acnesisconsistent withitscationicnaturewithitsbactericidalorbacteriostaticactivity. P5suppressesP.acnes-inducedexpressionofpro-inflammatory cytokinesinHKs WenextexaminedtheeffectofP5oninnateinflammatoryresponsestoP.acnesinfectionin vitro.BecauseIL-8andTNF-αareinflammatorymediatorslikelytoparticipateintheresponse tocutaneousinfections,weusedreal-timeRT-PCR(Fig2)andELISA(Fig3)tomeasurethe effectsofP5(0.8or1.6μM)ontheexpressionofIL-8andTNF-α24hafterpre-infection (1x108CFU/ml)ofHKswithP.acnes.WefoundthatrelativelevelsofbothIL-8andTNF-α mRNA(Fig2Aand2B,respectively)andprotein(Fig3Aand3Brespectively)weresignifi- cantlyupregulatedafterP.acnesinfection,andthoseresponsesweresignificantlyinhibitedby P5.ParentalCA-MAhadmuchlessabilitytoinhibittheincreaseinIL-8andTNF-αexpres- sioninducedbyP.acnesthanthemorehydrophobicP5analogue,whilethenegativecontrol peptideP4hadnoeffectonP.acnes-inducedIL-8andTNF-αexpressioninHKs.Bycontrast, theseAMPshadnoeffectonbasalIL-8orTNF-αexpressionwhenuninfectedHKswere treated(Fig3Aand3B).TheseresultsindicatethatP5specificallyinhibitstheexpressionof inflammatorycytokinesinducedbyP.acnesinfectioninHKs. P5significantlyinhibitsP.acnes-inducedTLR2expressioninHKcells ItisknownthatP.acnescontributestoinflammationinacnethroughactivationofthetoll-like receptors(TLRs),especiallyTLR2[19].Therefore,tofurtherexploretheeffectofP5oninnate PLOSONE|DOI:10.1371/journal.pone.0132619 July21,2015 7/18 InflammatoryResponsebytheAntimicrobialPeptideP5 Fig2.P5inhibitsexpressionofIL-8andTNF-αmRNAinducedbyP.acnesinfectioninHKs.TotalRNAwascollectedfromP.acnes-infectedHKswith andwithoutP5treatment.ExpressionofIL-8(A)andTNF-α(B)mRNAwasmeasuredusingquantitativeRT-PCRwithhumanIL-8-andTNF-α-specific primers.TherelativelevelofeachmRNAwasnormalizedtotheexpressionof18SrRNA.Alldatawerecomparedtotheuntreatedcontrolvalues.Thedata shownarerepresentativeoftriplicateexperiments.Allvaluesareexpressedasthemean±SD.*p<0.001. doi:10.1371/journal.pone.0132619.g002 inflammatoryresponses,weusedreal-timeRT-PCRtoassessexpressionofthepatternrecog- nitionreceptorTLR2inducedinHKsinresponsetoP.acnes(1x108CFU/ml)infectionand thentestedtheeffectof1.6μMP5.ExpressionofTLR2mRNAwasincreasedabout2-foldin HKs24hafterP.acnesinoculation,andthisoverexpressionwassignificantly(P<0.001) down-regulatedbytreatmentwithP5,butnotP4(Fig4A).P5alsoinhibitedP.acnes-induced Fig3.P.acnes-inducedsecretionofIL-8andTNF-αfromHKswasinhibitedbyP5treatment.IL-8(A)andTNF-α(B)weremeasuredinculture supernatantsafterincubatingP.acnes-infectedHKcellsfor24hinthepresenceorabsenceof1.6μMP5,P4orCA-MA.Thedatashownarerepresentative oftriplicateexperiments.Allvaluesareexpressedasmean±SD.*p<0.001. doi:10.1371/journal.pone.0132619.g003 PLOSONE|DOI:10.1371/journal.pone.0132619 July21,2015 8/18 InflammatoryResponsebytheAntimicrobialPeptideP5 Fig4.P5inhibitsexpressionofTLR2inducedbyP.acnesinHKs.(A)ExpressionofTLR2mRNAwasmeasuredusingreal-timeRT-PCRand normalizedtotheexpressionof18SrRNA.Allvaluesareexpressedasthemean±SD.*P<0.001.(B)ImmunofluorescentlocalizationofTLR2withinHKs.P. acnes-infectedHKswereincubatedfor24hinthepresenceorabsenceof1.6μMP5orP4,afterwhichthedistributionofTLR2wasdeterminedby immunofluorescentlabeling.FITC-labeledTLR2isshowningreen,whiletheHoechst-stainednucleiareblue:(a)treatedwithPBS;(b)treatedwithP.acnes; (c)treatedwithP.acnesplusP5;(d)treatedwithP.acnesplusP4;(e)treatedwithP5alone. doi:10.1371/journal.pone.0132619.g004 expressionofTLR2proteininHKsmeasured24haftertreatment(Fig4Bc),ascomparedto thenegativecontrolP4(Fig4Bd).Finally,treatmentwithP5alone(Fig4Be)hadnoeffecton basalTLR2expressioninHKs.TheseresultsdemonstratethatP5specificallyinhibitsTLR2 expressionrelatedtotheinnateimmuneresponsetoP.acnes-infectioninHKcells. P5blocksNF-κBnucleartranslocationinducedbyP.acnesinfectionin HKcells NF-κBisakeytranscriptionalregulatorofmultiplegenes,includingIL-8andTNF-α.TLR2 signalingleadstoactivationoftheNF-κBpathway,whichinturnstimulatesreleaseofpro- inflammatorycytokinessuchasIL-8andTNF-α.TotestwhetherP5affectsTLRsignalingto NF-κB,weusedimmunofluorescentstainingtoassesstheintracellulardistributionofNF-κB p65.InuntreatedHKs,NF-κBstainingwasobservedprimarilyinthecytoplasm(Fig5A),how- ever,nucleartranslocationofNF-κBwasrapidlyinducedbyP.acnesinfection(Fig5B).Co- incubationofHKswithP.acnesandP5effectivelyblockedP.acnes-inducedNF-κBnuclear translocation(Fig5C).Bycontrast,thenegativecontrolpeptideP4hadnoeffectonP.acnes- inducedNF-κBnucleartranslocation(Fig5D). BindingofCA-MAandP5toLTA TheabilityofAMPstobindLTAlikelyplaysasignificantroleintheirabilitytoneutralizeLTA shedfrombacteriaandthuspreventsinflammatoryresponses.Wethereforeanalyzedthepep- tides’CDspectratoaskwhetheranyofthepeptidesstudiedherecouldbindtopurifiedLTAin vitro.Whenthepeptideswerestudiedat50μMina0.1%LTAsuspension,P5adoptedamore foldedconformationthanCA-MA(S1Fig.),whichisindicativeofitsbindingtoLTA.Thissug- geststhatP5blockstheinductionofinflammatorycytokinesinHKcellsbybindingLTA. PLOSONE|DOI:10.1371/journal.pone.0132619 July21,2015 9/18 InflammatoryResponsebytheAntimicrobialPeptideP5 Fig5.P5inhibitsNF-κBnucleartranslocationinP.acnes-infectedHKcells.TheintracellulardistributionofNF-κBwasdeterminedby immunofluorescentlabelingofNF-κBp65(green),whilenucleiwereHoechststained(blue):(A)untreatedHKcells;(B)HKcellstreatedwithP.acnes;(C)HK cellstreatedwithP.acnesplusP5;HKcellstreatedwithP.acnesplusP4(D). doi:10.1371/journal.pone.0132619.g005 P5inhibitsP.acnes-inducedintracellularCa2+fluctuationinHKs Ca2+signalingappearstoplayaroleatseveralstepsduringbacterialinfectionandinthecon- trolofgeneexpression,especiallytheexpressionandsecretionofpro-inflammatorymediators inducedbybacterialpathogens[19].WethereforeexaminedtheeffectofP5ontheintracellu- larCa2+signalinginducedinHKsbyP.acnesinfection.AsshowninFig6,P.acnes(1x108 PLOSONE|DOI:10.1371/journal.pone.0132619 July21,2015 10/18

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(Mitutoyo 547-400S; MSI Viking Gage, Charleston, SC) prior to injection and at 24, 48, 72 and. 96 hours repeated measures ANOVA model using SAS Proc mixed software (SAS Institute, Inc., Cary,. NC). gests that P5 blocks the induction of inflammatory cytokines in HK cells by binding LTA. Fig 4.
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