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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