title: Streptococcus sanguis secretes CD14-binding proteins that stimulate cytokine synthesis: a clue to the pathogenesis of infective (bacterial) endocarditis?
abstract: Streptococcus sanguis is the major causative organism of infective (bacterial) endocarditis but, surprisingly, almost nothing is known about how it induces endocardial inflammation. In earlier studies we have shown that many bacteria secrete potent cytokine-inducing or -inhibiting proteins. We have therefore isolated the material secreted by S. sanguis grown on blood agar or in broth culture and have tested its ability to induce human peripheral blood monocytes to synthesize pro-inflammatory cytokines. The activation of monocytes by the secreted components of S. sanguis was almost totally blocked by heat and trypsin treatment but not by the lipopolysaccharide-inactivating antibiotic, polymyxin B, suggesting that activity is due to secreted proteins. The activity of the secreted material was significantly reduced by anti-CD14 monoclonal antibodies suggesting that the active protein (or proteins) was binding to the CD14/Toll-like receptor (TLR)4 complex. Fractionation of the secreted proteins by high performance liquid chromatography (HPLC) identified two proteins as being responsible for the majority of the cytokine induction: a manganese-dependent superoxide dismutase and a 190 kDa protein, which could not be sequenced, but which was neither CshA nor the PI/II proteins. These proteins, or the receptors to which they bind, may be therapeutic targets and may allow the development of adjunctive therapies to prevent endocardial damage during the often prolonged treatment of infective endocarditis with antibiotics. In addition, blocking of CD14 may have some therapeutic benefit.
authors.affiliation: Cellular Microbiology Research Group, Eastman Dental Institute, University College London, 256 Gray's Inn Road, London, Hertfordshire, WC1X 8LD, U.K.
authors.forename: Julia
authors.initials: J
authors.lastname: Banks
authors.forename: Stephen
authors.initials: S
authors.lastname: Poole
authors.forename: Sean P
authors.initials: SP
authors.lastname: Nair
authors.forename: Jo
authors.initials: J
authors.lastname: Lewthwaite
authors.forename: Peter
authors.initials: P
authors.lastname: Tabona
authors.forename: Rod
authors.initials: R
authors.lastname: McNab
authors.forename: Michael
authors.initials: M
authors.lastname: Wilson
authors.forename: Angela
authors.initials: A
authors.lastname: Paul
authors.forename: Brian
authors.initials: B
authors.lastname: Henderson
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000911:Antibodies, Monoclonal / Q000276:immunology; D001426:Bacterial Proteins / Q000276:immunology* / Q000302:isolation & purification; D004698:Endocarditis, Subacute Bacterial / Q000276:immunology* / Q000382:microbiology; D006361:Heating; D006801:Humans; D007375:Interleukin-1 / Q000096:biosynthesis*; D015850:Interleukin-6 / Q000096:biosynthesis*; D016209:Interleukin-8 / Q000096:biosynthesis*; D018950:Lipopolysaccharide Receptors / Q000276:immunology*; D009000:Monocytes / Q000166:cytology / Q000187:drug effects / Q000276:immunology; D011112:Polymyxin B / Q000494:pharmacology; D013298:Streptococcus sanguis / Q000276:immunology*; D014357:Trypsin; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D000911:Antibodies, Monoclonal; D001426:Bacterial Proteins; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D018950:Lipopolysaccharide Receptors; D014409:Tumor Necrosis Factor-alpha; D014357:Trypsin; D011112:Polymyxin B