title: Role of pneumolysin for the development of acute lung injury in pneumococcal pneumonia.
abstract: OBJECTIVE
  Acute respiratory failure is a significant complication of severe pneumococcal pneumonia. In a mouse model, we observed early-onset lung microvascular leakage after pulmonary infection with Streptococcus pneumoniae, and we hypothesized that the important virulence factor pneumolysin may be the direct causative agent.
  
  
  METHODS
  Controlled, in vivo, ex vivo, and in vitro laboratory study.
  
  
  METHODS
  Laboratory.
  
  
  METHODS
  Female mice, 8-12 wks old.
  
  
  METHODS
  Ventilated and blood-free perfused murine lungs were challenged with recombinant pneumolysin via the airways as well as via the vascular bed. In addition, we analyzed the impact of pneumolysin on electrical cell impedance and hydraulic conductivity of human umbilical vein endothelial cell (HUVEC) and alveolar epithelial cell (A549) monolayers.
  
  
  RESULTS
  Aerosolized pneumolysin dose-dependently increased capillary permeability with formation of severe lung edema but did not affect pulmonary vascular resistance. Intravascular pneumolysin caused an impressive dose-dependent increase in pulmonary vascular resistance and in lung microvascular permeability. By immunohistochemistry, pneumolysin was detected mainly in endothelial cells of pulmonary arterial vessels, which concomitantly displayed strong vasoconstriction. Moreover, pneumolysin increased permeability of HUVEC and A549 monolayers. Interestingly, immunofluorescence of endothelial cell monolayers exposed to pneumolysin showed gap formation and moderate stress fiber generation.
  
  
  CONCLUSIONS
  Pneumolysin may play a central role for early-onset acute lung injury due to severe pneumococcal pneumonia by causing impairment of pulmonary microvascular barrier function and severe pulmonary hypertension.
authors.affiliation: Charité-Universitätsmedizin Berlin, Department of Internal Medicine/Infectious Diseases and Pulmonary Medicine, Berlin, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Witzenrath
authors.forename: Birgitt
authors.initials: B
authors.lastname: Gutbier
authors.forename: Andreas C
authors.initials: AC
authors.lastname: Hocke
authors.forename: Bernd
authors.initials: B
authors.lastname: Schmeck
authors.forename: Stefan
authors.initials: S
authors.lastname: Hippenstiel
authors.forename: Katharina
authors.initials: K
authors.lastname: Berger
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Mitchell
authors.forename: Juan R
authors.initials: JR
authors.lastname: de los Toyos
authors.forename: Simone
authors.initials: S
authors.lastname: Rosseau
authors.forename: Norbert
authors.initials: N
authors.lastname: Suttorp
authors.forename: Hartwig
authors.initials: H
authors.lastname: Schütte
mesh_terms: D000336:Aerosols; D000818:Animals; D001426:Bacterial Proteins / Q000008:administration & dosage / Q000633:toxicity; D002199:Capillary Permeability / Q000187:drug effects; D002463:Cell Membrane Permeability / Q000187:drug effects; D004195:Disease Models, Animal; D042783:Endothelial Cells / Q000187:drug effects; D004847:Epithelial Cells / Q000187:drug effects; D005260:Female; D007150:Immunohistochemistry; D008171:Lung Diseases / Q000209:etiology*; D051379:Mice; D008833:Microcirculation / Q000187:drug effects; D011018:Pneumonia, Pneumococcal / Q000150:complications* / Q000503:physiopathology; D011650:Pulmonary Alveoli / Q000187:drug effects; D011652:Pulmonary Circulation / Q000187:drug effects; D013301:Streptolysins / Q000008:administration & dosage / Q000633:toxicity*; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D000336:Aerosols; D001426:Bacterial Proteins; D013301:Streptolysins; C032290:plY protein, Streptococcus pneumoniae