Yersinia pestis, the causative agent of plague, specializes in causing dense bacteremia following intradermal deposition of a small number of bacteria by the bite of an infected flea. This robust invasiveness requires the ability to evade containment by the innate immune system. Of the various mechanisms employed by Y. pestis to subvert the innate immune response and to proliferate rapidly in mammalian tissue, only a few are well-characterized. Here, I present two complementary genetic analyses of Y. pestis adaptations to the mammalian environment. In the first, genome-wide fitness profiling for Y. pestis by Tn-seq demonstrates that the bacterium has adapted to overcome limitation of diverse nutrients during mammalian infection. In the second, a series of combinatorial targeted mutations disentangles apparent functional redundancy among the effectors of the Y. pestis type III secretion system, and we report that YpkA, YopT, and YopJ contribute to virulence in mice. We have also begun to investigate a novel relationship between Y. pestis and mammalian platelets, a highly abundant cell type in plasma. I present evidence that Y. pestis has evolved specific mechanisms to interfere with platelet activation, likely in order to evade immune responses and promote maintenance of bacteremia by undermining platelet thrombotic and innate immune functions. The principles guiding this work – systematic genetic analysis of complex systems, coupled with rational modification of in vitro assays to more closely mimic the in vivo environment – are a generalizable approach for increasing the efficiency of discovering new virulence determinants in bacterial pathogens.

The primary objective of this thesis is to differentiate between the risk factors for pre-and post-monsoon cholera epidemics in rural Bangladesh by analyzing the complex interaction between select environmental, cultural/behavioral, and socioeconomic variables over space and time. In rural Bangladesh, cholera epidemics correspond with the annual monsoon: the first, and smallest, occurs between March and June, while the larger cholera peak occurs between September and December. The differences between the spatial and temporal patterns of seasonal cholera are analyzed, and the risk factors are calculated for pre-and post-monsoon cholera epidemics. The theoretical approach that underlies this medical geographical study is disease ecology, which espouses that risk of disease is caused by an interaction between people and their environment. This thesis is structured around a holistic understanding that human-environment interactions are inseparable. In Bangladesh, the monsoon season typically starts between May and June. The 1992 and 1993 cholera peaks occurred just before the monsoon in April and March respectively, while the 1994 cholera peak occurred between April and June. In 1992 and 1993 cholera incidence increased in the post-monsoon period, and peaked in October. The 1994 post-monsoon cholera peak occurred in November. There is a regular temporal pattern to cholera, as the peaks followed a seasonal pattern with the smaller epidemic occurring in the pre-monsoon period and the larger epidemic occurring in the post-monsoon period. This study shows that there are different risks associated with pre-monsoon cholera epidemics and post-monsoon cholera epidemics. The two main risk factors associated with cholera incidence pre-monsoon were bari population (i.e., crowding) and a house located within the flood controlled area. These two variables were even more strongly associated with post-monsoon cholera incidence to a greater degree, along with a number of other variables including water use, sanitation practices, and socioeconomic status.

Tuberculosis, an infectious disease caused by Mycobacterium tuberculosis, has been a global health problem for years. The emergence of drug resistance in this organism generates the necessity of exploring novel targets and developing new drugs. Topoisomerases are enzymes found in all kingdoms of life responsible for overcoming the topological barriers encountered during essential cellular processes. The genomes of mycobacteria encode only one type IA topoisomerase (MtopI), which has been validated as a novel TB drug target. The goal of this study is to obtain new information on the mechanism and resistance of endogenous and synthetic inhibitors of MtopI. Rv1495 is a M. tuberculosis toxin that belongs to the MazEF family (MazE is the antitoxin and MazF is the toxin), with endoribonuclease activity. Rv1495 (MazF homolog in M. tuberculosis) toxin has been shown to interact directly with the C-terminal domain of MtopI for mutual inhibition. In this study the interaction of Rv1495 with the positively charged C-terminal tail in Mtop I is reported. This new information is useful for rational design and discovery of antibiotics for mycobacteria. Ethacridine, an FDA approved drug has shown activity against MtopI. In this project we studied the mechanisms of resistance associated with this drug as well the use of Ethacridine in combination with Moxifloxacin, to potentiate the bactericidal effect of this current second line drug for TB treatment. Results from sequencing of the genomic DNA isolated from the resistant mutants suggested the involvement of the Holliday-junction Ruv resolvase. Further studies showed that co-treatment with Ethacridine can enhance the moxifloxacin-mediated killing of M. smegmatis. FP-11g, a novel fluoroquinophenoxazine inhibitor of bacterial topoisomerase I, has shown promising activity against M, tuberculosis. We explored the bactericidal activity and resistance mechanisms associated to FP-11g using M. smegmatis as model organism. Additionally, the inhibitory effect of FP-11g was also evaluated on M. abscessus. FP-11g at concentration 4X MIC showed complete bactericidal activity against M. smegmatis after 24 hours. Inhibitory activity against M. abscessus was also observed. Results from sequencing of the genomic DNA isolated from the M. smegmatis resistant mutants revealed mutations in genes associated with general drug resistance.

The breadth of genetic diversity in the mammalian immune response stands out amongst the ubiquity of variation seen in the genome, evidence that microbial infections have been a major driver of evolution. As technology has facilitated an understanding of the etiology of immunological diversity, so too has it enabled the assessment of its varied functions. Functional genomics, with its ability to assess both cause and effect, has revolutionized our understanding of fundamental biological phenomena and recalibrated our hypotheses. We build upon the model of host immunity established by rare genetic variants that are causative of immunodeficiencies, but that incompletely consider the complexities of the genome. To expand our understanding, we performed a series of forward genetic screens to identify regulators of distinct functions of the innate immune system. Our studies discovered genes with novel functions in antigen presentation and immunoregulation, including several involved in central metabolism. Studies in macrophages and dendritic cells identified mitochondrial respiration as a positive regulator of the interferon-gamma response, and cells incapable of respiration failed to activate T cells. Notably, human mutations in several of these genes are responsible for immune dysfunction. In summary, this work uses new methods in genetic engineering to systematically assess the regulation of innate immunity. Our results suggest that variation in these regulatory pathways is likely to alter immunity in states of health and disease. Thus, our work validates a new approach to identify candidate genes relevant to immune dysfunction.

For several decades amphibian populations have been declining. Historically, the bacterium A. hydrophila (Ah) was hypothesized to be the causal factor in amphibian disease and population declines. However, with the discovery of a chytrid fungus, Batrachochytrium dendrobatidis (Bd) in 1998, which was identified on the skin of amphibians during documented mortality events, Ah research became of minor interest as focus shifted to Bd. Recent studies into the immunocompromising abilities of Bd, however, have opened new questions about its relationship with Ah and their combined effects on a host. In this study, I explore the relationship between infection with these two pathogens, Bd and Ah, in two amphibian species from distinct regions of the United States. I developed a novel qPCR assay to measure the microbial load of Ah on the skin of two anuran species, Lithobates yavapaiensis (N=232) and Pseudacris ornata (N=169), which have confirmed Bd infections. I use a logistic regression model to identify whether significant relationships exist between these two pathogens, disease, and death. I find that even amongst the most severely infected frogs, Ah is not detectable on the skin and only appears post-mortem. I therefore conclude that Ah is an opportunistic bacterial pathogen, scavenging on anurans only after mortality events. This research is the first known study to quantitatively assess Ah in amphibians in conjunction with Bd. While there is no causal relationship between these pathogens, future work will examine potential Ah infections in other organs to more fully understand the relationship between Bd and Ah.

37.3 million Americans (11.2% of the US population) currently have Type 2 diabetes mellitus (T2DM) with over 1.5 million new cases being diagnosed each year. The multifactorial etiology of the patient having neuropathy, overweight/obesity, foot deformities, ischemia, and infection leads to a condition called diabetic foot ulcer (DFU). One in six patients with a DFU will require amputation with infected DFUs have a 155-fold increased risk of amputation. Staphylococcus aureus is the most common bacteria isolated from severe DFU infections that require amputation. Interestingly, diabetics are more heavily colonized with S. aureus compared to non-diabetics suggesting a unique advantageous adaptation to diabetes. The specifics of the underlying molecular mechanisms and triggers by which S. aureus adapts and thrives in the T2DM patient that increase its pathogenicity and colonization compared to non-diabetics with skin ulcer infections are not fully elucidated. Thus, our studies aimed to identify the key virulence components in the pathogenesis of S. aureus infected DFUs and using that information to develop therapeutics aimed at disrupting these components to increase the success rate of conservative treatment and prevent non-traumatic lower extremity amputations in T2DM patients. Our studies found that several different elevated sugars in T2DM patients can trigger virulence factor production in S. aureus. We also found by comparing several different clinical DFU S. aureus isolates that there are clear differences in the ability of each isolate to cause necrotic infections. And lastly, we identified a possible therapeutic, the amino acid L-arginine, that can help prevent/treat S. aureus infections in the Tallyho diabetic mouse model. In conclusion, we have increased the understanding of the pathogenesis of S. aureus infected DFU and have proposed a possible therapeutic to add to the conservative treatment regimen.

Asiatic cholera has been called the scourge of the nineteenth century, for it caused the untimely death of millions throughout the world. During its four visits to the United States, unknown thousands of Kentuckians fell victims to the disease. In attempting to prevent the dreaded scourge, Kentuckians became more conscious of the need for cleaner cities, pure water and adequate sewage disposal. Modern waterworks facilities, sewage treatment and disposal facilities have provided the means by which the United States has conquered this scourge of the nineteenth century, for with these facilities cholera is the easiest of all communicable diseases to prevent. But, as with the eradication of any disease, constant vigilance and continued use of modern scientific knowledge are necessary to prevent its return. The disease is presently ravaging India and the Far East, and with modern jet travel it could bypass quarantine stations and enter the United States undetected. The “seeds” of the pestilence could be sown across the nation within a few hours. The only safeguard is modern sanitation facilities, for no permanent inoculation or miraculous cure has been developed. Today many rural areas of Kentucky and other states use wells and old cisterns that are, or could easily become, contaminated by human fecal matter. A fifth visit from cholera should not be necessary to correct the ignorance and complacent attitudes concerning inadequate sanitation facilities that exist in these areas of the nation. This study attempts to show the horrors of cholera’s four visits to Kentucky, and how the fear of the disease stimulated interest in public health.

Estudos em nosso laboratório caracterizaram camundongos B10.A como susceptíveis e camundongos A/J como resistentes à infecção pulmonar pelo P. brasiliensis. Para investigar o papel das células PMN na paracoccidioidomicose (PCM) pulmonar, camundongos B10.A e A/J foram depletados destas células através da inoculação in vivo por via intraperitoneal (i.p.) do anticorpo monoclonal anti-células PMN e infectados pela via intratraqueal (i.t.) com um milhão de leveduras viáveis. Camundongos-controle receberam doses equivalentes de IgG normal de rato. A depleção de granulócitos diminuiu o tempo de sobrevida dos animais B10.A, mas não dos animais A/J. Quando comparados com os animais não depletados, camundongos resistentes apresentaram aumento da carga fúngica no pulmão somente no dia 7 pós-infecção. Ao contrário, camundongos susceptíveis depletados de PMN apresentaram números mais elevados de células leveduriformes no pulmão, fígado e baço nos dias 7, 15, 30 e 120 pós-infecção, com relação aos seus grupos-controle tratados com IgG. A depleção dos granulócitos, entretanto, não alterou as reações de hipersensibilidade do tipo tardio (HTT) desenvolvidas por ambas as linhagens de animais. Considerando a resposta imune humoral, a depleção de células PMN levou à maior produção de anticorpos específicos em animais B10.A (Ig Total, IgG1, IgA e IgG3) e em animais A/J (Ig Total, IgG2a, IgG2b e IgG3). A depleção também alterou o padrão de citocinas pulmonares. Nos animais B10.A-tratados foram encontradas concentrações mais elevadas de IL-12 aos 15 dias e de IL-4 aos 120 dias pós-infecção, em comparação aos animais controle. Níveis de IL-12 significativamente mais altos foram detectados no grupo de animais A/J-depletados aos 7 e 120 dias e o IFN-γ foi detectado em níveis mais elevados em todo o curso da doença. Então, a depleção de PMN induz níveis mais altos de anticorpos e um ambiente mais pró-inflamatório no local da infecção. De acordo com esses dados, pudemos verificar que os neutrófilos são células importantes na defesa do hospedeiro à infecção pelo P.brasiliensis. Entretanto, o efeito protetor desta população celular depende do patrimônio genético do hospedeiro e é mais marcante na linhagem susceptível de camundongos. Neste trabalho também investigamos o efeito da depleção in vivo de leucócitos PMN na imunidade adquirida e protetora desenvolvida pela pré-imunização de animais B10.A. Assim, os camundongos foram previamente imunizados pela via s.c., depletados ou não de células PMN e desafiados i.t. com 1 milhão de células leveduriformes. Não foram detectadas diferenças significativas na contagem de fungos viáveis do pulmão, fígado e baço, entre os grupos imunizados tratados ou não com o AcM anti-PMN. A depleção não alterou a produção de anticorpos específicos, porém aumentou significativamente a síntese de IL-3, bem como a reatividade de HTT. Portanto, nossos resultados mostraram que, diferentemente da imunidade natural, os leucócitos PMN não exercem um papel protetor na fase adquirida da resposta imune à infecção com o P.brasiliensis. / Previous studies in our laboratory defined susceptible (B10.A) and resistant (A/J) mice to pulmonary P.brasiliensis infection. To investigate the role of PMN cells in pulmonary PCM, resistant and susceptible mice were depleted in vivo of these cells by intraperitoneal (i.p.) injection of a granulocyte-depleting monoclonal antibody and infected intratracheally (i.t) with one million yeast cells. Control mice received equivalent doses of normal rat IgG. PMN depletion decreased survival times of B10.A, but not of A/J infected mice. When compared with the non-depleted counterparts, resistant mice presented increased fungal loads in the lung only at day 7 after infection. On the contrary, PMN-depleted susceptible mice presented higher number of yeast cells in the lung, liver and spleen at days 7, 15, 30 and 120 after infection than their IgG-treated controls. PMN cells depletion, however, did not alter the DTH reaction developed by both mouse strains. Regarding humoral immune response, PMN cells depletion caused increased production of specific antibodies in B10.A (Total Ig, IgG1, IgA and IgG3) and A/J (Total Ig, IgG2a, IgG2b and IgG3) mice. Levels of pulmonary cytokines were also altered after PMN depletion. B10.A-treated mice presented increased levels of IL-12 and IL-4 at days 15 and 120 post-infection, respective/y. In A/J-depleted mice, augmented levels of IL-12 were detected at days 7 and 120 after infection; IFN-γ, however, was produced in higher levels during whole course of infection. Thus, PMN depletion induces higher levels of specific antibodies and enhanced pro-inflammatory milieu at the site of infection. As a whole, our data on PMN depletion at the onset of infection showed that neutrophils are important cells in host defense to P.brasiliensis infection. However, the effect of PMN depletion depends on the genetic background of the host and has a more pronounced effect in the susceptible strain of mice. We have also assessed the effect of in vivo depletion of the leukocytes on the acquired phase of immunity developed by B10.A mice previously immunized by the subcutaneous (s.c.) route were depleted or not of PMN cells and challenged i.t. with one million yeast cells. No differences were detected in the CFU counts in the lung, liver and spleen between untreated and PMN depleted vaccinated mice. PMN depletion also did not alter the production of specific antibodies but enhanced IL-3 synthesis as well as DTH reactivity. In conclusion, our results showed that, differently from natural immunity, PMN cells do not play a protective role in the acquired phase of immune response to P.brasiliensis infection.

Estudos em nosso laboratório caracterizaram camundongos B10.A como susceptíveis e camundongos A/J como resistentes à infecção pulmonar pelo P. brasiliensis. Para investigar o papel das células PMN na paracoccidioidomicose (PCM) pulmonar, camundongos B10.A e A/J foram depletados destas células através da inoculação in vivo por via intraperitoneal (i.p.) do anticorpo monoclonal anti-células PMN e infectados pela via intratraqueal (i.t.) com um milhão de leveduras viáveis. Camundongos-controle receberam doses equivalentes de IgG normal de rato. A depleção de granulócitos diminuiu o tempo de sobrevida dos animais B10.A, mas não dos animais A/J. Quando comparados com os animais não depletados, camundongos resistentes apresentaram aumento da carga fúngica no pulmão somente no dia 7 pós-infecção. Ao contrário, camundongos susceptíveis depletados de PMN apresentaram números mais elevados de células leveduriformes no pulmão, fígado e baço nos dias 7, 15, 30 e 120 pós-infecção, com relação aos seus grupos-controle tratados com IgG. A depleção dos granulócitos, entretanto, não alterou as reações de hipersensibilidade do tipo tardio (HTT) desenvolvidas por ambas as linhagens de animais. Considerando a resposta imune humoral, a depleção de células PMN levou à maior produção de anticorpos específicos em animais B10.A (Ig Total, IgG1, IgA e IgG3) e em animais A/J (Ig Total, IgG2a, IgG2b e IgG3). A depleção também alterou o padrão de citocinas pulmonares. Nos animais B10.A-tratados foram encontradas concentrações mais elevadas de IL-12 aos 15 dias e de IL-4 aos 120 dias pós-infecção, em comparação aos animais controle. Níveis de IL-12 significativamente mais altos foram detectados no grupo de animais A/J-depletados aos 7 e 120 dias e o IFN-γ foi detectado em níveis mais elevados em todo o curso da doença. Então, a depleção de PMN induz níveis mais altos de anticorpos e um ambiente mais pró-inflamatório no local da infecção. De acordo com esses dados, pudemos verificar que os neutrófilos são células importantes na defesa do hospedeiro à infecção pelo P.brasiliensis. Entretanto, o efeito protetor desta população celular depende do patrimônio genético do hospedeiro e é mais marcante na linhagem susceptível de camundongos. Neste trabalho também investigamos o efeito da depleção in vivo de leucócitos PMN na imunidade adquirida e protetora desenvolvida pela pré-imunização de animais B10.A. Assim, os camundongos foram previamente imunizados pela via s.c., depletados ou não de células PMN e desafiados i.t. com 1 milhão de células leveduriformes. Não foram detectadas diferenças significativas na contagem de fungos viáveis do pulmão, fígado e baço, entre os grupos imunizados tratados ou não com o AcM anti-PMN. A depleção não alterou a produção de anticorpos específicos, porém aumentou significativamente a síntese de IL-3, bem como a reatividade de HTT. Portanto, nossos resultados mostraram que, diferentemente da imunidade natural, os leucócitos PMN não exercem um papel protetor na fase adquirida da resposta imune à infecção com o P.brasiliensis. / Previous studies in our laboratory defined susceptible (B10.A) and resistant (A/J) mice to pulmonary P.brasiliensis infection. To investigate the role of PMN cells in pulmonary PCM, resistant and susceptible mice were depleted in vivo of these cells by intraperitoneal (i.p.) injection of a granulocyte-depleting monoclonal antibody and infected intratracheally (i.t) with one million yeast cells. Control mice received equivalent doses of normal rat IgG. PMN depletion decreased survival times of B10.A, but not of A/J infected mice. When compared with the non-depleted counterparts, resistant mice presented increased fungal loads in the lung only at day 7 after infection. On the contrary, PMN-depleted susceptible mice presented higher number of yeast cells in the lung, liver and spleen at days 7, 15, 30 and 120 after infection than their IgG-treated controls. PMN cells depletion, however, did not alter the DTH reaction developed by both mouse strains. Regarding humoral immune response, PMN cells depletion caused increased production of specific antibodies in B10.A (Total Ig, IgG1, IgA and IgG3) and A/J (Total Ig, IgG2a, IgG2b and IgG3) mice. Levels of pulmonary cytokines were also altered after PMN depletion. B10.A-treated mice presented increased levels of IL-12 and IL-4 at days 15 and 120 post-infection, respective/y. In A/J-depleted mice, augmented levels of IL-12 were detected at days 7 and 120 after infection; IFN-γ, however, was produced in higher levels during whole course of infection. Thus, PMN depletion induces higher levels of specific antibodies and enhanced pro-inflammatory milieu at the site of infection. As a whole, our data on PMN depletion at the onset of infection showed that neutrophils are important cells in host defense to P.brasiliensis infection. However, the effect of PMN depletion depends on the genetic background of the host and has a more pronounced effect in the susceptible strain of mice. We have also assessed the effect of in vivo depletion of the leukocytes on the acquired phase of immunity developed by B10.A mice previously immunized by the subcutaneous (s.c.) route were depleted or not of PMN cells and challenged i.t. with one million yeast cells. No differences were detected in the CFU counts in the lung, liver and spleen between untreated and PMN depleted vaccinated mice. PMN depletion also did not alter the production of specific antibodies but enhanced IL-3 synthesis as well as DTH reactivity. In conclusion, our results showed that, differently from natural immunity, PMN cells do not play a protective role in the acquired phase of immune response to P.brasiliensis infection.

Chlamydia trachomatis is the most prevalent agent of bacterial sexually transmitted infections in the world. However, a profuse number of cases are unreported, as the infection is often asymptomatic. Sequelae such as pelvic inflammatory disease, an increased risk of cervical cancer, premature birth, and perinatal infections in pregnant women can occur. Inflammation occurs in the body in response to infection or injury. Although inflammation can lead to some unwanted secondary effects, such as pain, it serves to return the body to homeostasis by restoring injured tissues and eliminating pathogens. One recently identified connection between the central nervous system and the immune system that regulates inflammation is the cholinergic anti-inflammatory pathway (CAP). In the CAP, pathogen-associated molecular patterns stimulate the vagus nerve to activate the pathway, which ultimately results in acetylcholine (ACh) release, which down regulates inflammation. We hypothesized that genital chlamydial infection would increase the expression of choline acetyltransferase (ChAT), the enzyme that synthesizes ACh, in the female murine genital tract, therefore down regulating inflammation and promoting chlamydial infection. Transgenic female mice carrying a ChAT-promoter driven GFP reporter gene were vaginally infected with C. muridarum. Mice were sacrificed on days 3, 9, 15, and 21 post infection; cervical, uterine horn, and ovarian tissues were removed and embedded in paraffin. Small sections of each tissue were cut and mounted onto slides. The tissue sections were then stained for the expression of ChAT using immunohistochemical techniques. Finally, tissue sections were viewed under a microscope for positive staining and the data was analyzed. The results indicated that there is a significant increase in the number of cells that express ChAT in genital tract of chlamydia-infected mice versus non-infected mice.