Abstract available in the Journal of Investigative Medicine.

Background: Pertussis diagnosis may go unrecognized when other pathogens, such as respiratory syncytial virus (RSV) circulate. Methods: A prospective cross-sectional study was conducted in Lima, Peru from January 2009 to September 2010. A total of 596 children under 5 years old admitted with clinical diagnoses of acute respiratory infections were test for B. pertussis and RSV detection by polymerase chain reaction (PCR). Results: The pertussis toxin and IS481 genes were detected in 19.12% (114/596) of the cases and the respiratory syncytial viruses (RSV-A and RSV-B) were identified in 17.28% (103/596) of patients. Infants under 3 months old were the most frequently affected by this pathogens in 43% (49/114) and 35.9% (37/103) respectively. An increase of B. pertussis was observed from February to March and from October to November with a Seasonal index between 1.32-1.51 and 1.24-3.5 respectively. Conclusions: Epidemiologic surveillance for B. pertussis is essential in Peru, especially in children that could most benefit from the vaccine. B. pertussis should be suspected in infants hospitalized for acute respiratory symptoms for early treatment and prevent complications. / Tesis

Bordetella pertussis produces a number of virulence determinants believed to contribute to its survival in the host as well as to the pathogenesis of disease. One of these factors, adenylate cyclase toxin (ACT), has been implicated to penetrate human neutrophils and macrophages and abrogate their function by virtue of unregulated production of intracellular cAMP. In order to adequately study the nature of ACT and its role in pathogenesis, it is necessary to isolate the toxin from other virulence factors produced by the organism. Attempts by other investigators to purify ACT and maintain both its invasive and catalytic properties have not been successful. B. pertussis produces a cell associated ACT during mid-log phase of growth in Stainer-Scholte medium. Purification of ACT with both activities from urea extracted whole cells has been achieved by hydroxylapatite and calmodulin-sepharose chromatography. ACT is a single protein of 220 kd molecular weight with an isoelectric point of 7.0. The protein probably contains regions which are strongly hydrophobic. ACT has a specific activity of nearly 17,000 μM cAMP formed/min. An 850 ng sample of ACT induced over 1,400 pmoles cAMP/10⁶ S49 mouse lymphoma cells while 660 ng of ACT inhibited human neutrophil chemiluminescence by 65%.

Introduction: Bordetella pertussis is an important human pathogen that causes whooping cough (pertussis), an endemic illness responsible of significant morbidity and mortality, especially in infants and children. Worldwide, there are an estimated of 16 million cases of pertussis, resulting in about 195,000 child deaths per year. In Peru, pertussis is a major health problem that has been on the increase despite immunization efforts. The objective of this study was to determine the prevalence of B. pertussis among children under five years of age suspected to have whopping cough in Cajamarca, Peru. Methodology: Children diagnosed with whooping cough admitted to the Hospital Regional de Cajamarca from August 2010 to July 2013 were included. Nasopharyngeal samples were obtained for B. pertussis culture and polymerase chain reaction (PCR) detection. Results: In 133 children, the pertussis toxin and IS481 gene were detected in 38.35% (51/133) of the cases by PCR, while only 9.02% (12/133) of the Bordetella cultures were positive. The most frequent symptoms in patients with positive B. pertussis were paroxysm of coughing 68.63% (35/51), cyanosis 56.86% (29/51), respiratory distress 43.14% (22/51), and fever 39.22% (20/51). Pneumonia and acute bronchial obstructive syndrome were present in 17.65% (9/51) and 13.72% (7/51) of the cases, respectively. Conclusions: B. pertussis is responsible for an important proportion of whooping cough in hospitalized children in Cajamarca. Epidemiologic surveillance programs for B. pertussis are essential in Peru, especially in children who could most benefit from the vaccine.

Das Tex Protein aus Bordetella pertussis definiert eine neue Familie hoch konservierter Proteine in Eubakterien. Ursprünglich wurde das tex Gen aufgrund seines Einflusses auf die Toxinexpression in bestimmten regulatorischen Mutanten von B. pertussis gefunden (Fuchs et al. (1996), J Bacteriol 178, 4445-52). Wie hier gezeigt wird, sind Leserahmen für entsprechende Proteine bei den Eubakterien ubiquitär und mehrheitlich zu über 69 Prozent konserviert. Eine Ausnahme bilden einige wenige Taxa mit bekanntermaßen reduzierten Genomen, bei denen das Gen wahrscheinlich verloren gegangen ist, wie zum Beispiel verschiedene Mycoplasma spp. oder der obligate Blattlaus- (Aphiden-) Symbiont Buchnera aphidicola. In Eukaryonten und Archaeen konnte ein zu tex homologes Gen bisher nicht gefunden werden. Die Funktion von Tex in der Bakterienzelle ist unklar. Während das Gen in B. pertussis essenziell ist und auch nicht überexprimiert werden kann, sind Deletionsmutanten in Neisseria meningitidis und Escherichia coli phänotypisch nicht von den entsprechenden Wildtypen unterscheidbar. Ausgiebige Wachstumsstudien mit einer E. coli tex-Mutante unter verschiedenen Wachstums- und Stressbedingungen ergaben ebenfalls keinen Hinweis auf eine Bedeutung von Tex, die die außerordentliche Konservierung des Proteins erklären könnte. Das Protein zeigt in seinem N-Terminus ausgeprägte Ähnlichkeit mit dem Mannitol-Repressor (MtlR) von Escherichia coli und besitzt eine C-terminale S1-Domäne. Da die meisten der Proteine mit S1-Domänen als RNA-bindende Proteine gelten, wurde die Fähigkeit von Tex untersucht, mit Nukleinsäuren zu interagieren. In Festphasen-Bindeassays mit an Magnetkügelchen immobilisiertem Tex Protein aus E. coli konnte eine spezifische Bindung an RNA-Gesamtpräparationen gezeigt werden. DNA wurde hingegen nicht gebunden. Durch Verkürzung des N-Terminus geht die präferenzielle Bindung an RNA jedoch verloren und die Bindung von DNA erfolgt mit der gleichen Effizienz wie die von RNA. Festphasen-Bindeassays wurden weiterhin dazu benutzt, mögliche spezifische Interaktionspartner von Tex aus RNA-Gesamtpräparationen zu finden. Tatsächlich konnten über diesen Ansatz die regulatorische RNA CsrB und die ribosomale 16S RNA als spezifische Liganden isoliert werden. Über die biologische Relevanz dieser Interaktion kann zum gegenwärtigen Zeitpunkt allerdings noch keine Aussage gemacht werden. / The Bordetella pertussis Tex protein defines a new family of highly conserved eubacterial proteins. The tex gene was originally found due to its negative influence on toxin expression when over-expressed slightly in certain regulatory mutants of B. pertussis (Fuchs et al. (1996), J Bacteriol 178, 4445-52). As shown in this work apparently homologous reading frames are ubiquitous within the Eubacteria. The majority of these mostly putative proteins are more than 69 per cent conserved. Only some of the genomes of some obligate intracellular pathogens, e. g. various Mycoplasma ssp., or the aphid symbiont Buchnera aphidicola known for their reduced gene numbers were found to lack a tex gene and probably have lost it during phylogeny. The actual function of Tex within the bacterial cell is as yet mysterious as the gene can neither be deleted nor can it be highly over-expressed in B. pertussis. However, deletion mutants in Neisseria gonorrhoeae and Escherichia coli do not show any phenotype different to the respective wild type. Extensive growth studies on an E. coli tex-mutant did not reveal any clue to the reason for the extraordinary conservation of the protein. The N-terminus of Tex shows extensive similarity to the mannitol repressor (MtlR) of E. coli whereas the C-terminus contains an S1 domain. Because most S1 domain containing proteins have been shown to bind RNA, the capacity of Tex to interact with nucleic acids was investigated. In solid phase binding assays with purified Tex protein from E. coli immobilized to magnetic beads the protein showed specific binding of RNA but not DNA. NÓterminal deletions of different length abolished this preference for RNA and both types of nucleic acid bound equally well. Again a solid phase binding assay was used to enrich for specific ligands of Tex from total cellular RNA preparations. This approach identified the regulatory CsrB RNA and ribosomal 16S RNA as preferential binding targets. However, it is not yet possible to comment on the biological relevance of these findings.

Kälteschockproteine werden in Bakterien, gleichermaßen wie die gut charakterisierten Hitzeschockproteine, bei hohen Temperaturschwankungen stark induziert und ermöglichen der Zelle durch unterschiedliche Funktionen ein Wachstum in der Kälte. In dieser Promotionsarbeit wurde begonnen, die Kälteschock-Antwort von Bakterien des Genus Bordetella zu charakterisieren. Sowohl B. bronchiseptica als auch B. pertussis codieren für fünf Kälteschockproteine, die als CspA, CspB, CspC, CspD und CspE bezeichnet werden. Die fünf Proteine weisen eine signifikante Homologie zum Haupt-Kälteschockprotein CspA aus E. coli auf. Während in den Modellorganismen E. coli und B. subtilis mindestens vier (E. coli) bzw. alle drei (B. subtilis) csp-Gene deletiert sein müssen, um einen Wachstumsdefizit zu erkennen, genügt im Falle von B. bronchiseptica eine einzige Insertionsmutation im Gen cspB, um einen temperaturunabhängigen Wachstumsdefekt zu beobachten. Nach einem Kälteschock werden in B. bronchiseptica drei der fünf csp-Gene, cspA, cspB und cspC, deutlich induziert. Betrachtet man das Expressionsmuster der fünf csp-Gene unter verschiedenen Stressbedingungen, wie Zugabe von translationshemmenden Antibiotika, Hitzeschock oder osmotischer Stress, so lässt sich ein komplexes Expressionsmuster aufzeichnen. Außerdem besitzen die drei kälteinduzierbaren Gene cspA, cspB und cspC mehrere Transkriptionsstartpunkte, deren Transkriptmengen unter den verschiedenen Schockbedingungen stark variieren. Es stellte sich heraus, dass eine Überexpression von CspB aus B. bronchiseptica für die E. coli – Zelle toxisch ist, daher wurde das CspB-Protein als GST-Fusionsprotein exprimiert und über Glutathion-Sepharose aufgereinigt. Um eine potentielle Funktion von CspB in der Zelle zu untersuchen, wurden Filterbindeassays mit CspB::GST durchgeführt. Es wurde eine hochaffine, aber unspezifische Bindung an ssDNA festgestellt, was auf eine mögliche Funktion von CspB als Chaperon hindeutet. Nach Synthese eines CspB-spezifischen Antikörpers wurde die Kälteinduktion von CspB auch auf Proteinebene nachgewiesen. Durch 2D-Gelelektrophorese und massenspektrometrische Charakterisierung konnten 17 weitere kälteinduzierbare Proteine aus B. bronchiseptica identifiziert werden. Darunter waren u. a. ein Chaperon mit Ähnlichkeit zu GroES, ein Translationsinhibitor BB2940 und das CspB. Diese kälteinduzierbaren Proteine ähneln den CIPs aus E. coli. Weiterhin konnten noch das UspA und mehrere am Metabolismus beteiligte Proteine als CIPs aus B. bronchiseptica identifiziert werden, was signifikante Unterschiede in Bezug auf die Kälteadaptation zwischen den beiden Organismen aufzeigt. Betrachtet man die Promotorbereiche aller identifizierten csp-Gene, so fällt eine für diese Gene typische sehr lange 5’UTR auf. Innerhalb dieser upstream Region findet man in vier der fünf csp-Gene einen 9 bp langen Consensus mit der Sequenz TCCTTGATT, der in nahezu gleichem Abstand vom postulierten Startcodon vorkommt. Diese identifizierte 9bp-box ist für eine effiziente Transkription in der Kälte jedoch nicht von Bedeutung. Auf posttranskriptioneller Ebene wird die lange 5’UTR für die Stabilisierung der cold-shock mRNA in der Kälte verantwortlich gemacht. Außerdem ist das Vorhandensein der kompletten 5’UTR essentiell für eine effiziente Translation bei niedriger Temperatur, wobei eine Mutation der 9bp-box einen geringen, aber signifikanten negativen Effekt auf die Translation ausübt. Sechs Gene, der neu identifizierten CIPs, beinhalten ebenfalls eine 9bp-box in ihrer upstream Region. Interessanterweise werden zwei der fünf csp-Gene, cspC und cspD, vom BvgAS Zweikomponentensystem, dem Haupttranskriptionsregulator der Virulenzgene im Genus Bordetella, reguliert. Die beiden Gene gehören zu den Bvg-negativ regulierten Genen, die in der Bvg-minus-Phase exprimiert werden. Weiterhin beeinflusst eine leichte Überexpression von CspB aus B. pertussis die Expression der Adenylatzyklase sowohl in B. pertussis, als auch in B. bronchiseptica negativ. Dieser für das CspB spezifische Effekt erinnert an das strukturell verwandte Tex-Protein (Fuchs et al, 1996; König et al, 2002). Beide Proteine beeinflussen die Expression der Virulenzfaktoren negativ, wobei für CspB gezeigt werden konnte, dass es einen direkten Einfluss auf die verminderte cyaA-Expression auf Transkriptionsebene besitzt. Dies zeigt eine Verbindung der Kälteschockantwort mit dem Virulenz-Regulon der Bordetellen, deren Rolle im Infektionszyklus bislang ungeklärt ist. / Bacterial cold shock proteins (CSPs), like the well characterized heat shock proteins (HSPs) are highly induced in response to strong variation in temperature and cell growth at lower temperatures could be attributed to the different functions of CIPs. In this work we have studied the cold shock response of bacteria of the genus Bordetella. Both B. bronchiseptica and B. pertussis code for five CSPs (termed CspA to CspE) with significant amino acid homology to the major CspA of Escherichia coli. Mutations of a single csp gene (cspB) strongly affected the growth of B. bronchiseptica independent of temperature while a similar effect was observed in E. coli when four out of nine csp genes and in B. subtilis when all three csp genes were deleted. Transcription of cspA, cspB and cspC increased strongly after cold shock. The exposure to other stress conditions including translational inhibitors, heat shock and osmotic stress resulted in a complex pattern of changes in the transcription of the five cold shock genes. In the case of three csp genes (cspA, cspB, cspC), more than one specific transcript could be detected. To investigate the function of one of the cold shock proteins, CspB was purified as GSTfusion over a glutathion-sepharose column, because overexpression of pure CspB was shown to be toxic for the E. coli cell. Due to its high affinity but rather unspecific binding to ssDNA as tested by filter binding assays, it is possible that CspB functions as a chaperone. Induction of CspB was confirmed using a specific antibody and subsequently 17 other cold inducible proteins (CIPs) were identified by 2D-gelelectrophoresis and mass spectrometric characterization. Among these CIPs are some proteins which resemble the cold shock response of E. coli, like CspB, a chaperone with similarities to GroES and a translation inhibitor protein. Furthermore, interesting examples are the universal stress protein UspA and some proteins that are involved in the amino acid metabolism indicating signficant differences in the cold shock response of the two organism. The coding regions of all cold shock genes are preceeded by a long non-translated upstream region. Within this 5’UTR of four of the csp genes an identical sequence of 9 nucleotides with the consensus TCCTTGATT (9bp box) was identified which is located at similar positions with respect to their start codons. This identified 9bp-box was found to be irrelevant for transcription in the cold. Furthermore by in silico analysis a putative 54- binding site in the upstream region of cspB could be identified which has a regulatory function on cspB transcription. The long 5’ UTR itself seems to be important for transcript stabilization and efficient translation under cold shock conditions. Furthermore mutation or deletion of the 9bp box has a negative effect on translation. Six of the new identified CIPs are encoded by genes that contain the 9bp box in their 5’-UTR. Using bioinformatic tools (HMMR search) we identified 131 genes in the B. bronchiseptica RB50 genome that contain such a 9mer, but only 17 of the genes contain these consensus at appropriate position. Using this approach, infB, encoding for IF-2, could be identified as cold inducible. A connection between the occurence of the 9bp box and the cold induction could not be shown yet. Interestingly, two cold shock genes (cspC and cspD) were found to be under the negative control of the BvgAS system, the main transcriptional regulator of Bordetella virulence genes. Morover, a negative effect of a slight overexpression of CspB, but not of the other CSPs, on the transcription of the adenylate cyclase toxin CyaA in both B. pertussis and B. bronchiseptica was observed. Like the overexpression of previously described Tex protein (Fuchs et al, 1996; König et al, 2002), both proteins have a negative effect on the expression of the virulence factors. In this work, a direct influence of CspB on the cyaA transcription could be confirmed, suggesting a cross talk between the CSP mediated stress response stimulon and the Bordetella virulence regulon.

A coqueluche é uma doença contagiosa, causada por Bordetella pertussis e B. parapertussis e as vacinas de células inteiras (WCPs) contra pertussis, embora eficazes, foram associadas a efeitos indesejáveis. Já as vacinas pertussis acelulares são menos reatogênicas, mas caras, o que as torna inviáveis para países em desenvolvimento. Nesse estudo, avaliamos a resposta imune induzida por uma vacina pertussis celular com menor teor de LOS (Plow), desenvolvida pelo Instituto Butantan. Para isso, camundongos C57BL-6 foram imunizados com WCP tradicional ou Plow, formulada com MPL-A de B. pertussis ou com Hidróxido de Alumínio e vacinas tríplice bacterianas com componente pertussis acelular, Pertacel ou Adacel. Após o esquema de imunização, foi avaliada a resposta imune humoral e celular contra a B. pertussis, e B. parapertussis, além de resposta inata a um antígeno não relacionado, BCG. Ensaio de transmissão também foi realizado, após desafio com B. pertussis ou B. parapertussis. Nossos resultados consolidam a avaliação da resposta imune humoral e celular induzida pela Plow, além de apresentar resultados bastante interessantes relativos à atividade da Plow na diminuição da transmissão bacteriana, tanto de pertussis quanto de parapertussis. / Bordetella pertussis and B. parapertussis are the causative agents of whooping cough. Whole cell pertussis (wPs) vaccines, although effective, were associated with undesirable effects. On the other hand, aP vaccines are less reactogenic, but expensive, which made their use unable for developing countries. In this study, we assessed the immunological response, induced by a whole cell pertussis vaccine with low LOS content (Plow), developed by Instituto Butantan. To this, C57BL-6 mice were immunized with traditional whole cell pertussis vaccine or Plow, administrated with Monophosporil lipid A from B.pertussis or Aluminum hydroxide, and diphtheria-tetanus-acellular pertussis vaccines, Pertacel or Adacel. After the immunization scheme, were evaluated humoral and cellular immune responses against B. pertussis and B. parapertussis, in addition to innate response to an unrelated antigen, BCG. Transmission assay was also performed, after B. pertussis or B. parapertussis challenge. Our results consolidated the immune humoral and cellular responses induced by Plow, besides interesting results with regards the efficacy of the vaccine in decreasing the transmission of B. pertussis and B. parapertussis in mice.

Objectives To report the incidence, epidemiology, and clinical features of Bordetella pertussis in Peruvian infants under 1 year old. Patients and methods A prospective cross-sectional study was conducted in five hospitals in Peru from January 2010 to July 2012. A total of 392 infants under 1 year old were admitted with a clinical diagnosis of whooping cough and tested for B. pertussis by PCR. Results The pertussis toxin and IS481 genes were detected in 39.54% (155/392) of the cases. Infants aged less than 3 months were the most affected, with a prevalence of 73.55% (114/155). The most common household contact was the mother, identified in 20% (31/155) of cases. Paroxysm of coughing (89.03%, 138/155), cyanosis (68.39%, 106/155), respiratory distress (67.09%, 104/155), and breastfeeding difficulties (39.35%, 61/155) were the most frequent symptoms reported. Conclusion An increase in pertussis cases has been reported in recent years in Peru, despite national immunization efforts. Surveillance with PCR for B. pertussis is essential, especially in infants less than 1 year old, in whom a higher rate of disease-related complications and higher mortality have been reported. / This 312 work was supported by Sanofi Aventis del Peru. Conflict 313 of interest: On behalf of all authors, the corresponding author 314 states that there are no conflicts of interest or funding related 315 to this study

In this study, a suite of single antigen DNA vaccines, combination DNA vaccines and dual modality vaccines, were developed and evaluated for their potential to induce humoral and cell-mediated immune responses, and protective efficacy against Bordetella pertussis, the aetiological agent of whooping cough, using the mouse respiratory challenge model.

Objetivos generales de la tesis: Con el desarrollo de esta propuesta se espera contribuir al conocimiento que sirva de base para el diseño de una vacuna más efectiva contra pertussis, no sólo en términos generales, sino en lo que se refiere a su efectividad en Argentina, determinando la definición de la/s cepas / componentes a incluir en una nueva formulación. Objetivos específicos de la tesis: En este marco conceptual y tomando como hipótesis la divergencia de la población bacteriana circulante respecto a las cepas vacunales hoy en uso, se proponen los siguientes objetivos: 1-Caracterizar mediante la aplicación de técnicas de genómica funcional los aislamientos de B. pertussis locales. Identificar de nuevos inmunógenos. Los aislamientos clínicos de nuestra colección han sido previamente agrupados en base a sus divergencias a nivel de las secuencias que codifican para antígenos específicos, así como en su genoma completo a través de los ensayos de PFGE y los años en que fueron aislados. Proponemos abordar la búsqueda de diferencias específicas, a nivel de expresión génica, entre los aislamientos circulantes y las cepas que hoy se usan en la producción de vacunas. Para ello hemos emplearemos herramientas de genómica funcional, proteómica e inmunoblot; para identificar potenciales candidatos vacunales a incorporar en una formulación acelular. 2-Analizar la relevancia de la divergencia genética entre la Población Bacteriana Circulante (PBC) y las cepas vacunales respecto a la protección contra pertussis. Para abordar este punto emplearemos el modelo animal de desafío intranasal. Consideramos que la información obtenida marcará la necesidad o no de incluir determinadas variantes polimórficas para obtener una nueva vacuna más efectiva. El abordaje de este aspecto se espera también contribuya al conocimiento general de la adaptación y evolución bacteriana bajo la presión de selección ejercida por las diferentes estrategias de vacunación (celular/acelular). / Tesis digitalizada en SEDICI gracias a la Biblioteca Central de la Facultad de Ciencias Exactas (UNLP).