Die bakterielle Meningitis ist trotz der Anwendung modernster Antibiotika mit einer hohen Letalität und neurologischen Spätkomplikationen verbunden. Ein entscheidendes Ereignis ist dabei der Zusammenbruch der Blut-Hirn-Schranke (BHS). Die genauen Mechanismen, die zu ihrer Schädigung führen, sind bis heute unklar. In dieser Arbeit wurde untersucht, ob lebende Pneumokokken in einem Zellkulturmodell der BHS zu einer apoptotischen Zellschädigung von zerebralen Endothelzellen, als wichtigstem zellulären Bestandteil der BHS, führen und damit zu ihrer strukturellen Schädigung beitragen. Mittels verschiedener Detektionsmethoden (TUNEL, Fluoreszenzmikroskopie, Elektronenmikroskopie) konnte nachgewiesen werden, daß Streptococcus pneumoniae zu einem apoptotischen endothelialen Zelltod führt. Eine Beteiligung von Caspasen konnte weder mit direkter Aktivitätsmessung noch mittels Inhibitionsexperimenten oder dem Nachweis von Caspase-spezifischen Substraten gezeigt werden. Insgesamt sind die Morphologie der Zellkerne und die spezifische Degradation der endothelialen DNS hinweisend für einen Apoptosis-Inducing-Factor-vermittelten Zelltod ohne Caspasenbeteiligung. Diese Form des Zelltodes ist bereits in anderen Zellmodellen, bisher jedoch nicht bei zerebralen Endothelzellen beschrieben worden. Auf Seiten des Bakteriums konnten Wasserstoffperoxid und Pneumolysin als Auslöser der Apoptose identifiziert werden. Die zytotoxische Potenz des Pneumolysins ist dabei an dessen Poren-formende Aktivität gebunden. Die Ergebnisse sind von potentieller klinischer Relevanz, da es bei einer Bakteriämie und während der Invasion der Pneumokokken in das ZNS zu einem direkten Kontakt zwischen Bakterien und zerebralen Endothelzellen kommt und sich daraus eine Möglichkeit zur Entwicklung adjuvanter Therapien ergeben könnte. / Despite sufficient antibiotic treatment, pneumococcal meningitis has remained a disease associated with high mortality and neurological sequelae. The disruption of the blood brain barrier (BBB) is regarded a key event in the initial phase of pneumococcal meningitis. However, the exact molecular mechanisms involved in this process are still unknown. The aim of this study was to determine if living pneumococci are able to induce apoptosis in cerebral endothelial cells - the main cellular component of BBB - and therefore might contribute to its damage. Using several different detection methods (TUNEL, fluorescence and electron microscopy), induction of apoptotic cell death of endothelial cells by pneumococci could be verified. An accompanying activation of caspases was not detectable, despite the use of specific detection techniques such as inhibition experiments, direct enzyme measurements and detection of caspase-specific protein cleavage. These results as well as the specific nuclear morphology and degradation of endothelial DNA suggest an involvement of the mitochondrial protein Apoptosis inducing factor (AIF). This is the first time this specific form of apoptotic, AIF-driven cell death has been described to be engaged in endothelial cells. On the part of the bacterium, pneumolysin and hydrogen peroxide were identified as the two main inducers of apoptosis. The cytotoxic potency of pneumolysin is related to its pore-forming activity. These results are of clinical relevance since pneumococci are known to reside in close proximity to cerebral endothelial cells during bacteriemia and their entry into the CNS. These findings could contribute to the development of adjuvant treatment of bacterial meningitis.

Bakterielle Pneumonien sind weltweit eine der häufigsten Todesursachen und S. pneumoniae ist das häufigste klinische Isolat. Neutrophile Granulozyten gehören zur Klasse der myeloiden Zellen und sind eine wichtige Komponente der angeborenen Immunität gegen bakterielle Infektionen. Krüppel-like factor 4 (KLF4) spielt dabei nicht nur eine Rolle in der Differenzierung der Zellen des Immunsystems, sondern auch während der Infektion bei der Vermittlung inflammatorischer Signale in unterschiedlichen Zelltypen. Diese Studie zeigt zum ersten Mal in vivo, dass myeloides KLF4 Einfluss auf den Krankheitsverlauf hat und die mit einer bakteriellen Pneumonie einhergehende Entzündungsreaktion reguliert. Die hier aufgeführten Ergebnisse demonstrieren, dass der Transkriptionsfaktor KLF4 während einer Pneumokokken Pneumonie in humanen und murinen neutrophilen Granulozyten induziert wird. Diese Induktion ist Zeit- und Dosisabhängig. Außerdem wird die Expression von myeloidem KLF4 durch die Autolyse von S. pneumoniae reguliert, aber nicht über Toll-like Rezeptor 2 (TLR2), TLR4 oder TLR9 vermittelt. Studien in einem Maus-Pneumonie Modell zeigen, dass myeloides KLF4 einen proinflammatorischen Phänotyp bewirkt. Mäuse mit einem KLF4 knockout (KLF4-/-) in myeloiden Zellen haben im Vergleich zu Wildtyp (KLF4+/+) Mäusen eine höhere Bakterienlast in Lunge, Blut und Milz. Obwohl die Produktion proinflammatorischer Zytokine (wie TNF-α, IL-1β und KC) in BALF und Plasma von KLF4-/- Mäusen geringer war, gab es keine Unterschiede bei der Zellrekrutierung in der BALF von KLF4-/- und KLF4+/+ Mäusen. Allerdings war die Zellrekrutierung im Blut der KLF4-/- Mäuse geringer als bei den KLF4+/+ Mäusen. Außerdem wurde eine erhöhte vaskuläre Permeabilität verbunden mit perivaskulären Ödemen und Pleuritis bei KLF4-/- Mäusen während der S. pneumoniae-induzierten Infektion beobachtet. Diese Mäuse erreichten auch eher die humanen Endpunkte als die vergleichbaren KLF4+/+ Mäuse. / Bacterial pneumonia is one of the leading causes of death worldwide. Streptococcus pneumoniae is the most frequently isolated pathogen from clinical pneumonia samples. Neutrophils belong to the class of myeloid cells and forms an important component of this innate immune system against bacterial infections. Krüppel-like factor 4 (KLF4) has been reported to not only play a role in differentiation of cells of the immune system but also in mediating inflammatory signals in different kinds of host cells during infection. This study shows myeloid KLF4 has an impact on pneumococcal pneumonia outcome and regulates the inflammation associated with bacterial pneumonia in vivo in mice. The results presented in the work show that the transcription factor KLF4 is induced in human and mice neutrophils during pneumococcal pneumonia. The induction of KLF4 is time and dose dependent. Additionally, the expression of myeloid KLF4 is regulated by the autolysis of S. pneumoniae but is not mediated via Toll-like receptor (TLR) 2, TLR4 or TLR9. Studies using a mouse pneumonia model showed that myeloid KLF4 exhibits a pro-inflammatory phenotype. Mice with KLF4 knockout (KO) or KLF4-/- in myeloid cells had higher bacterial load in their lungs, blood and spleen in comparison to wildtype (WT) or KLF4+/+ mice. Although there was less pro-inflammatory cytokine (such as TNF-α, IL-1β and KC) production in the broncho-alveolar lavage fluid (BALF) and plasma of KLF4-/- mice yet there no differences in cell recruitment in the BALF of the KLF4-/- and KLF4+/+ mice. There was however less cell recruitment in the blood of KLF4-/- mice in comparison to KLF4+/+ mice. Additionally, an increased vascular permeability associated with perivascular edema and pleuritis was seen during Streptococcus pneumoniae-induced infection in KLF4-/- mice, which also reached earlier the human endpoints than the KLF4+/+ mice.

INTRODUÇÃO: A doença pneumocócica invasiva (DPI) tem alta mortalidade sendo o pulmão órgão de intenso acometimento. Na DPI caracterizou-se localmente importante processo inflamatório agudo com expressivo aumento de macrófagos, polimorfonucleares e fenômenos exsudativos como edema e hemorragia intra-alveolar. Concretizou-se uma resposta inflamatória proeminente com redução dos fenômenos de apoptose que se traduziu por aumento significativo de citocinas pró-inflamatórias, exceto IL-6 e IL-8, aumento de Toll-2, ativação do complemento, aumento de expressão de ICAM- 1 e CD 14 que em conjunto favorecem o estabelecimento dos fenômenos inflamatórios. A diminuição significativa das células NK e das células de Langherhans, IL-6 e IL-8 reflete comprometimento da imunidade inata. Tal comprometimento poderia ser responsável pela diminuição dos linfócitos TCD4+ e TCD8+ com consequente baixa produção de IFN. Em resumo, as lesões teciduais graves na DPI seriam decorrentes do comprometimento parcial da imunidade inata, em especial das células NK e das células de Langherhans, do prejuízo da imunidade adaptativa e da redução da apoptose como possível estratégia defensiva do pneumococo / INTRODUCTION: Invasive pneumococcal disease (IPD) is a condition with high mortality rates, the lungs being intensely attacked. The in situ immune response was determined, in blocks recovered from 22 necropsies of adults who died from IPD in the lungs, by quantitative immune cell phenotype (CD57-NK, CD1a, CD68, antigen S-100, TCD4, TCD8, CD20), Complement-C3, ICAM-1, CD14, Caspase-3 and cytokine (interferon , TNF, TGF, interleukin - IL-1, IL-2, IL-4, IL-6, IL-8, IL- 10), Toll-2 and SP-A (surfactant). A locally important acute inflammation process was characterized in IPD, with significant rise in macrophages, neutrophils and exsudative phenomena such as edema and intra-alveolar hemorrhage. Compared with the lungs from age-matched controls, results from patients with IPD showed significant depletion of NK, CD1a,CD4+, CD8+, CD20+ cells, interferon , IL-4, IL- 6 , IL-8, TGF and Caspase-3 (apoptosis). On the other hand, S-100, Toll-2, IL-1, IL-2R, IL-10, ICAM-1, CD14 and SP-A were more frequently seen in the alveoli of patients with IPD than in controls. A pronounced inflammatory response was detected, with decrease in apoptosis phenomena that translated into significant increase of pro-inflammatory cytokines, except for IL-6 and IL-8, increase in Toll-2, complement activation, increased ICAM-1 and CD-14 expression, which altogether favored installation of the inflammatory processes. A significant decrease in NK and Langherhans cells, IL-6 and IL-8 reflect the harm to the innate immune system. This could respond for the decrease in TCD4+ and TCD8+ lymphocytes, with a consequent low IFNy output. Briefly, the severe tissue lesions in IPD could be a consequence of the partial damage to the innate immunity, particularly of NK and Langherhans cells, of adaptive immune dysfunction, and of apoptosis reduction possibly as a defense strategy of the pneumococcus

The anti-pneumococcal function of native C-reactive protein (CRP) involves its binding to phosphocholine molecules present on Streptococcus pneumoniae and subsequent activation of the complement system. However, when pneumococci recruit complement inhibitory protein factor H on their surface, they escape complement attack. Non-native forms of CRP have been shown to bind immobilized factor H. Accordingly, we hypothesized that modified CRP would bind to factor H on pneumococci, masking its complement inhibitory activity, allowing native CRP to exert its anti-pneumococcal function. As reported previously, native CRP protected mice from lethal pneumococcal infection when injected 30 minutes before infection but not when injected 24 hours after infection. However, a combination of native and mutant CRP was found to protect mice even when administered 24 hours after infection. Therefore, it is concluded that while native CRP is protective only against early-stage infection, a combination of native and mutant CRP offers protection against late-stage infection.

"December 2004" / Includes bibliographical references (leaves 342-379) / xiii, 379 leaves : ill. (col.) ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Medicine, 2005

FtsL, DivIC et DivIB sont trois protéines membranaires impliquées dans la division bactérienne. Leur fonction n'est pas totalement comprise, mais semble mutuellement dépendante, notamment à travers la formation de complexes. Pour contribuer à la connaissance structurale des protéines de la division bactérienne et apporter des indices sur la fonction des trois protéines citées, une étude structurale a été menée sur un système modèle de protéines recombinantes solubles de S. pneumoniae: FtsL, DivIC et DivIB. La partie extracellulaire de DivIB, un complexe contraint des parties extracellulaires de FtsL et DivIC, et l'interaction entre ce complexe et la partie extracellulaire de DivIB ont été étudiés par plusieurs techniques biophysiques (RMN, SAXS, SANS, BIA par SPR). La partie extracellulaire de DivIB est composée de trois domaines dont le domaine central est structuralement proche de son orthologue chez E. coli, et interagit avec un complexe des parties extracellulaires de DivIC et FtsL, via ce domaine central. Un épitope d'interaction sur ce domaine a été identifié. Les domaines C-terminaux de FtsL et divIC sont essentiels à l'interaction avec la partie extracellulaire de DivIB. Un modèle à basse résolution du complexe de ces trois protéines présente en effet le domaine central de la partie extracellulaire de DivIB à l'extrémité du complexe des parties extracellulaires de DivIC et FtsL. Différents modèles d'association dans la cellule, des protéines DivIB, DivIC et FtsL ont été évalués avec ces nouvelles données structurales.

Les Penicillin-Binding Proteins (PBP) sont des enzymes intervenant dans les étapes finales de la synthèse de la paroi bactérienne et sont les cibles des antibiotiques de la famille des β-lactamines. Dans les souches cliniques de Streptococcus pneumoniae résistantes aux β-lactamines, les PBPs ont de nombreuses mutations qui ont pour effet une diminution d'affinité de ces enzymes pour les antibiotiques. Il y a en moyenne 40 substitutions dans le domaine transpeptidase des deux acteurs majeurs de la résistance PBP2x et PBP1a.<br />Des études précédentes ont décrit le rôle de quatre mutations de PBP2x et de trois de PBP1a, mais celles-ci ne sont responsables que d'une partie de la résistance. Il n'y a très probablement qu'un nombre restreint de mutations responsables de la perte d'affinité des PBPs pour les β-lactamines ayant pour conséquence une augmentation du niveau de résistance.<br />Pour identifier toutes les mutations impliquées, une série de protocoles automatisés permettant de faire de la mutagénèse dirigée, de l'expression, de la purification et de la caractérisation fonctionnelle d'enzymes en utilisant des robots de types manipulateurs de liquides ont été développés. L'application de cette méthode nous a permis de réaliser une caractérisation exhaustive de plus de 40 mutations de PBP2x de la souche clinique<br />résistante 5204. Cette étude a abouti à l'identification de toutes les substitutions clés ainsi qu'à l'élucidation d'un nouveau mécanisme moléculaire de baisse d'affinité de PBP2x pour les β-lactamines. De plus, une étude fonctionnelle et phénotypique de la résistance impliquant PBP1a a été réalisée.<br />Ce travail apporte une vue globale des mécanismes moléculaires de la résistance de S. pneumoniae aux β-<br />lactamines impliquant les PBPs en utilisant une méthode exhaustive originale.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2005. / Härtill 5 uppsatser.

Thesis (Ph.D.)--University of Melbourne, The School of Population Health and Department of Medicine, 2007. / Typescript. Includes bibliographical references (leaves 174-186).

INTRODUÇÃO: A doença pneumocócica invasiva (DPI) tem alta mortalidade sendo o pulmão órgão de intenso acometimento. Na DPI caracterizou-se localmente importante processo inflamatório agudo com expressivo aumento de macrófagos, polimorfonucleares e fenômenos exsudativos como edema e hemorragia intra-alveolar. Concretizou-se uma resposta inflamatória proeminente com redução dos fenômenos de apoptose que se traduziu por aumento significativo de citocinas pró-inflamatórias, exceto IL-6 e IL-8, aumento de Toll-2, ativação do complemento, aumento de expressão de ICAM- 1 e CD 14 que em conjunto favorecem o estabelecimento dos fenômenos inflamatórios. A diminuição significativa das células NK e das células de Langherhans, IL-6 e IL-8 reflete comprometimento da imunidade inata. Tal comprometimento poderia ser responsável pela diminuição dos linfócitos TCD4+ e TCD8+ com consequente baixa produção de IFN. Em resumo, as lesões teciduais graves na DPI seriam decorrentes do comprometimento parcial da imunidade inata, em especial das células NK e das células de Langherhans, do prejuízo da imunidade adaptativa e da redução da apoptose como possível estratégia defensiva do pneumococo / INTRODUCTION: Invasive pneumococcal disease (IPD) is a condition with high mortality rates, the lungs being intensely attacked. The in situ immune response was determined, in blocks recovered from 22 necropsies of adults who died from IPD in the lungs, by quantitative immune cell phenotype (CD57-NK, CD1a, CD68, antigen S-100, TCD4, TCD8, CD20), Complement-C3, ICAM-1, CD14, Caspase-3 and cytokine (interferon , TNF, TGF, interleukin - IL-1, IL-2, IL-4, IL-6, IL-8, IL- 10), Toll-2 and SP-A (surfactant). A locally important acute inflammation process was characterized in IPD, with significant rise in macrophages, neutrophils and exsudative phenomena such as edema and intra-alveolar hemorrhage. Compared with the lungs from age-matched controls, results from patients with IPD showed significant depletion of NK, CD1a,CD4+, CD8+, CD20+ cells, interferon , IL-4, IL- 6 , IL-8, TGF and Caspase-3 (apoptosis). On the other hand, S-100, Toll-2, IL-1, IL-2R, IL-10, ICAM-1, CD14 and SP-A were more frequently seen in the alveoli of patients with IPD than in controls. A pronounced inflammatory response was detected, with decrease in apoptosis phenomena that translated into significant increase of pro-inflammatory cytokines, except for IL-6 and IL-8, increase in Toll-2, complement activation, increased ICAM-1 and CD-14 expression, which altogether favored installation of the inflammatory processes. A significant decrease in NK and Langherhans cells, IL-6 and IL-8 reflect the harm to the innate immune system. This could respond for the decrease in TCD4+ and TCD8+ lymphocytes, with a consequent low IFNy output. Briefly, the severe tissue lesions in IPD could be a consequence of the partial damage to the innate immunity, particularly of NK and Langherhans cells, of adaptive immune dysfunction, and of apoptosis reduction possibly as a defense strategy of the pneumococcus