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1 Department of Periodontics, University of Washington, Health Sciences Center, Box 357444, Seattle, WA 98195, USA; and
2 The United States Army Dental Corps;
* corresponding author,rdarveau{at}u.washington.edu
| ABSTRACT |
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KEY WORDS: lipopolysaccharide (LPS) lipid A CD14 TLR innate immunity
| (1) INTRODUCTION |
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LPS are ubiquitous within our environment, in vivo and in vitro, and can express potent bioactivity in extremely small amounts (
g to
g range) (Rietschel and Westphal, 1999). LPS are known to be capable of initiating the morbidity and mortality associated with Gram-negative sepsis, as well as modulation of myriad other host innate inflammatory responses. For example, the classic description of the innate host response to LPS is that LPS significantly activate the innate host defense system. Specifically, LPS have been characterized as the prototypical stimuli for host activation through myeloid cells (neutrophils, monocytes, macrophages) and non-myeloid cells (fibroblasts, platelets), as well as other innate host defense mechanisms, such as serum complement, as well as specific components within the intrinsic coagulation pathway.
Conservation within structural components, like LPS, serves as the basis for host identification and response by creating molecular signals that are unique to prokaryotic cells, thus allowing for host distinction between self and non-self (Medzhitov and Janeway, 2000). However, new insights within the relatively recently discovered Toll-like receptors (TLRs) and co-associated molecules have revealed that even subtle differences in conserved LPS structures and their consequent molecular signals can be identified by host cells, resulting in profound host responses. For example, specific synthetic alterations within conserved segments of LPS were shown to be not only recognized by host cells but also capable of blocking or down-regulating the response to other LPS forms normally associated with robust innate cell activation. Furthermore, naturally occurring LPS heterogeneity of specific pathogenic bacteria, resulting from either altered bacterial growth or environmental conditions, was shown to result in differential and altered innate host cell responses in vitro that could potentially represent or confer some inoculation or evasion advantage, resulting in survival and sustained pathogenicity for the bacterium in vivo.
Discoveries such as these have propagated a new way of thinking about bacterial LPS and host interactions that has differed from the classic LPS-host interaction dogma. The purpose of this review, therefore, is to introduce to the reader possible reasons for these subtle LPS host-response differences by first reviewing the classic LPS structures normally associated with host activation and discussing identified bacterial LPS heterogeneity and its effect on known endotoxic components.
| (2) WHAT ARE LIPOPOLYSACCHARIDES (LPS)? |
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(2.1) Schematic
The majority of Gram-negative bacteria contain various amphiphilic molecules within the outer membrane; however, LPS represent the main surface antigen, possessing both microbiologic and immunologic significance. Although there are some notable exceptions, many species contain a common form or architecture that consists of specific components: an outer or distal segment, the O-chain or O-antigen; the outer core segment; an inner core segment; and, finally, the medial lipid A portion (Luderitz et al., 1981; Rietschel et al., 1992). Fig. 1
illustrates the major components of LPS and their relative positions on the bacterial outer membrane surface.
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For the host, the LPS structure then serves as an important molecular pattern or signal that represents the presence of Gram-negative bacteria, as compared with other signals characteristic of other types of organisms or host components (self), thereby allowing the host to identify it as a potentially infectious, microbial, non-self agent (Medzhitov and Janeway, 2000, 2002).
(2.3) Lipid A: Classic Lipid A Structure is Represented by E. coli
During the late 1980s, experimentation with LPS and separated lipid A fractions revealed that lipid A was, in fact, the bioactive component of LPS, responsible for the majority of IL-1 induction and immunoregulation in human mononuclear cells within the pg/mL range (Loppnow et al., 1989, 1990). These experiments were based on and correlated with findings from earlier and contemporary experimentation with synthetic lipid A components (Kotani et al., 1985) and Re-mutants strains (Luderitz et al., 1966; Kasai and Nowotny, 1967)both of which are devoid of any additional polysaccharide (PS) additionswhich resulted in full endotoxic activity when compared with the original LPS forms (Kim and Watson, 1967; Kotani et al., 1985; Rietschel and Westphal, 1999). Results from these and other pivotal experiments (Galanos, 1975) confirmed the role of lipid A as the active LPS constituent, relegating other subcomponents of LPS to non-essential for endotoxicity status (Rietschel and Westphal, 1999). Therefore, the latter part of this review will focus mainly on the conserved segments and observed heterogeneity within a specific sub-component of LPS, lipid A, and the biologic ramification(s) thereof.
| (3) HIGH vs. LOW BIOACTIVITY |
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(3.1) A Profile of Classic Potent Endotoxic Effects and Assays
Potency of the toxic nature of LPS components has been historically quantified through the use of host response assays. Here, immunostimulatory and/or immunoregulatory systems were developed to facilitate ranking of LPS components based on the specific structural requirements for activation. For example, the three most common assays used to describe potent endotoxic effects are: (1) the chick embryo lethality test (LD50 dosages calculated after intravenous injection and observation of embryo death by intoxication within 48 hrs); (2) the rabbit pyrogenicity assay (positive results have been defined as an increase in rectal temperature of more than 0.6°C after LPS sample challenge); and (3) the local Shwartzman reaction (where two injections of LPS samples are given 24 hrs apart, the first injected dermally and the second intravenously; a positive reaction occurs if a hemorrhagic reaction develops at the dermal [1st] injection site). Additional in vivo and in vitro assays include lethal toxicity in galactosamine-loaded mice (animals are sensitized with an intraperitoneal injection with D-galactosamine HCl, followed immediately by intravenous injection of test material; death by intoxication is usually observed in 24 hrs), induction or enhancement of IL-1, PGE2, O2 production in murine macrophages, and activation of the human complement cascade. A complete review of the biologic activities and structural requirements to induce these specific activities has been discussed by Takada and Kotani (1992).
(3.2) Structures Associated with High Bioactivity
Lipid A structures required to produce the highest or most potent bioactivity, as measured by the above assays, include: a ß, (1'-6)-linked D-glucosamine disaccharide backbone; phosphorylation at positions 1 and 4' on the disaccharide unit; an appropriate number (two was determined to have maximum effect) (Shimizu et al., 1987) of 3-acyloxyacyl groups; the position of these 3-acyloxyacyl groups on either the reducing GlcN I or the distal GlcN II residues of the disaccharide (Takada and Kotani, 1992); and an appropriate number (usually 6) of hydrophobic fatty acid chains with a suitable carbon length (C12-C18) (Kumazawa et al., 1988; Nakatsuka et al., 1989), with or without hydroxylation (Fig. 2A
). Interestingly, these structures, which yield the most potent endotoxic effects, are highly conserved within enteric and non-enteric Gram-negative bacteria, and are often referred to as the canonical lipid A structure. Furthermore, alteration in any part of the canonical structuresuch as changing the number, position, or length of the primary or secondary acyl groups, or subtraction of phosphate or monosaccharide groupsresults in dramatic alteration of the biologic effects (Loppnow et al., 1989; Takada and Kotani, 1992; Schumann et al., 1996).
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Further explanations of the various bioactivities seen with different lipid A structures could lie within the three-dimensional changes occurring as a result of the presence or absence of specific lipid A structures themselves. Here, experimental evidence has accumulated which suggests that if the aggregate lipid A structure contains an increased cross-sectional hydrophobic region, compared with that of the hydrophilic part, this will yield a conical lipid A shape with increased bioactivity, whereas cylindrical (both regions equal in cross-section) lipid A molecules are biologically inactive (Rietschel et al., 1991; Schromm et al., 2000). Furthermore, residual 3-deoxy-D-manno-oct-2-ulosonic acid (Kdo) groups, if attached to the lipid A structure, have been known to modify or alter lipid A conformation, resulting in higher bioactivity compared with purified (Kdo absent) preparations (Caroff et al., 1986, 2002; Brade et al., 1997; Muroi and Tanamoto, 2002; Caroff and Karibian, 2003). These results not only imply that there is a critical role for symmetry of acyl chain position and overall molecular shape, but also suggest that Kdo molecules and their corresponding charge groups affect responses to lipid A as well (Caroff et al., 1986, 2002; Brade et al., 1997; Muroi and Tanamoto, 2002; Caroff and Karibian, 2003).
(3.4) Enteric Bacteria vs. Oral Bacteria (High vs. Low Bioactivity)
The interest in differential host responses to LPS generated an expansion of research efforts in other areas of non-enteric microbiologic study, yielding some interesting observations. For example, in the field of oral microbiology, early studies revealed (Mansheim et al., 1978; Fujiwara et al., 1990), and more recent studies confirmed (Darveau et al., 1995; Pulendran et al., 2001), the observation that LPS and their isolated lipid A component, obtained from Gram-negative oral anaerobic bacteria, do not elicit host responses in a manner consistent with the responses observed with the classic E. coli-type endotoxin. Early studies examining endotoxin lethality in mice demonstrated that LPS obtained from Gram-negative oral anaerobic bacteria were significantly reduced in potency when directly compared with enterobacterial LPS (Takada and Galanos, 1987; Isogai et al., 1988) and did not induce a Shwartzman reaction (Mansheim et al., 1978; Fujiwara et al., 1990), a systemic innate immune inflammatory response typically associated with E. coli-type endotoxin (Takada and Kotani, 1992). These observations resulted in this type of LPS being initially designated as having no or very low biological activity. However, one explanation for this lowered activity could be due to the number of phosphate groups or altered lengths and positions of the fatty acids present in lipid A from certain oral bacteria compared with those in enteric E. coli, which has been proven to be critical in Shwartzman reaction induction (Takada and Kotani, 1989). In addition, evidence is accumulating to suggest that, although different from E. coli, P. gingivalis LPS do in fact contain significant biologic activity. For example, LPS obtained from P. gingivalis induce inflammatory responses in non-responder LPS mice (Kirikae et al., 1999), subsequently shown to have a mutation in TLR4 (Poltorak et al., 1998; Qureshi et al., 1999), suggesting that these LPS contain, potentially, a TLR4-independent mechanism for cell activation. Subsequently, numerous in vitro studies by our laboratory (Darveau et al., 1995; Cunningham et al., 1996, 1999) and others (Mansheim et al., 1978; Ogawa et al., 1994; Ogawa and Uchida, 1996) have confirmed that P. gingivalis LPS are less potent, but, perhaps more importantly, they elicit a different pattern or repertoire of inflammatory mediators in innate immune cells (Ogawa and Uchida, 1996; Tanamoto et al., 1997), when compared directly with E. coli LPS. Furthermore, it has also been reported that dendritic cell recognition and response to P. gingivalis and E. coli isolated LPS are significantly different, characterized by altered TLR4 signaling, separate cytokine subset production, and induction of separate and distinctly different in vivo adaptive immune responses (Pulendran et al., 2001).
(3.5) Binding Properties and Host Presentation May Partially Explain Low Biologic Reactive LPS
(i) Lipopolysaccharide Binding Protein (LBP) Binding Affinity, the Highs and Lows
Microbial component-LBP binding affinities might explain, in part, low biological reactive LPS. Since the discovery of the LBP/CD14 host activation pathway (Schumann et al., 1990; Wright et al., 1990), it has become increasingly clear that the release of numerous inflammatory mediators and the expression of cell adhesion molecules necessary for inflammation occur in response to LBP and/or CD14 complexed with microbial components (Pugin et al., 1993b; Wright, 1995). It has been shown that aggregate forms of LPS initially bind LBP (an acute-phase serum protein), which then facilitates the transfer of separated, monomeric LPS to either mCD14, a membrane-bound form, or sCD14, a soluble form found in serum (Pugin et al., 1993b; Tobias et al., 1995; Wright, 1995; Yu and Wright, 1996; Heumann and Roger, 2002). mCD14-positive cells (usually cells of myeloid origin) contain mCD14 as a glycosylphosphatidylinositol (GPI)-anchored membrane protein, whereas the sCD14/LPS complex is required for CD14-negative cell (i.e., endothelial and certain epithelial cells) activation by LPS (Pugin et al., 1993a; Heumann and Roger, 2002).
However, LPS obtained from different bacteria have significantly different binding affinities for LBP, and this is one mechanism by which the host may be able to differentiate between LPS molecules (Cunningham et al., 1996). For example, LPS from both Helicobacter pylori and Porphyromonas gingivalis bind LPB 10 to 100 times less efficiently than E. coli (Cunningham et al., 1996). Less efficient LBP binding may represent one mechanism responsible for the low biologic reactivity especially seen in the activation of human monocytes to specific LPS species (Darveau et al., 1995; Cunningham et al., 1996). Consistent with this, reports of LPS activity within in vitro systems have shown that different concentrations of serum (serum being the major source of both endogenous LBP and sCD14), serum from various species, or heat-inactivated serum affect the level of observed activation (Wright et al., 1990; Pugin et al., 1993a; Shapira et al., 1994). The mechanisms by which LPS bind LBP are not fully understood; however, a bactericidal/permeability-increasing protein (BPI), a protein closely related to LBP, has recently been crystallized (Beamer et al., 1997). Analysis of the structural data obtained from this study demonstrates that BPI contains two apolar pockets which interact with the acyl chains of phosphatidylcholine. This information may now potentially serve as a structural model for LBP interaction with LPS acyl chains. As previously mentioned, the number and type of fatty acyl chain and the corresponding interaction with host-derived molecules/cells are key factors influencing the strength of the inflammatory host response to the lipid A component of LPS.
(ii) CD14/LPS Transfer and Presentation to Host Cells
The second potential interaction that may contribute to low reactive LPS is the LPS-LBP-mediated transfer to CD14. After initial LBP-LPS binding, the next step toward host cell activation is the transfer of LBP-LPS complex to either soluble or membrane-bound CD14. Since this occurs through an enzymatic process (Cunningham et al., 1996; Yu and Wright, 1996), comparisons of the ability of different LPS species to interact with CD14 have been normally performed by measurement of the Km as well as the
Satmax (the concentration of LPS required to obtain half the maximum amount of binding to CD14) (Cunningham et al., 1996). Results from these CD14 transfer comparison experiments, with the use of LPS obtained from E. coli, P. gingivalis, and H. pylori, have revealed significant differences among these bacteria that correlated with the species-specific LPS ability to bind LBP (Cunningham et al., 1996).
An additional site where structural differences in LPS-lipid A composition may be differentially recognized is during the LBP/CD14-dependent presentation of the LPS to the host cell itself. For example, even before the discovery of Toll-like receptors (TLRs), there was evidence that recognition of specific lipid A structural details occurred after CD14 binding (Delude et al., 1995; Kitchens and Munford, 1995). It was demonstrated that inhibition of LPS responses by R. sphaeroides lipid A and synthetic lipid IVA was not due to LPS recognition by CD14 alone (Delude et al., 1995). In this particular study, the authors capitalized on the fact that lipid IVA inhibits human and activates mouse monocyte LPS responses. Here, by transfecting human cells with mouse CD14 and vice versa, they showed that transfectants responded to these LPS analogues according to their cell, and not CD14, type. Furthermore, Akashi et al.(2001) demonstrated that MD-2, a membrane-bound molecule that co-associates with TLR4, selectively conferred responsiveness to lipid A but not to the synthetic precursor lipid IVA, thus influencing the specificity of the TLR and resultant activation pathway. Likewise, moesin, a 78-kDA protein that has recently been identified as another cell-surface molecule on human monocytes, potentially functions as either a TLR4 co-molecule or an independent LPS receptor, capable of transducing CD14-mediated signals itself (Iontcheva et al., 2004).
(iii) Conflicting Roles for Toll-like Receptors (TLRs) in Bacterial LPS Structural Recognition
The discovery of TLRs and their associated co-molecules has generated much excitement in recent years, since it reveals functional cell membrane components that are responsible for host recognition of specifically conserved microbial structures, or PAMPS (pathogen-associated molecular patterns) present on invading organisms (Medzhitov and Janeway, 1997). Generating equal excitement is the possibility that this might represent a specific mechanism that can distinguish even subtle structural differences between microbial LPS components, thereby generating a different response to specific bacterial LPS. However, since their discovery, some confusion still remains regarding the exact intracellular pathway, TLR or combination of TLRs, as well as the contributions from associated co-molecules, adhesion molecules (Corbi and Lopez-Rodriguez, 1997; Flaherty et al., 1997; Todd and Petty, 1997; Triantafilou and Triantafilou, 2002), or membrane ion channels (Ishii and Nakae, 1993; Hoang et al., 1997; Blunck et al., 2001) responsible for individual bacterial-mediated host inflammatory activation. For example, early in vitro studies suggested that TLR2 could interact with mCD14that had previously recognized LBP-bound bacterial LPS (Wright et al., 1990; Ulevitch and Tobias, 1995)forming an LPS/receptor complex (Yang et al., 1999). Additonally, later studies showed that specific over-expression of TLR2 conferred a much higher LPS responsiveness, via the NF-
B pathway, with the use of HEK (human embryonic kidney) 293 cells, when compared with the low basal activation seen with the same cells transfected with TLR4 (Kirschning et al., 1998; Yang et al., 1998). However, accumulated evidence from studies with LPS from E. coli and Salmonella suggested that TLR4, and not TLR2, was the Toll receptor responsible for cell activation in the presence of an LPS challenge (Tapping et al., 2000). Additionally, evidence based on positional cloning experiments targeting the Lps gene responsible for C3H/HeJ LPS hyporesponsiveness (Poltorak et al., 1998), TLR4 knock-out mice (Hoshino et al., 1999), or synthetic monosaccharide lipid A analogue preparations (Tamai et al., 2003) allowed researchers to argue that the LPS response observed was, in effect, mediated through TLR4 (Takeuchi et al., 1999). Furthermore, Hirschfeld et al.(2000) revealed that, through added re-purification of LPS preparations, removal of contaminating proteins (which were shown to possess potent bioactivity themselves) eliminated activation signals through both human and murine TLR2. Consequently, conflicting TLR recognition data might have arisen from multiple factors, such as: additional intracellular pathways activated but not yet identified through TLRs, purity of LPS preparations, various amounts or availability of soluble or membrane-bound factors or expression levels of TLRs on the cell lines or primary cells assayed, or the inability of transiently transfected or overexpressed TLR cells in vitro to display accurately the exact role or function displayed by the in vivo, indigenous TLRs (Takeuchi et al., 1999). Therefore, as the numbers of identified TLRs and co-molecules increase, as well as their ability to recognize specific ligands or the biologic effect of TLRs working in combination, exact in vivo TLR functionregarding bacterial recognition and host activationstill remains to be elucidated.
| (4) NATURAL LIPID A HETEROGENEITY |
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(4.1) Natural Yersinia pestis LPS Heterogeneity (Growth Temperature Effects)
One of the most interesting findings in natural lipid A research was the observation that specific bacteria possess the ability to alter or regulate their lipid A form under specific environmental conditions. For example, early bacterial growth and physiology studies indicated that the molecular size of the highly pathogenic Yersinia pestis (the causative agent for bubonic plague) changed when growth temperature shifted from 26 to 37°C (Darveau et al., 1983). In addition, at around the same time, lipid researchers found an increase in the overall amount of an unsaturated fatty acid [hexadecanoic acid (C16:1)] in E. coli when grown at lower temperatures (Van Alphen et al., 1979). This observation led others to propose that specific fatty acid alterations, in relation to environmental temperature changes, might occur in Yersinia pestis (Kawahara et al., 2002), since this same fatty acid (C16:1) was identified within its lipid A structure (Bordet et al., 1977; Dalla Venezia et al., 1985; Aussel et al., 2000). What Kawaharas group found was that, at 27°C, which is the environmental temperature of its flea vector, Y. pestis displayed lipid A heterogeneity containing a mix of tri-, tetra-, penta-, and hexa-acylated lipid A species. Incubation at 37°C (mammalian host temperature) significantly altered the lipid A species composition, in that the hexa-acylated lipid A species was missing, and the penta-acylated species was significantly reduced, leaving predominantly tri- and tetra-acylated lipid A. Based upon structural analogies with the closely related E. coli lipid A, specific lipid A species modifications, such as predominance of lower acylated lipid A species and down-regulation of higher acylated forms, should result in less potent innate defense activation, consistent with this bacteriums strategy to evade host defenses. This exact effect was observed in human macrophage cell lines in which activation of TNF-
was reduced significantly by Yersinia lipid A produced at 37°C, when compared directly with production at 27°C (Kawahara et al., 2002; Rebeil et al., 2004).
(4.2) Environmental Modulation of Two-component Regulatory Systems in Salmonella (PhoP/PhoQ) Results in a Natural Increase of LPS Heterogeneity
Another example of lipid A structure modification in response to environmental conditions comes from research involving two-component regulatory systems within specific bacteria. Salmonellae typhimurium contains a PhoP-PhoQ sensor kinase and transcriptional activator system which regulates genes required for intracellular survival and cationic peptide resistance (Miller et al., 1989). It has been demonstrated that a constitutive S. typhimurium mutant designated PhoPc, which mimics, in part, the intracellular regulation state of the bacteria, contains a modified lipid A species composition (Guo et al., 1997). These modifications resulted in S. typhimurium LPS that contained two additional lipid A species, one modified with an amino-arabinose moiety, and the other containing a 2-OH myristic fatty acid instead of myristic acid (Guo et al., 1997). These additional lipid A species rendered both whole bacteria and isolated LPS less potent activators of E-selectin and TNF-
when compared with wild-type or another PhoP mutant (Guo et al., 1997). This was the first description of genetic regulation that resulted in lipid A alterations that modified the innate host response. Another example was found upon examination of the LPS structure found in Pseudomonas aeruginosa strains grown under different cultural conditions and isolated from the lungs of individuals with cystic fibrosis (CF) (Ernst et al., 1999). In this study, it was found that the lipid A species of P. aeruginosa was altered by magnesium concentration in the culture medium under control of a phoP regulator, such that lipid A species now contained an additional palmitic acid as well as amino-arabinose. In this situation, both whole bacteria and isolated LPS preparations were more potent activators of E-selectin and TNF-
(Ernst et al., 1999). Strains of P. aeruginosa, isolated from the lungs from patients with CF, contained these same modifications and also were demonstrated to be more potent activators of IL-8 production from human endothelial cells (Ernst et al., 1999). Recently, these researchers, utilizing chimeric human or mouse TLR4 proteins, were able to identify the exact site (an 82-amino-acid region within the hypervariable, extracellular domain of human TLR4) that was able to discriminate between these penta- or hexa-acylated LPS forms from P. aeruginosa and alter host response, indicating a direct link between species-specific differences (e.g., mouse vs. human) in bacterial modification recognition and modulation of the innate host response (Hajjar et al., 2002).
(4.3) Outer Membrane Enzymes Affect Lipid A Heterogeneity
In Salmonella typhimurium, once the two-component regulatory system PhoP/PhoQ senses environmental changes, it modulates its lipid A structure, as described above, through the use of two recently identified outer membrane enzymes. PagP, a lipid A palmitoyltransferase, was the first identified example of an outer membrane enzyme under functional PhoP/PhoQ control that was capable of biosynthesizing these hexa-acylated lipid A forms with resistance to cationic anti-microbial peptides (Bishop et al., 2000). Since this discovery, a new enzyme, PagL, determined to be located mainly on the outer membrane, has been identified (Trent et al., 2001). Functional PagL expression was determined to involve deacylase activity, selectively cleaving R-3 hydroxymyristate that may be attached to the C3 position of certain lipid A precursors (Trent et al., 2001). The specific functional ramification of PagL is currently unknown, but it has been suggested that this lipid A alteration might modify host cytokine responses in Salmonella-type infections (Trent et al., 2001).
(4.4) Limited vs. Substantial Lipid A Heterogeneity in P. gingivalis
With regard to oral bacteria, one of the most extensively studied lipid A structures comes from Porphyromonas gingivalis. Initially, early studies suggested that P. gingivalis possessed limited lipid A structural heterogeneity, with LPS preparations consisting of only a tri-acylated monophosphorylated form with a negative ion mass of m/z 1195 (Ogawa, 1993). Later, a second study reported multiple P. gingivalis lipid A structural isoforms; however, in this particular study, certain forms predominated, including tetra- and penta-acylated monophosphorylated lipid As with molecular mass ions of m/z 1435, m/z 1449, and m/z 1690, respectively (Kumada et al., 1995). These structures are depicted in Fig. 3
and differ from the canonical E. coli lipid A structure in the number of phosphates, and the numbers, types, and positions of the fatty acid chains. The reasons for the apparent discrepancies in the predominant type of P. gingivalis lipid A found between these two studies were not clear at the time of their publication. Variations in the strain of P. gingivalis used, growth conditions, and isolation procedures were considered as possible mechanisms contributing to the description of different lipid A species. Recently, however, a study from our laboratory has demonstrated that at least three of these P. gingivalis lipid A species (1195, 1435, and 1450) (Bainbridge et al., 2002), as well as others (Darveau et al., 2004), are present in our purified LPS preparations (obtained from multiple laboratory as well as clinical isolates), demonstrating that P. gingivalis, similar to other bacteria (Caroff et al., 2002), contains multiple lipid A species. Additional studies with either phenol and guanidine thiocyanate (Yi and Hackett, 2000) or cold MgCl2 (Darveau and Hancock, 1983) techniques to extract LPS, as well as different lipid A hydrolysis procedures (Caroff et al., 1988; Ogawa et al., 2002), have also found that P. gingivalis contains multiple lipid A moieties, further confirming the presence of heterogeneity within lipid A preparations. These observations, obtained from different laboratories, suggest that the increased heterogeneity within LPS preparations from P. gingivalis might not be a result of specific extraction techniques alone, and efforts have been initiated to determine the in vitro and/or in vivo mechanisms responsible for the observed diversity. Based on structure-activity relationships, discussed previously, it is predicted that these lipid A modifications will elicit specific alterations in innate host response, with potential pathogenic significance.
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B activation by 30- to 100-fold, when compared with the unaltered lipid A samples. Furthermore, Darveau et al.(2004), using highly purified P. gingivalis lipid A preparations, showed that extracted preparations enriched in tetra-acylated lipid A forms (m/z 1435/1450) were capable of activation through both human and mouse TLR4, TLR2+TLR1, and even TLR2, when transiently transfected HEK 293 cells co-expressing mCD14 were used. In addition, it was determined from these experiments that MD-2 was required for the functional engagement of TLR4, but not TLR2+TLR1 or TLR2. However, it was also reported that MD-2, which in humans and mice has also been suggested to play a role in species-specific recognition of lipid IVA and taxol (a plant-derived molecule), was not responsible for the observed P. aeruginosa LPS differential recognition in either clinical or laboratory samples, thereby confirming the importance of a newly identified region within human TLR4 in bacterial LPS recognition (Hajjar et al., 2002). Therefore, it is becoming increasingly clear that in vitro detection of subtle changes in LPS structure, ones that are most likely seen in vivo by the host, require the presence of multiple factors (TLRs) and co-factors (LBP, mCD14/sCD14, MD-2, etc.), thus complicating the extrapolation of data from different assay systems as well as different bacterial species and/or preparations. However, it has been proposed that in vivo biologic effects for down-regulation or differential regulation of TLRs, due to heterogeneity in lipid A from bacteria such as Salmonella typhimurium or P. gingivalis, could potentially assist these known pathogens in adaptation to changing host environments, colonization persistence, or pathogenesis (Darveau et al., 2004; Kawasaki et al., 2004). | (5.0) PERSPECTIVES |
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Received August 20, 2004; Accepted February 10, 2005
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