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1 Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical School, Houston, TX, USA
2 Center for the Study of Emerging and Re-emerging Pathogens, University of Texas Medical School, Houston, TX, USA
3 Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
4 Center for Extracellular Matrix Biology, Institute of Biosciences and Technology, Texas A&M University Health Science Center, Houston, TX, USA
5 Department of Microbiology and Molecular Genetics, University of Texas Medical School, Houston, TX, USA
Correspondence
Barbara E. Murray
bem.asst{at}uth.tmc.edu
| ABSTRACT |
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These authors contributed equally to this work.
Supplementary methods, describing bacterial isolates, identification and structural analysis of CWA proteins, and sources of extracellular matrix proteins; supplementary results, describing sequence variation in fms15, fms16 and fms19, and structural motifs of the putative E. faecium MSCRAMMs; supplementary references; three supplementary figures, showing Coomassie-stained SDS-PAGE results for purified recombinant His6-Scm proteins, analysis of Scm expression on the cell surface of E. faecium isolates, and conserved lysine and glutamic acid residues in the pilin motif and E-box of predicted E. faecium major pilus proteins; and a supplementary table, listing oligonucleotides used in this study, are available with the online version of this paper.
| INTRODUCTION |
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It is known that pathogenic bacteria have evolved a plethora of proteins to adhere to and invade host tissues and to resist host defences (Pizarro-Cerda & Cossart, 2006
). Among these is a family of surface proteins with well-established roles in host–pathogen adherence which have been termed microbial surface components recognizing adhesive matrix molecules (MSCRAMMs; Patti et al., 1994
). MSCRAMMs share several characteristics, including (i) an N-terminal signal peptide, (ii) a non-repeated A-domain consisting of immunoglobulin (Ig)-like fold(s), (iii) a B-domain with a variable number of repeats among different strains, and (iv) a C-terminal cell wall anchor (CWA) domain. Some of these MSCRAMMs have been shown recently to be tethered to each other by a designated sortase to make up multimeric cell surface structures, named pili (Mora et al., 2005
; Nallapareddy et al., 2006
). Sortases, encoded by the srtA to srtD classes of genes (Dramsi et al., 2005
), were originally described as membrane-bound transpeptidases that cleave the LPXTG-like motif in the CWA domain and covalently link CWA proteins to the peptidoglycan (Marraffini et al., 2006
). While class A sortases appear to be ubiquitous and involved in cell surface anchoring of a large number of LPXTG-containing proteins (Marraffini et al., 2006
), the class C (subfamily 3) sortase enzymes, which have a more limited substrate specificity, have recently been shown to be involved in pilus biogenesis, in addition to their role in surface anchoring (Kemp et al., 2007
; Scott & Zahner, 2006
; Telford et al., 2006
).
Studies that have characterized the binding interactions of staphylococcal and enterococcal MSCRAMMs have identified that the ligand-binding A-domains consist of two to three subdomains (N1-N2/N3), each adopting an Ig-like fold (Liu et al., 2007
; Nallapareddy et al., 2007
; Ponnuraj et al., 2003
; Zong et al., 2005
). Based on the crystal structures of prototype MSCRAMMs, two slightly different models have been proposed to explain their binding mechanisms to linear peptides of fibrinogen and to triple-helical collagen. In the dock, lock and latch binding model, a fibrinogen chain is inserted into a cleft between two Ig-folded subdomains and is then secured by a C-terminal N3 extension (latch) that is reoriented upon ligand binding and complements a β-sheet on the N2 subdomain (Ponnuraj et al., 2003
). A variation of this two-subdomain binding model, the collagen hug, has been proposed for the collagen-binding MSCRAMMs (Liu et al., 2007
; Zong et al., 2005
).
Previous in silico analyses have identified a family of genes that encode MSCRAMM-like proteins in the genomes of several Gram-positive bacteria, including our reports of the ebp (endocarditis and biofilm-associated pilus of Enterococcus faecalis) operon, Ace (adhesin of collagen from E. faecalis) and Acm (adhesin of collagen from E. faecium) (Bowden et al., 2005
; Nallapareddy et al., 2000
, 2003
, 2006
; Roche et al., 2003
; Sillanpää et al., 2004
; Xu et al., 2004
). Recently, Hendrickx et al. (2007)
predicted 22 CWA proteins from the E. faecium TX0016 [formerly DO (Arduino et al., 1994
)] genome, of which five were found to be enriched in isolates of the hospital-adapted clonal complex 17 (CC17). However, with the exception of the prototype MSCRAMM Acm (Nallapareddy et al., 2003
), there has been no demonstration of other MSCRAMMs in E. faecium. Although our previous report identified an essential and secreted broad-spectrum adhesin, SagA, that exhibits binding to fibrinogen, collagen type I (CI), collagen type IV (CIV), fibronectin and laminin, this protein lacks a CWA domain and other MSCRAMM characteristics (Teng et al., 2003
).
In the present study, we identified 14 genes (in addition to acm) that encode predicted MSCRAMMs in the genome of E. faecium TX0016. Recombinant forms of one of these proteins, designated Scm (for second collagen adhesin of E. faecium), were characterized to confirm the structural predictions and to identify its ligand. Cell-surface expression of Scm by selected E. faecium strains was quantified using FACS, and antibodies raised against a recombinant form of one of the major pilus proteins showed a high-molecular mass (HMM) ladder pattern characteristic of Gram-positive pili. Co-transcription of one of the pilus-encoding gene clusters was demonstrated by Northern hybridization and RT-PCR. In addition, we determined the distribution of the MSCRAMM-encoding genes among 30 diverse E. faecium clinical isolates.
| METHODS |
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Identification and structural analysis of CWA proteins.
Bioinformatics methods used for genome-wide identification of CWA proteins are described in the Supplementary Methods. Domain architecture as well as fold-recognition analyses were carried out by comparing the protein sequences against domain databases, as described in Supplementary Methods.
Construction of expression plasmids.
Genomic DNA from E. faecium strains was isolated as described earlier (Wilson, 1994
). DNA regions encoding amino acids 27–624 (A-domain and B-repeats) and 27–333 (A-domain) of Scm, and amino acids 33–590 of EbpCfm [Fms9 was renamed EbpCfm based on its 74 % amino acid identity (84 % similarity) with EbpC of E. faecalis over the entire protein (mature protein without the signal peptide and the CWA domain)], were amplified using primers listed in Supplementary Table S1 and cloned into the expression vector pQE30 (Qiagen) to obtain pTEX5432, pTEX5628 and pTEX5630 (Table 1
). The corresponding expressed protein segments of Scm were designated rScm65 and rScm36, based on their calculated molecular masses. Similarly, the cloned segment of EbpCfm was designated rEbpCfm62. Constructs were confirmed by sequencing.
Purification of recombinant proteins.
Recombinant proteins with N-terminal His6-tags were expressed and purified using nickel affinity chromatography followed by anion-exchange chromatography (Nallapareddy et al., 2007
; Sillanpää et al., 2004
). Protein concentrations were determined by absorption spectroscopy at 280 nm using calculated molar absorption coefficient values. Molecular masses were determined with MALDI-TOF MS for rScm36 and rScm65.
Circular dichroism (CD) spectra.
Far-UV CD spectroscopy data were collected as described previously (Sillanpää et al., 2004
). Secondary structure compositions were quantified with ContinLL, SELCON3 and CDSSTR (http://www.cryst.bbk.ac.uk/cdweb/html/home.html) (Lobley et al., 2002
; Whitmore & Wallace, 2004
).
ELISA-type solid-phase ligand-binding assays.
Binding of the recombinant His-tag fusion proteins to components of the extracellular matrix (ECM) was tested using an assay described previously, with minor modifications (Nallapareddy et al., 2000
). In brief, 1 µg of each ECM protein (for sources, see Supplementary Methods) was coated in 100 µl PBS (137 mM NaCl, 2.7 mM KCl, 4.3 mM Na2HPO4, 1.4 mM KH2PO4, pH 7.4) in Immulon 2HB (Thermo Scientific) 96-well microplate wells. Wells were incubated with various concentrations of rScm, and bound His-tag proteins were detected with anti-His6 mAb (GE Healthcare) followed by alkaline-phosphatase-conjugated anti-mouse antibody (Bio-Rad). p-nitrophenyl phosphate (Sigma) was used for signal detection.
Production of polyclonal antibodies and purification of antigen-specific Igs.
Polyclonal goat antibodies against rScm36 and rEbpCfm62 were raised at Bethyl Laboratories. Scm36- and EbpCfm62-specific Igs were eluted from CNBr-activated Sepharose 4B coupled with the corresponding antigen, according to the manufacturer's protocol (GE Healthcare). Glycine (0.1 M, pH 2.8) was used for elution of bound antibodies, which were neutralized immediately by 1 M Tris/HCl, pH 8.0, and dialysed extensively against PBS. Antibody concentrations were determined using an estimated IgG molar absorption coefficient value of 210 000 M–1 cm–1 and a molecular mass of 150 000 Da.
Whole-cell ELISA and FACS.
Surface expression of Scm on E. faecium cells was detected by a whole-cell ELISA assay (Nallapareddy et al., 2003
) using affinity-purified rScm36-specific Igs. Antiserum against formalin-killed TX0016 whole cells (Rakita et al., 2000
) was used as a positive control.
To quantify surface expression of Scm by FACS analysis, bacteria grown in BHI for 14 h from an inoculum of OD600=0.01 were labelled with preimmune or affinity-purified anti-Scm-specific antibodies followed by donkey anti-goat IgG conjugated with F(ab')2-fragment-specific R-phycoerythrin, as described previously (Kemp et al., 2007
). Cells were then fixed in 1 % paraformaldehyde in PBS and analysed with a Coulter EPICSXL AB6064 flow cytometer (Beckman Coulter) and System II software.
Extraction of CWA proteins and Western blot analysis.
CWA proteins were extracted from E. faecium strains grown for 8 h in BHI broth to late-exponential phase (starting inoculum, OD600
0.01) with mutanolysin as described previously (Nallapareddy et al., 2006
). Equal amounts of concentrated mutanolysin extracts were separated using 4–15 % gradient SDS-PAGE gels (Bio-Rad) under reducing conditions, and transferred to PVDF membranes according to the manufacturer's protocol. Membranes were probed with affinity-purified anti-Scm36 and anti-EbpCfm62 antibodies (see above) followed by HRP-conjugated anti-goat IgG antibodies, and as a control, total IgG antibodies purified from preimmune goat sera were used. Signal was detected using SuperSignal West Pico chemiluminescent detection reagents (Thermo Scientific).
Northern hybridization.
Using the RNAprotect bacteria reagent and RNeasy Mini kit (Qiagen), total RNA was isolated from TX0082 grown in BHI to mid-exponential phase. Samples (30 µg) of total RNA were separated using a formaldehyde-containing agarose gel under denaturing conditions and transferred to a Hybond-N+ membrane, as described by the manufacturer (GE Healthcare). DNA probes obtained with primers listed in Supplementary Table S1 were radiolabelled by using the RadPrime DNA labelling system (Invitrogen). Hybridization was performed under high-stringency conditions, as detailed previously for Southern blots (Murray et al., 1993
).
RT-PCR.
Total RNA (isolated as above for Northern hybridization) was treated twice with 20 U RQ1 DNase (Promega) for 30 min at 37 °C. DNase was removed using the RNeasy Mini kit and purification protocol (Qiagen). Total RNA was then reverse-transcribed with specific primers (Supplementary Table S1) using the SuperScript One-Step RT-PCR with Platinum Taq kit (Invitrogen) according to the manufacturer's instructions. DNA sequencing verified that the primer regions of TX0082 were 100 % identical to the corresponding sequences in TX0016. As an internal control, a 509 bp fragment of gyrA (encoding gyrase A) was amplified using the FmGyrF and FmGyrR primers (Supplementary Table S1). Reactions without reverse transcriptase were used as controls to verify lack of DNA contamination in the total RNA preparations.
Colony hybridization.
Preparation of colony lysate membranes and hybridization under high-stringency conditions were performed as described previously (Coque et al., 1995
; Singh et al., 1998
). DNA probes were generated and radiolabelled as described above for Northern hybridization.
| RESULTS AND DISCUSSION |
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Among these 22 putative CWA proteins, 18 contained a predicted N-terminal signal peptide sequence required for Sec-dependent secretion. Further analysis of the 5' regions of the remaining four ORFs (Fms14, Fms15, Fms16 and Fms19) that lack a signal peptide revealed the presence of N-terminal signal peptides in the ORFs immediately upstream of Fms15, Fms16 and Fms19. Careful examination of the junction regions showed the presence of a premature stop codon due to a point mutation or frame-shift in fms15, fms16 and fms19 (Supplementary Results). Sequencing of fms16 and fms19 regions from additional isolates identified intact fms16 and fms19 genes in two of 10 E. faecium clinical isolates tested (Supplementary Results). However, we did not find an E. faecium strain with an intact fms15 gene (Supplementary Results).
Subsequently, using the fold recognition servers 3D-PSSM and PHYRE, we identified 15 of the predicted Fms proteins (Table 2
) as containing one or more Ig-like folds enriched with β-sheets, and only a small quantity of
-helices; similar secondary structure compositions have been found in the ligand-binding A-regions of MSCRAMMs (Deivanayagam et al., 2002
). One of these, Fms8, had been previously identified in our laboratory as Acm (Nallapareddy et al., 2003
). The percentage of E. faecium LPXTG proteins containing Ig-like folds is greater than the percentages for other Gram-positive bacteria (22–45 %) (Ponnuraj et al., 2003
). The Ig-like fold-containing modules of the A-domain of a number of well-characterized Staphylococcus aureus MSCRAMMs (e.g. the fibronectin-, fibrinogen- and elastin-binding protein FnbpA, the fibrinogen-binding proteins ClfA and ClfB, and the collagen-binding protein Cna) and the prototype MSCRAMM of E. faecium, Acm, have been shown to play a direct role in interactions with their respective ECM protein ligands (Nallapareddy et al., 2007
; Ponnuraj et al., 2003
; Zong et al., 2005
).
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Characteristics of recombinant Scm protein segments
Total yields of the recombinant protein rScm65 (fully mature protein consisting of the A-domain and B-repeats; amino acids 27–624) were low. Although we estimated that this protein was over 95 % pure immediately after eluting from the chromatographic columns, as shown in Supplementary Fig. S1, it was susceptible to partial degradation even after brief storage. rScm65 migrated as a larger band than expected from the calculated molecular mass of 64.5 kDa, likely due to the highly acidic nature (pI 3.9) of the protein. To obtain a stable construct with higher yields, we next expressed rScm36 encompassing the complete A-domain (amino acids 27–333; Supplementary Fig. S1). A MALDI-TOF MS analysis determined the molecular mass of rScm36 to be 35 711 Da, which is in good agreement with the calculated mass of 35 691 Da, and confirmed the absence of post-translational modifications and the homogeneity of the purified protein. As an additional confirmation of the identities of the purified protein segments and evidence of their intact N termini, a monoclonal anti-His6 antibody detected the N-terminal His6 fusion in both purified protein segments in a Western blot assay (data not shown).
Recombinant Scm binds to collagen in a dose-dependent manner
Since the adhesive functions of previously studied MSCRAMM proteins have mostly been ascribed to binding to protein components of the host ECM, we examined the potential ECM-adhesive functions of Scm by testing its binding to a panel of individual ECM proteins in an ELISA-type solid-phase ligand-binding assay. As seen in Fig. 2(a)
, both rScm65 (containing the full mature protein) and Scm36 (containing only the A-domain) exhibited significant binding to CV (35-fold and 82-fold, respectively, higher than the background level seen with immobilized BSA). Interestingly, stronger binding of these rScm proteins (especially rScm36) to fibrinogen and CI was also observed compared with their binding to CIV, laminin, and fibronectin (Fig. 2a
).
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The three collagen types included in our assays have distinct structures and tissue distributions. CI is the most abundant form and the main component of the collagen fibres that are widely distributed in human tissues, while CIV forms structurally different cross-linked networks and is found nearly exclusively in basement membranes. CV, although quantitatively less abundant, has a critical role in formation of the fibrillar collagen matrix and connecting interstitial collagen fibrils with membranous collagen networks (Nicholls et al., 1996
; Wenstrup et al., 2004
). Considering the diverse tissue localizations and structural differences of the various collagen types, the possession of two collagen adhesins with different binding specificities to various collagen types could give E. faecium the ability to fine-tune its adherence phenotype to suit a given tissue. Since collagens, including CV, are also present in the intestinal submucosa (Liang et al., 2006
), Scm could alternatively be involved in colonization and persistence in the intestinal tract, a major natural reservoir of both commensal and infection-associated strains of E. faecium in humans, or in facilitating translocation through damaged intestinal epithelium.
Structural analysis of recombinant Scm protein
To investigate the structural predictions made above, we analysed the full A-domain of Scm with far-UV CD spectroscopy. The spectra obtained showed a maximum at 197 nm, another at 191 nm, and a minimum at 217 nm (Fig. 3a
). A similar overall pattern was observed with the collagen-binding A-domain of the E. faecium prototype MSCRAMM Acm, which we have characterized previously (Nallapareddy et al., 2003
, 2007
), and also with the minimal collagen-binding region of Ace from E. faecalis, which crystal structure studies have recently revealed folds into a similar DEv variant of the Ig-fold as that found previously in the ligand-binding A-domains of staphylococcal MSCRAMMs (Liu et al., 2007
). Deconvolution of the collected data showed a secondary structure composition of 0.15±0.03
-helix and 0.34±0.01 β-sheet for rScm36 (Fig. 3b
). Although the helical content of this protein is slightly higher than in the two control proteins, these results generally resemble the overall secondary structure compositions of the ligand-binding regions of Acm and Ace, and are in good agreement with earlier CD analyses and crystal structure data of other MSCRAMM A-regions (Rich et al., 1999
). While fold analyses and multiple alignments predicted a single Ig-folded subunit from amino acids 125–325 in the A-domain of Scm, our CD measurements indicate a high β-sheet composition for the entire Scm A-domain, thus suggesting that an Ig-folded or similar β-sheet-rich structure may extend over the whole A-domain (amino acids 27–333).
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63 kDa) in mutanolysin cell wall extracts from TX0074 and TX2535, but not from TX0016 (data not shown).
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Subsequent in silico predictions identified conserved pilin motifs and E-boxes of Gram-positive pilus proteins in all four predicted major pilus protein homologues (EbpCfm, Fms13, Fms16 and Fms21) and all five of the predicted accessory protein homologues (EbpAfm, EbpBfm, Fms14, Fms17 and Fms19) associated with the four gene clusters described above (Supplementary Fig. S3). The lysine (K) residue of the pilin motif and the glutamic acid (E) of the E-box that have been demonstrated to be essential in the polymerization of the Corynebacterium diphtheriae pilus (Ton-That & Schneewind, 2003
; Ton-That et al., 2004
) were found to be 100 % conserved. Two accessory proteins, namely EbpAfm and Fms14, have a von Willebrand factor type A-domain with a MIDAS motif which is frequently found in pili-associated accessory proteins. Recently, crystal structure analyses of the minor pilin protein GBS52 of Streptococcus agalactiae and the major pilin Spy0128 of Streptococcus pneumoniae have demonstrated that these proteins contain two Ig-like domains (Kang et al., 2007
; Krishnan et al., 2007
), consistent with our prediction of Ig-like folds in E. faecium pilus proteins. These features, together with the presence of an independent class C sortase (class C sortases are used in the assembly of pili of related Gram-positive bacteria) in each of the four clusters, indicate that E. faecium may harbour genes for multiple pilus-like structures. Recent studies on the pili of C. diphtheriae, E. faecalis, group A and B streptococci, and pneumococci have demonstrated their role in bacterial adherence and biofilm formation, and their contribution to bacterial pathogenesis and modulation of the host immune system (Barocchi et al., 2006
; Dramsi et al., 2006
; Mandlik et al., 2007
; Nallapareddy et al., 2006
; Singh et al., 2007
; Telford et al., 2006
).
EbpCfm is present as an HMM polymeric protein complex at the cell surface of E. faecium
To confirm the predicted location of EbpCfm on the surface of E. faecium as part of polymeric pili, we probed mutanolysin cell wall extracts of endocarditis-derived E. faecium strains TX0082 and TX0016 with affinity-purified anti-rEbpCfm62 antibodies. A ladder-like pattern of HMM bands with sizes greater than 200 kDa was detected from strain TX0082 (Fig. 5
). In contrast, only a single band has been observed with Acm in mutanolysin extracts of TX0082 (Nallapareddy et al., 2003
). The HMM banding pattern is consistent with observations of a large number of pilus proteins from other Gram-positive bacteria and suggests that EbpCfm is assembled similarly into multimeric pilus structures on the E. faecium cell surface. In contrast to TX0082, no signal was detected from the cell wall extract of TX0016, which is similar to our whole-cell ELISA results (data not shown) and indicates that the EbpCfm-containing pilus is not expressed in this strain under the growth conditions used.
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-independent transcriptional terminator, thus predicting an efbAfm to efbCfm transcript and an independent bpsfm transcript. To validate this, we carried out transcriptional analyses of the ebpAfm to bpsfm locus using Northern hybridization. The ebpAfm, ebpBfm and ebpCfm probes all hybridized to a single RNA band of
7 kb (Fig. 6a
1 kb), consistent with the expected size of a monocistronic bpsfm mRNA transcript, suggesting that this transcript either is produced at low levels at this time point or has a relatively short half-life. RT-PCR using three independent sets of internal bpsfm primer pairs amplified fragments of the expected sizes (lane 4 of Fig. 6b
8 kb was also observed with the bpsfm-probed Northern blots; while its identity is currently unclear, it might represent a related mRNA sequence such as one transcribed from the other predicted pilus operons.
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Genes encoding MSCRAMM and pili proteins are commonly found in E. faecium isolates of clinical origin
We next examined 30 diverse (source/year/geographical location) human clinical isolates by colony hybridization using PCR-generated DNA probes. E. faecium strain TX0016 and the acm gene served as controls for the hybridization studies. As shown in Table 2
, the percentage of isolates showing hybridization to the individual gene probes varied from 73 % (fms20) to 100 %. The range in the number of probes hybridizing per isolate varied from 11 genes in one isolate (that lacked fms15, fms18, fms20 and fms21) to all 15 genes in 16 isolates (53 %). One isolate lacked the ebpABCfm (fms1-5-9) operon and another lacked the fms11-19-16 operon. The scm (fms10), fms14, fms17 and fms13 genes were present in all isolates tested, while fms15 was present in all but one. Among the endocarditis isolates included in this analysis, the multilocus sequence type 18 (ST18) isolate TX0068, belonging to the global epidemic hospital-associated clonal complex CC17 (Leavis et al., 2003
), had all 15 genes, as did the sequenced ST18 isolate TX0016. Another endocarditis isolate, TX2535 (ST17), which also belongs to CC17, lacked fms18. A fourth endocarditis isolate, TX0074 (non-CC17, ST337), had 14 genes and lacked fms20. Thus, our results indicate broad but variable distribution of MSCRAMM-encoding genes in clinical isolates, consistent with a recent study of 22 E. faecium CWA-protein-encoding genes in which four of the genes, fms11-19-16 (orf903-905-907) and fms18 (orf2430) were shown to be specifically enriched in CC17 isolates, while the remaining nine genes were considered to be widespread in both CC17 and non-CC17 nosocomial isolates (Hendrickx et al., 2007
). Notably, our preliminary data from screening for scm in several hundred E. faecium isolates belonging to clinical and non-clinical groups indicate that scm is absent only rarely from clinical isolates but is frequently absent from stool isolates (S. R. Nallapareddy, J. Sillanpää and B. E. Murray, unpublished data).
In summary, this study identified genes for 14 new E. faecium CWA proteins with MSCRAMM-like features. We characterized the function of one of these proteins, Scm, and demonstrated that it is a second collagen-binding protein for E. faecium with specificity for CV. We further showed that the identified minimal ligand-binding region has a β-sheet-rich secondary structure composition characteristic of the A-domains of MSCRAMMs. Scm was shown to be expressed on the surface of many E. faecium clinical isolates during in vitro growth. Eleven of the 14 MSCRAMM-like protein-encoding genes were clustered in four loci, and nine are predicted to encode the components needed to form multiple, distinct, pilus-like structures. We characterized one of these clusters (ebpABCfm-bpsfm) and showed that the four genes of this cluster are expressed in TX0082 as two transcripts, ebpABCfm and bpsfm. Subsequent detection of an HMM ladder pattern with anti-EbpCfm in Western blots of cell surface extracts from TX0082 provides experimental evidence for the assembly of EbpCfm into polymeric structures, such as pili. Our hybridization results for all 14 genes indicate a broad distribution of MSCRAMM- and pilus-encoding genes among clinical isolates; a future study will assess their distribution in natural E. faecium populations from a variety of sources. The ability of E. faecium to produce two surface-anchored collagen adhesins with different collagen type specificities, and the common occurrence of the scm gene as well as the 13 other newly identified MSCRAMM- and pilus-encoding genes among clinical E. faecium isolates, may have important implications for colonization and infection by this opportunistic pathogen.
| ACKNOWLEDGEMENTS |
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Edited by: K. E. Weaver
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Received 2 February 2008;
revised 26 May 2008;
accepted 13 June 2008.
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