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Comparative toll-like receptor 4-mediated innate host defense to Bordetella infection.

Bordetella pertussis, B. parapertussis, and B. bronchiseptica are closely related species associated with respiratory disease in humans and other mammals. While B. bronchiseptica has a wide host range, B. pertussis and B. parapertussis evolved separately from a B. bronchiseptica-like progenitor to naturally infect only humans. Despite very different doubling times in vitro, all three establish similar levels of infection in the mouse lung within 72 h. Recent work has revealed separate roles for Toll-like receptor 4 (TLR4) in immunity to B. pertussis and B. bronchiseptica, while no role for TLR4 during B. parapertussis infection has been described. Here we compared the requirement for TLR4 in innate host defense to these organisms using the same mouse infection model. While B. bronchiseptica causes lethal disease in TLR4-deficient mice, B. pertussis and B. parapertussis do not. Correspondingly, TLR4 is critical in limiting B. bronchiseptica but not B. pertussis or B. parapertussis bacterial numbers during the first 72 h. Interestingly, B. bronchiseptica induces a TLR4-dependent cytokine response that is considerably larger than that induced by B. pertussis or B. parapertussis. Analysis of their endotoxins using RAW cells suggests that B. bronchiseptica lipopolysaccharide (LPS) is 10- and 100-fold more stimulatory than B. pertussis or B. parapertussis LPS, respectively. The difference in LPS stimulus is more pronounced when using HEK293 cells expressing human TLR4. Thus, it appears that in adapting to infect humans, B. pertussis and B. parapertussis independently modified their LPS to reduce TLR4-mediated responses, which may compensate for slower growth rates and facilitate host colonization.

Animals↗

The role of Bordetella infections in patients with acute exacerbation of chronic bronchitis.

BACKGROUND: Acute exacerbations of chronic bronchitis (AECB) are associated with a variety of viral and bacterial infectious agents, some of which are potentially preventable by immunization. Bordetella pertussis, which causes whooping cough, has not been studied in this context. We aimed to assess the role of Bordetella infections in patients with AECB. PATIENTS AND METHODS: Patients with AECB, who presented to participating private practices in Basel, Switzerland, between October 2000 and June 2002, were evaluated by a standardized questionnaire, nasopharyngeal swabs for culture (Bordetella spp.), and PCR (Bordetella spp. and selected other respiratory pathogens) and paired blood samples for serologic diagnosis of Bordetella infection. RESULTS: A total of 26 patients (34-86 years of age) were recruited. All culture and PCR samples were negative. Serology revealed Bordetella infection in eight (31%) patients. Duration of cough was shorter in patients with Bordetella infection compared to those without Bordetella infection (mean 15 days vs 41 days, p = 0.04). Cough > or = 21 days duration was present in three (43%) of seven patients with evidence of Bordetella infection compared to 17 (94%) of 18 controls (p = 0.012). Progression to convalescence from initial to follow-up visit after 4-6 weeks was comparable between both groups. CONCLUSION: Bordetella infections appear to play a significant role in AECB and preventive measurements such as immunization with acellular pertussis vaccines should be considered. Extended investigations are necessary to confirm our preliminary and provocative findings.

Adult↗

Role of antibodies in immunity to Bordetella infections.

The persistence of Bordetella pertussis and B. parapertussis within vaccinated populations and the reemergence of associated disease highlight the need to better understand protective immunity. The present study examined host immunity to bordetellae and addressed potential concerns about the mouse model by using a comparative approach including the closely related mouse pathogen B. bronchiseptica. As previously observed with B. pertussis, all three organisms persisted throughout the respiratory tracts of B-cell-deficient mice, indicating that B cells are required for bacterial clearance. However, adoptively transferred antibodies rapidly cleared B. bronchiseptica but not human pathogens. These results obtained with the mouse model are consistent with human clinical observations, including the lack of correlation between antibody titers and protection, as well as the limited efficacy of intravenous immunoglobulin treatments against human disease. Together, this evidence suggests that the mouse model accurately reflects substantial differences between immunities to these organisms. Although both B. pertussis and B. parapertussis are more closely related to B. bronchiseptica than they are to each other, they share the ability to resist rapid clearance from the lower respiratory tract by adoptively transferred antibodies, an adaptation that correlates with their emergence as human pathogens that circulate within vaccinated populations.

Animals↗

The morphologic and immunophenotypic assessment of the lymphocytosis accompanying Bordetella pertussis infection.

Bordetella pertussis (Bp) infection in infants and young children can be associated with a significant increase in small lymphocytes with convoluted and cleaved nuclei (SLCCN) in the peripheral blood (PB). Buffy coat smears were studied that were prepared from the PB of 11 children with documented Bp infection, whose ages ranged from one month to four years. The white blood cell count ranged from 8.4 to 72.9 X 10(9)/L, with a mean of 28.6 X 10(9)/L. In all cases, the percentage of PB lymphocytes was in the normal range; the absolute lymphocyte count ranged from 6.5 to 54.8 X 10(9)/L, with a mean of 20.3 X 10(9)/L. SLCCN represented 12-56% of the lymphocyte population. B and T lymphocytes, identified with monoclonal antibodies with the use of an immunoalkaline phosphatase method, accounted for a mean of 21% and 53%, respectively, of the total nucleated cells (TNCs) on buffy coat smears. The T-helper and T-suppressor subsets represented 38% and 16% of the TNCs, respectively, resulting in a CD4-CD8 ratio of 2.4. Most SLCCN were of the T-helper phenotype; SLCCN of the T-suppressor subset and, rarely, of the B-cell type also were identified. These observations document that the lymphocytosis associated with Bp infection in infants and young children is characterized by the presence of morphologically abnormal cells that are predominantly CD4 positive and appear to represent an expansion of an immunophenotypically normal lymphocyte population.

Antigens, CD↗

Outcomes of Bordetella infections in vaccinated children: effects of bacterial number in the nasopharynx and patient age.

Five outbreaks of infection (three pertussis, one parapertussis, and one mixed) in schools were studied prospectively. Nasopharyngeal swabs were obtained from a total of 697 children for culture of Bordetella organisms. Of 50 vaccinated children with culture-confirmed Bordetella infections (29 with pertussis and 21 parapertussis), 40 were symptomatic and 10 remained symptom-free. Smaller numbers of colonies were recovered from the nasopharyngeal swabs of the asymptomatic children than from those of the symptomatic children. Older children had longer durations of illness than younger ones. Our results indicate that during outbreaks children who do not develop disease may have small amounts of Bordetella organisms in their nasopharynges and/or better immune defenses against the disease.

Adolescent↗

Polymorphism in the pertussis toxin promoter region affecting the DNA-based diagnosis of Bordetella infection.

The pertussis toxin (PT) promoter region is a frequently used target for DNA-based diagnosis of pertussis and parapertussis infections. The reported polymorphism in this region has also allowed discrimination of species in mixtures with several Bordetella species by their specific PCR amplicon restriction patterns. In the present study, we investigated the degree of polymorphism in order to confirm the reliability of the assay. Five different sequence types of the amplified 239- or 249-bp region were found among the 33 Bordetella pertussis, B. parapertussis, and B. bronchiseptica American Type Culture Collection reference strains and patient isolates analyzed. According to the sequences that were obtained and according to the PT promoter sequences already available in the databases, restriction enzyme analysis with TaqI, BglI, and HaeII, which gave four different patterns, can be performed to reliably identify B. pertussis, B. parapertussis, and B. bronchiseptica.

Base Sequence↗

Studies on the efficacy of different adjuvants in live stock specific bacterial vaccines for turkeys against Bordetella infection and onset of antibody titers in respect to the age of the turkey poults.

For evaluating the influence of the age of the vaccinated birds on the development of antibodies, five groups of turkey poults were inoculated subcutaneously at day 1, 7, 10, 14 and 21 of life with vaccine containing inactivated Bordetella avium and Freund's incomplete adjuvant. No matter which vaccine schedule was used, serum antibodies with the ELISA were first detected at the 28th day of life and increased continuously until the 49th day, when it exhibited either a peak or a plateau. Aluminium hydroxide, Freund's complete and incomplete adjuvant and a mineral oil-arlacel-tween-mixture being permitted adjuvants (appendix II EWG 2377/90) and the adjuvant Gerbu 100 were evaluated for their suitability. Turkeys were vaccinated at the age of three weeks and examined clinically as well as serologically up to the 11th week. Humoral antibodies were detected quantitatively using an ELISA for IgG and a microagglutination test for IgM and qualitatively using immunodiffusion. The damage at the application site was rated by measurement of the swelling of the tissue. In the 10th week, the animals were infected with the agent for challenge. The serological examination for IgG antibodies in the ELISA both treatments with Freund's adjuvants resulted in high titers, which differed significantly from the unvaccinated control after 21 days. IgM could be detected from day 7 onwards in all vaccinated groups and showed the highest titers when aluminium hydroxide was used as adjuvant. In the immunodiffusion assay, precipitating antibodies could be found from the first week after vaccination onwards. There was no correlation between the occurrence of precipitating antibodies and ELISA titers. The measurements of the swelling of the tissue in the beginning showed the largest swellings in the animals injected with Freund's incomplete adjuvant and differed significantly from the unvaccinated control. In the 10th week, the animals were infected with Bordetella avium for challenge. In comparison to the unvaccinated animals, all vaccinated turkeys, no matter which adjuvant was used, showed a distinct and significant reduction of the reisolation rate.

Adjuvants, Immunologic↗

Frequency of serological evidence of Bordetella infections and mixed infections with other respiratory pathogens in university students with cough illnesses.

Banked acute-phase and convalescent-phase serum samples from a previous study of respiratory illness in university students were examined for significant (>/=2-fold) increases in ELISA titers of IgA and IgG antibody to Bordetella pertussis filamentous hemagglutinin, pertactin, and fimbriae-2 and >/=4-fold titer increases to agglutinogens by agglutination. ELISA titers of antibody to pertussis toxin could not be determined because of technical problems. Chlamydia pneumoniae infections were diagnosed by culture or by a >/=4-fold increase in immunofluorescence assay titer or a single high titer (>/=512). Mycoplasma pneumoniae, influenza A and B, adenovirus, and respiratory syncytial virus infections were diagnosed by >/=4-fold increases in complement fixation titer or a single high titer (>/=64). There were 319 subjects with cough of >/=5 days' duration, and of these, 47 (15%) had significant increases in antibody to B. pertussis antigens; 26 (8%) had significant increases to fimbriae-2 or agglutinogens, indicative of B. pertussis infection, and 2 (1%) had evidence of non-B. pertussis bordetella infections. Seventeen (36%) had evidence of mixed infections or cross-reacting antibodies (influenza B infections, 5; adenovirus infections, 4; influenza A infections, 3; C. pneumoniae infections, 3; and M. pneumoniae infections, 2). Our findings suggest that bordetella infections are common in young adults with cough illnesses (incidence, 9%), and a surprising number of these are mixed infections with other respiratory pathogens.

Adenovirus Infections, Human↗

A causal relationship between Bordetella pertussis and Bordetella parapertussis infections.

Bordetella parapertussis is isolated during the late stages of pertussis outbreaks and occasionally from patients infected with pertussis. The relationship between Bordetella pertussis and B. parapertussis was investigated in mice with monoinfections and mixed infections. Four groups of 10 2-week-old suckling mice were studied: mice born to mice vaccinated against pertussis during pregnancy and unvaccinated controls consequently did and did not receive antipertussis toxin (PT) antibody transcolostrally. The mice were infected transnasally with B. parapertussis strain 422 and 2 identical groups were infected transnasally with B. parapertussis strain 422 and B. pertussis strain 18-323. Bacterial colonization of the lungs and trachea was studied at 1, 2, and 3 weeks after challenge. No persistent colonization by B. parapertussis of the lungs or trachea of monoinfected suckling mice were observed. Persistent colonization by B. parapertussis was observed when suckling mice that received anti-PT antibody transcolostrally were infected with both species. These findings are consistent with the clinical characteristics of B. parapertussis. The results of this study demonstrate that B. pertussis infection facilitates B. parapertussis infection.

Animals↗

An agglutination test for the detection of Bordetella bronchiseptica infection in swine.

An agglutination test with the use of formalin-killed antigen of the cell carrying the capsule was developed and used for the detection of antibody in swine naturally infected with Bordetella bronchiseptica. Under optimum antigen concentration and reaction temperature 210 or 60% of 342 serum samples tested from 42 conventional swine herds were positive for Bordetella infection. In contrast, only 34 or 10% of 342 nasal swabs from the same animals were positive for Bordetella by culture technique. The test was relatively free of cross-reactivity to related organism. However, 2.7 and 13.0% of sera from growing pigs and mature hogs, respectively, reacted with antigen of Pasteurella multocida. Because of this, only agglutinin reactions in 1:20 dilutions or higher to Bordetella were considered positive. The bulk of the antibody activity of selected sera tested from various age ranges of swine was mercaptoethanol sensitive, suggesting that serum antibody in Bordetella infection may be associated with immunoglobulin IgM. Because of the high agglutinability and stability of formalin-killed antigen the test may be useful as an auxiliary aid for the diagnosis of Bordetella infection where the organism cannot be identified by culture means.

Agglutination Tests↗

Bordetella bronchiseptica infection in human immunodeficiency virus-infected patients.

Bordetella bronchiseptica is a pleomorphic gram-negative coccobacillus that commonly causes respiratory tract infections in dogs. We identified nine human immunodeficiency virus (HIV)-infected persons with culture-confirmed B. bronchiseptica infections (eight respiratory tract and one disseminated infection). The respiratory illnesses ranged in severity from mild upper respiratory tract infection to pneumonia. All nine patients had had at least one AIDS-defining condition before the B. bronchiseptica infection. Two patients had household contact with dogs before their illnesses, and one had household contact with cats. Infection due to B. bronchiseptica is uncommon in HIV-infected persons. Additional data are needed to fully define the spectrum of disease due to B. bronchiseptica infections and to evaluate the possibility that this infection may be acquired from pets. Treatment of B. bronchiseptica infection should be tailored to the patient and should be based on the results of susceptibility testing.

AIDS-Related Opportunistic Infections↗

Enhancement of histamine--induced vascular permeability in guinea pigs infected with Bordetella bronchiseptica.

In the nasal mucosa, histamine induces vascular permeability, stimulates nociceptive nerves, and recruits parasympathetic reflexes that regulate glandular exocytosis. Unilateral histamine nasal provocations were performed in a group of guinea pigs in the prodromal stage of undiagnosed Bordetella bronchiseptica infection. Vascular permeability in the histamine challenged nostrils was increased approximately 2- to 4-fold compared to healthy animals (p < 0.001). The duration of significant vascular leak was prolonged from 10 to 30 minutes. In the contralateral, nonchallenged nostrils, secretion of total protein and albumin, but not exudation of intravenously infected 125I-bovine serum albumin, was increased, suggesting an augmentation of parasympathetic reflexes without changes in contralateral vascular leak. These observations suggest that Bordetella bronchiseptica infection leads to hyperresponsiveness to histamine in the nasal mucosa with increased vascular permeability and recruitment of nociceptive nerve-parasympathetic reflexes.

Animals↗

Multiple roles for Bordetella lipopolysaccharide molecules during respiratory tract infection.

Bordetella pertussis, Bordetella parapertussis, and Bordetella bronchiseptica are closely related subspecies that cause respiratory tract infections in humans and other mammals and express many similar virulence factors. Their lipopolysaccharide (LPS) molecules differ, containing either a complex trisaccharide (B. pertussis), a trisaccharide plus an O-antigen-like repeat (B. bronchiseptica), or an altered trisaccharide plus an O-antigen-like repeat (B. parapertussis). Deletion of the wlb locus results in the loss of membrane-distal polysaccharide domains in the three subspecies of bordetellae, leaving LPS molecules consisting of lipid A and core oligosaccharide. We have used wlb deletion (Deltawlb) mutants to investigate the roles of distal LPS structures in respiratory tract infection by bordetellae. Each mutant was defective compared to its parent strain in colonization of the respiratory tracts of BALB/c mice, but the location in the respiratory tract and the time point at which defects were observed differed significantly. Although the Deltawlb mutants were much more sensitive to complement-mediated killing in vitro, they displayed similar defects in respiratory tract colonization in C5(-/-) mice compared with wild-type (wt) mice, indicating that increased sensitivity to complement-mediated lysis is not sufficient to explain the in vivo defects. B. pertussis and B. parapertussis Deltawlb mutants were also defective compared to wt strains in colonization of SCID-beige mice, indicating that the defects were not limited to interactions with adaptive immunity. Interestingly, the B. bronchiseptica Deltawlb strain was defective, compared to the wt strain, in colonization of the respiratory tracts of BALB/c mice beginning 1 week postinoculation but did not differ from the wt strain in its ability to colonize the respiratory tracts of B-cell- and T-cell-deficient mice, suggesting that wlb-dependent LPS modifications in B. bronchiseptica modulate interactions with adaptive immunity. These data show that biosynthesis of a full-length LPS molecule by these three bordetellae is essential for the expression of full virulence for mice. In addition, the data indicate that the different distal structures modifying the LPS molecules on these three closely related subspecies serve different purposes in respiratory tract infection, highlighting the diversity of functions attributable to LPS of gram-negative bacteria.

Animals↗

Tryptophan 2,3-dioxygenase activity in turkey poults infected with Bordetella avium.

1. Liver tryptophan 2,3-dioxygenase (TPO) activity was depressed significantly by the Bordetella avium infection localized in the trachea of the turkey poult. 2. Tryptophan, given orally, induced a significant increase in TPO activity in both control and infected poults. 3. Hydrocortisone induced TPO activity in the turkey in a dose dependent manner.

Animals↗

Effect of various oral dose levels of a trimethoprim/sulphadiazine mixture on Bordetella bronchiseptica infection and on the proliferation of trimethoprim-resistant faecal coliforms in pigs.

When a 1:5 mixture of trimethoprim (TMP) and sulphadiazine was fed to pigs intra-nasally infected with bordetella bronchiseptica, 10 mg/kg/day was shown to be highly effective in suppressing the organism. This dose level had little effect on numbers of TMP-resistant coliforms in faeces, but oral doses of 30 mg/kg/day eventually selected a resistant population. It is suggested that the proliferation of resistant coliforms would be minimized by administration of the lowest oral dose rates of antibacterial drugs compatible with efficacy.

Administration, Oral↗