With the aging of population, the number of indications for total joint replacement is continuously increasing. However, prosthesis loosening can happen and is related to two major mechanisms: (1) ...aseptic loosening due to prosthesis micromotion and/or corrosion and release of wear particles from the different components of the implanted material and (2) septic loosening due to chronic prosthetic joint infection (PJI). The "aseptic" character of prosthesis loosening has been challenged over the years, especially considering that bacteria can persist in biofilms and be overlooked during diagnosis. Histological studies on periprosthetic tissue samples reported that macrophages are the principle cells associated with aseptic loosening due to wear debris. They produce cytokines and favor an inflammatory environment that induces formation and activation of osteoclasts, leading to bone resorption and periprosthetic osteolysis. In PJIs, the presence of infiltrates of polymorphonuclear neutrophils is a major criterion for histological diagnosis. Neutrophils are colocalized with osteoclasts and zones of osteolysis. A similar inflammatory environment also develops, leading to bone resorption through osteoclasts.
,
, and
are the main staphylococci observed in PJIs. They share the common feature to form biofilm. For
and
, the interaction between biofilm and immunes cells (macrophages and polymorphonuclear neutrophils) differs regarding the species. Indeed, the composition of extracellular matrix of biofilm seems to impact the interaction with immune cells. Recent papers also reported the major role of myeloid-derived suppressor cells in biofilm-associated PJIs with
. These cells prevent lymphocyte infiltration and facilitate biofilm persistence. Moreover, the role of T lymphocytes is still unclear and potentially underestimates. In this review, after introducing the cellular mechanism of aseptic and septic loosening, we will focus on the interrelationships between staphylococcal biofilm, immune cells, and bone cells.
Human T-cell leukemia virus type 1 (HTLV-1) is a retrovirus associated with adult T-cell leukemia (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). To date, it is the ...unique published example of a virus able to form a biofilm at the surface of infected cells. Deeply studied in bacteria, bacterial biofilms represent multicellular assemblies of bacteria in contact with a surface and shielded by the extracellular matrix (ECM). Microbial lifestyle in biofilms, either viral or bacterial, is opposed structurally and physiologically to an isolated lifestyle, in which viruses or bacteria freely float in their environment. HTLV-1 biofilm formation is believed to be promoted by viral proteins, mainly Tax, through remodeling of the ECM of the infected cells. HTLV-1 biofilm has been linked to cell-to-cell transmission of the virus. However, in comparison to bacterial biofilms, very little is known on kinetics of viral biofilm formation or dissemination, but also on its pathophysiological roles, such as escape from immune detection or therapeutic strategies, as well as promotion of leukemogenesis. The switch between production of cell-free isolated virions and cell-associated viral biofilm, although not fully apprehended yet, remains a key step to understand HTLV-1 infection and pathogenesis.
is responsible for severe and necrotizing infections in humans and dogs. Contrary to
, the pathophysiological mechanisms involved in this virulence are incompletely understood. We previously showed ...the intracellular cytotoxicity induced after internalization of
. Herein, we aimed to identify the virulence factors responsible for this cytotoxic activity. After addition of filtered
supernatants in culture cell media, MG63 cells, used as representative of non-professional phagocytic cells (NPPc), released a high level of LDH, indicating that the cytotoxicity was mainly mediated by secreted factors. Accordingly, we focused our attention on
toxins.
analysis found the presence of two PSMs (δ-toxin and PSMε) as well as Luk-I leukotoxin, the presence of which was confirmed by PCR in all clinical strains tested (
= 17). Recombinant Luk-I leukotoxin had no cytotoxic activity on NPPc but the ectopic expression of the CXCR2 receptor in U937 cells conferred cytotoxity to Luk-I. This is in agreement with the lack of Luk-I effect on NPPc and the previous report of Luk-I cytoxic activity on immune cells. Contrary to Luk-I, synthetic δ-toxin and PSMε had a strong cytotoxic activity on NPPc. The secretion of δ-toxin and PSMε at cytotoxic concentrations by
in culture supernatant was confirmed by HPLC-MS. In addition, the supplementation of such supernatants with human serum, known to inhibit PSM, induced a complete abolition of cytotoxicity which indicates that PSMs are the key players in the cytotoxic phenotype of NPPc. The results suggest that the severity of
infections is, at least in part, explained by a combined action of Luk-I that specifically targets immune cells expressing the CXCR2 receptor, and PSMs that disrupt cell membranes whatever the cell types. The present study strengthens the key role of PSMs in virulence of the different species belonging to
genus.
Implicated in more than 60% of bone and joint infections (BJIs), Staphylococci have a particular tropism for osteoarticular tissue and lead to difficult-to-treat clinical infections. To date, ...Staphylococcus aureus internalization in non-professional phagocytic cells (NPPCs) is a well-explored virulence mechanism involved in BJI chronicity. Conversely, the pathophysiological pathways associated with Staphylococcus non-aureus (SNA) BJIs have scarcely been studied despite their high prevalence. In this study, 15 reference strains from 15 different SNA species were compared in terms of (i) adhesion to human fibronectin based on adhesion microplate assays and (ii) internalization ability, intracellular persistence and cytotoxicity based on an in vitro infection model using human osteoblasts. Compared to S. aureus, S. pseudintermedius was the only species that significantly adhered to human fibronectin. This species was also associated with high (even superior to S. aureus) internalization ability, intracellular persistence and cytotoxicity. These findings were confirmed using a panel of 17 different S. pseudintermedius isolates. Additionally, S. pseudintermedius internalization by osteoblasts was completely abolished in β1 integrin-deficient murine osteoblasts. These results suggest the involvement of β1 integrin in the invasion process, although this mechanism was previously restricted to S. aureus. In summary, our results suggest that internalization into NPPCs is not a classical pathophysiologic mechanism of SNA BJIs. S. pseudintermedius appears to be an exception, and its ability to invade and subsequently induce cytotoxicity in NPPCs could explain its severe and necrotic forms of infection, notably in dogs, which exhibit a high prevalence of S. pseudintermedius infection.
Les infections ostéo-articulaires (IOA) regroupent plusieurs entités cliniques hétérogènes ayant en commun l'invasion et la destruction progressive des tissus osseux et cartilagineux par un ou ...plusieurs micro-organismes. Le genre Staphylococcus, impliqué dans plus de 65% des IOA, représente la première étiologie dans ces infections particulièrement sévères et difficiles à traiter. Les Staphylococcus non-aureus (SNA) incluant des espèces tels que Staphylococcus epidermidis sont responsables de près de 40% de certaines formes cliniques notamment les IOA sur matériels. Contrairement à S. aureus, pour lequel les mécanismes physiopathologiques incluent : (i) la capacité d'internalisation dans les cellules de l'hôte et (ii) la formation de biofilm, peu de données sont disponibles concernant ceux impliqués dans les IOA dues aux SNA. Dans ce contexte, mon travail de doctorat s'est attaché à caractériser les mécanismes physiopathologiques impliqués dans la genèse des IOA causées par différentes espèces de SNA. A l'aide d'une approche in silico puis in vitro conduite dans un modèle d'invasion d'ostéoblastes humains, nos travaux ont mis en évidence une capacité d'internalisation et de persistance dans les cellules osseuses pour seulement deux espèces (S. pseudintermedius et S. delphini) sur les 17 testées. De façon similaire à S. aureus, le processus d'invasion cellulaire pour ces espèces fait intervenir une liaison tripartite entre les adhésines bactériennes liant la fibronectine (FnBPs), la fibronectine de la matrice extracellulaire et l'intégrine cellulaire α5β1. Un autre point essentiel de ce travail est la mise en évidence du phénotype hautement cytotoxique de l'espèce S. pseudintermedius après internalisation dans les cellules hôtes. Nous démontrons ici que cette cytotoxicité est, au moins en partie, médiée par une action combinée de (i) la leucocidine Luk-I (toxine homologue de la leucocidine Panton-Valentine de S. aureus) qui cible spécifiquement les cellules immunitaires exprimant le récepteur CXCR2 (récepteur 2 à l'interleukine 8) et (ii) les phénol-soluble modulins (PSMs) qui perturbent les membranes des cellules immunes et non immunes. Sachant que les SNA sont les agents infectieux les plus incriminés dans les IOA sur matériel, une technique d'étude du biofilm sur biomatériaux orthopédiques (acier inoxydable, titane et polyéthylène) a été mise au point pour étudier le biofilm mature formé par les six espèces SNA les plus prévalentes dans les IOA (S. epidermidis, S. lugdunensis, S. heamolyticus, S. warneri, S. caprae, S. capitis). A l'exception de S. epidermidis qui forme plus de biofilm sur le polyéthylène, constituant placé à l'interface des pièces métalliques et/ou des os dans les prothèses orthopédiques, aucune différence significative n'a été observée entre les trois biomatériaux orthopédiques pour l'ensemble des espèces de SNA testées. Néanmoins, nos observations indiquent une forte hétérogénéité au sein des SNA en matière de capacité à former un biofilm mature. Les espèces telles que S. capitis et S. lugdunensis se distinguent significativement de S. haemolyticus et S. warneri par leurs aptitude à former plus de biofilm. La grande diversité des phénotypes observés vis-à-vis des mécanismes physiopathologiques impliqués lors des IOA par les différentes espèces de SNA testées démontre qu'il ne faut pas considérer les SNA comme une entité clinique unique. L'amélioration des connaissances apportées au cours de ce travail devraient contribuer à l'optimisation de la prise en charge chirurgicale, médicale, et thérapeutique des patients
Bone and joint infections (BJI) include several heterogeneous clinical entities that share the invasion and the progressive destruction of bone and cartilage tissue by one or more microorganisms. The genus Staphylococcus, involved in over 65% of the BJI, represents the first etiology in these particularly severe and difficult-to-treat infections. Staphylococcus non-aureus (SNA), including species such as Staphylococcus epidermidis, are responsible for nearly 40% of some clinical forms, including device-associated BJI. In contrast to S. aureus, for which pathophysiological mechanisms include (i) internalization capacity in host cells and (ii) biofilm formation, few data are available regarding those involved in BJIs due to SNA. In this context, my PhD work focused on characterizing the pathophysiological mechanisms involved in the genesis of BJI caused by different SNA species. Using an in silico together with an in vitro approach conducted in a human osteoblast invasion model, our work revealed an ability to internalize and persist in bone cells for only two species of SNA out of the 17 tested. Indeed, we have been able to demonstrate that only S. pseudintermedius and S. delphini have the ability to invade the cytoplasmic compartment of the host cells. Similar to S. aureus, the cellular invasion process for these species involves a tripartite association between bacterial adhesins fibronectin-binding proteins (FnBPs), fibronectin of the extracellular matrix, and α5β1 cell integrin. Another key point of this work is the demonstration of the highly cytotoxic phenotype of the S. pseudintermedius species after internalization in the host cells. We demonstrate here that this cytotoxicity is, at least in part, mediated by a combined action of (i) the Leukocidin Luk-I (homologous to S. aureus Panton-Valentine Leukocidin) that specifically targets immune cells expressing the CXC chemokine receptor 2 (CXCR2) with (ii) phenol-soluble modulins (PSMs) that disrupt the membranes of immune and non-immune cells. Knowing that SNA are the most incriminated infectious agents in device-associated BJI, a technique for studying biofilm on orthopedic biomaterials (stainless steel, titanium and polyethylene) has been developed to study the mature biofilm formed by the six SNA species with the highest prevalence in BJI (S. epidermidis, S. lugdunensis, S. heamolyticus, S. warneri, S. caprae, S. capitis). With the exception of S. epidermidis, which forms more biofilm on polyethylene (constituting at the interface of metal parts and / or bone in orthopedic prostheses), no significant difference was observed between the three orthopedic biomaterials for all the SNA species tested. The great diversity of phenotypes observed with respect to the pathophysiological mechanisms involved in BJI by the different SNA species tested demonstrates that SNA should not be considered as a single clinical entity. Improved knowledge provided during this work should contribute to the optimization of the surgical management, medical and therapeutic patient
The intracellular lifestyle of bacteria is widely acknowledged to be an important mechanism in chronic and recurring infection. Among the
genus, only
and
have been clearly identified as intracellular ...in nonprofessional phagocytic cells (NPPCs), for which the mechanism is mainly fibronectin-binding dependent. Here, we used bioinformatics tools to search for possible new fibronectin-binding proteins (FnBP-like) in other
species. We found a protein in
called
surface protein Y (SdsY). This protein shares 68% identity with the
surface protein D (SpsD), 36% identity with
FnBPA, and 39% identity with
FnBPB. The SdsY protein possesses the typical structure of FnBP-like proteins, including an N-terminal signal sequence, an A domain, a characteristic repeated pattern, and an LPXTG cell wall anchor motif. The level of adhesion to immobilized fibronectin was significantly higher in all
strains tested than in the fibronectin-binding-deficient
DU5883 strain. By using a model of human osteoblast infection, the level of internalization of all strains tested was significantly higher than with the invasive-incompetent
DU5883. These findings were confirmed by phenotype restoration after transformation of DU5883 by a plasmid expression vector encoding the SdsY repeats. Additionally, using fibronectin-depleted serum and murine osteoblast cell lines deficient for the β
integrin, the involvement of fibronectin and β
integrin was demonstrated in
internalization. The present study demonstrates that additional staphylococcal species are able to invade NPPCs and proposes a method to identify FnBP-like proteins.
This study aims at genetic characterization and phylogenetic relationships of Nocardia brasiliensis focusing by using housekeeping rrs, hsp65, and sodA genes. N. brasiliensis is the species ...responsible for 80% of cases of actinomycetoma, one form of cutaneous nocardiosis which occurs mainly in tropical regions reaching immunocompetent patients in which the disease can lead to amputation. We analyze 36 indigenous cases of N. brasiliensis that happened in France. Phylogenetic analysis targeting rrs gene showed no robustness at phylogenetic nodes level. However, the use of a concatenation of hsp65 and sodA genes showed that the tested strains surprisingly ranked in 3 well-defined genotypes. Genotypes 2 and 3 were phylogenetically closer to each other and both diverged from genotype 1 sustained by a high bootstrap of 81%. This last genotype hosts all the cases of pulmonary forms (3), the sole cerebral form, and almost all the cases of immunocompromised patients (3 out of 4). Moreover, excepting one of them, all the strains belonging to this group present a susceptibility to imipenem which is not the case in the other genotypes that rarely count among them strains being susceptible to this drug. The haplotype diversity (Hd) of hsp65 (0.927) and sodA (0.885) genes was higher than that of rrs (0.824). For this gene, we obtained 16 polymorphic sites whereas, for hsp65 and sodA genes, up to 27 and 29 were identified, respectively. This study reveals that these two genes have an important genetic discriminatory power for the evaluation of the intraspecies genetic variability of N. brasiliensis and they may be useful for identification purposes at species level. This study also reveals the possible existence of a new species harbored by genotype 1.
Background: Neutrophils are key mediators of inflammation during acute liver injury (ALI). Emerging evidence suggests that they also contribute to injury resolution and tissue repair. However, the ...different neutrophil subsets involved in these processes and their kinetics are undefined. Herein, we characterized neutrophil kinetics and heterogeneity during ALI. Methods: We used the carbon tetrachloride model of ALI and employed flow cytometry, tissue imaging, and quantitative RT-PCR to characterize intrahepatic neutrophils during the necroinflammatory early and late repair phases of the wound healing response to ALI. We FACS sorted intrahepatic neutrophils at key time points and examined their transcriptional profiles using RNA-sequencing. Finally, we evaluated neutrophil protein translation, mitochondrial function and metabolism, reactive oxygen species content, and neutrophil extracellular traps generation. Results: We detected 2 temporarily distinct waves of neutrophils during (1) necroinflammation (at 24 hours after injury) and (2) late repair (at 72 hours). Early neutrophils were proinflammatory, characterized by: (1) upregulation of inflammatory cytokines, (2) activation of the noncanonical NF-κB pathway, (3) reduction of protein translation, (4) decreased oxidative phosphorylation, and (5) higher propensity to generate reactive oxygen species and neutrophil extracellular traps. In contrast, late neutrophils were prorepair and enriched in genes and pathways associated with tissue repair and angiogenesis. Finally, early proinflammatory neutrophils were characterized by the expression of a short isoform of C-X-C chemokine receptor 5, while the late prorepair neutrophils were characterized by the expression of C-X-C chemokine receptor 4. Conclusions: This study underscores the phenotypic and functional heterogeneity of neutrophils and their dual role in inflammation and tissue repair during ALI.
This study aimed to shed light on the Palestinian Nakba and its reflection on the short story. The short story is nothing but a reflection of human experiences that have become a reflection of the ...human and political suffering and experiences that the Palestinian refugee lived through after the Nakba, and gave birth to a state of despair in him after he lost his land, which is the source of his livelihood, and he became homeless inside and outside the country, sheltered by some tents provided by international organizations such as the Red Cross and UNRWA. These bad conditions cast a shadow over the Palestinian literature, so the writers devoted themselves to writing their novels and stories, describing the suffering of the Palestinian people in all aspects of their lives. This study also attempted to analyze the story of Until We Return and link it to historical and human events in addition to the spatial event.
The twentieth century witnessed a colonial conspiracy that led to the division of the Arab world in its Asian wing between the Western colonial countries (Britain and France). Britain sought, during ...its mandate for Palestine, to facilitate the establishment of the Zionist entity on its land, and since that time until this day the Palestinian national resistance in its various forms is still struggling to obtain independence. It is no secret to anyone that the Palestinian woman played a prominent role in confronting the Zionist occupation, and we will try, through our study, to present a picture of one of the Palestinian women fighters, who was able to prove to the world that the Palestinian refugee woman was and still is in the front lines facing the occupation to gain independence.
PDF
