1. Introduction
Bacterial urinary tract infections (UTI) afflict 150 million people annually worldwide[
1], with a lifetime incidence of 50-60% in women[
2], 25-30% of whom suffer recurrent UTI within six months[
3]. Uropathogenic
Escherichia coli (UPEC) is the most common cause of UTI, accounting for 80-90% of cases[
1,
3]. The risk of ascending UTI and pyelonephritis is elevated in young children, people with diabetes, and the geriatric population, and this can lead to acute kidney injury and chronic kidney disease due to renal scarring[
4,
5,
6]. The choice of antibiotics to manage UTI has been limited by mounting antimicrobial resistance [
7,
8]. These circumstances drive the demand for novel measures to identify patients most at risk for UTI recurrence.
A greater understanding of the human immune response to UTI should yield insights into mechanisms that account for heightened susceptibility to infection along with new strategies to combat UTI. Experiments in preclinical models of UTI attest that the innate immune system is chiefly responsible for UPEC detection and clearance [
9,
10,
11]. The innate immune system of the urinary tract relies upon a combination of pattern recognition receptors, complement activation, phagocyte recruitment, and antimicrobial peptides and proteins (AMPs) to detect and destroy invading uropathogens [
10,
12,
13]. The antimicrobial mechanisms of AMPs include among others: membrane disruption, microbial agglutination, blockade of cell division, impaired ribosomal translation, and micronutrient sequestration [
14,
15,
16,
17].
In vitro and
in vivo studies have implicated AMPs in host defense against UTI. AMPs are synthesized by multiple cell types in the urinary tract, including urothelial cells, renal intercalated cells, neutrophils, monocytes, and macrophages[
12,
18,
19].
Mounting evidence suggests that AMP levels and antimicrobial properties are reduced in patients with recurrent UTI (rUTI). Urine from girls with rUTI contains lower levels of AMPs, such as RNase 4, RNase 7, and Lipocalin-2/NGAL, compared to healthy controls[
20,
21,
22]. Such quantitative defects may have an underlying genetic basis, as patients with fewer copies of immune related genes such as the defensin
DEFA1A3 and
DMBT1 genes experience rUTI more frequently [
23,
24]. Moreover, non-synonymous single nucleotide polymorphisms (SNP) in AMP encoding genes can result in defective antimicrobial activity. Along these lines, a common SNP in
RNASE7 that encodes a Pro103 to Ala substitution (rs1263872) reduces its bactericidal activity toward UPEC and is more prevalent in children with UTI[
25]. Altogether, these studies indicate promising roles for AMP levels and genotypes as new prognostic tools to identify patients at high risk for recurrence.
We previously identified RNase 6 as a monocyte and macrophage -derived AMP that is expressed in the urinary tracts of humans and mice [
16]. RNase 6, also named RNase k6, was originally identified as an orthologue of bovine kidney RNase 2 when tracing the evolutionary divergence within the RNaseA superfamily[
26], a family that groups proteins endowed with a diversity of host defense properties[
27]. By structure-functional studies we demonstrated that RNase 6 antimicrobial mechanism mostly relies on its action at the bacteria envelope and is dependent on both surface exposed hydrophobic and cationic residues[
28]. The protein is more active on Gram-negative bacteria, showing a high affinity for lipopolysaccharide (LPS)[
28]. Interestingly, recombinant human and mouse RNase 6 proteins exhibited bactericidal activity toward uropathogenic
Escherichia coli (UPEC) at low-micromolar concentrations [
16]. Accordingly,
RNASE 6 transgenic mice are less susceptible to UPEC induced experimental UTI than non-transgenic controls[
29]. In this study, we have characterized the most common non-synonymous
RNASE6 SNP in the human population and assessed its impact on RNase 6 antimicrobial activity toward UPEC.
3. Discussion
While the human genome exhibits considerable diversity particularly in its compendium of genes associated with innate immunity, the functional implications of this diversity in many cases have not been fully addressed[
14,
36]. Mounting evidence indicates that differences in UTI susceptibility among humans may have a genetic basis[
23,
24,
25]. Within the RNase A superfamily, some SNPs have been associated with disease predisposition and infection susceptibility[
25,
37,
38,
39].In this study, we focused on the functional consequences of the most common, non-synonymous SNP in
RNASE6 on its antimicrobial properties toward UPEC, the most common cause of bacterial UTI.
The comparison of the antimicrobial properties of the resulting RNase 6-Q66 and RNase6-R66 variants toward UPEC strains illustrated significant differences (
Figure 2). RNase 6 antimicrobial potency has been partly associated with its capacity to bind to LPS at the bacterial cell wall and agglutinate cells[
28]. In this regard, it is noteworthy that RNase 6-Q66, the minor variant (
Figure 1), was less effective in LPS binding and
E. coli agglutination when compared to the predominant RNase 6-R66 protein (
Table 1). A close structural inspection revealed that R66 contributes to a cationic region that favors anion ligand binding (
Figure 3), as observed in the solved crystal structures of RNase 6 in complex with either sulphate or phosphate anions (PDB IDs: 4X09 and 5OAB)[
33,
34]. Indeed, the N64-R66 stretch was identified by PDBe motif as a cation region prone to bind anionic molecules, and R66 was identified as a key residue for the protein’s putative saccharide binding by molecular modelling[
40]. Likewise, the cationic residues at the protein surface were identified to interact with the anionic bacterial LPS in RNase 3, another RNase A family homologue with antimicrobial properties[
41]. RNase binding to LPS was correlated to the induction of bacterial agglutination by screening a battery of LPS progressively truncated
E.coli strains[
42]. Thus, we posit that decreased surface cationic charge accounts for reduced LPS binding,
E. coli agglutination, and microbicidal activity of RNase 6-Q66.
On the other hand, R66Q substitution did not alter the enzyme catalytic activity (
Table 2). Kinetic results using dinucleotides as substrates did not reveal any significant in the catalytic efficiency or in the enzyme base preference. Although structural data indicates that the 64-68 loop is the main anchoring region for RNase 6 binding to adenine at the B2 site, residue 66 would not interact directly with the base ring. Recent solving of RNase 6 crystal structure in complex with an adenine mononucleotide revealed direct hydrogen bonding with N64 and N68, but no direct interaction with R66 [
43]. Overlapping of the predicted 3D structure of the RNase6-Q66 variant onto the RNase6-R66 in complex with AMP (PDB ID: 6MV7) [
43] suggests equivalent interactions with the nucleotide, where N64 and N68 in both variants could bind to the adenine ring and the neighbor R/Q66 residues cannot make direct interactions (
Figure S1B). Previous structural analysis by molecular dynamics within the RNase A superfamily highlighted position 66 in RNase 6 as counterpart to Q69 in RNase A[
33,
44], where Q69 can complement the role of N71 (N68 in RNase 6). The prior work by molecular dynamics also highlighted the potential roles of both N64 and N68 for direct binding to adenine at B
2 but no direct contribution to R66[
44]. Overlapping of RNase 6-AMP complex with RNase A- d(CpA) corroborates the equivalent roles of N64/N67 and N68/N71 in both RNases, but alternate orientation for R66 in RNase 6 and Q69 in RNase A (
Figure S2). Besides, whereas R66 side chain in RNase 6 is determined by electrostatic interactions with D107 (
Figure S1A), in the Q66 variant, the side chain might perform equivalent to Q69 in RNase A. Therefore, further work would be needed to fully evaluate the implications of R66Q substitution on RNase 6 substrate selectivity.
Interestingly, evolutionary studies of RNase 6 lineage indicated an unusual low substitution rate in comparison to other family lineage types [
45]. Among the few non-synonymous substitutions we observe a trend for Gln to Arg substitution at position 66 from lower to higher order primates, which correlates with a slight increase in the protein cationicity [
45]. In fact, position 66 stands out as RNase 6 lineage specific when mapping the sequence evolutionary rates among the RNase A superfamily homologues using the
Consurf server (
Figure S3A)[
46]. Whereas R66 is conserved in the 4 hominid species, all the old-world monkeys have a Gln at this position (
Figure S3B) and the new-world monkeys present significant differences at this region, with overall an average lower estimated pI [
45]. Further work would be required to consider the functional significance of sequence diversity at this location.
Our query of dbSNP identified
RNASE6 rs1045922 as the most common, non-synonymous SNP in the human population. Studies are warranted to examine
RNASE6 rs1045922 genotypes in combination with other common variants in genes associated with the innate immune response in patients with UTI. Such studies will benefit from examination of additional, common SNP haplotypes within
RNASE6 and more broadly within the RNase A Superfamily, such as the
RNASE7 rs1263872 polymorphism recently associated with UTI susceptibility [
25], as it is plausible that combinations of these SNP converge to impact UTI risk.
In this study, we have identified RNASE6 rs1045922 as a common, functionally significant SNP within the human population and implicated R66 as a key amino acid residue for the antimicrobial potency of RNase 6 toward UPEC. Additional work is envisaged to consider the association of this and other RNASE6 SNPs with UTI susceptibility.
Author Contributions
For research articles with several authors, a short paragraph specifying their individual contributions must be provided. The following statements should be used “Conceptualization, E.B. and B.B.; methodology, E.B., R.A:, G.P-E., M.M.; data curation, R.A., E.B. and B.B.; writing—original draft preparation, B.B and E.B..; writing—review and editing, E.B. and B.B.; supervision, E.B., B.B., M.M. and G. P-E.; funding acquisition, E.B. and B.B. All authors have read and agreed to the published version of the manuscript.”