1. Introduction
Campylobacter jejuni is one of the most important bacterial agents causing gastrointestinal infections with varying symptoms ranging from mild to bloody diarrhea. The infection is common also in developed and under developed countries. Outbreaks were reported in Eurasia, America, Africa and even in Oceania, which means that campylobacteriosis is a global problem. Epidemics caused by C. jejuni are not negligible, and these are registered more frequently in developing countries [1-5].
The typical source of infection is chicken meat, but besides, infection can also be transmitted to humans through the consumption of contaminated water, -milk, and -meats, through animal contact and in general by inadequate hygienic-sanitary conditions [
6,
7]. The prevalence of
C. jejuni in India and Africa correlates with contaminated water that they drink and give to their animals [
8,
9].
Living near to and together with animals is also a risk factor [
10,
11], similarly to malnutrition, especially in case of children [
12,
13].
Although there is a big difference among the isolates in their pathogenic potential, virulence and genome organisation, the general pathogenicity process of
C. jejuni can be described with the following stages.
C. jejuni enters the host intestine through the gastric acid barrier of the stomach, and colonises the mucosa covering the distal ileum and colon. During the passage into the small intestine and the migration of the bacteria towards the mucus-filled crypts,
C. jejuni reacts, presumably as an adaptive response, to the microenvironment of the current intestinal section, where it synthesizes a new set of proteins facilitating their subsequent interaction with the host’s target cells. It can penetrate enterocytes by paracellular or transcellular route [
14,
15]. The flagellae and the screw-shape of the bacterial cells play an important role in reaching the epithelial cells through the mucus layer [
16]. A group of adhesion proteins support the binding of the bacterial cell to extracellular matrix proteins (ECMPs), including fibronectin and laminin,. This process is facilitated by several factors such as CadF, Peb1, Peb2, Peb3, Peb4, CapA, CjaA, FlpA, FbpA, JlpA, DocA [
17].
As the first step of the invasion the pathogen interacts with the host through biochemical signals, such as Campylobacter invasion antigens (Cia) [
18,
19]. As a result, a signaling cascade triggers the rearrangement of the host's cytoskeleton, leading to the internalisation of the bacterium in a vacuole [
20]. At this point a two-sided game begins in which the
C. jejuni cell, in order to assure its survival, tries to maintain the vacuolised form by avoiding its fusion with lysosomes. On the other side, the eukaryotic cell attempts to eliminate the invader. Some recent studies have outlined molecular changes, such as the expression of capsule, lipooligosaccharide, and different membrane transport systems, and also the activation of stress related genes accompanying the invasion process and assuring the survival of the bacterial cell [
17,
21,
22]. Other studies primarly focused on immunologic aspects such as the appearance of interleukines in the supernatant of invaded cells, showing increased expression of IL-8 due to infection [
23] in a strain dependent manner, as well as minor changes in the expression of IL-1 and IL-4 in a time dependent manner with a slight increase at the 1
st and 4
th hour and a subsequent decrease by the 24
th hour following infection [
24]. Other studies demonstrated the massive expression of TNF-alpha suggesting that the immun response was shifted towards Th-1 type [
25].
Transcriptomic methods have also been used to estimate activation of different interleukines, such as IL-4, IL-8, IL-10, also in the case of Guillan-Barre syndrome (GBS), one sequelae of C. jejuni infection [26-29]. However, during the invasion process, genes other than those with immunological function were not typically examined, so not much is known about the other side of the infectious process, which is how internalisation of C. jejuni affects the eukaryotic transcriptome of the invaded cell. This is an important issue, since the outcome of bacterial infections depends not only on the infectious agent, but also on the host itself, influencing in several cases the development of certain late onset complications following C. jejuni infection [30-32].
Aim of this study was to get a view about those molecular changes that occur between the 1
st and 3
rd hour following internalisation and to determine whether these changes help maintain or eliminate the internalised state of the
C. jejuni cells. For this purpose a Whole Transcriptome Analysis (WTA) was performed by using the INT407 cell line and the recently isolated and partially characterised highly invasive
C. jejuni strain CjTD-119 [
17].
4. Discussion
Up-, and downregulation of the 2.764 and 2.200 genes, respectively, from the 41.769 ORFs reflects intensive transcriptomic changes in the INT407 intestinal human cell line upon the invasion of C. jejuni. Our preliminary findings have revealed that by the first hour after infection, 85% of the C. jejuni cells became stably internalised. From that point the possible routes for elimination of the invader can be outlined.
Activation of immune functions was represented by the increased expression of several relevant gene products. Overexpression of ULBP3 (ULBP3, Fc.: 10.109x) (
Table 1), encoding for an MHC I related cell surface protein, clearly indicates that the invaded cell prepares itself for antigene presentation, which is a crucial step in the immune recognition of cells infected with viruses or invasive bacteria [
40]. Due to antigen presentation, cytotoxic T cells are able to recognise infected eukaryotic cells [
100]. However, a proper processing of antigens is a prerequisite for this, in which the recently discussed [45-47] role of
cd36 (CD36, Fc.:2,74x),
procr (PROCR, Fc.:2.53x),
cd209 (CD209, Fc.:2.523x) and
il10ra (IL10RA, Fc.: 2.53x) is also supported by our results. Antigene presentation on the surface of the affected eukaryotic cell can not be effective without attracting immune cells, which makes the increased expression levels of
cr1 (CR1, Fc.:7,59x) and
ifi44L (IFI44L, Fc.: 3,317x) [
40,
43] not surprising, since these proteins make the infected cell more accessible to macrophages [
33]. Cytokines and interleukins play an important role in the attraction of immune cells and coordination of immunological processes for which the expression of the proper receptors is inevitable. Increased expression rates of the IL10 (IL10RA, Fc.:2.53x) and IL23 (IL23R, Fc.:6.31x) (
Table 1) receptors strongly suggests that these two interleukins contribute to the immune reaction evoked by the vacuolised pathogen. IL10RA activates the tyrosine phosphorylation of JAK1 and TYK2 kinases, two enzymes contributing to the alteration of the IFN-alpha/beta and gamma signaling pathways, thereby affecting the production of certain groups of cytokines [
101]. The mild expression change of IL4 (IL4I1, Fc.: 1.25x) was in accordance with the findings of other authors [
25], while the decreased expression of IL8 (IL8, Fc.:-2.74x) by the 3
rd hour of infection is seemingly in contrast with an earlier finding [
23]. A plausible explanation would be that our data were generated from the 3
rd hour, while in the study of Hickey, samples were taken 24 hours following infection. Another possible explanation may be the strain dependent manner of the IL8 expression rate [
23]. In a recent study the steep increase of the proinflammatoric citokines IL6, IL8 and IFN-γ and that of a regulator citokine IL10 was detected from the 5
th hour following infection [
102]. Our results are in partial accordance with these findings, showing moderate increases in the case of IL6 (IL6R, Fc.:1.7x), IL10 (IL10RA, Fc.:2.52x) and IFN-γ (IFNGR2, Fc.:1.4x), while the level of IL8 transcript dropped (IL8, Fc.:-2.74x) in the investigated time range (S
Table 1.)
Based on our data, campylobacter infection outlines two possibilities for the invaded eukaryotic cell. One is survival by activating the immune system, while the other option is to sacrifice the eukaryotic cell by apoptosis in order to eliminate the pathogen from the body [
103]. In certain situations, for an infected cell it is much more rewarding to drive itself toward apoptosis, a notion supported by the upregulation of 12 genes listed in
Table 4. In contrast, expression of
serpinB9 and
cd74 acts against apoptosis (
Table 1), of which the latter one, as a positive regulator of the type-2 immune response [
44], directs the process toward activation of adaptive immune processes.
Be it the activation of the immune system or apoptosis, both potential routes drastically reprogram metabolism and with that, require either the activation or the depression of transcription factors (S
Table 1). The coordinated increased expression of
znf491 (ZNF491, Fc.:2.52x),
znf560 (ZNF560, Fc.:2.52x),
znf516 (ZNF516, Fc.:2.52x)[
104],
esrrg (ESRRG, Fc.:2.52x) [
105] and the enhanced expression of translation and post-translation factors, such as GALNT5 (GALNT5 Fc.:8.84x), MUC3A (MUC3A, Fc.:6.31x) MUC6 (MUC6 Fc.:3.36x), MUC4 (MUC4 Fc.:3.15x) [106-108], PIWIL3 (PIWIL3 Fc.:3.79x), PIWIL4 (PIWIL4, Fc:3.79x, F9 (F9, Fc.:2,52x) and GFPT2 (GFPT2 Fc.:2.52x) support the existence of this highly accelerated metabolism. Downregulation of NDUFA13 (-4.11x), a negative regulator of translation [
109], suggests that also the activity of genes or group of genes controlled by this regulator is crucial in the battle between the invader and the host. During this encounter, maintenance of the intracellular homeostasis is crucial that is represented by the increased expression of TRPM6 contributing to Mg homeostasis (
Table 2) a key element of several enzymatic functions.
The markedly activated levels of CHCA1 (CHCA1, Fc.:8.84x)[
59] and LPO (LPO, Fc.:5.05) [
60] showed that the eukaryotic cell containing the vacuolised
C. jejuni 1-3 hours after infection underwent a marked stress situation. Decreased expression of CHRNE, a regulator of membrane potential (CHRNE, Fc.:-4.74x), assumes the development of an osmotic shock. On the other hand, the drastically decreased expression of GAPDHS ( GAPDHS, Fc.:-4.43x), an enzyme taking part in glycolysis [
110], clearly indicates a partial slowdown of some parts of the metabolic machinery of the eukaryotic cell.
Stress situations are characterised by the fact that the cell pauses its non-essential activities and focuses on saving energy. One feature of this may be the activation of the cell cycle arrest gene,
sesn2 (SESN2, Fc.:3.23x) [
111], thus stopping proliferation, an energy consuming process. Another example for energy saving is the decreased expressions of PARVG (PARVG, Fc.: -3.95x) [
112] taking part in matrix protein synthesis and matrix protein processes. The reduced expression of matrix proteins could either facilitate the killing of the infected cell by making itself more accessible and at the same time more vulnerable to the damaging enzymes of macrophages. This hypothesis is supported by the powerful increase of EDN2 (EDN2, Fc.:3,68x) [
42] a macrophage chemoattractant and the increased expression of the formerly mentioned ULBP3, responsible for natural killer cell activation.
The decreased expression of FAM132A, a negative regulator of inflammation [
113], suggests an induced inflammation in the invaded INT407 cell. Activation of
relb, birC3, nfkbia [
114] further supports this observation. It is important to note, that as a consequence of bacterial infections inflammatory diseases and other pathological conditions, such as tumors can develop. In this context,
C. jejuni infection has been implicated in the development of Guillan-Barre and Miller-Fisher syndromes (GBS and MFS). Reason of the more or less unaffected expression levels of genes coding for,
ptgs2 (PTGS2, Fc.:1.2x),
anxa3 (ANXA3, Fc.:1.32x) and
cerb1 (CERB1, 1.73x) (
Table 5.), four gene products considered to be associated with GBS, may be that the effects of the affected genes manifest themselves only after a long period of time or, as it was recently suggested, they are associated only with certain
C. jejuni serotypes [
81,
82,
115].
The slight increase in the expression levels of genes associated with tumor genesis supports recent assumptions and findings that certain bacterial infections increase the risk of developing malignant tumors in the colon [
116], the biliary tract [
117], and the esophagus [
118]. Although tumor genesis is a complex process about which our knowledge is still limited, the high expression levels of
serpinB9 (SERPINB9, Fc.: 11.37x) and
tacr2 (TACR2, Fc.: 8.84x) [
66,
90], two proteins associated with tumor formation, supports the potential role of
C. jejuni in the development of these pathological conditions.