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Journal of Bacteriology, October 2008, p. 6909-6912, Vol. 190, No. 20
0021-9193/08/$08.00+0 doi:10.1128/JB.00451-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.
Trade-Off between Iron Uptake and Protection against Oxidative Stress: Deletion of cueO Promotes Uropathogenic Escherichia coli Virulence in a Mouse Model of Urinary Tract Infection
Jai J. Tree,1
Glen C. Ulett,1
Cheryl-Lynn Y. Ong,1
Darren J. Trott,2
Alastair G. McEwan,1 and
Mark A. Schembri1*
School of Molecular and Microbial Sciences,1
School of Veterinary Science, University of Queensland, Brisbane, Queensland 4072, Australia2
Received 2 April 2008/
Accepted 12 August 2008

ABSTRACT
The periplasmic multicopper oxidase (CueO) is involved in copper
homeostasis and protection against oxidative stress. Here, we
show that the deletion of
cueO in uropathogenic
Escherichia coli increases its colonization of the urinary tract despite
its increased sensitivity to hydrogen peroxide. The
cueO deletion
mutant accumulated iron with increased efficiency compared to
its parent strain; this may account for its advantage in the
iron-limited environment of the urinary tract.

TEXT
Urinary tract infections (UTI) are among the most common infectious
diseases of humans and a major cause of morbidity. It is estimated
that 40 to 50% of healthy adult women have experienced at least
one UTI episode in their lifetime (
6). Uropathogenic
Escherichia coli (UPEC) is the cause of the majority (>80%) of UTI in
humans. UPEC isolates exhibit a high degree of genetic diversity
due to the possession of specialized virulence genes located
on pathogenicity islands (
21). Although no single virulence
factor is uniquely definitive of UPEC, its ability to cause
symptomatic UTI is enhanced by adhesins (e.g., type 1 and P
fimbriae) and toxins (e.g., hemolysin) (
16,
38). Another important
virulence property of UPEC is its ability to sequester iron.
The concentration of soluble iron is very low in urine and represents
an important growth-limiting factor for bacteria. UPEC possesses
multiple mechanisms to acquire iron, including the production
of siderophores, such as aerobactin and enterobactin (and the
glycosylated enterobactin derivative, salmochelin), and the
direct utilization of host iron compounds (particularly heme
or hemoglobin) (
1,
3,
10,
23,
25,
26). UPEC mutants deleted
in these processes display reduced virulence in the mouse urinary
tract (
32).
The global oxidative stress response regulator OxyR is required for virulence in a mouse model of UTI (14). This indicates that UPEC responds to oxidative stress during infection, consistent with evidence that the attachment of UPEC to the uroepithelium leads to neutrophil recruitment (11, 14). OxyR also acts in concert with Dam methyltransferase to regulate the expression of the antigen 43-encoding flu gene (9, 12, 28). Antigen 43 is an autotransporter protein that promotes aggregation, biofilm formation, and long-term persistence of UPEC in the urinary bladder (15, 36).
The cueO gene encodes a periplasmic multicopper oxidase which is known to be involved in copper homeostasis and protection against oxidative stress. CueO possesses ferroxidase (Fe2+
Fe3+), cuprous oxidase (Cu+
Cu2+), and polyphenol oxidase (oxidation of phenolic compounds, including enterobactin) activities (8, 24, 30). Both Cu+ and Fe2+ generate toxic hydroxyl radicals via the Fenton reaction (Fe2+ or Cu+ + H2O2
Fe3+ or Cu2+ + OH– + OH). Oxidation of enterobactin by CueO prevents Cu2+ reduction by the reactive catechol groups on enterobactin and has been proposed to form a 2-carboxymuconate derivative in the periplasm that may sequester both copper and iron ions (8) and thereby protect bacteria against metal ion-promoted oxidative stress. In view of the role of CueO in E. coli K-12, we were interested in determining whether it contributes to the pathogenesis of the prototypical UPEC strain CFT073 (19, 37).
CueO is required for copper resistance in UPEC CFT073.
The deletion of cueO renders E. coli K-12 sensitive to CuSO4, a phenotype that is enhanced under conditions of iron limitation in which high concentrations of enterobactin are produced. To assess the role of CueO from E. coli CFT073 in copper tolerance, a cueO deletion strain (CFT073cueO) was constructed by
red-mediated homologous recombination, as previously described (5). Copper sensitivity was assessed by growing CFT073 and CFT073cueO on Tris-buffered mineral salts agar supplemented with 0.2% glycerol and 0.3% CAS amino acids in the presence of filter discs impregnated with 5 µl of 1 M CuSO4. In this assay, CFT073 was resistant to copper and produced a distinct brown pigment in the region of growth at the periphery of the clearing zone (Fig. 1). In contrast, CFT073cueO was highly sensitive to copper. The copper resistance phenotype of CFT073cueO could be restored by complementation with a plasmid containing the cueO gene (pCueO) (Fig. 1).
Deletion of cueO promotes colonization of the mouse bladder and shedding in urine.
An established mouse model of UTI was employed to examine the
role of
cueO in UPEC virulence (
36). Briefly, female C57BL/6
mice (8 to 10 weeks old) were catheterized using a sterile Teflon
catheter by inserting the device directly into the bladder through
the urethra. An inoculum of 25 µl, containing 5
x 10
8 CFU of CFT073 or CFT073
cueO in phosphate-buffered saline (PBS),
was instilled directly into the bladder by using a 1-ml tuberculin
syringe attached to the catheter. Mice were euthanized at 18
h after challenge by cervical dislocation; bladders and kidneys
were then excised aseptically, weighed, and homogenized in PBS
for colony counts. Urine samples were also collected from each
mouse prior to euthanasia for quantitative colony counts. Compared
to CFT073, CFT073
cueO colonized the mouse bladder in significantly
higher numbers in this infection model (Fig.
2A). This also
correlated with increased shedding of CFT073
cueO in urine compared
to that of CFT073 (Fig.
2B). No colonization of the kidneys
was observed for CFT073 or for CFT073
cueO; this is consistent
with previous data from our laboratory using C57BL/6 mice (
36).
Deletion of cueO does not affect type 1 fimbria expression, adhesive capacity, or growth in urine.
Expression of type 1 fimbriae significantly enhances the attachment
of UPEC to uroepithelial cells and the subsequent colonization
of the mouse bladder (
2,
4,
20). We compared the levels of type
1 fimbria expression in CFT073 and in CFT073
cueO by using a
combination of standard techniques. First, the abilities of
CFT073 and CFT073
cueO to cause mannose-sensitive agglutination
of yeast cells were examined. There was no difference in the
agglutination titers for the two strains (data not shown). Second,
the amounts of FimA produced by the two strains were compared
by Western blot analysis using a polyclonal serum raised against
purified type 1 fimbriae. There was no difference in the amounts
of FimA produced by the two strains (Fig.
3A). Third, a PCR-based
assay was employed to determine the orientation of the phase-variable
fimA promoter (
7,
29). There was no difference in the amounts
of "on" and "off" fragments amplified from both strains (Fig.
3B). Finally, we compared the abilities of CFT073 and CFT073
cueO to adhere to HeLa epithelial cells as previously described (
35).
In these assays, CFT073 and CFT073
cueO displayed equivalent
adherence levels (Fig.
3C). Taken together, the data suggest
that the expression levels of type 1 fimbriae were the same
in CFT073 and CFT073
cueO.
In
E. coli K-12, deletion of
cueO results in increased aggregation,
and this phenotype correlates with the enhanced expression of
genes encoding antigen 43 and curli (
33). CFT073 and CFT073
cueO produced equal levels of antigen 43, as determined by Western
blot analysis (data not shown). We also examined the growth
of CFT073 and CFT073
cueO and their concordant production of
catechols in human urine as previously described (
8,
26). No
significant difference was observed between the two strains
(data not shown).
CueO is required for hydrogen peroxide resistance.
The generation of hydroxyl radicals from hydrogen peroxide and iron (the Fenton reaction) is thought to be the primary bactericidal activity of hydrogen peroxide as, in the presence of iron chelators, hydrogen peroxide toxicity is greatly reduced (13). CueO has previously been shown to protect Salmonella enterica serovar Typhimurium from peroxide stress (17). Given the significant increase in the colonization of the mouse bladder by CFT073cueO, we tested whether this strain displayed increased susceptibility to hydrogen peroxide stress by using an established protocol (34). Despite its hypercolonization phenotype, CFT073cueO was significantly more sensitive to hydrogen peroxide challenge than CFT073 (Fig. 4). CFT073cueO resistance to hydrogen peroxide could be restored by complementation with plasmid pCueO (Fig. 4).
Deletion of cueO increases ferrous iron uptake.
A possible explanation for the hypercolonization phenotype of
CFT073
cueO is that this strain can take up iron with increased
efficiency. Thus, while excessive iron accumulation may be detrimental
under conditions of oxidative stress, iron is a limiting nutrient
in urine, and enhanced uptake could provide a growth advantage.
To compare the abilities of CFT073 and CFT073
cueO to take up
iron, we performed
55Fe
2+ uptake experiments as previously described
(
18). In these assays, CFT073
cueO accumulated 5.5-fold more
55Fe
2+ than did CFT073 (Fig.
5). The introduction of plasmid
pCueO into CFT073
cueO restored the level of
55Fe
2+ accumulated
to approximately wild-type levels (Fig.
5).
Deletion of cueO does not confer a growth advantage in a systemic infection model.
To examine if the increased colonization observed for CFT073
cueO in the mouse bladder was also reflected in colonization of other
sites, we tested CFT073 and CFT073
cueO in a mouse systemic infection
model. Mice were infected with 2
x 10
7 cells of CFT073 (
n =
15) or CFT073
cueO (
n = 15) by a subcutaneous injection into
the abdomen and monitored to assess the clinical effects of
infection, as previously described (
22). There was no difference
in the virulence levels of the two strains (the time taken to
kill the mice was approximately 24 h for both strains). Bacterial
colony counts were also performed from the liver, spleen, and
kidneys of each mouse; there was no significant difference in
the abilities of the strains to colonize these organs.
Conclusions.
The results presented herein show that while deletion of cueO in E. coli CFT073 renders the cell sensitive to hydrogen peroxide stress, it also promotes increased uptake of iron. Under the iron-limited conditions encountered in the urinary tract (25, 27, 31, 32), this may represent a competitive advantage, though the consequence may be that it leaves the cell vulnerable to iron-promoted oxidative stress. Recent work by Grass and coworkers (8) has shown that CueO in E. coli K-12 has a high affinity for Fe-enterobactin (Km of 1.5 µM) and that oxidation of the enterobactin precursor 2,3-dihydroxybenzoic acid leads to formation of a polymer capable of chelating copper and iron in the periplasm (8). Production of an iron-chelating polymer in the periplasm of CFT073 under iron-limited conditions may account for the restricted iron uptake observed in this strain; loss of this biological function in the cueO mutant may lead to increased uptake of ferrous iron.
Although the CFT073cueO strain displayed enhanced bladder colonization in comparison to CFT073, this did not translate into increased growth in human urine. Recent transcriptional profiling of UPEC during the formation of intracellular bacterial communities within epithelial cells revealed that the intracellular environment is iron limited and aerobic (23). Increased iron acquisition from damaged epithelial cells could explain the enhanced colonization of CFT073cueO in the mouse bladder. Our results lead us to conclude that CueO is critical for iron and copper homeostasis in UPEC and that it has a key role in maintaining a tightly controlled flux of iron into the cell to avoid oxidative stress. The attachment of UPEC to the uroepithelium induces neutrophil recruitment with a concomitant oxidative burst that would expose UPEC to reactive oxygen species (11). In view of this, the superior colonization of the bladder by the cueO mutant is surprising. However, we note that we employed a short-term infection model, and thus, it is possible that the long-term fitness of CFT073cueO would be diminished in inflamed tissues in which reactive oxygen species cause oxidative stress. This is consistent with our observations that the CFT073cueO mutant is not attenuated in a systemic infection model.

ACKNOWLEDGMENTS
This work was supported by grants from the Australian National
Health and Medical Research Council (455914), the Australian
Research Council (DP0666852), and the University of Queensland.

FOOTNOTES
* Corresponding author. Mailing address: School of Molecular and Microbial Sciences, University of Queensland, Brisbane 4072, Australia. Phone: 61 7 3365 3306. Fax: 61 7 3365 4699. E-mail:
m.schembri{at}uq.edu.au 
Published ahead of print on 22 August 2008. 

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Journal of Bacteriology, October 2008, p. 6909-6912, Vol. 190, No. 20
0021-9193/08/$08.00+0 doi:10.1128/JB.00451-08
Copyright © 2008, American Society for Microbiology. All Rights Reserved.