Phage-derived protein induces increased platelet activation and is associated with mortality in patients with invasive pneumococcal disease
To improve our understanding about the severity of invasive pneumococcal disease (IPD), we investigated the association between the genotype of Streptococcus pneumoniae and disease outcomes for 349 bacteremic patients. A pneumococcal genome-wide association study (GWAS) demonstrated a strong correla...
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| Format: | Journal Article |
| Language: | English |
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AMER SOC MICROBIOLOGY
2017
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| Subjects: | |
| Online Access: | http://hdl.handle.net/20.500.11937/80736 |
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| author | Tunjungputri, R.N. Mobegi, Fredrick Cremers, A.J. van der Gaast-de Jongh, C.E. Ferwerda, G. Meis, J.F. Roeleveld, N. Bentley, S.D. Pastura, A.S. van Hijum, S.A.F.T. van der Ven, A.J. de Mast, Q. Zomer, A. de Jonge, M.I. |
| author_facet | Tunjungputri, R.N. Mobegi, Fredrick Cremers, A.J. van der Gaast-de Jongh, C.E. Ferwerda, G. Meis, J.F. Roeleveld, N. Bentley, S.D. Pastura, A.S. van Hijum, S.A.F.T. van der Ven, A.J. de Mast, Q. Zomer, A. de Jonge, M.I. |
| author_sort | Tunjungputri, R.N. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | To improve our understanding about the severity of invasive pneumococcal disease (IPD), we investigated the association between the genotype of Streptococcus pneumoniae and disease outcomes for 349 bacteremic patients. A pneumococcal genome-wide association study (GWAS) demonstrated a strong correlation between 30-day mortality and the presence of the phage-derived gene pblB, encoding a platelet-binding protein whose effects on platelet activation were previously unknown. Platelets are increasingly recognized as key players of the innate immune system, and in sepsis, excessive platelet activation contributes to microvascular obstruction, tissue hypoperfusion, and finally multiorgan failure, leading to mortality. Our in vitro studies revealed that pblB expression was induced by fluoroquinolones but not by the beta-lactam antibiotic penicillin G. Subsequently, we determined pblB induction and platelet activation by incubating whole blood with the wild type or a pblB knockout mutant in the presence or absence of antibiotics commonly administered to our patient cohort. pblB-dependent enhancement of platelet activation, as measured by increased expression of the ɑ-granule protein P-selectin, the binding of fibrinogen to the activated ɑ IIbβ3 receptor, and the formation of platelet-monocyte complex occurred irrespective of antibiotic exposure. In conclusion, the presence of pblB on the pneumococcal chromosome potentially leads to increased mortality in patients with an invasive S. pneumoniae infection, which may be explained by enhanced platelet activation. This study highlights the clinical utility of a bacterial GWAS, followed by functional characterization, to identify bacterial factors involved in disease severity.
IMPORTANCE The exact mechanisms causing mortality in invasive pneumococcal disease (IPD) patients are not completely understood. We examined 349 patients with IPD and found in a bacterial genome-wide association study (GWAS) that the presence of the phage-derived gene pblB was associated with mortality in the first 30 days after hospitalization. Although pblB has been extensively studied in Streptococcus mitis, its consequence for the interaction between platelets and Streptococcus pneumoniae is largely unknown. Platelets are important in immunity and inflammation, and excessive platelet activation contributes to microvascular obstruction and multiorgan failure, leading to mortality. We therefore developed this study to assess whether the expression of pblB might increase the risk of death for IPD patients through its effect on enhanced platelet activation. This study also shows the value of integrating extensive bacterial genomics and clinical data in predicting and understanding pathogen virulence, which in turn will help to improve prognosis and therapy. |
| first_indexed | 2025-11-14T11:16:33Z |
| format | Journal Article |
| id | curtin-20.500.11937-80736 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:16:33Z |
| publishDate | 2017 |
| publisher | AMER SOC MICROBIOLOGY |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-807362021-01-07T07:46:47Z Phage-derived protein induces increased platelet activation and is associated with mortality in patients with invasive pneumococcal disease Tunjungputri, R.N. Mobegi, Fredrick Cremers, A.J. van der Gaast-de Jongh, C.E. Ferwerda, G. Meis, J.F. Roeleveld, N. Bentley, S.D. Pastura, A.S. van Hijum, S.A.F.T. van der Ven, A.J. de Mast, Q. Zomer, A. de Jonge, M.I. Science & Technology Life Sciences & Biomedicine Microbiology COMMUNITY-ACQUIRED PNEUMONIA STREPTOCOCCUS-PNEUMONIAE ORGAN DYSFUNCTION CRITICAL ILLNESS SEPSIS SYSTEM ADULTS EPIDEMIOLOGY INFLAMMATION METAANALYSIS To improve our understanding about the severity of invasive pneumococcal disease (IPD), we investigated the association between the genotype of Streptococcus pneumoniae and disease outcomes for 349 bacteremic patients. A pneumococcal genome-wide association study (GWAS) demonstrated a strong correlation between 30-day mortality and the presence of the phage-derived gene pblB, encoding a platelet-binding protein whose effects on platelet activation were previously unknown. Platelets are increasingly recognized as key players of the innate immune system, and in sepsis, excessive platelet activation contributes to microvascular obstruction, tissue hypoperfusion, and finally multiorgan failure, leading to mortality. Our in vitro studies revealed that pblB expression was induced by fluoroquinolones but not by the beta-lactam antibiotic penicillin G. Subsequently, we determined pblB induction and platelet activation by incubating whole blood with the wild type or a pblB knockout mutant in the presence or absence of antibiotics commonly administered to our patient cohort. pblB-dependent enhancement of platelet activation, as measured by increased expression of the ɑ-granule protein P-selectin, the binding of fibrinogen to the activated ɑ IIbβ3 receptor, and the formation of platelet-monocyte complex occurred irrespective of antibiotic exposure. In conclusion, the presence of pblB on the pneumococcal chromosome potentially leads to increased mortality in patients with an invasive S. pneumoniae infection, which may be explained by enhanced platelet activation. This study highlights the clinical utility of a bacterial GWAS, followed by functional characterization, to identify bacterial factors involved in disease severity. IMPORTANCE The exact mechanisms causing mortality in invasive pneumococcal disease (IPD) patients are not completely understood. We examined 349 patients with IPD and found in a bacterial genome-wide association study (GWAS) that the presence of the phage-derived gene pblB was associated with mortality in the first 30 days after hospitalization. Although pblB has been extensively studied in Streptococcus mitis, its consequence for the interaction between platelets and Streptococcus pneumoniae is largely unknown. Platelets are important in immunity and inflammation, and excessive platelet activation contributes to microvascular obstruction and multiorgan failure, leading to mortality. We therefore developed this study to assess whether the expression of pblB might increase the risk of death for IPD patients through its effect on enhanced platelet activation. This study also shows the value of integrating extensive bacterial genomics and clinical data in predicting and understanding pathogen virulence, which in turn will help to improve prognosis and therapy. 2017 Journal Article http://hdl.handle.net/20.500.11937/80736 10.1128/mBio.01984-16 English http://creativecommons.org/licenses/by/4.0/ AMER SOC MICROBIOLOGY fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Microbiology COMMUNITY-ACQUIRED PNEUMONIA STREPTOCOCCUS-PNEUMONIAE ORGAN DYSFUNCTION CRITICAL ILLNESS SEPSIS SYSTEM ADULTS EPIDEMIOLOGY INFLAMMATION METAANALYSIS Tunjungputri, R.N. Mobegi, Fredrick Cremers, A.J. van der Gaast-de Jongh, C.E. Ferwerda, G. Meis, J.F. Roeleveld, N. Bentley, S.D. Pastura, A.S. van Hijum, S.A.F.T. van der Ven, A.J. de Mast, Q. Zomer, A. de Jonge, M.I. Phage-derived protein induces increased platelet activation and is associated with mortality in patients with invasive pneumococcal disease |
| title | Phage-derived protein induces increased platelet activation and is associated with mortality in patients with invasive pneumococcal disease |
| title_full | Phage-derived protein induces increased platelet activation and is associated with mortality in patients with invasive pneumococcal disease |
| title_fullStr | Phage-derived protein induces increased platelet activation and is associated with mortality in patients with invasive pneumococcal disease |
| title_full_unstemmed | Phage-derived protein induces increased platelet activation and is associated with mortality in patients with invasive pneumococcal disease |
| title_short | Phage-derived protein induces increased platelet activation and is associated with mortality in patients with invasive pneumococcal disease |
| title_sort | phage-derived protein induces increased platelet activation and is associated with mortality in patients with invasive pneumococcal disease |
| topic | Science & Technology Life Sciences & Biomedicine Microbiology COMMUNITY-ACQUIRED PNEUMONIA STREPTOCOCCUS-PNEUMONIAE ORGAN DYSFUNCTION CRITICAL ILLNESS SEPSIS SYSTEM ADULTS EPIDEMIOLOGY INFLAMMATION METAANALYSIS |
| url | http://hdl.handle.net/20.500.11937/80736 |