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  • 1.
    Gulati, Sunita
    et al.
    Sch Med, Div Infect Dis & Immunol, Univ Massachusetts, Worcester MA, USA.
    Schoenhofen, Ian C.
    Human Hlth Therapeut Portfolio, Natl Res Council Canada, Ottawa ON, Canada.
    Whitfield, Dennis M.
    Human Hlth Therapeut Portfolio, Natl Res Council Canada, Ottawa ON, Canada.
    Cox, Andrew D.
    Human Hlth Therapeut Portfolio, Natl Res Council Canada, Ottawa ON, Canada.
    Li, Jianjun
    Michael, Frank St.
    Human Hlth Therapeut Portfolio, Natl Res Council Canada, Ottawa ON, Canada.
    Vinogradov, Evgeny V.
    Human Hlth Therapeut Portfolio, Natl Res Council Canada, Ottawa ON, Canada.
    Stupak, Jacek
    Human Hlth Therapeut Portfolio, Natl Res Council Canada, Ottawa ON, Canada.
    Zheng, Bo
    Sch Med, Div Infect Dis & Immunol, Univ Massachusetts, Worcester MA, USA.
    Ohnishi, Makoto
    Natl Inst Infect Dis, Tokyo, Japan.
    Unemo, Magnus
    Örebro University Hospital. WHO Collaborating Ctr Gonorrhoea & Other STIs, Dept Lab Med Microbiol, Örebro University Hospital, Örebro, Sweden.
    Lewis, Lisa A.
    Sch Med, Div Infect Dis & Immunol, Univ Massachusetts, Worcester MA, USA.
    Taylor, Rachel E.
    Dept Med, Biomed Sci Grad Program, Univ Calif San Diego, La Jolla CA, USA; Glycobiol Res & Training Ctr, Dept Cellular & Mol Med, Univ Calif San Diego, La Jolla CA, USA.
    Landig, Corinna S.
    Dept Med, Biomed Sci Grad Program, Univ Calif San Diego, La Jolla CA, USA; Glycobiol Res & Training Ctr, Dept Cellular & Mol Med, Univ Calif San Diego, La Jolla CA, USA.
    Diaz, Sandra
    Dept Med, Biomed Sci Grad Program, Univ Calif San Diego, La Jolla CA, USA; Glycobiol Res & Training Ctr, Dept Cellular & Mol Med, Univ Calif San Diego, La Jolla CA, USA.
    Reed, George W.
    Sch Med, Prevent & Behav Med, Univ Massachusetts, Worcester MA, USA.
    Varki, Ajit
    Dept Med, Biomed Sci Grad Program, Univ Calif San Diego, La Jolla CA, USA; Glycobiol Res & Training Ctr, Dept Cellular & Mol Med, Univ Calif San Diego, La Jolla CA, USA.
    Rice, Peter A.
    Sch Med, Div Infect Dis & Immunol, Univ Massachusetts, Worcester MA, USA.
    Ram, Sanjay
    Sch Med, Div Infect Dis & Immunol, Univ Massachusetts, Worcester MA, USA.
    Utilizing CMP-Sialic Acid Analogs to Unravel Neisseria gonorrhoeae Lipooligosaccharide-Mediated Complement Resistance and Design Novel Therapeutics2015In: PLoS Pathogens, ISSN 1553-7366, E-ISSN 1553-7374, Vol. 11, no 12, article id e1005290Article in journal (Refereed)
    Abstract [en]

    Neisseria gonorrhoeae deploys a novel immune evasion strategy wherein the lacto-N-neotetraose (LNnT) structure of lipooligosaccharide (LOS) is capped by the bacterial sialyltransferase, using host cytidine-5'-monophosphate (CMP)-activated forms of the ninecarbon nonulosonate (NulO) sugar N-acetyl-neuraminic acid (Neu5Ac), a sialic acid (Sia) abundant in humans. This allows evasion of complement-mediated killing by recruiting factor H (FH), an inhibitor of the alternative complement pathway, and by limiting classical pathway activation ("serum-resistance"). We utilized CMP salts of six additional natural or synthetic NulOs, Neu5Gc, Neu5Gc8Me, Neu5Ac9Ac, Neu5Ac9Az, legionaminic acid (Leg5Ac7Ac) and pseudaminic acid (Pse5Ac7Ac), to define structural requirements of Sia-mediated serum-resistance. While all NulOs except Pse5Ac7Ac were incorporated into the LNnT-LOS, only Neu5Gc incorporation yielded high-level serum-resistance and FH binding that was comparable to Neu5Ac, whereas Neu5Ac9Az and Leg5Ac7Ac incorporation left bacteria fully serum-sensitive and did not enhance FH binding. Neu5Ac9Ac and Neu5Gc8Me rendered bacteria resistant only to low serum concentrations. While serum-resistance mediated by Neu5Ac was associated with classical pathway inhibition (decreased IgG binding and C4 deposition), Leg5Ac7Ac and Neu5Ac9Az incorporation did not inhibit the classical pathway. Remarkably, CMP-Neu5Ac9Az and CMP-Leg5Ac7Ac each prevented serum-resistance despite a 100-fold molar excess of CMP-Neu5Ac in growth media. The concomitant presence of Leg5Ac7Ac and Neu5Ac on LOS resulted in uninhibited classical pathway activation. Surprisingly, despite near-maximal FH binding in this instance, the alternative pathway was not regulated and factor Bb remained associated with bacteria. Intravaginal administration of CMP-Leg5Ac7Ac to BALB/c mice infected with gonorrhea (including a multidrug-resistant isolate) reduced clearance times and infection burden. Bacteria recovered from CMP-Leg5Ac7Ac-treated mice were sensitive to human complement ex vivo, simulating in vitro findings. These data reveal critical roles for the Sia exocyclic side-chain in gonococcal serum-resistance. Such CMP-NulO analogs may provide a novel therapeutic strategy against the global threat of multidrug-resistant gonorrhea.

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