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Journal of Bacteriology, July 2004, p . 4808-4812, Vol . 186,
No . 14
Identification of a Broadly Active Phage Lytic Enzyme with Lethal Activity
against Antibiotic-Resistant Enterococcus faecalis and Enterococcus
faecium
Pauline Yoong, Raymond Schuch, Daniel Nelson, and Vincent A .
Fischetti*
Laboratory of Bacterial Pathogenesis and Immunology, The Rockefeller
University, New York, New York 10021
Received 6 February 2004/ Accepted 14 April 2004
Enterococcus faecalis and Enterococcus faecium infections are
increasingly difficult to treat due to high levels of resistance
to antibiotics . PlyV12, a bacteriophage lytic enzyme, was isolated
and shown to effectively kill both E . faecalis and E . faecium
(including vancomycin-resistant strains), as well as other human
pathogens . We propose its development and use as an alternative
therapeutic tool .
Enterococcus faecalis and Enterococcus faecium are gram-positive
bacteria that commensally colonize the lower intestinal tract,
oral cavity, and vaginal tract of humans . In healthy individuals,
E . faecalis and E . faecium colonization normally has no adverse
effect on the host; however, the acquisition of virulence factors
and high-level antibiotic resistance by enterococci are causing
these organisms to emerge as a leading source of nosocomial
infections, particularly in immunocompromised patients (3,
8, 9, 16) .
Common diseases caused by enterococcal infections include
endocarditis, abdominal abscesses, bacteremia, and urinary tract
infections .
We are currently developing a novel approach to the control of
pathogenic microorganisms through the action of purified
bacteriophage lytic enzymes, termed lysins, produced during the
natural life cycle of the bacteriophage . Lysins have evolved to
rapidly break down the bacterial cell wall in order to release
progeny phage (23) . Structurally, lysins are commonly found
as modular proteins with an amino-terminal domain that confers
the enzymatic activity for a peptidoglycan bond and a carboxy-terminal
domain that confers binding specificity to a carbohydrate epitope
in the bacterial cell wall (13-15,
20) . These highly evolved enzymes are normally
very specific to the bacterial host of the phage from which they are
derived (5, 6) . When lysins are
purified and applied extrinsically, their binding efficiency and
catalytic activity can be harnessed to achieve targeted killing of
select pathogenic bacteria with minimal effects on other commensal
bacteria; this capacity is an advantage over conventional
antibiotics . The efficacy of various lysins in killing Bacillus
anthracis (19), Streptococcus pyogenes (a group
A streptococcus) (17), and Streptococcus pneumoniae
(10, 11) has been demonstrated
both in vitro and in animal models of colonization and/or infection
with these pathogens .
In this report, we describe a lysin, PlyV12, from the enterococcal
bacteriophage
1
which infects the host, E . faecalis strain V12 .
1
(obtained from the d'Herelle collection, Laval University, Quebec,
Canada) was originally isolated from sewage in 1975 and belongs to
the Myoviridae family, whose members are characterized by
contractile tails and icosahedral heads (2, 7) .
PlyV12 is a proposed amidase that exhibits a substantial lytic effect
on multiple E . faecalis strains . Significantly, PlyV12 also
lyses vancomycin-resistant strains of E . faecalis and strains
of the closely related enterococcal pathogen E . faecium . Distinct
from other reported lysins, PlyV12 was also found to be active
against several disease-causing streptococcal and staphylococcal
strains, making it one of the first lysins to demonstrate a spectrum
of activity outside that of the host and closely related bacterial
strains . This broad activity spectrum suggests the presence of a
unique cell wall carbohydrate epitope common to these diverse human
pathogens .
PlyV12 was identified based on a previously described genetic
screening process (12) whereby a
1
genomic library was screened for lytic agents active against E .
faecalis strain V12 . A 945-bp open reading frame was identified
after DNA sequencing of a lytic clone . The open reading frame
translates into a protein of 314 amino acids with a molecular mass of
approximately 34 kDa . The plyV12 gene was initially cloned
into several Escherichia coli expression systems; however, the
enzyme yields were very low in all cases . PlyV12 (as other lytic
enzymes) is translated without a leader sequence; thus, it remains in
the cytoplasm, where it cannot exert an effect on its peptidoglycan
substrate, therefore making it possible to be expressed in a wide
range of systems . Subsequently, the plyV12 gene and
approximately 100 bp of the flanking sequence were amplified by PCR
and cloned into the E . coli-Bacillus shuttle vector pDG148 (21),
yielding pPY1 . plyV12 was then expressed in Bacillus
megaterium strain WH320 (MoBiTec, Marco Island, Fla.) by
induction with isopropyl-ß-D-thiogalactopyranoside
for 1 h, at which time the culture was centrifuged . The pelleted
bacteria were suspended in 100 ml of a lysis reagent, BugBuster
(diluted from a 10x concentration to a 1x
concentration in phosphate-buffered saline [PBS] containing 100 µg of
lysozyme/ml) (Novagen, San Diego, Calif.) . This cell lysate was
allowed to remain at 37°C for 1 h, followed by centrifugation at
4,000 rpm in an Eppendorf centrifuge to pellet the cell debris . The
supernatant containing the crude lysin was diluted 1:3 in 50 mM
morpholineethanesulfonic acid at pH 6.7 prior to being loaded on
three 5-ml HiTrap SP HP columns (Amersham Biosciences, Piscataway,
N.J.) connected in a series . The columns were washed with the 50 mM
morpholineethanesulfonic acid buffer until the optical density at a
wavelength of 280 nm (OD280) reached the baseline . PlyV12
was eluted with a 20-column-volume linear gradient to a concentration
of 1 M sodium chloride (NaCl), and a peak at
330
mM NaCl was found to contain the lytic activity . Furthermore, sodium
dodecyl sulfate-polyacrylamide gel electrophoresis revealed a 34-kDa
band corresponding to this peak, which matched the predicted size of
PlyV12 . Fractions constituting the peak were pooled and concentrated
to 25 U/ml (see below) in an Amicon Ultra unit with a cutoff of 10
kDa (Millipore, Billerica, Mass.) . The final PlyV12 sample was
purified >85% based on spot densitometry (AlphaImager; Alpha
Innotech, San Leandro, Calif.) of the gel images of crude and
purified PlyV12 that were obtained by sodium dodecyl
sulfate-polyacrylamide gel electrophoresis .
PlyV12 lytic activity was expressed in units per milliliter, in
which units represent the reciprocal of the highest dilution of
enzyme resulting in a 50% reduction in bacterial OD600 in
15 min . Subsequent bacterial killing experiments were carried out
with a PlyV12 preparation of 25 U/ml .
For the lysin killing assays, the bacterial strains to be assayed
were grown to mid-logarithmic phase in brain heart infusion broth,
pelleted, and resuspended in PBS at pH 7.4 to an OD600 of
2.0 . The pH profile experiments for PlyV12 activity were performed
after the bacterial cells were resuspended in 100 mM acetate buffer
at pH 5.2, 100 mM morpholinepropanesulfonic acid at pH 6.5, or 100 mM
Tris at pH 7.5 or 8.5 instead . A 100-µl volume of bacterial
suspension was mixed with 100 µl of PlyV12 at 25 U/ml . For the OD
assays, the OD600 of the mixture was monitored every 15 s
with shaking over a 15-min period on an automated 96-well plate
reader (SpectraMax Plus384; Molecular Devices, Sunnyvale,
Calif.) . For viability assays, the mixture of a bacteria and PlyV12
was incubated at room temperature with gentle shaking for specified
amounts of time, and at designated time points, aliquots were
removed, serially diluted, and plated on agar plates for viability
counts .
An alignment of the PlyV12 sequence from E . faecalis bacteriophage
1
with lysins from bacteriophages of Streptococcus agalactiae (a
group B streptococcus), S . pyogenes, S . pneumoniae,
Streptococcus mitis, and Streptococcus thermophilus
revealed similarities primarily limited to the amino termini of these
molecules, which correspond to the catalytic domains of most lysins
(Fig . 1) . Since several of these lysins are known
to confer N-acetylmuramyl-L-alanine
amidase activity, PlyV12 may also be an amidase . The diminished
sequence similarity among the carboxy-terminal portions of all these
lysins suggests that they have distinct cell wall binding epitopes
and hence different bacterial specificities .
|
FIG . 1 . Alignment of the amino acid sequence of PlyV12 from E .
faecalis bacteriophage
1
(Ef) with lysins from five other gram-positive bacteriophages . Those
phages include
Sa2
from S . agalactiae, a group B streptococcus, (Sa); 315.3 from
S . pyogenes, a group A streptococcus (Spy); Dp-1 from S .
pneumoniae (Spn); SM1 from S . mitis (Sm); and Sfi19 from
S . thermophilus (St) . Identical residues are highlighted by black
boxes, while conserved residues are highlighted with gray boxes.
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PlyV12 was found to have maximal activity at about pH 6.0 while
retaining partial yet significant activity at pH values of 5.0 and
7.5 (Fig . 2) . The activity decreased rapidly at higher pHs,
resulting in near inactivation at pH 8.5, a profile common among
bacteriophage lysins (11) . Although not optimum, all
subsequent assays were carried out in PBS at pH 7.4 to determine the
PlyV12 activity under physiological conditions . While PlyV12
functioned well at physiological salt concentrations, sodium chloride
at concentrations upwards of 250 mM deteriorates its activity
(results not shown) .
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FIG . 2 . pH profile of PlyV12 activity . PlyV12 activity against E .
faecalis strain V12 was tested at pHs 5.2, 6.5, 7.5, and 8.5 . PlyV12
activity was measured by an OD assay and plotted as the percent decrease
in OD600 in 15 min.
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In addition to killing its host bacterial strain, E . faecalis
strain V12, PlyV12 also had lytic activity against 14 clinical and
laboratory E . faecalis and E . faecium strains tested, including
two vancomycin-resistant E . faecalis strains and three
vancomycin-resistant E . faecium strains (Table 1
and Fig . 3) . Interestingly, PlyV12 also exhibited a
significant killing effect on strains of pathogenic streptococci,
including S . pyogenes (a group A streptococcus), which are
responsible for pharyngitis, toxic shock syndrome, and rheumatic
fever (4); group B streptococci, which are responsible
for neonatal meningitis (1); and group C streptococci,
which constitute an emerging pathogen group causing diseases similar
to those caused by S . pyogenes (18) . While the
sequence alignment of PlyV12 from the E . faecalis
bacteriophage
1
with lysins of group A and group B streptococcal bacteriophages (from
S . pyogenes and S . agalactiae, respectively) (Fig.
1) suggests that these lysins target different cell
wall epitopes, the ability of PlyV12 to lyse strains of E .
faecalis, S . pyogenes, and group B streptococci shows that
PlyV12 recognizes a receptor common among these different pathogens .
Additionally, PlyV12 had some lytic effect against Staphylococcus
aureus, another high-level, antibiotic-resistant nosocomial
pathogen that is responsible for sepsis, necrotizing pneumonia, and
toxic shock syndrome (22) .
| TABLE 1 . Bacterial strains tested for lysin activity
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FIG . 3 . Range of activity of PlyV12 . PlyV12 activity against
enterococcal, streptococcal, and staphylococcal strains was measured as
the rate of decrease in OD per minute, expressed in milliunits of OD600
per minute . This initial velocity measurement allowed direct comparison
of PlyV12 activities among bacterial species . VRE, vancomycin-resistant
enterococci . (Inset) Viability assay of E . faecalis strain V12
treated with PlyV12 . Viability was measured in CFU per milliliter . E .
faecium strains EFSK-2, EFSK-16, and EFSK-33 as well as E .
faecalis strains JH2-2, EF-24, EF-25, EF-1, and EF-17 were obtained
from A . Tomasz . All other strains are part of the Rockefeller University
Bacteria Collection.
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The assays described above were carried out using a measurement of
OD, which corresponds with bacterial viability . However, to better
quantitate the extent of bacterial killing, a direct viability assay
was performed with E . faecalis strain V12 incubated with
PlyV12 . The results revealed a >4-log reduction in viability when the
mixture was exposed to 2.5 U of PlyV12 for 15 min, which corresponds
to a drop of 200 mOD600/min in the OD assay (Fig.
3, inset) . The viability of this strain continued to decrease
upon further incubation with PlyV12 .
PlyV12 has bactericidal activity against all strains of E . faecalis
and E . faecium tested, which is very significant for clinical
strains and strains resistant to the antibiotic vancomycin .
Vancomycin is considered the last line of defense against many
bacterial pathogens that are already resistant to other available
antibiotics (3) . Enterococci are a leading cause of nosocomial
infections, and treating these infections with conventional
antibiotics has become increasingly difficult in light of the
acquisition of antibiotic resistance genes by these organisms . It is
anticipated that soon enterococci will be untreatable by current
antibiotics, and alternative means of combating infections caused by
these organisms will be urgently needed . We have shown that PlyV12 is
a viable candidate for such an antienterococcal therapeutic agent .
PlyV12 exhibited significant lethal activity against other pathogens,
such as S . pyogenes and group B, C, E, and G streptococci, with
minimal effects against commensal bacteria (with the exception
of Streptococcus gordonii) . This finding suggests a broader
application for this lysin whereby PlyV12 is used as a therapeutic
agent specific for multiple pathogens that are responsible for
serious infections . While the organization of its primary structure
and the nature of its enzymatic activity make PlyV12 consistent with
other bacteriophage lysins previously studied, PlyV12 is believed to
be the first bacteriophage lysin described to have activity against
Enterococcus species . In addition, previously studied
bacteriophage lysins generally have a narrow spectrum of activity
specific to the host bacterial species from which the phage was
isolated . PlyV12's comparatively broad spectrum of activity against
numerous bacterial strains indicates that this is a truly unique
enzyme . Furthermore, the PlyV12 binding activity determined in this
study suggests a previously undiscovered surface structure common to
several different pathogens, which could serve as a target in the
development of new antibiotics .
Nucleotide sequence accession number. The nucleotide
sequence of PlyV12 has been deposited into GenBank under accession
number
AY581208 .
This work was supported by a grant from the Defense Advance Research
Project Agency (DARPA) to V.A.F .
We thank Alexander Tomasz for providing the bacterial strains and
Vasant Kumar for plasmid pDG148 .
* Corresponding author . Mailing address: Laboratory of
Bacterial Pathogenesis and Immunology, The Rockefeller University, 1230 York
Ave., New York, NY 10021 . Phone: (212) 327-8166 . Fax: (212) 327-7584 . E-mail: vaf@rockefeller.edu .
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