Affiliation:
1. Department of Biomolecular Health Sciences, Division of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
2. Department of Chemistry and Chemical Biology, Harvard University, Cambridge, Massachusetts, USA
3. Howard Hughes Medical Institute, Harvard University, Cambridge, Massachusetts, USA
Abstract
ABSTRACT
Bacterial vaginosis (BV) is a polymicrobial infection of the female reproductive tract. BV is characterized by replacement of health-associated
Lactobacillus
species by diverse anerobic bacteria, including the well-known
Gardnerella vaginalis. Prevotella timonensis,
and
Prevotella bivia
are anerobes that are found in a significant number of BV patients, but their contributions to the disease process remain to be determined. Defining characteristics of anerobic overgrowth in BV are adherence to the mucosal surface and the increased activity of mucin-degrading enzymes such as sialidases in vaginal secretions. We demonstrate that
P. timonensis,
but not
P. bivia,
strongly adheres to vaginal and endocervical cells to a similar level as
G. vaginalis
but did not elicit a comparable proinflammatory epithelial response. The
P. timonensis
genome uniquely encodes a large set of mucus-degrading enzymes, including four putative fucosidases and two putative sialidases, PtNanH1 and PtNanH2. Enzyme assays demonstrated that fucosidase and sialidase activities in
P. timonensis
cell-bound and secreted fractions were significantly higher than for other vaginal anerobes. In infection assays,
P. timonensis
efficiently removed fucose and α2,3- and α2,6-linked sialic acid moieties from the epithelial glycocalyx. Recombinantly expressed
P. timonensis
NanH1 and NanH2 cleaved α2,3 and α2,6-linked sialic acids from the epithelial surface, and sialic acid removal by
P. timonensis
could be blocked using inhibitors. This study demonstrates that
P. timonensis
has distinct virulence-related properties that include initial adhesion and a high capacity for mucin degradation at the vaginal epithelial mucosal surface. Our results underline the importance of understanding the role of different anerobic bacteria in BV.
IMPORTANCE
Bacterial vaginosis (BV) is a common vaginal infection that affects a significant proportion of women and is associated with reduced fertility and increased risk of secondary infections.
Gardnerella vaginalis
is the most well-known BV-associated bacterium, but
Prevotella
species including
P. timonensis
and
P. bivia
may also play an important role. We showed that, similar to
G. vaginalis
,
P. timonensis
adhered well to the vaginal epithelium, suggesting that both bacteria could be important in the first stage of infection. Compared to the other bacteria,
P. timonensis
was unique in efficiently removing the protective mucin sugars that cover the vaginal epithelium. These results underscore that vaginal bacteria play different roles in the initiation and development of BV.
Publisher
American Society for Microbiology