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Clinical and Diagnostic Laboratory Immunology, March 2000, p. 251-257, Vol. 7, No. 2
1071-412X/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Conservation of the 17-Kilodalton Antigen Gene
within the Genus Bartonella
Debra
Sweger,1,*
Sandra
Resto-Ruiz,1
David P.
Johnson,2
Michael
Schmiederer,1
Noel
Hawke,1 and
Burt
Anderson1,2
Department of Medical Microbiology and
Immunology, College of Medicine, University of South Florida,
Tampa, Florida 33612,1 and Division of
Infectious Diseases, Bay Pines Veterans Affairs Medical Center, Bay
Pines, Florida 335042
Received 19 July 1999/Returned for modification 17 September
1999/Accepted 12 December 1999
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ABSTRACT |
The 17-kDa antigen of Bartonella henselae has
previously been shown to elicit a strong humoral immune response in
patients with cat scratch disease (CSD) and to be useful in screening
human serum samples for CSD. In this study, PCR amplification of genes homologous to the 17-kDa antigen gene of B. henselae was
performed using genomic DNAs from several species of
Bartonella, including the currently recognized human
pathogens. Amplicons of similar size were demonstrated using the
following chromosomal DNA templates: B. henselae (two
strains), B. quintana (two strains), B. elizabethae, B. clarridgeiae, B. vinsonii
subsp. vinsonii, and B. vinsonii subsp.
berkhoffii. No evidence of a B. bacilliformis
homolog of the 17-kDa antigen gene was obtained using multiple primer
pairs. DNA sequencing revealed open reading frames capable of coding for proteins with sizes similar to that of the 17-kDa antigen of
B. henselae in all of the amplicons; however, extensive
sequence divergence across the genus was noted. Cloning of the
amplified products into pUC19 resulted in recombinants that directed
synthesis of homologs of the 17-kDa protein. Immunoblot analysis using
human sera from CSD cases demonstrated very little cross-reactivity among different species for this protein. In contrast, immunoblots using rabbit serum raised to the recombinant B. henselae
antigen showed extensive cross-reactivity with the proteins of other
Bartonella species. The data suggest that the use of the
17-kDa antigen as a serologic reagent may allow the development of more
specific diagnostic assays. Furthermore, the nucleotide sequences from the various versions of the 17-kDa antigen gene should be useful for
rapid identification of Bartonella at the species level.
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INTRODUCTION |
The genus Bartonella
consists of several recognized species that were reclassified by
merging the genera Rochalimaea and Grahamella with Bartonella (11, 14). All species are
oxidase-negative, fastidious gram-negative bacilli (14).
Presently there are four species that are established human pathogens:
B. bacilliformis, B. henselae, B. quintana, and B. elizabethae (6). Recently, a newly described species, B. clarridgeiae, has been
associated with cat scratch disease (CSD) in humans (15, 28,
30). Bartonella species that have not yet been linked
to human disease include, B. vinsonii, isolated from a
Canadian vole (39); B. vinsonii subsp.
berkhoffii, isolated from dogs (13, 29); and
several species isolated from rodents (11, 20, 21). However,
a new subspecies, B. vinsonii subsp. arupensis,
was recently isolated from the blood of a single patient
(40). Specific and practical diagnostic tests have not yet
been developed for most of these species, and hence the tools necessary
to associate them with human disease do not exist.
The disease spectrum among the human pathogens ranges from severe
life-threatening infections such as the hemolytic anemia caused by
B. bacilliformis, the agent of Carrion's disease and Oroya
fever (1), to the relatively benign but common CSD caused by
B. henselae. It is estimated that annually in the United
States there are 22,000 cases of CSD contracted from domestic cats
(26). In addition, both B. henselae and B. quintana have been shown to cause more severe disease syndromes,
including fever with bacteremia, endocarditis, bacillary angiomatosis,
and peliosis hepatis, in both immunocompromised and immunocompetent
patients (6, 37). In one case a novel bacterium, B. elizabethae, was isolated from a 31-year-old man with aortic
tissue vegetation (17); however, additional reports linking
this organism to human disease have not been published.
Diagnosis of Bartonella infection is most frequently
accomplished by serology. Isolation is possible but requires extended incubation periods far greater than are needed for most bacteria. Extended incubation times and fastidious growth requirements result in
low sensitivity associated with isolation and problems with contamination of primary plating media (6). PCR is an option in laboratories with the proper equipment and expertise but has not yet
gained widespread use in clinical diagnostic laboratories (7). For these reasons as well as convenience, serology
remains the most frequently utilized means of diagnosis. Serologic
assays are simple and easy to perform, but currently used methods only confirm exposure and do not conclusively indicate an acute infection (6). The indirect fluorescent-antibody assay (IFA) is the
most common and thoroughly evaluated serologic test (2, 9, 16, 33,
35, 41). However, cross-reactivity among Bartonella species (23, 27) and variable sensitivities observed for the IFA in different laboratories have led some investigators to question the usefulness of this test (2, 9, 33). To address these concerns, we have focused on identifying and characterizing protein antigens of the various Bartonella species that may be of
value as diagnostic reagents. One such protein, the 17-kDa antigen, was
identified from B. henselae (5). The reactivity
of a recombinant fusion protein derived from the 17-kDa antigen of
B. henselae in a Western blot format was shown to correlate
well with IFA results and diagnosis of CSD (5). The focus of
this study is to identify homologs of the 17-kDa protein in other
species of Bartonella. Recombinant versions of these
proteins should prove useful for serodiagnosis, and the corresponding
genes may be of value as targets for species-specific amplification.
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MATERIALS AND METHODS |
Bacterial strains and preparation of genomic DNA.
The
sources and designations of the various isolates, representing six
species of Bartonella, used in this study are summarized in
Table 1. Bacteria were cultivated on
heart infusion agar supplemented with 5% defibrinated rabbit blood at
37°C in 5% CO2. Cultures were incubated for 3 to 5 days
until growth was sufficient. B. bacilliformis was cultivated
at 28°C without supplemental CO2 for 7 to 10 days. Colony
morphology and staining of bacterial cells by the Gimenez procedure
(18) were used to monitor cell growth and purity. DNA was
extracted using a procedure previously described (3).
Briefly, cell growth was harvested into sterile TE buffer (10 mM Tris
[pH 8.0] and 1 mM EDTA). Sodium lauryl sarcosinate was added to a
final concentration of 1.0%, and proteinase K was added to a final
concentration of 100 µg/ml. After 2 h of incubation at 65°C,
the bacterial lysate was repeatedly extracted with an equal volume of
buffer-saturated phenol and chloroform. DNA was precipitated by the
addition of 1/10 volume of 3 M sodium acetate and 2.5 volumes of cold
ethanol. The yield and size of the genomic DNA were assessed by agarose
gel electrophoresis.
PCR amplification of the 17-kDa antigen gene homologs.
Genomic DNAs from the species listed in Table 1 were used as a template
for PCR. Multiple primer pair combinations were constructed from
regions surrounding the B. henselae (Houston-1) 17-kDa
antigen gene; however, four different primer pair combinations were
shown to be optimal and were used to amplify each template as follows. B. clarridgeiae was amplified with primer pair 17KAF
(5' GGAATGAATGATGAGATCGC 3') and 17KBR (5'
GTTGAGAAGACTATTCATCG-3'). B. quintana and B. henselae, were amplified with primer pair 240 (5'
GCTCTAGACAGGGACAAAGTTCCGTTGTTGC 3') and 241 (5'-CGGGGTACCGCCATTGTCGTCACAATGACG 3'). B. elizabethae and B. vinsonii subsp. vinsonii
were amplified with primer pair 17KAF and R2 (5'
TGAAAAGAGGTCCAAGACCT 3'). B. vinsonii subsp. berkhoffii was amplified with primer pair 17KBR (5'
CTGAGCGAGAATTTGAGCTG 3') and 17KAR (5' CCAGAAATGCTCTCAAACGG
3'). The positions of these primers are indicated in Fig.
1. An additional primer pair derived from
highly conserved sequences internal to the 17-kDa antigen gene,
consisting of IntF (5' GAAAAAATATAGCTTAGTCAC 3') and IntR (5'CTAAAGTCGGACATCAGATT 3'), was also used to confirm the
presence of a 17-kDa antigen gene homolog in all of the
Bartonella species that tested positive. Amplification was
performed using the following conditions: 94°C for 2 min, followed by
30 cycles of 94°C for 1 min, 50°C for 2 min, and 70°C for 2 min.
The last cycle was followed by incubation at 70°C for 7 min to ensure
the adenylation of the 3' end. PCR amplifications were performed in a
DNA thermocycler (MJ Research, Watertown, Mass.) using EasyStart 100 prealiquoted tubes (Molecular BioProducts, Inc., San Diego, Calif.).

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FIG. 1.
Line diagram showing relative positions of
oligonucleotide primers used for PCR amplification of the 17-kDa
antigen gene from Bartonella species. The positions of the
oligonucleotides are with respect to the sequence of the 17-kDa antigen
gene and flanking sequences of B. henselae Houston-1
(accession number U23447). Nucleotide positions: 17KBF, 2921 to 2940;
240, 2986 to 3008; 17KAF, 3035 to 3054; 17KAR, 3609 to 3629; 17KBR,
3772 to 3791; 241, 3806 to 3826; R2, 4012 to 4031; Intf, 3158 to 3178;
and IntR, 3583 to 3601.
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Cloning.
Amplicons were cloned directly from the PCR mixture
or following gel extraction into pCR2.1-TOPO according to the
directions of the manufacturer (Invitrogen, Carlsbad, Calif.). The
ligation junction of pCR2.1 is located between two EcoRI
cleavage sites. The resulting ligation mixture was transformed into One
Shot cells (Invitrogen) and plated on Luria-Bertani (LB) agar
containing ampicillin (100 µg/ml) and 80 µl of X-gal
(5-bromo-4-chloro-3-indolyl-
-D-galactopyranoside) at 20 mg/ml. White colonies were selected and cultured overnight in LB broth
with ampicillin. Plasmid DNA was isolated by alkaline lysis and cleaved
with EcoRI, and the insert size was confirmed by agarose gel electrophoresis.
DNA sequencing.
Plasmid DNA was isolated using the standard
protocol from a QIAprep Spin Plasmid Kit (Qiagen Inc., Valencia,
Calif.). Clones representing each strain were manually sequenced by a
modification (42) of the dideoxy chain termination method of
Sanger et al. (36). The resulting denatured double-stranded
plasmid was sequenced using a Sequenase Quick-Denature Plasmid
Sequencing Kit according to the directions of the manufacturer
(Amersham Life Science, Cleveland, Ohio). 35S-dATP-labeled
sequencing reaction mixtures were electrophoresed on a 6% acrylamide
gel. The dried gel was exposed to X-ray film, and the sequence was
recorded. Analysis of DNA sequences was performed using DNAsis version
2.5 for Windows (Hitachi, San Bruno, Calif.).
PCR amplification for ligation into pUC19.
Specific
oligonucleotide pairs derived from the sequence obtained from each
species were synthesized in order to amplify the entire 17-kDa gene
with the putative ribosome binding site from each individual
Bartonella strain. Each oligonucleotide primer derived from
the 5' end of the gene was designed with an XbaI site
(-TCTAGA-) near the 5' end, and the primer derived from the 3' end of the gene contained a BamHI site (-GGATCC-)
near the 5' end to allow directional cloning. Amplification was
achieved through initial denaturation at 94°C for 4 min; 3 cycles of
94°C for 1 min, 42°C for 2 min, and 67°C for 2 min; and 30 cycles
of 94°C for 1 min, 50°C for 2 min, and 70°C for 1 min 30 s.
Each amplicon was digested with XbaI and BamHI
and ligated into pUC 19 cleaved with the same two enzymes so that the
17-kDa antigen gene homologs were immediately downstream of the
inducible lacZ
-peptide promoter. The ligation mixtures
were transformed into E. coli JM109 as previously described
(19), and clones to be used for expression were identified
by restriction endonuclease analysis and agarose gel electrophoresis.
All recombinants were sequenced again using fluorescent-dye-labeled
primers with a Thermosequenase cycle sequencing kit (Amersham) and an
automated DNA sequencing and genetic analysis system (Li-Cor Inc.,
Lincoln, Nebr.).
SDS-PAGE and immunoblotting.
Clones were grown to early log
phase at 37°C in 5 ml of LB broth containing ampicillin (100 µg/ml)
and induced with 1 mM isopropyl thio-
-D-galactopyranoside (IPTG) for an additional
3.5 h. Bacterial cells were harvested by centrifugation and
resuspended in one-third of the original culture volume of 1× sample
buffer (63 mM Tris [pH 6.8], 10% glycerol, 2% sodium dodecyl
sulfate [SDS], 0.0025% bromophenol blue) (Novex, San Diego, Calif.),
and
-mercaptoethanol was added to a final concentration of 1%. The
samples were boiled for 5 min and subjected to SDS-polyacrylamide gel
electrophoresis (SDS-PAGE) using a 4 to 20% gradient minigel (Novex).
MultiMark multicolored standards were used to determine the approximate molecular weight (Novex). The proteins were transferred to
nitrocellulose and blocked overnight in Tris-buffered saline (TBS) with
5% skim milk. The resulting membrane filter was incubated with serum
diluted 1:200 (human sera) or 1:300 (rabbit serum) in TBS-5% skim
milk for 2 h. The membrane filter was washed in TBS with 0.05%
Tween 20 four times and exposed to either peroxidase-labeled goat
anti-rabbit affinity-purified antibodies (Kirkegaard and Perry,
Gaithersburg, Md.; diluted 1:7,000 in TBS with 5% skim milk) or
peroxidase-labeled goat anti-human affinity purified antibodies
(Kirkegaard and Perry; diluted 1:5,000 in TBS with 5% skim milk). The
filter was then washed, and bound antibody was detected with TMB
membrane substrate according to directions of the manufacturer
(Kirkegaard and Perry).
The human sera used for immunoblots were collected from human
immunodeficiency virus (HIV)-infected patients attending the HIV Clinic
at the Bay Pines Veterans Affairs Medical Center, Bay Pines, Fla.,
after informed consent was obtained using a protocol approved by the
Institutional Review Board. Serum samples were tested for antibodies to
Bartonella by IFA as previously described (35).
Only sera with IFA titers of 128 or greater were included, and these
were tested individually (at a 1:200 dilution) or pooled (and then
diluted 1:200). In another experiment, an individual serum sample
obtained from a patient diagnosed with CSD with an IFA titer of 2,048 was provided by Patricia Emmanuel, Department of Pediatrics, University
of South Florida College of Medicine. In other experiments, polyclonal
hyperimmune rabbit serum raised to a fusion protein of the B. henselae (Houston-1) 17-kDa antigen was used at a 1:300 dilution.
To produce this serum, a New Zealand White rabbit was immunized with
500 µg of the fusion protein, which has been previously described
(5). The rabbit was boosted with an additional 500 µg
after 4 weeks, and the animal was bled 1 week later and the serum was
collected. The B. henselae (Houston-1) 17-kDa antigen
expressed in Escherichia coli was used as a positive control, and E. coli JM109 harboring pUC19 with no insert
was used as a negative control.
In vitro transcription-translation.
Plasmid template was
used in an in vitro transcription-translation reaction designed for
circular prokaryotic templates (Promega, Madison, Wis.).
Plasmid-encoded proteins were labeled with
[35S]methionine and resolved on a 4 to 20% gradient gel
(Novex). The resulting gel was exposed to Enhance autoradiography
enhancer (NEN Life Science Products, Boston, Mass.), dried, and exposed to X-ray film.
Nucleotide sequence accession numbers.
The nucleotide
sequence for the 17-kDa antigen gene of B. henselae has been
previously published (5) and deposited in the GenBank
database under accession number U23447. The accession numbers for the
genes from other strains of Bartonella are as follows:
B. henselae (San Antonio-1), AF199503; B. quintana (Fuller), AF199006; B. quintana (U.Mass),
AF199007; B. elizabethae, AF195504; B. clarridgeiae, AF195506; B. vinsonii subsp. vinsonii, AF195505; and B. vinsonii subsp.
berkhoffii, AF200337.
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RESULTS |
PCR amplification.
PCR amplification of templates from various
Bartonella species resulted in products of the approximate
predicted size from B. henselae (San Antonio-1 strain),
B. clarridgeiae, B. quintana (Fuller strain),
B. quintana (U.Mass strain), B. vinsonii subsp. vinsonii, B. vinsonii subsp.
berkhoffii, and B. elizabethae with one or more
primer pairs. The primer pairs which provided the best amplification
for subsequent cloning and sequencing are described in Materials and
Methods. B. bacilliformis produced small amounts of a PCR
product that was much larger than predicted for a homolog of the 17-kDa
antigen gene using primer pairs 17KAF-17KAR, 17KAF-17KBR, and 240-241. Sequencing of clones harboring these amplicons resulted in the
identification of an open reading frame capable of coding for a protein
of 18 kDa. However, despite the similarity in predicted size with the
17-kDa antigen, no obvious amino acid sequence identity was observed.
In an additional experiment utilizing primers internal to the most
highly conserved coding regions of the 17-kDa antigen gene (IntF and
IntR), product was amplified from all Bartonella species
tested except B. bacilliformis (data not shown). Thus, despite the use of multiple primer pairs for amplification, no evidence
of a 17-kDa antigen gene was found for either strain of B. bacilliformis.
Sequence analysis.
DNA sequencing revealed open reading frames
capable of coding for proteins with deduced sizes similar to that
previously described for the B. henselae 17-kDa antigen.
Proteins of similar sizes were predicted from the sequence obtained
from B. henselae (San Antonio-1 strain). B. quintana (Fuller strain and U.Mass strain), B. clarridgeiae, and B. vinsonii subsp.
berkhoffii (Table 1). However, the B. vinsonii
subsp. vinsonii and B. elizabethae versions of
the gene were substantially larger (Table 1). Thus, there seems to be
some discontinuity in predicted size among the various species,
including both a human pathogen (B. elizabethae) and a
strain currently thought to be nonpathogenic for humans (B. vinsonii subsp. vinsonii).
All homologs of the gene exhibited certain characteristics of
prokaryotic gene structure. The antigen genes from B. henselae (San Antonio), B. clarridgeiae, B. quintana (Fuller), B. quintana (U.Mass.), B. vinsonii subsp. vinsonii, B. vinsonii subsp.
berkhoffii, and B. elizabethae contained the
identical polypurine-rich sequence (AGGAG) immediately
upstream of the presumed ATG initiator methionine codon. These
sequences presumably serve as ribosome binding sites for the antigen
genes from the various species and strains. Similar sequences have been
found immediately upstream of other B. henselae genes
(4, 5, 12; A.W.O. Burgess, J.-Y. Paquet,
and J.-J. Letesson, and B. Anderson, submitted for publication).
The putative initiator methionine is followed by a stretch of 18 to 25 residues that define a hydrophobic domain in all of the species that
were analyzed using the algorithm of Hopp and Woods (24). In
addition, two lysine codons follow the methionine start codon in all
species. These properties are strongly predictive of bacterial signal
peptides involved in targeting proteins for translocation across the
cytoplasmic membrane (25). The deduced amino acid sequence
alignment for B. henselae (San Antonio-1), B. vinsonii subsp. berkhoffii, and B. clarridgeiae indicates potential A-X-A peptidase cleavage sites
(Fig. 2). Identical sequences have been
shown on two other proteins of B. henselae that are
processed and cleaved by signal peptidase before insertion into the
outer membrane (12; Burgess and Anderson,
submitted). Likewise, similar or identical peptide sequences have been
shown to function as signal peptidase cleavage sites in E. coli (25). The other species revealed potential
cleavage site variations that are similar to sites reported for
E. coli, differing at one position from the consensus
sequence of A-X-A (25): T-I-A, B. quintana
(Fuller); T-I-A, B. quintana (U.Mass); A-F-S, B. elizabethae; and S-M-A, B. vinsonii subsp.
vinsonii.

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FIG. 2.
Multiple-sequence alignment of the deduced amino acid
sequences of the 17-kDa antigen gene homologs from various
Bartonella strains. The alignment was generated using the
alignment routine of Higgins and Sharp (22) with a gap
penalty of 5 and a window size of 5. The start codon (Met) is indicated
at position 1, and stop codons are shown with asterisks. Putative
signal sequences are underlined at residues 1 to 17, and potential
signal peptidase cleavage sites are shown in boldface and underlined at
positions 17 to 20. At positions where there is agreement between five
or more of the different strains, a consensus sequence (CONS) is
indicated by an asterisk. The sequences are identified on the left as
follows. B. henselae Houston-1 strain, B.h. (Hous); B. henselae San Antonio-1 strain, B.h. (S.a.); B. clarridgeiae, B.c.; B. quintana U.Mass strain, B.q.
(U.M.); B. quintana Fuller strain, B.q. (Full); B. vinsonii subsp. berkhoffii, B.v.b.; B. elizabethae, B.e.; and B. vinsonii subsp.
vinsonii, B.v.v.
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When the deduced amino acid sequence for the 17-kDa antigen gene is
used to study phylogenetic relationships among the genus Bartonella, a number of interesting observations are noted
(Fig. 3). First, no sequence variation
was observed between the two different strains of B. henselae. Likewise, no amino acid variation was noted among the
two strains of B. quintana sequenced, even though over 30 years separates their isolation. Second, B. henselae appears
to be more closely related to B. clarridgeiae (approximately 15% amino acid sequence divergence) than to B. quintana
(approximately 30% sequence divergence). Third, the remaining species,
including B. elizabethae, B. vinsonii subsp.
vinsonii, and B. vinsonii subsp. berkhoffii, appear to be only remotely related to the
B. henselae, B. quintana, and B. clarridgeiae group. Finally, the two subspecies of B. vinsonii have homologs of the 17-kDa antigen that exhibit extensive sequence divergence (50%) (Fig. 3).

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FIG. 3.
Dendrogram of the deduced amino acid sequences from the
17-kDa antigen genes from each of the Bartonella species or
subspecies. The multiple-sequence alignment was generated by the
CLUSTAL package, with the branching order and matching percentages
indicated at each branch point (22).
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Expression and antigenicity of the 17-kDa antigen homologs.
Immunoblot analysis with polyclonal anti-17-kDa rabbit serum
demonstrated reactivity with clones of the antigen genes from B. henselae (Fig. 4, lanes B and C),
B. clarridgeiae (lane D), and B. quintana (lanes
E and F). These clones produce a doublet band with a size identical to
that of the 17-kDa antigen from the Houston-1 strain of B. henselae. It is likely that the sources of the two bands seen in
the doublet are proteins that are cleaved to various degrees by
E. coli signal peptidase. An additional band is seen with
B. henselae and B. clarridgeiae at approximately 28 kDa (Fig. 4, lanes B to D); it is possible that this protein is
either incompletely solubilized (denatured) 17-kDa antigen or a dimer
of the protein. It should be noted that only the B. henselae
and B. clarridgeiae genes produced the 28-kDa band in E. coli, suggesting that some intrinsic variation of these
versions of the protein results in the slower-migrating form of the
antigen. Unlike those of the other Bartonella species, the
B. elizabethae version of the antigen migrated at
approximately 21 kDa (Fig. 4, lane H). The two subspecies of B. vinsonii failed to show any obvious immunoreactive bands at any
size (Fig. 4, lanes G and I). When the DNAs from the recombinant
E. coli strains harboring the genes derived from the two
subspecies of B. vinsonii were used as templates in in vitro
transcription-translation reactions, both plasmids directed synthesis
of proteins of the predicted size (data not shown). Thus, these
proteins are expressed in E. coli but are not reactive with
the rabbit anti-B. henselae 17-kDa antigen serum.
Cross-reactive rabbit antibodies are observed to react with bands at
other sizes but are also reactive with the E. coli-plus-vector control (Fig. 4, lane A), indicating they are
E. coli proteins. These data indicate that epitope(s)
recognized by the immunized rabbit is conserved in some but not all
species of Bartonella.

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FIG. 4.
Immunoblot of E. coli strains containing
plasmids encoding homologs of the 17-kDa antigen gene from different
Bartonella species reacted with polyclonal rabbit serum
raised to the 17-kDa antigen of B. henselae. Total proteins
from E. coli strains were resolved by SDS-PAGE and
transferred to nitrocellulose. The serum sample used was raised to
recombinant B. henselae 17-kDa antigen as described in the
text. The sources of the antigen genes in the recombinants are as
follows: lane B, B. henselae (Houston-1); lane C, B. henselae (San Antonio-1); lane D, B. clarridgeiae; lane
E, B. quintana (Fuller); lane F, B. quintana
(U.Mass); lane G, B. vinsonii subsp. berkhoffii;
lane H, B. elizabethae; and lane I, B. vinsonii
subsp. vinsonii. Lane A, E. coli host strain
without cloned Bartonella DNA. The positions of molecular
mass standards are indicated at the left in kilodaltons, and the
position of the 17-kDa antigenic proteins is indicated with an arrow.
The position of the larger B. elizabethae homolog is marked
with an asterisk.
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The immunoblot shown in Fig. 5 was
reacted with a representative human serum specimen from a patient
diagnosed with CSD who was shown to have a positive IFA titer to
B. henselae. Reactivity with a protein of approximately 17 kDa was noted only with the two strains of B. henselae
(lanes B and C) and B. clarridgeiae (lanes D). However,
unlike the immunoblot with the rabbit serum, there was no
cross-reactivity with either strain of B. quintana (lanes E
and F), B. elizabethae (lane H), or the two strains of B. vinsonii (lanes G and I). A pool of three other human
sera gave identical results, reacting only with the B. henselae and B. clarridgeiae clones (data not shown).
Additional bands are observed at other sizes but are reactive with the
E. coli-plus-vector control, indicating that they are
E. coli proteins. These results suggest that infection in
humans may elicit antibodies that are not broadly reactive across the
genus.

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FIG. 5.
Immunoblot of E. coli strains containing
plasmids encoding homologs of the 17-kDa antigen gene from different
Bartonella species reacted with human serum. Total proteins
from E. coli strains were resolved by SDS-PAGE and
transferred to nitrocellulose. The serum sample used was from a patient
clinically diagnosed with CSD and having an IFA titer to B. henselae of 2,048. The sources of the antigen genes in the
recombinants are as follows: lane B, B. henselae
(Houston-1); lane C, B. henselae (San Antonio-1); lane D,
B. clarridgeiae; lane E, B. quintana (Fuller);
lane F, B. quintana (U.Mass); lane G, B. vinsonii
subsp. berkhoffii; lane H, B. elizabethae; and
lane I, B. vinsonii subsp. vinsonii. Lane A,
E. coli host strain without cloned Bartonella
DNA. The positions of molecular mass standards are indicated at the
left in kilodaltons. The positions of the 17-kDa antigen homologs is
indicated with an arrow.
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DISCUSSION |
Human infection by B. henselae and B. quintana results in a diverse array of clinical symptoms.
Laboratory diagnosis of infections caused by these two agents requires
isolation and identification, PCR amplification of bacterial DNA, or
the presence of specific antibodies detected by serology. Only
serologic testing is widely available, and it remains the most common
means of diagnosing infections caused by Bartonella species.
Several serologic assays have been described for detecting specific
antibodies, including enzyme-linked immunosorbent assay (8, 23,
38) and IFA (35). Of these the IFA is the most widely
used and thoroughly evaluated test (16). However, recent
reports have indicated that the predictive value of the IFA may vary
among different investigators (2, 9, 16, 33, 41). Variable
results and sensitivities of this test have resulted in reports
questioning the use of the IFA for diagnosis (9). The cause
of such variability is not known, but it may be due to different
methods of antigen preparation. Likewise, cross-reactivity between
Bartonella and Coxiella, Chlamydia, and other bacteria has been well documented (23, 27). It is also known that the IFA is not specific for individual
Bartonella species, with a patient's serum usually being
reactive with antigens from one or more Bartonella species
by IFA (6).
B. quintana appears to be a common pathogen both in the
United States and abroad, and B. elizabethae and B. clarridgeiae have been associated with human disease
(6). A number of other Bartonella species,
subspecies, and strain variants have been associated with rodents,
providing a common potential reservoir for transmission. In addition,
B. vinsonii subsp. vinsonii and B. vinsonii subsp. berkhoffii have been identified as
being capable of causing diseases of veterinary importance.
Standardized antigens for serologic testing to detect specific
antibodies to many of these Bartonella species have not been
described. By characterizing individual protein antigens of various
Bartonella species, we may be able to identify antigens or
epitopes specific for each of the Bartonella species that
are more specific than current serologic tests.
To investigate the humoral immune response to Bartonella
infection, we have focused on individual protein antigens. One such antigen, the 17-kDa antigen of B. henselae, has been
expressed as a fusion protein and shown to be reactive with sera from
92% of the CSD cases tested, suggesting that it may be of value as a
diagnostic reagent (5). A homologous version of this antigen was found in all species of Bartonella tested except
B. bacilliformis. The nucleotide sequence and the
corresponding deduced amino acid sequence shared various levels of
homology among the species tested (Fig. 2). However, the first 4 amino
acids (MKKY) were identical for all species, and the first 20 residues
were similar with regard to overall hydrophobicity and charge. The
hydrophobicity and presence of lysine residues at the immediate amino
terminus are characteristic of translocated proteins of bacteria. The
lysines are thought to interact with the phosphate groups of the
membrane phospholipids, and the hydrophobic core domain is thought to
interact with the lipid moieties (25). The hydrophobic core
is followed by a potential signal peptidase cleavage site. Alanine is
frequently found at the
3 and
1 positions upstream of the cleavage
site in E. coli (25) and was found in the
B. henselae and B. elizabethae antigens in this
study. Other small neutral side chains, such as glycine, serine, and
threonine, are often seen in these positions (25), which was
consistent with findings for B. quintana (Fuller and U.Mass), B. elizabethae, and B. vinsonii subsp.
vinsonii. The signal sequence of A-X-A has been shown by our
laboratory to be a signal peptidase cleavage site for two other outer
membrane proteins of B. henselae (12;
Burgess and Anderson, submitted). The presence of doublet bands on the
immunoblots is also consistent with the role of signal peptidase in
processing this antigenic protein. Thus, it is likely that the proteins
from each of the Bartonella species included in this study
are translocated across the cytoplasmic membrane.
The deduced amino acid sequences were used to construct a dendrogram of
phylogenetic relationships. Surprisingly, the two species that were the
most closely related were B. henselae and B. clarridgeiae (84.5%). The B. henselae and B. quintana versions of the 17-kDa antigen showed extensive sequence
divergence (>30%), and no variation for different strains within
B. henselae (Houston-1 and San Antonio-1 strains) and
B. quintana (Fuller and U.Mass strains) was noted. In
contrast, the two subspecies of B. vinsonii produced vastly
different deduced amino acid sequences with extensive sequence
divergence for the antigen (45.6%). It is possible that these two
subspecies are more remotely related than previously thought
(29), or, alternatively, that genetic exchange involving the
17-kDa antigen gene has hastened the evolutionary process.
When the cloned versions of the 17-kDa antigen from each of the species
were reacted with human serum samples from patients with
Bartonella infections, only B. henselae and the
B. clarridgeiae were reactive. These data are also
consistent with the phylogenetic relationship showing that the antigen
is more closely related between B. henselae and B. clarridgeiae than any two other species. These results also
suggest that the epitope(s) recognized by human sera from
patients infected with B. henselae is not cross-reactive with B. quintana; however, since isolation from the patients
whose sera were used in this study was not attempted, this observation cannot be confirmed. If this lack of cross-reactivity is confirmed upon
further evaluation, recombinant 17-kDa antigens could be used to
differentiate infections caused by B. henselae and B. clarridgeiae from those caused by B. quintana. Since
B. henselae and B. clarridgeiae are associated
with CSD and B. quintana is more frequently associated with
severe systemic disease, identification of B. quintana as a
causative agent may indicate the need for more aggressive treatment
with antibiotics that are not always prescribed for CSD. The rabbit
serum raised to purified recombinant B. henselae 17-kDa
protein was broadly cross-reactive with all species except B. vinsonii, showing that at least one epitope recognized by the
rabbit serum is well conserved.
The identification and sequencing of homologs of the 17-kDa antigen
should facilitate the development of both serologic and genetic tools
for the diagnosis of Bartonella infections. The use of
recombinant protein derived from each of the pathogenic species of
Bartonella as an antigen for enzyme-linked immunosorbent assay should permit rapid serologic testing that discriminates infections caused by B. henselae from those caused by
B. quintana. If the need arises for serologic assays that
are specific for other Bartonella species, then it should be
possible to utilize the appropriate 17-kDa antigen homolog as an
antigen. Additionally, the use of conserved antigen genes as targets
for gene probes and PCR primers has proven useful for rapid detection
and identification of bacteria directly in clinical specimens or
clinical isolates. Currently, the species level identification of
Bartonella isolates is often based on PCR amplification of
conserved genes followed by the use of specific probes (7)
or restriction fragment length polymorphism analysis (10,
32). The use of PCR primers derived from segments of the 17-kDa
antigen gene which are unique to each species could easily shorten and
simplify this process.
 |
ACKNOWLEDGMENTS |
We thank Dorsey Kordick of North Carolina State University for
providing the strains of B. clarridgeiae and B. vinsonii and Gary Litman, All Children's Hospital, for automated
sequencing services. We are also greatly appreciative of Pat Emmanuel,
USF Department of Pediatrics, for providing the serum sample from a
clinically diagnosed case of CSD.
This research was supported by Public Health Service grant R29-AI38178
from the National Institutes of Health.
 |
FOOTNOTES |
*
Corresponding author. Mailing address: Department of
Medical Microbiology and Immunology, College of Medicine, MDC10,
University of South Florida, 12901 Bruce B. Downs Blvd., Tampa, FL
33612. Phone: (813) 974-2109. Fax: (813) 974-4151. E-mail:
dsweger{at}com1.med.usf.edu.
 |
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