Diversidade de respostas de Corynebacterium diphtheriae frente a agentes oxidantes: resistência, adaptação e envolvimento do determinante de resistência ao telurito (TeR) e do sistema OxyR na virulência bacteriana

Abstract

Corynebacterium diphtheriae is an important human pathogen and the main causal agent of diphtheria. Although a reduction in the number of diphtheria cases is observed worldwide, diphtheria remains endemic in many countries and outbreaks are still reported sporadically. In Brazil, the last outbreak occurred in Maranhão and revealed changes in clinical and epidemiological diphtheria aspects. Despite most Brazilian C. diphtheriae belong to mitis biovar, in this outbreak were isolated two different pulsotypes of C. diphtheriae biovar intermedius. Furthermore, diphtheria pathognomonic features were absent in some cases. C. diphtheriae has also been associated with invasive infections, although typically recognized as extracellular pathogen. Together, these changes in profile of C. diphtheriae infections suggest the existence of other virulence factors besides the diphtheria toxin. In order to access the genetic diversity and the potential virulence of C. diphtheriae strains isolated from classical diphtheria and invasive infections, molecular typing and comparative genomics analyzes were conducted. The results demonstrated the circulation of different invasive clones in Brazil. Furthermore, they revealed differences in the presence and in the gene content of pathogenicity islands among C. diphtheriae strains. Differences were also found in DtxR regulon and in corynephages sequences. Once the bacterial invasiveness and persistence in the environment may be related to the tolerance to oxidative stress, determinants involved in this process were searched in C. diphtheriae genomes. Among these, the genes DIP0906, predicted as tellurite (TeO32-) resistance gene and DIP1421, an oxyR homolog, were characterized. Moreover, their roles in diphtheria bacilli pathogenesis were investigated. In vivo assays, using the nematode Caenorhabditis elegans, showed that both genes are important for C. diphtheriae virulence. DIP0906 seems to contribute to the resistance to hydrogen peroxide (H2O2) and to intracellular survival in human respiratory cells, besides involved in resistance to TeO32-. OxyR negatively controls the H2O2 response and appears to be involved with C. diphtheriae binding to plasma and extracellular matrix proteins. Additionally, bacterial resistance and adaptation, through the induction of adaptive response and / or cross-resistance and biofilm formation, of C. diphtheriae strains against oxidative agents were investigated. C. diphtheriae strains showed different oxidative resistance levels and a heterogeneous behavior in the presence of the agents, which suggest the existence of different strategies for adaptation of diphtheria bacilli under oxidative stress conditions.