The acute morphologic changes induced by
S Typhimurium infection in calves, as well as the profile of cytokines and chemokines, have been well documented in previous studies using the ligated intestinal loop model.
7,13,26,27,40,42 Currently, the massive tissue influx of neutrophils is considered the histopathological hallmark of nontyphoidal salmonellosis.
35 The typical neutrophilic influx has been suggested to represent the major event triggering tissue necrosis and diarrhea.
25,27,41 Here we describe the morphologic changes induced by
S Typhimurium infection in CD18− calves that essentially lack tissue neutrophils.
Our findings demonstrate remarkable morphologic differences in the intestine, in the absence of tissue influx of neutrophils. Whereas the first histologic lesions of villous blunting in normal calves (CD18 +/+) appeared as early as 15 minutes postinfection,
27 blunting in CD18− calves was absent at 1 HPI and first detected at 4 HPI (WT-infected samples only). Moreover, the MT strain, well known for its attenuated pathogenicity, induced the first detectable blunting at 8 HPI. In addition to blunting, detachment of epithelial cells in CD18− calves infected with the WT strain was mainly observed at 8 HPI, with only occasional occurrence at 4 hours. In contrast, this finding was commonly observed at 3 HPI
27 and first detected as early as 1 hour in CD18+ calves.
40Although evidence of neutrophil extravasation in CD18− calves with experimental pasteurellosis has been reported to occur in the lungs,
1–3 significant mucosal neutrophilic inflammation was not observed in any of the infected intestinal tissues. The lung, unlike other tissues, has been classically recognized as being able to recruit neutrophils through CD-18 independent pathways in studies with lung inflammatory models.
22 When present, neutrophils were limited to the perivascular connective tissue in the submucosa at 8 and 12 HPI, always associated with vascular lesions. Our data suggest that submucosal extravasation of neutrophils was caused by loss of vascular integrity secondary to vasculitis, formation of fibrin thrombi, and vascular necrosis. Vasculitis and thrombosis have been reported in CD18− calves with dermatitis.
4What was not observed in CD18− calves was the typical widespread necrosis of the uppermost mucosa, with complete loss of the intestinal epithelium extending to crypts reported at 8 to 12 hours in
S Typhimurium–infected calves.
34,41 In contrast, necrosis in CD18− samples was limited to tips of villi, progressing to the basolateral surface, and a few scattered foci in the lamina propria, presumably reflecting the pattern of bacterial invasion and dissemination. Instead of massive mucosal necrosis, the most impressive morphologic change in CD18− tissue at 12 HPI was complete atrophy and fusion of villi. This finding indicates that changes in villi morphology during nontyphoidal salmonellosis can be induced by epithelial invasion in the absence of neutrophilic inflammation.
Ultrastructurally, lesions in enterocytes induced by
S Typhimurium infection in CD18− calves—including detachment and disruption of the brush border, apical membrane ruffling formation, and cellular degeneration—were similar to the ones reported in the literature for CD18+ calves submitted to similar experiments.
27 In addition, the published data were confirmed in our CD18− samples, identifying cell tropism of
S Typhimurium for M cells in the follicle-associated epithelium of Peyer’s patches and epithelial cells at the tips of absorptive villi.
10,27The most remarkable and surprising morphologic difference between the typical lesions of
S Typhimurium–induced enteritis in normal calves compared to CD18− calves in this study was the complete absence of lesions in Peyer’s patches. Acute salmonellosis in calves is typically associated with lymphocyte depletion in Peyer’s patches follicles,
27 progressing to necrosis in chronic stages of infection.
39 The absence of significant lesions in CD18− calves suggests that necrosis of Peyer’s patches in salmonellosis occurs as a consequence of neutrophilic infiltration within lymphoid follicles, as opposed to the bacterial infection of cells and their transport into the lymphoid follicles. This hypothesis is supported by evidence that neutrophilic infiltration in Peyer’s patches–infected samples precedes lymphoid depletion and necrosis in calves.
27Invasion of
S Typhimurium in bovine ligated jejunal–ileal loops is dependent on the synergistic effects of TTSS-1-encoded effector proteins sipA, sopA, sopB, sopD, sopE, and sopE2.
23,42 In this study, mucosal invasion of
Salmonella was generally increased in CD18− compared to CD18+ calves, though not statistically significant at any time point. In addition, for most time points (4 to 12 HPI), we observed that the MT strain was not found to be significantly less invasive than the WT strain in CD18− calves. This finding was opposed to the lower invasiveness of MT compared to WT bacteria as confirmed by our data on CD18+ calves and as reported in the literature.
40,41 Collectively, these data suggest that tissue influx of neutrophils partially reduces mucosal invasion of WT
S Typhimurium and largely contributes to preventing the invasion of the MT strain. The mechanism responsible for fluid secretion and diarrhea in nontyphoidal models of salmonellosis remains to be elucidated. Studies in bovine ligated ileal loops strongly support an exudative mechanism, rather than secretory diarrhea (chloride secretion), as the most likely mechanism.
41 Accordingly, the massive intestinal influx of neutrophils in calves infected with
S Typhimurium results in necrosis with loss of epithelial integrity and diarrhea by an exudative mechanism.
41 Our data provide strong evidence that fluid accumulation in CD18− calves is significantly reduced compared to CD18+ calves at later time points when inflammation is normally most severe (ie, at 8 and 12 HPI). As with bacterial invasion, the markedly different degree of responses between WT- and MT-infected samples observed in CD18+ calves was less evident in CD18− calves, supporting the hypothesis that the neutrophilic influx plays a crucial role in the pathogenesis of both strains, especially preventing pathologic effects caused by the MT strain. Our findings support the hypothesis of exudative diarrhea secondary to inflammation as the major contributor to the fluid secretion in nontyphoidal salmonellosis. However, it is important to realize that, though markedly reduced, fluid secretion in CD18− calves still occurred. It is yet to be determined if the mild fluid accumulation observed in CD18− calves resulted from either secretory mechanisms secondary to the necrosis and vascular lesions or a combination thereof as commonly observed at 8 and 12 hours postinfection.
The type of inflammatory infiltrate that characterizes a disease is controlled in part by the profile of inflammatory cytokines and chemokines.
18 The proinflammatory cytokines IL-1β and TNF-α, as well as potent neutrophil chemoattractants, the CXC chemokines IL-8 and GRO-α, have been suggested to play major roles during
S Typhimurium–induced enteritis and diarrhea in calves.
25,27,41 Besides being often expressed in the bovine model of nontyphoidal salmonellosis, IL-8 gene expression is induced in human epithelial cell lines by the
S Typhimurium TTSS-1.
14 We found that gene expression of IL-8 in WT-infected samples was significantly higher in CD18− than in CD18+ calves at 4 and 8 HPI. A possible interpretation of this finding is that the absence of tissue neutrophils in CD18− triggers a positive feedback mechanism for production of more IL-8 via unknown pathways in an attempt to recruit neutrophils necessary to control infection. This finding also suggests that neutrophils are unlikely to be the major source of IL-8 during
S Typhimurium infection in calves given that increased gene expression in CD18− occurred in the absence of significant tissue influx of neutrophils. Studies using the bovine ligated ileal loop model have identified the GRO-α chemokine as the major chemoattractant for neutrophils during
S Typhimurium–induced enteritis.
40 Our data on GRO-α gene expression in CD18+ calves confirmed the high expression levels—up to an 80-fold increase over uninfected control in WT-infected samples, especially in the later stages of acute infection (ie, at 12 HPI). This finding suggests that the massive influx of neutrophils observed in the later phase of acute infection is mainly driven by GRO-α. In CD18− calves, however, the GRO-α gene expression at WT-infected samples at this late stage of infection was significantly reduced compared to CD18+, indicating that the neutrophil influx may play a role in triggering GRO-α gene expression in the later phase of acute infection by either directly secreting this chemokine or stimulating its production in other cell types indirectly. IL-1β and TNF-α are classic proinflammatory cytokines increased during
Salmonella infection in all organs studied to date using in vivo models of infection.
8,17,27 Extensive evidence from studies in mice indicates that these cytokines are essential for host defense against
Salmonella infection.
9 In bovine ligated ileal loops infected with
S Typhimurium, the gene expression of these two cytokines was determined by conventional reverse transcription polymerase chain reaction. Accordingly, the expression of IL-1β was elevated at 3 and 6 HPI, whereas no changes in gene expression was detected for TNF-α after infection.
24 Although not statistically significant, our data confirmed that the gene expression levels of IL-1β in CD18− calves were lower than those of CD18+ calves, especially in WT-infected samples (
P = .109 at 8 HPI). These data were expected in view of the essentially absent tissue inflammation in the CD18− calves. The lack of statistical significance in the different expression levels of IL-1β between CD18− and CD18+ calves could be explained by the high standard deviation observed in our data as a result of marked individual variability. More experimental samples are necessary to increase the statistical power and confirm our findings regarding IL-1β gene expression. The TNF-α gene expression in our CD18− samples was variable in WT-infected samples, with significantly higher expression in CD18− at 1 HPI, but with the opposite relationship (ie, higher expression) occurring in CD18+ calves at 4 HPI. These results, combined with our finding of no significant differences in TNF-α gene expression between CD18− and CD18+ calves at later time points, suggest that neutrophil influx likely plays a minor role in the gene expression of this cytokine during
S Typhimurium–induced enteritis in calves.
In conclusion, infection by S Typhimurium of ligated ileal loops in calves with BLAD resulted in markedly distinct morphologic changes as well as chemokine and cytokine profiles, compared to normal animals negative for BLAD. The most important differences essentially included the absence of typical S Typhimurium–induced neutrophilic enteritis, the unique pattern and reduced magnitude of necrosis, and the differential gene expression profiles of major neutrophil chemokines and proinflammatory cytokines. The differences in CD18− calves were associated with a significantly increased bacterial invasion and reduced fluid accumulation, supporting the hypothesis that S Typhimurium–induced diarrhea in normal calves is primarily exudative and caused by the massive tissue influx of neutrophils. New evidence provided by these experiments significantly extends our understanding of the morphologic and molecular pathogenesis of diarrhea of human and ruminant nontyphoidal salmonellosis.