Microbial crossing of host barriers is a critical step of invasive infections. Understanding how microbes cross the intestinal barrier is thus key to comprehend the pathophysiology of foodborne infections.
Lm is a model microorganism for which a great deal of knowledge has been obtained by combining in vitro and in vivo approaches. Yet how this foodborne pathogen actually crosses the intestinal barrier has remained elusive.
Pentecost et al. (2006,
2010) have reported that
Lm targets intestinal villus tips to invade the epithelium at sites of cell extrusion and, based on in vitro observation obtained in cultured kidney epithelial cells, proposed that these were sites of accessible Ecad. Nevertheless, the existence of other sites of intestinal translocation as well as the precise molecular mechanism by which
Lm is actually transferred across the intestinal barrier monolayer have so far not been addressed. This prompted us to set up an experimental approach based on the comprehensive imaging of uninfected and infected intestinal tissues of
iFABP-hEcad transgenic mice. This approach preserves the intrinsic cell heterogeneity in a tissue context, allowing us to perform a detailed study of the initial steps of
Lm invasion and of the mechanisms of translocation across the intestinal epithelium with a level of scrutiny usually reserved for cultured cells. We demonstrate that Ecad is luminally accessible at cell–cell junctions between mucus-expelling GCs and adjacent enterocytes all along the vertical axis of intestinal villi. We show that
Lm accesses the intestinal lamina propria mostly all along the villus longitudinal axis and mainly targets luminally accessible Ecad of GCs to adhere to and invade the intestinal epithelium in an InlA-dependent manner. We demonstrate that
Lm is then rapidly translocated from the apical to basolateral side of IECs enclosed in a vacuole. This translocation is microtubule dependent but independent of the virulence factors LLO and ActA. Furthermore, the exocytic machinery is involved in
Lm release in the lamina propria. Finally,
Lm rapid transepithelial transcytosis leads to a similarly rapid systemic dissemination. Together, these results demonstrate that
Lm is transcytosed across the intestinal epithelium (Fig. S6 B), thus revealing a novel and unsuspected pathway hijacked by
Lm that is crucial for its rapid dissemination within the host.
We have identified novel in vivo sites of accessible Ecad around GCs, at cell–cell junctions with their neighbors, and along villus epithelial folds. Moreover, as previously reported in vitro (
Pentecost et al., 2006,
2010), we found that Ecad is luminally accessible at cell extrusion sites. In a similar fashion as extruding cells, mucus-producing GCs undergo extensive shape changes such as stretch and compression during mucus secretion. These shape changes are accompanied with junctional reorganization, notably variations in length and strand cross-linking and discontinuities (
Hull and Staehelin, 1976;
Madara and Trier, 1982;
Porvaznik et al., 1983;
Madara, 1990). Accordingly, we demonstrate here that TJs are disorganized between cells on which Ecad is luminally exposed and establish a correlation between mucus secretion and luminal access to Ecad. Furthermore, cortical actin at the apex of GCs is greatly reduced compared with IECs (
Oliver and Specian, 1990). We indeed observed a reorganized apical actin network at sites with accessible Ecad (Fig. S4 M), a result which is consistent with the well-established importance of the actin cytoskeleton in maintaining cell junction integrity by stabilizing Ecad clusters (
Hagen and Trier, 1988;
Cavey et al., 2008;
Schill and Anderson, 2009). Finally, we also show that Ecad is luminally accessible in villus intestinal folds (Fig. S4 I and Video 9). The forces of tension and constriction generated at these sites induce cell shape changes that may account for the relocation of Ecad to the apical luminal side, as previously described for adherens junction protein remodeling occurring during
Drosophila gastrulation and ventral furrow formation (
Dawes-Hoang et al., 2005;
Kölsch et al., 2007). Altogether, our investigations point to a correlation between physical tensions, localization of adherens junction components and TJ remodeling at the intestinal epithelium level.
Lm targeting of accessible Ecad illustrates how a microbial pathogen can take advantage of tissue dynamics and heterogeneity in vivo, a facet of microbial pathogenesis which cannot be investigated in vitro in more static and homogenous systems.
We have demonstrated
Lm preferential targeting of GC accessible Ecad and a correlation between GC numbers and
Lm intestinal invasion and systemic dissemination. Even though mucus secretion is at the front line of the innate host defense in the gastrointestinal tract,
Lm seems to exploit this innate defense mechanism by binding in an InlA-dependent manner to GCs. Moreover, although GCs are specialized in basal-apical transport, they also possess an endocytic and apicobasal transcytosis activity that
Lm may hijack (
Colony and Specian, 1987). Thus,
Lm takes advantage of an intestinal defense mechanism, namely mucus secretion, to target and cross the epithelium by transcytosis, uncovering an unsuspected Achilles’ heel of the innate immune system that
Lm has evolved to take advantage of. Nevertheless, we have also observed that
Lm interacts with intestinal GCs not expressing accessible Ecad, although this is far less frequent than with GCs that express accessible Ecad (). It has been previously reported that other internalins of
Lm, such as InlB, InlC, and InlJ, contain mucin-binding domains able to bind secreted Mucin-2 (
Lindén et al., 2008). However, they do not bind to the membrane-bound Mucin-1, suggesting that
Lm attraction to GCs in vivo is not caused by Inl–Muc interactions, but rather results from InlA–Ecad interactions. However, Inl–Muc interactions may retain
Lm within the mucus layer in an environment close to their source, the GCs, thus facilitating InlA–Ecad-mediated bacterial adhesion. This is further supported by the >15-fold increase of relative infection of accessible Ecad-expressing GCs compared with
ΔinlA interactions with GCs ().
In vitro studies have shown that bacteria can transcytose across cultured cell monolayers, including
Campylobacter jejuni (
Grant et al., 1993;
Russell and Blake, 1994;
Bacon et al., 2001;
Kopecko et al., 2001;
Hu et al., 2008;
Watson and Galán, 2008),
Neisseria gonorrhoeae and
Neisseria meningitidis (
Makino et al., 1991;
Merz and So, 2000;
Kuespert et al., 2006;
Wang et al., 2008;
Sutherland et al., 2010),
Streptococcus pneumoniae (
Zhang et al., 2000;
Kaetzel, 2001), and
Escherichia coli (
Burns et al., 2001;
Xie et al., 2004). Yet, with the exception of bacterial sampling by M cells (see next paragraph), this is the first time to our knowledge that a bacterium has been shown to translocate across an epithelial layer by transcytosis in vivo, resulting in its systemic dissemination. That
Lm follows a transcytosis pathway rather than its classical infection cycle was unexpected, as
Lm is considered a prototypic intracytosolic pathogen (Fig. S6 A). Yet, having evolved such a furtive means to cross the intestinal barrier seems perfectly in line with the observed rapidity of
Lm transepithelial transfer, the absence of intraepithelial bacterial proliferation and epithelial damage during the intestinal phase of listeriosis, and the fact that actin-based motility directionality does not preferentially route
Lm to the basal pole of enterocytes. But why doesn’t
Lm escape its vacuole at the intestinal epithelium level to cross the intestinal epithelium? It could be that transcytosis is too rapid to allow LLO-dependent
Lm escape from its internalization vacuole. In addition, it has been recently shown in macrophages that LLO activity is activated by GILT (
Singh et al., 2008). GILT is constitutively expressed in antigen-presenting cells and is inducible by IFN-γ in other cell types (
Arunachalam et al., 2000). Because GILT is not constitutively expressed in enterocytes, it may not activate LLO early on in the infection, thus allowing the
Lm-containing vacuole to be transcytosed apicobasally. Later on, as IFN-γ expression is triggered, GILT induction would lead to the activation of LLO, allowing
Lm to be diverted from transcytosis and delivered into the cytosol. In line with this hypothesis, intracytosolic
Lm can be observed in vivo in enterocytes later on in the infection (
Lecuit et al., 2001;
Pentecost et al., 2006,
2010).
We also show here that inhibition of NSF blocks the release of
Lm in the lamina propria and consequently its exit from epithelial cells. NSF and soluble NSF attachment proteins (SNAPs) are essential components of the intracellular membrane fusion apparatus (
Jahn and Scheller, 2006). This suggests that
Lm-containing vacuoles fuse with the basolateral membrane and exocytose, releasing
Lm subepithelially. There are only two in vitro studies illustrating bacterial exocytosis, by means of electron microscopy pictures of
C. jejuni (
Hu et al., 2008;
Baker and Graham, 2010), but the putative role of the exocytic machinery in bacterial escape has not been addressed in vivo in the context of a bacterial infection.
Lm seems to exploit the full range of Ecad recycling, not only by mimicking its natural ligand Ecad, binding to it and inducing its internalization, but also by subverting its basolateral recycling in polarized epithelial cells by transcytosis and exocytosis.
Lm transcytosis is strictly InlA dependent and LLO independent, whereas we have shown that the intestinal host response to
Lm is InlA independent and strictly LLO dependent (
Lecuit et al., 2007). We can interpret these findings as follows: at the intestinal villus level, in which
Lm enters via InlA without inducing tissue damage, the bacterium follows a furtive intravacuolar path that avoids detection by cytosolic sensors and remains undetected in the lamina propria, possibly because of its extracellular location and its ability to escape innate immune system recognition (
Boneca et al., 2007;
Gouin et al., 2010;
Personnic et al., 2010). In contrast, after translocation through M cells in an InlA-independent manner (
Pron et al., 1998;
Lecuit et al., 2001;
Corr et al., 2006;
Chiba et al., 2011),
Lm is phagocytosed by antigen-presenting cells, where LLO mediates vacuolar rupture, switching on the host response. This scenario illustrates how
Lm has evolved mechanisms that allow its dissemination into the host via the intestinal lamina propria without inducing, at least initially, strong innate immune responses. This is in sharp contrast with enteropathogens such as
Shigella flexneri that are contained at the intestinal level to the expense of strong and destructive inflammation responses.
Lm is a model microorganism that has been particularly instrumental for key discoveries in the fields of microbiology, cell biology, and immunology. By extending the cellular microbiology approach to tissues and by using high-resolution tissue-imaging techniques, we have demonstrated that the well-established dogma of Lm access to the cytosol for host tissue invasion does not apply to its early, rapid, and efficient crossing of the intestinal barrier. These results not only revisit and enrich our understanding of Lm pathogenesis, but also provide new clues as to how microbial pathogens breach host barriers. Future investigations will have to focus on the mechanisms of Lm breaching of the placental and blood-brain barriers and also on how other microbial pathogens cross host barriers.