SUMMARY Virulence of the emerging Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) and other highly pathogenic S. aureus depends on the recently discovered phenol-soluble modulin (PSM) peptide toxins, which combine the capacities to attract and lyse neutrophils. The molecular basis of PSM-stimulated neutrophil recruitment has remained unknown. We demonstrate that the human formyl peptide receptor 2 (FPR2/ALX), which has previously been implicated in control of endogenous inflammatory processes, senses PSMs at nanomolar concentrations and initiates proinflammatory neutrophil responses to CA-MRSA. Specific blocking of FPR2/ALX or deletion of PSM genes in CA-MRSA led to severely diminished capacities of neutrophils to detect CA-MRSA. A specific inhibitor of FPR2/ALX and its functional mouse counterpart blocked PSM-mediated leukocyte infiltration in vivo in a mouse model. Thus, the innate immune system uses a new FPR2/ALX-dependent mechanism to sense bacterial peptide toxins and detect highly virulent bacterial pathogens. FPR2/ALX represents an attractive target for new anti-infective or anti-inflammatory strategies.

The extravasation of leukocytes from the peripheral blood stream to inflammatory sites is a key feature in the innate immune response to infection (1). Different chemoattractants (e.g. N-formylated peptides, C5a, interleukin-8, leukotriene B 4 , and platelet-activating factor) and chemokines induce leukocyte infiltration and activation through binding to G proteincoupled seven-transmembrane cell-surface receptors (2, 3). The chemoattractant-mediated dissociation of G␣ i2 from the G␤␥ subunit complex results in the activation of several downstream signaling effector enzymes that promote intracellular calcium mobilization, modifications in the metabolism of phosphoinositides, and activation of mitogen-activated protein kinases (4). The integration by the cell of the different chemoattractant-activated signaling pathways results in directed cell migration, recruitment of new receptors from the granules to the cell surface, release of proteolytic enzymes, production of large amounts of superoxide by the neutrophil NADPH oxidase, and increased gene transcription (5-8). The extent of the cellular response is dependent on the identity of the agonist and on the level of expression and desensitization of the receptors involved in the activation process (9).Two synthetic hexapeptides, Trp-Lys-Tyr-Met-Val-Met-NH 2 (WKYMVM)andTrp-Lys-Tyr-Met-Val-D-Met-NH 2 (WKYMVm), that stimulate phosphoinositide hydrolysis in myeloid cells were identified by screening a peptide library (10, 11). The D-methionine-containing hexapeptide (WKYMVm) was found to be a very potent activator of several leukocyte effector functions such as chemotaxis, mobilization of complement receptor-3, and activation of the NADPH oxidase (11). The peptide WKYMVm activates neutrophils through both the N-formyl peptide receptor (FPR) 1 and FPRL1 (N-formyl peptide receptor-like-1) (12, 13). The latter was originally cloned from human phagocytes by low-stringency hybridization of a cDNA library with the FPR cDNA sequence, and it was initially defined as an orphan receptor (14 -16). FPRL1 was later referred to as the LXA 4 receptor since it was shown to bind lipoxin A 4 with high affinity (17). In addition, several different peptides/proteins have been reported to stimulate this receptor. These include a leucine zipper-like domain of the HIV-1

Thrombin increases endothelial permeability in a rapid and reversible way. This effect requires the catalytic activity of the enzyme and thrombin receptor engagement. Endothelial cell permeability is mostly regulated by intercellular junction organization. In the present study, we investigated whether opening of intercellular gaps after thrombin treatment could be related to changes in adherence-junction molecular organization. By immunofluorescence analysis, we found that thrombin stimulation of endothelial cells caused a marked alteration of the distribution of vascular endothelial (VE)-cadherin and of the associated catenins. These molecules, which are strictly localized at intercellular boundaries in confluent resting cells, were absent in the areas of intercellular retraction. Immunoprecipitation analysis indicated that thrombin disrupted the VE-cadherin/catenin complex. This effect was reversible and correlated with the increase in endothelial permeability. The use of a protein kinase C inhibitor (calphostin C) blocked both thrombin-induced permeability and disassembly of adherence-junction components. We propose that thrombin's effect on endothelial cell junction organization is an important determinant in the increase in endothelial permeability induced by this agent.