Group B Streptococcus (GBS) is the leading cause of bacterial pneumonia, sepsis and meningitis among neonates and a cause of morbidity among pregnant women and immunocompromised adults. GBS epithelial cell invasion is associated with expression of alpha C protein (ACP). Loss of ACP expression results in a decrease in GBS internalization and translocation across human cervical epithelial cells (ME180). Soluble ACP and its 170 amino acid N-terminal region (NtACP), but not the repeat protein RR9, bind to ME180 cells and reduce internalization of wild-type GBS to levels obtained with an ACP-deficient isogenic mutant. In the current study, ACP colocalized with a 1 b 1 -integrin, resulting in integrin clustering as determined by laser scanning confocal microscopy. NtACP contains two structural domains, D1 and D2. D1 is structurally similar to fibronectin's integrin-binding region (FnIII10). D1's (KT)D146 motif is structurally similar to the FnIII10 (RG)D1495 integrin-binding motif, suggesting that ACP binds a 1 b 1 -integrin via the D1 domain. The (KT)D146A mutation within soluble NtACP reduced its ability to bind a 1 b 1 -integrin and inhibit GBS internalization within ME180 cells. Thus ACP binding to human epithelial cell integrins appears to contribute to GBS internalization within epithelial cells.
INTRODUCTIONGroup B Streptococcus (GBS; Streptococcus agalactiae) is the leading cause of neonatal bacterial invasive diseases (Arisoy et al., 2003;Manning et al., 2004). The organism colonizes the vagina, rectum and urethra of 10-35 % of adults without causing disease. Neonates acquire GBS either in utero or during birth, aspirating GBS-containing fluid. GBS enters the lungs, binds to and invades the alveolar epithelial cells, and enters the blood, allowing the organisms to infect multiple organs. Invasive disease occurs within hours of birth, with 4-6 % mortality (Baker & Edwards, 1995;Schrag et al., 2000). In a survey in the USA, the incidence of early-onset disease (within the first week of life) declined by 65 % (from 1.7 per 1000 live births to 0.6 per 1000) from 1993 to 1998, due to intrapartum antimicrobial prophylaxis (Schrag et al., 2000) and stabilized at 0.35 per 1000 in 2004 . The incidence of late-onset disease (.1 week to 3 months of age) remained stable, with an average of 0.35 per 1000 live births during the same time period (CDC, 1997(CDC, , 2005.GBS was more recently found to be pathogenic in the elderly, and in adults with underlying medical conditions, including diabetes (Dahl et al., 2003;Jackson et al., 1995;Tyrrell et al., 2000). Adult invasive GBS diseases result in bacteraemia, meningitis, skin and soft-tissue infection, and bone and joint infections. The rate of invasive diseases is significantly higher in neonates than in adults. However, the case fatality rates are greater in adults (Schuchat, 1999), with the incidence of GBS disease increasing with advanced age (Farley et al., 1993). Despite the clinical importance of these diseases, little is known about the events that lead up to GBS inv...