The anthrax edema toxin (ET) of Bacillus anthracis is composed of the receptor-binding component protective antigen (PA) and of the adenylyl cyclase catalytic moiety, edema factor (EF). Uptake of ET into cells raises intracellular concentrations of the secondary messenger cyclic AMP, thereby impairing or activating host cell functions. We report here on a new consequence of ET action in vivo. We show that in mouse models of toxemia and infection, serum PA concentrations were significantly higher in the presence of enzymatically active EF. These higher concentrations were not caused by ET-induced inhibition of PA endocytosis; on the contrary, ET induced increased PA binding and uptake of the PA oligomer in vitro and in vivo through upregulation of the PA receptors TEM8 and CMG2 in both myeloid and nonmyeloid cells. ET effects on protein clearance from circulation appeared to be global and were not limited to PA. ET also impaired the clearance of ovalbumin, green fluorescent protein, and EF itself, as well as the small molecule biotin when these molecules were coinjected with the toxin. Effects on injected protein levels were not a result of general increase in protein concentrations due to fluid loss. Functional markers for liver and kidney were altered in response to ET. Concomitantly, ET caused phosphorylation and activation of the aquaporin-2 water channel present in the principal cells of the collecting ducts of the kidneys that are responsible for fluid homeostasis. Our data suggest that in vivo, ET alters circulatory protein and small molecule pharmacokinetics by an as-yet-undefined mechanism, thereby potentially allowing a prolonged circulation of anthrax virulence factors such as EF during infection.
The Bacillus anthracis virulence plasmid pXO1 encodes the three anthrax toxin proteins linked most directly to the symptoms and lethality associated with infection. The protective antigen protein (PA) interacts with the cellular receptor capillary morphogenesis gene 2 (CMG2) and tumor endothelial marker 8 (TEM8) and combines with either lethal factor (LF) or edema factor (EF) to form two toxins, lethal toxin (LT) and edema toxin (ET). PA, a secreted 83-kDa polypeptide, is cleaved by the host protease furin upon binding to its receptors, allowing the 63-kDa receptor-bound moiety to form oligomers. Secreted LF and/or EF bound to oligomerized PA are shuttled into the cell via clathrinmediated endocytosis, and subsequent acidification of the endocytic compartment induces channel formation by PA and release of the toxins into the cytosol. While LF is a zinc-dependent protease that cleaves cellular mitogen-activated protein kinase kinases (MAPKKs), EF functions as a highly active calmodulin-dependent adenylyl cyclase, raising cellular concentrations of the secondary messenger cyclic AMP (cAMP). The enzymatic activities of both toxins greatly affect cellular functions by modulation of signaling pathways. LF cleavage of the MAPKK proteins causes effects as varied as cell cycle arrest, apoptosis, modulation of immune ...