A hallmark of acute relapsing fever borreliosis is severe bacteremia. Some Borrelia species, such as B. duttonii and B. crocidurae, associate with erythrocytes and induce aggregation recognized as erythrocyte rosetting. Erythrocyte rosettes contribute to disease severity by increased tissue invasiveness (such as invasion of CNS and encephalitis), hemorrhaging, and reduced blood flow in affected microcapillaries. Here we report that relapsing fever Borrelia binds to neolacto (Gal4GlcNAc3Gal4Glc1)-carrying glycoconjugates that are present on human erythrocytes. This interaction is of low affinity but is compensated for by the multivalency of neo-lacto-oligosaccharides on the erythrocyte cell surface. Hence, the protein-carbohydrate interaction is dependent on multivalent neolacto-glycans to mediate binding. '' (1-4). Borrelia species capable of rosetting induce more severe symptoms, increased organ invasiveness, hemorrhaging, microemboli formation, and a delayed immune response (3, 4), suggesting that rosetting represents an important virulence factor. In vitro, rosette formation is influenced by both Borrelia species and temperature (1). However, the molecular mechanism that supports rosetting has not been described.Carbohydrates are abundant surface-exposed structures on all eukaryotic cells. Given their ubiquitous nature and immense diversity, it is not surprising that some common motifs have been exploited by pathogens as binding sites for adherence to host cells and in addition to facilitate and/or promote entry into and invasion of the host cells (5, 6). In this study, RF Borrelia bound specifically to a subset of glycosphingolipids (GSLs) isolated from human erythrocytes. The GSL was characterized as Gal4GlcNAc3Gal4Glc1Cer (neolactotetraosylceramide) by proton NMR and by liquid chromatography-mass spectrometry (LC/MS) of the saccharide released by hydrolysis with Macrobdella decora ceramide glycanase.* As a natural model system, B. hispanica was found to bind to Neisseria meningiditis, which expresses neolactotetra glycans in its LOS/LPS. The results show that the Borrelia interaction with neolacto glycans is of low affinity and that the interaction necessitates multivalent neolacto epitopes to achieve high affinity. Here we present for the first time a molecular mechanism based on a lectin-glycan interaction that supports RF Borrelia-mediated erythrocyte rosetting.
ResultsVariable Erythrocyte Rosetting of RF Borrelia Species. We developed an in vitro rosetting assay measuring hemoglobin release of captured erythrocyte rosettes, allowing detection of subtle changes in rosetting. Assay results correlate with rosetting assessed by microscopy. B. hispanica displayed the greatest capability followed by B. duttonii and B. coriaceae, whereas B. hermsii, B. turicatae, B. recurrentis, and B. crocidurae produced few or no rosettes (Fig. 1). Previous reports have indicated that B. duttonii (2) and B. crocidurae (1, 3, 4) are high rosetters, whereas B. hermsii (1, 3, 4) and B. recurrentis (unpublished) are no...