Bacteroides fragilis produces an approximately 20-kDa heat-labile toxin (B. fragilis enterotoxin, BFT) which is known to be associated with diarrhea. To determine whether cyclooxygenase (COX)-2, via NF-jB activation, can contribute to BFT-induced diarrhea, the relationship between COX-2 expression and fluid secretion in BFT-stimulated human intestinal epithelial cells was examined. BFT stimulation increased the expression of COX-2, but not COX-1, in human intestinal epithelial cells. Suppression of the NF-jB signal significantly decreased COX-2 expression in response to BFT stimulation. Prostaglandin E 2 (PGE 2 ) levels were increased in parallel with COX-2 expression, and, conversely, PGE 2 production was significantly inhibited when COX-2 or NF-jB activities were suppressed using COX-2 small interfering RNA (siRNA), p65 NF-jB subunit siRNA, or a retrovirus encoding the IjBa superrepressor. In addition, a selective COX-2 inhibitor, NS-398, significantly inhibited the increased cAMP level induced by BFT stimulation. Furthermore, a selective COX-2 inhibitor prevented BFTinduced PGE 2 production and ileal fluid secretion in a mouse ileal loop model. These results suggest that the secretory response to BFT stimulation may be mediated by the production of PGE 2 , through NF-jB activation and the up-regulation of COX-2 in intestinal epithelial cells.
IntroductionEnterotoxigenic Bacteroides fragilis (ETBF) has been shown to be associated with non-invasive diarrheal diseases in animals and young children [1][2][3][4][5], and B. fragilis enterotoxin (BFT), an approximately 20-kDa heat-labile metalloprotease, is regarded as a virulence factor for this diarrheal disease. BFT stimulates NF-jB activation and IL-8 secretion [6][7][8][9], which is predicted to lead to mucosal transmigration of neutrophils with release of prostaglandins (PG). In addition, animal loop experiments and gnotobiotic piglet infection indicate that BFT is proinflammatory and BFT stimulates a brief chloride current and a loss of barrier function in vitro [3,10], suggesting that these findings are potential mechanisms accounting for ETBF-induced diarrhea. Several studies have shown that secretion of PG from intestinal mucosal epithelial cells is closely associated with diarrheal diseases [11,12], and administration of PG analogues, such as PGE 2 , causes increased fluid secretion in human subjects [13,14]. In addition, the roles of PG in the secretory response to cholera toxin and enterotoxigenic Escherichia coli have been demonstrated [15][16][17]. These results suggest the hypothesis that the diarrhea associated with ETBF may be PG-derived. PGE 2 is a metabolite of arachidonic acid and is synthesized by cyclooxygenase (COX). There are two isoforms of this enzyme [18]: COX-1, which is constitutively expressed in crypt epithelial cells, and COX-2, which can be induced in a variety of cell types, including epithelial cells, macrophages and fibroblasts. COX-2 is induced by proinflammatory cytokines, lipopolysaccharide and infectious agents [19]. The expr...