e Streptococcus intermedius secretes a human-specific cytolysin, intermedilysin (ILY), which is considered to be the major virulence factor of this pathogen. We screened for a repressor of ily expression by using random gene disruption in a low-ILY-producing strain (PC574). Three independent high-ILY-producing colonies that had plasmid insertions within a gene that has high homology to lacR were isolated. Validation of these observations was achieved through disruption of lacR in strain PC574 with an erythromycin cassette, which also led to higher hemolytic activity, increased transcription of ily, and higher cytotoxicity against HepG2 cells, compared to the parental strain. The direct binding of LacR within the ily promoter region was shown by a biotinylated DNA probe pulldown assay, and the amount of ILY secreted into the culture supernatant by PC574 cells was increased by adding lactose or galactose to the medium as a carbon source. Furthermore, we examined lacR nucleotide sequences and the hemolytic activity of 50 strains isolated from clinical infections and 7 strains isolated from dental plaque. Of the 50 strains isolated from infections, 13 showed high ILY production, 11 of these 13 strains had one or more point mutations and/or an insertion mutation in LacR, and almost all mutations were associated with a marked decline in LacR function. These results strongly suggest that mutation in lacR is required for the overproduction of ILY, which is associated with an increase in pathogenicity of S. intermedius.
Streptococcus intermedius is a facultatively anaerobic member of the normal flora of the human oral cavity and the upper respiratory, gastrointestinal, and female urogenital tracts. S. intermedius belongs to the Anginosus group of streptococci (AGS), which also includes Streptococcus anginosus and Streptococcus constellatus (1, 2). AGS tend to form local suppurative infections, and these organisms are the most common pathogens associated with bacterial intracerebral abscesses (1-6). S. intermedius is the most pathogenic species of AGS and a leading cause of deepseated, serious purulent infections, including brain and liver abscesses (1, 2). This pathogen secretes a human-specific cytolysin, intermedilysin (ILY), which was originally identified in studies using an S. intermedius strain, UNS46, isolated from a human liver abscess (7). ILY is a member of the cholesteroldependent cytolysin (CDC) family and is considered the major virulence factor for infectivity and cytotoxicity toward human cells by S. intermedius (8-11). Therefore, investigation of the mechanisms that regulate ily expression could help elucidate how S. intermedius mediates its pathogenicity by controlling the amount of ILY secreted. To date, two factors have been reported to control the expression of ily. The first is autoinducer 2 (AI-2) (a LuxS product used by several bacteria in quorum-sensing signaling), which is reported to be an exponential-growth-phase-specific activator of ily transcription (12). In addition, we recently revealed th...