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Infection by tubercular mycobacteria is spread by nonlytic
ejection from their amoeba hosts
Monica Hagedorn1, Kyle H. Rohde2, David G. Russell2, and Thierry Soldati1,*
1Département de Biochimie, Faculté des Sciences, Université de Genève, Sciences II, 30 quai
Ernest Ansermet, CH-1211-Genève-4, Switzerland. 2Microbiology and Immunology, College of
Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
Abstract
To generate efficient vaccines and cures for Mycobacterium tuberculosis, we need a far better
understanding of modes of infection, persistence and spreading. Host cell entry and establishment
of a replication niche are well understood, but little is known about how tubercular mycobacteria
exit host cells and disseminate the infection. Using the social amoeba Dictyostelium as a genetically
tractable host for pathogenic mycobacteria, we discovered that M. tuberculosis and M. marinum but
not M. avium are ejected from the cell through an actin-based structure, the ejectosome. This
conserved nonlytic spreading mechanism requires a cytoskeleton regulator from the host and an intact
mycobacterial ESX-1 secretion system. This insight offers new directions for research into the
spreading of tubercular mycobacteria infections in mammalian cells.
Keywords
Mycobacterium marinum; Infection; nonlytic release
Intracellular bacterial pathogens have evolved strategies to exploit host cell resources and
replicate inside a variety of cell types, staying out of reach of the host’s immune system. The
concept is emerging that pathogenic bacteria evolved from environmental species by adapting
to an intracellular lifestyle within free-living, bacteria-eating protozoans. Consequently,
cellular defense mechanisms active in animal immune phagocytes may have originated in
amoebae (1,2). For example, during differentiation of the social amoeba Dictyostelium to form
a multicellular structure, Sentinel cells are deployed to combat pathogens (1).
Generally, infection follows entry of a bacterium inside a host cell, giving rise to a pathogen-
containing vacuole usually called a phagosome. From this common starting point, pathogens
subvert or resist the mechanisms that usually transform the phagosome into a bactericidal
environment. Understanding of the passive or triggered uptake mechanisms and of the
subsequent hijacking of host cell processes is increasing steadily, but little is known about how
the pathogens exit their primary host cell and spread the infection.
Mycobacterium tuberculosis causes tuberculosis and other granulomatous lesions and is a
major threat to human health. M. marinum is a close relative (3) responsible for fish and
*To whom correspondence should be addressed. thierry.soldati@unige.ch.
One-sentence summary: Mycobacteria exit host cells without lysing them via an ejectosome generated by the concerted action of host
and pathogen factors.
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Science. Author manuscript; available in PMC 2009 October 29.
Published in final edited form as:
Science. 2009 March 27; 323(5922): 1729–1733. doi:10.1126/science.1169381.
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amphibian tuberculosis, in which it causes almost indistinguishable pathologies and lesions
[reviewed in (4)]. Several elegant cross-species complementation studies between these two
pathogens highlight their common mechanisms of pathogenicity [reviewed in (4)].
After passive uptake by immune phagocytes, M. tuberculosis and M. marinum arrest or bypass
phagolysosome maturation and replicate inside a compartment of endosomal nature (57). Both
species can escape from this vacuole into the host cytosol (8–11), though at varying frequencies.
Efficient translocation into the cytosol depends on an intact region of difference (RD) 1 locus
(10,11), which encodes components of a type seven secretion system and essential secreted
effectors (12). This ESX-1 secretion system has been implicated in arrest of phagosome
maturation (13), granuloma formation and the spread of infection (14,15); however, it is not
essential for replication inside macrophages (14). It has also been directly associated with the
secretion of a membranolytic activity (15). Specifically, the secreted effector ESAT-6 has
recently been linked to niche breakage and pore-forming activity in macrophages (11).
M. marinum and M. tuberculosis can disseminate through release of bacilli following host cell
lysis via necrotic or apoptotic cell death (16–18), but studies also document cell-to-cell,
antibiotic-insensitive spreading inside an epithelial monolayer (19,20). M. marinum induces
plasma membrane protrusions (2,9) suggested to participate in dissemination between
macrophages in culture (21) and inside zebrafish embryos (22). Hence, escape into the cytosol
may be a necessary precursor for cell-to-cell spread and may involve a direct nonlytic
transmission process occuring within the granuloma (5,6).
Here, we adopted the genetically tractable Dictyostelium-M. marinum model system to unravel
basic mechanisms of intercellular dissemination. The course of M. marinum infection in
Dictyostelium amoebae is very similar to that in macrophages (8). The mycobacteria replication
vacuole accumulates a flotillin-like raft protein, then ruptures and releases M. marinum into
the cytosol (see fig. S1). A Dictyostelium mutant lacking the RacH GTPase, which is involved
in regulation of the actin cytoskeleton and endosomal membrane trafficking and acidification,
was more permissive for M. marinum proliferation (8). Detailed FACS analysis (fig. S2) of
these infected cells suggested an interference with intercellular dissemination (fig. S3).
To test this hypothesis, we designed a quantitative dissemination assay (Fig. 1A). Briefly, an
infected Dictyostelium donor strain (either wild type or racH-) is mixed with a green fluorescent
wild type acceptor strain at a donor:acceptor ratio of 1:5. Over the course of infection, the
number of bacteria per donor and acceptor cell was determined by visual inspection. The
proportion of wild type infected donor cells decreased concomitantly with a sharp increase of
infected acceptor cells at 21 hours post infection (hpi), and the number of bacteria per acceptor
cell increased over time (Fig. 1B, bar shadings). This indicated successful transmission of
bacteria and replication in acceptor cells. In contrast, the proportion of infected racH-donor
cells remained relatively constant (above 50%). Strikingly, infection of acceptor cells from
racH-donor cells was about 8-fold less than from wild type donor cells (Fig. 1C). The racH-
cells were deficient in intercellular spreading of mycobacteria and it appears that a
RacHdependent release mechanism is required for cell-to-cell transmission under these
conditions.
Cytosolic pathogens, such as Listeria and Shigella use actin-based tails and filopodia for
intercellular spreading. During M. marinum infection of macrophages, unidentified
mycobacterial proteins induce actin tails in a Wiscott Aldrich Syndrome protein (WASP)
dependent manner (23), as well as structures reminiscent of Shigella-induced filopodia (9) that
can be captured by neighboring cells ((9) and fig S4). Hence, we monitored F-actin dynamics
in infected cells expressing a GFP-fusion with the actin binding domain (ABD) of filamin
(24) by live microscopy (Movies S1–S7,Fig. 1D–F and fig. S5A,B). At late stages of infection,
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despite the presence of many cytosolic bacteria, cells exhibited apparently normal amoeboid
motility (Movie S1) and cell division (Movie S2). In contrast to the observation in macrophages
((9) fig. S4), no persistent actin tails were visible on cytosolic bacteria, possibly due to the high
rate of actin depolymerisation in Dictyostelium (25). However, transient actin flashes were
produced when bacteria contacted the cell cortex (fig. S5A, Movie S3).
Bacteria were “ejected” through an F-actin-dense structure we called an “ejectosome” (Fig.
1D, Movie S4). Mycobacteria were also caught “spanning” the plasma membrane without
inducing host cell lysis, a situation stable for the duration of the observation (e.g. 17 min, Fig.
1E, Movie S5). A significant proportion of cells harbored multiple similar structures (fig. S5B,
Movie S6). Ejectosomes can apparently exert a contractile force, forming a tight septum around
the bacteria as they are towed behind motile host cells (Fig. 1D, Movie S4). We also captured
images of synchronized ejection from a donor cell and phagocytosis by an acceptor cell (Fig.
1F, Movie S7). Hence, an actin-based mechanism appeared to be responsible for nonlytic
ejection of cytosolic mycobacteria, which, concomitantly with capture by neighboring cells,
ensured efficient and antibiotic-insensitive intercellular spreading.
The live observations were confirmed by staining fixed infected cells with fluorescent
phalloidin. During phagocytosis, the cell deforms towards the bacteria and extends
lamellipodia that surround it along most of its length (Fig. 2A, 3E). By contrast, ejectosomes
are short barrel-shaped structures usually found in flat membrane regions (Fig. 2B). Multiple
ejectosomes were often observed to cluster (Fig. 2C, D). Cell fixation preserved the structure
of ejectosomes “coupled” to phagocytic cups suggesting direct donor-to-acceptor transmission
(Fig. 2E).
What propels bacteria during ejection is unclear, because we rarely observed bacteria with
typical F-actin-tails (Fig. 1G). Ejection may be powered by a mechanical process resulting
from a combination of cortical tension, cytoplasmic pressure and a reaction of the actin-cortex
to bacteria-induced deformation. Myosin IB and coronin were strongly enriched at the
ejectosome (fig. S5G, H), whereas myosin II and the Arp2/3 complex were not or weakly
enriched in the Factin barrel (fig. S5I, J). Thus, the ejectosome may either assemble de novo
or result from a rearrangement of preexisting cortical structures.
In all cases of ejection, the part of the bacterium inside the cell was devoid of membrane markers
from endosomes (Fig. 2F and fig. S5C) or the replication compartment (Fig. 2F, G), which
excludes the phenomenon being an exocytic event. The protruding part of the bacterium
induced a bulge in the plasma membrane (Fig. 2F, fig. S5C), demonstrating that the bacterium
is on an outward journey through the cell surface. The membrane labeling often appeared
patchy at the tip of the bulge (Fig. 2F, fig. S5C), suggesting local loss of integrity. Sometimes,
extracellular mycobacteria were wrapped in plasma membrane remnants (Fig. 2H, fig. S5D).
Outward plasma membrane deformation (Fig. 3A, C) and partial membrane rupture (Fig. 3B,
C) were also observed by scanning and transmission electron microscopy.
Labelling of the protruding part of ejected M. marinum with an anti-M. marinum serum in non-
permeabilised cells indicated accessibility of the bacterium surface, and hence local loss of
plasma membrane integrity (Fig. 2I, K). However, infected cells do not lyse, as judged by live
imaging (Fig. 1E, Movies S1–S7), and they are also not leaky, as demonstrated by the exclusion
of a membrane-impermeant DNA-binding dye during a two hours-long incubation (fig. S5E).
Serial sections through an ejectosome (Fig. 3C) showed a cytosolic bacterium protruding from
a cell with the plasma membrane ruptured towards the tip of the bacterium, but at the same
time invaginated between the bacterium and a zone of dense actin meshwork. We propose that,
during ejection, the ingressing plasma membrane stays tightly apposed to the bacterium surface
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and finally reseals at the posterior of the bacterium, resulting in a dynamic but tight seal that
prevents host cell lysis or leakage (schematically depicted in Fig. 3D).
During Dictyostelium infections, M. tuberculosis was first found in spacious vacuoles (fig. S7)
that accumulated vacuolin, the Dictyostelium flotillin homologue (fig. S6A). Then, with an
efficiency lower than that of M. marinum, the bacilli translocated into the cytosol (Fig. 4A, fig.
S6A, S7) where they induced ejectosomes (Fig. 4A, fig. S6B, C). In Dictyostelium, M.
avium also accumulated in spacious compartments decorated with vacuolin, but, in contrast to
M. tuberculosis and M. marinum, no vacuole breakage was detected (Fig. 4A), and no
ejectosome was observed. Vacuole escape and nonlytic ejection from the host cell may
represent conserved strategies among tubercular mycobacteria that could play a prominent role
in dissemination of infection, rather than intracellular survival per se.
We expected a direct correlation between the observed number of ejectosomes and the
spreading of infection. Indeed, in wild type cells, there were 14–15 ejectosomes/100 cells at
37 hpi, whereas no ejectosome was ever observed in racH-cells (Fig. 4B, fig. S8B). This is not
due to deficient vacuole escape, because at 37 hpi, over 90 % of M. marinum were cytosolic
and free of vacuolin staining, compared to 75% in wild type cells (Fig. 4B, fig. S9).
Complementation of racH-cells with GFP-RacH partially restored the capacity to form
ejectosomes (fig. S8C). In accordance, membrane fragments carrying GFP-RacH polymerize
actin around them upon addition of GTPγS in a cell-free assay (26).
In correlation with the capacity to induce ejectosomes, the RD1 locus is present in M.
tuberculosis and M. marinum (13–15), but absent from M. avium (12). A M. marinum mutant
deleted of its RD1 locus (ΔRD1) replicated inefficiently in Dictyostelium (Fig. 4D), and the
population of infected cells steadily decreased with time (Fig 4E and fig. S8D). Vacuole escape
was readily detectable (Fig. 4B and fig. S9), but was about 4-to 5-fold less efficient than for
wild type M. marinum, as measured by colocalization with vacuolin or p80. This corroborates
recent findings in macrophages using a collection of ESX-1 mutants (11). But the most striking
observation was the complete absence of ejectosomes (Fig. 4B). If the ESX-1 locus secretes
vacuole escape factors (11) it may also secrete factors that coordinate egress of the resulting
cytosolic bacteria. It is possible that ESAT-6, one of the major secreted effectors, plays a role
in both processes. We designed a trans-complementation strategy in which M. marinum
ESAT-6 was conditionally expressed directly inside the cytosol of its host Dictyostelium (Fig.
4C). M. marinum ΔRD1 apparently replicated better in ESAT-6 expressing cells than in wild
type cells (Fig. 4D) and showed a 1.5-to 2-fold increased frequency of niche escape. Most
importantly, it induced ejectosome formation (Fig. 4B). Our data demonstrated that nonlytic
ejection of tubercular mycobacteria from Dictyostelium is a concerted process that necessitates
host and pathogen factor(s), and is crucial for the maintenance of an infection in a cell
population.
Conceptually, the ejectosome bears intriguing analogies with the contracting actin-ring formed
during purse-string closure of membrane wounds in Xenopus oocytes (27) and during the repair
of toxin-induced macroapertures in endothelial cells (28). Because lytic release from a single-
celled amoeba would be lethal, the ejectosome may have first evolved as a plasma membrane
repair mechanism. This concerted and mutually benefitial strategy might have been conserved
during evolution to ensure dissemination of mycobacteria between immune phagocytes of their
metazoan host.
Dictyostelium can be thought of as a rudimentary innate immune phagocyte and this model has
allowed us to identify a conserved strategy for egress and cell-to-cell spread that is shared by
M. marinum and M. tuberculosis.
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Supplementary Material
Refer to Web version on PubMed Central for supplementary material.
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29. Acknowledgements. We gratefully acknowledge Lalita Ramakrishnan and Christine Cosma for
providing strains of M. marinum, various GFP-expression vectors and advice; Gareth Griffiths for
GFP-expressing M. avium; Brian C. VanderVen for providing GFP-expressing M. tuberculosis;
Francisco Rivero and Markus Maniak for providing Dictyostelium mutant strains; Christoph Bauer
of the NCCR imaging platform for his help with microscopy; Paul Walther and Eberhard Schmid for
their expert help with the SEM; Dominique Soldati for critical reading of the manuscript. The work
was supported by the Swiss National Science Foundation in the form of a grant to TS and an individual
short-term fellowship to MH. The TS group participates in the NEMO (non-mammalian experimental
models for the study of bacterial infections) network supported by the Swiss 3R Foundation. DGR
and KHR are supported by grants AI 067027 and HL 055936 from the US National Institutes of
Health.
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Fig. 1.
Direct cell-to-cell transmission of M. marinum occurs via ejectosomes and is RacH dependent.
(A) Quantitative dissemination assay. A donor strain (wild type or racH-cells) was infected
with DsRed-expressing M. marinum and, at 12 hpi, mixed with a green fluorescent acceptor
strain. Presence of bacteria in donor and acceptor cells was scored. Dissemination efficiency
for wild type (B) and racH-(C) donor cells. Number of bacteria per cell (classified into groups
of 1–3, 4–10 and >10 bacteria/cell) are indicated. (D–F) Live GFP-ABD expressing
Dictyostelium cells (green) infected with DsRed-expressing M. marinum (red) were imaged at
35 hpi for the indicated times (upper left corner). (D) Nonlytic ejection of mycobacteria occurs
through actin-dense ejectosomes (white arrowhead). (E) Cells with mycobacteria spanning the
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plasma membrane retain normal motility. (F) Cell-to-cell transmission of a cytosolic bacterium
(black arrowhead) from a donor cell (do) to an acceptor cell (ac) through an ejectosome (white
arrowhead) into a phagocytic cup (white arrows). (G) A bundle of bacteria are ejected from a
donor cell (do). The plasma membrane bulge (small arrows) is ruptured at the tip (asterisk),
where it contacts an acceptor cell (ac). Actin tails stained by phalloidin (green, arrowheads),
were polarized at the posterior of bacteria (blue). Vertical distance from the first section is
indicated in µm. Scale bars 1 µm.
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Fig. 2.
Biogenesis, structure and topology of ejectosomes. Paraformaldehyde-fixed cells infected with
GFP-expressing M. marinum (green), stained for F-actin (red). (A) A phagocytic cup lined
with F-actin (arrows). A single (B) or multiple bacteria (C, D) spanning the host cell plasma
membrane (asterisks) through ejectosomes (white arrowheads) with the intracellular part of
the bacterium devoid of actin-labeling (black arrowhead). (E) Cell-to-cell transmission of
bacteria from a donor (do) to an acceptor (ac) cell through an ejectosome into a phagocytic cup
(arrows). (F) Movement of cytosolic bacteria (blue) through ejectosomes (F-actin, green)
induces a plasma membrane bulge (small arrows) that ruptures at the tip (F, asterisk). The
intracellular part of the ejecting bacterium is devoid of p80, a plasma membrane marker (F),
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and vacuolin, a niche marker (asterisk, G). Some extracellular bacteria were positive for p80
(small arrows, H). (I–K) Live infected cells (M. marinum, blue, actin, green) were incubated
in the presence of an anti-M. marinum serum. The extracellular parts of ejecting (small arrows,
I, K) or outside (small arrow, J) bacteria were accessible to the antibody and labeled red, in
contrast to intracellular bacteria (black arrowhead, J), confirming partial loss of plasma
membrane integrity. Scale bars 1 µm.
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Fig. 3.
Electron microscopy of ejecting bacteria and schematic representation of an ejection event.
Scanning electron microscopy (A–B, A’ is the magnified inset of A) showed bulges of the
plasma membrane (small arrows), some ruptured at the tip of the ejecting bacterium (B,
asterisk). Scale bars 0.5 µm. (C) Serial sections through an ejectosome revealed the
organization of the Factin (white arrowheads) and the plasma membrane. The posterior of the
ejecting bacterium (black arrowhead) was in the cytosol. The bacterium was separated from
the F-actin by the invaginated plasma membrane, which was tightly apposed to its surface.
Membrane fragments were scattered along the extracellular part of the bacterium (small
arrows). (D) Schematic representation of an ejection. During outward movement of a bacterium
(green), the F-actin barrel exerts contraction (red arrows), and the invaginating plasma
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membrane (PM) reseals at the posterior of the bacterium (black arrows), maintaining a tight
septum despite partial membrane rupture. (E) Micrograph of a phagocytic cup. The actin-filled
lamellipodia (white arrowheads) extend and engulf a bacterium. Scale bars 1µm.
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Fig. 4.
Ejection is a process involving both host and pathogen factors and is a strategy shared by
tubercular mycobacteria. (A) In wild type cells (Dd wt) both, M. marinum (mar) and M.
tuberculosis (tuber) were able to escape their vacuolin–coated (green) niche (upper row, black
arrowheads) and form ejectosomes (lower row, green, white arrowheads). Plasma membrane
fragments on ejecting bacteria were positive for p80 (red, small arrows), but the intracellular
part of the bacteria was devoid of p80 labeling (black arrowhead). In contrast M. avium
remained in a vacuolin-positive compartment (upper row) and did not form ejectosomes. (B)
In racH-cells GFP-expressing M. marinum (red) translocated into the cytosol (upper row), but
no ejectosome was detected (lower row; actin, green; p80, red). M. marinum ΔRD1 escaped
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its niche in wild type and ESAT-6 (E6) expressing cells; however, ejectosomes (white
arrowhead) were only detected in ESAT-6 expressing cells. (C–E) Trans-complementation by
expression of M. marinum ESAT-6 in the Dictyostelium cytosol. Removal of tetracycline-
induced ESAT-6 expression (C). Wild type and ESAT-6 expressing cells were infected with
GFP-expressing M. marinum ΔRD1 and the infection monitored by FACS. Quantification of
total fluorescence of infected cells indicated increased replication of M. marinum ΔRD1 in
ESAT-6 expressers (D, red curve, normalized to T=0.5 hpi). Infected ESAT-6 expressers with
high fluorescence (FL1) persisted longer (E, red curve), compared to infected wild type
Dictyostelium (D, E, blue curve).
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