Perspectives for systems biology in the management of tuberculosis

Standardised management of tuberculosis may soon be replaced by individualised, precision medicine-guided therapies informed with knowledge provided by the field of systems biology. Systems biology is a rapidly expanding field of computational and mathematical analysis and modelling of complex biological systems that can provide insights into mechanisms underlying tuberculosis, identify novel biomarkers, and help to optimise prevention, diagnosis and treatment of disease. These advances are critically important in the context of the evolving epidemic of drug-resistant tuberculosis. Here, we review the available evidence on the role of systems biology approaches - human and mycobacterial genomics and transcriptomics, proteomics, lipidomics/metabolomics, immunophenotyping, systems pharmacology and gut microbiomes - in the management of tuberculosis including prediction of risk for disease progression, severity of mycobacterial virulence and drug resistance, adverse events, comorbidities, response to therapy and treatment outcomes. Application of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach demonstrated that at present most of the studies provide "very low" certainty of evidence for answering clinically relevant questions. Further studies in large prospective cohorts of patients, including randomised clinical trials, are necessary to assess the applicability of the findings in tuberculosis prevention and more efficient clinical management of patients.Publisher PDFPeer reviewe

Reproducible diagnostic metabolites in plasma from typhoid fever patients in Asia and Africa.

Salmonella Typhi is the causative agent of typhoid. Typhoid is diagnosed by blood culture, a method that lacks sensitivity, portability and speed. We have previously shown that specific metabolomic profiles can be detected in the blood of typhoid patients from Nepal (Näsström et al., 2014). Here, we performed mass spectrometry on plasma from Bangladeshi and Senegalese patients with culture confirmed typhoid fever, clinically suspected typhoid, and other febrile diseases including malaria. After applying supervised pattern recognition modelling, we could significantly distinguish metabolite profiles in plasma from the culture confirmed typhoid patients. After comparing the direction of change and degree of multivariate significance, we identified 24 metabolites that were consistently up- or down regulated in a further Bangladeshi/Senegalese validation cohort, and the Nepali cohort from our previous work. We have identified and validated a metabolite panel that can distinguish typhoid from other febrile diseases, providing a new approach for typhoid diagnostics

Physiology and Genetics of Acidithiobacillus species : Applications for Biomining

Bacteria from the genus Acidithiobacillus are often associated with biominingand acid mine drainage. Biomining utilises acidophilic, sulphur and ironoxidising microorganisms for recovery of metals from sulphidic low grade oresand concentrates. Acid mine drainage results in acidification and contaminationwith metals of soil and water emanating from the dissolution of metal sulphidesfrom deposits and mine waste storage. Acidophilic microorganisms play acentral role in these processes by catalysing aerobic oxidation of sulphides.Acceleration of mineral solubilisation is a positive aspect in biomining whereas,in acid mine drainage it is undesirable and accordingly, microbial iron andsulphur oxidation is promoted in the first case and measures are taken to inhibitit in the second case. In this thesis, several approaches were taken in order tounderstand and increase oxidation efficiency in biomining and to gain an insightinto the biochemical reactions taking place in these environments. A laboratoryscale bioreactor was designed and tested allowing simulation of bioleaching inheaps of mine tailings at different aeration, irrigation and particle size conditions(Paper I). A new psychrotolerant strain of Acidithiobacillus ferrooxidans wascharacterised that has an application in boreal heap bioleaching. Iron, reducedinorganic sulphur compound oxidation and bioleaching of various ores by thisstrain was studied as well as gene expression during oxidation of tetrathionateand/or ferrous iron (Papers III & IV). Expression and regulation of atetrathionate hydrolase from Acidithiobacillus caldus, a key enzyme in reducedinorganic sulphur compound metabolism of this bacterium was investigated andthe presence of this enzyme in a bioleaching mixed culture was shown. The genecluster that harbours the gene coding for tetrathionate hydrolase (tetH) wasdescribed for the first time (Paper II)

Type III secretion system expression in oxygen-limited Pseudomonas aeruginosa cultures is stimulated by isocitrate lyase activity

Pseudomonas aeruginosa is an opportunistic human pathogen and a common cause of chronic infections in individuals with cystic fibrosis (CF). Oxygen limitation was recently reported to regulate the expression of a major virulence determinant in P. aeruginosa, the type III secretion system (T3SS). Here, we show that expression of the T3SS in oxygen-limited growth conditions is strongly dependent on the glyoxylate shunt enzyme, isocitrate lyase (ICL; encoded by aceA), which was previously shown to be highly expressed in CF isolates. ICL-dependent regulation of the T3SS did not alter the expression level of the master transcriptional regulator, ExsA, but did affect expression of the T3 structural proteins, effectors and regulators (ExsC, ExsD and ExsE). An aceA mutant displayed enhanced biofilm formation during anaerobic growth, which suggested that AceA-dependent modulation of type III secretion might impinge upon the RetS/LadS signalling pathways. Indeed, our data suggest that RetS is able to mediate some of its effects through AceA, as expression of aceA in trans partially restored T3SS expression in a retS mutant. Our findings indicate that AceA is a key player in the metabolic regulation of T3SS expression during oxygen-limited growth of P. aeruginosa. To the best of our knowledge, this is the first demonstration that the T3SS can be regulated by factors that do not affect ExsA expression levels

Influence of Chelation Strength and Bacterial Uptake of Gallium Salicylidene Acylhydrazide on Biofilm Formation and Virulence by Pseudomonas aeruginosa

Development of antibiotic resistance in bacteria causes major challenges for our society and has prompted a great need for new and alternative treatment methods for infection. One promising approach is to target bacterial virulence using for example salicylidene acylhydrazides (hydrazones). Hydrazones coordinate metal ions such as Fe(III) and Ga(III) through a five-membered and a six-membered chelation ring. One suggested mode of action is via restricting bacterial Fe uptake. Thus, it was hypothesized that the chelating strength of these substances could be used to predict their biological activity on bacterial cells. This was investigated by comparing Ga chelation strength of two hydrazone complexes, as well as bacterial Ga uptake, biofilm formation, and virulence in the form of production and secretion of a toxin (ExoS) by Pseudomonas aeruginosa. Equilibrium constants for deprotonation and Ga(III) binding of the hydrazone N′-(5-chloro-2-hydroxy-3-methylbenzylidene)-2,4-dihydroxybenzhydrazide (ME0329), with anti-virulence effect against P. aeruginosa, were determined and compared to bacterial siderophores and the previously described Ga(III) 2-oxo-2-[N-(2,4,6-trihydroxy-benzylidene)-hydrazino]-acetamide (Ga-ME0163) and Ga-citrate complexes. In comparison with these two complexes, it was shown that the uptake of Ga(III) was higher from the Ga-ME0329 complex. The results further show that the Ga-ME0329 complex reduced ExoS expression and secretion to a higher extent than Ga-citrate, Ga-ME0163 or the non-coordinated hydrazone. However, the effect against biofilm formation by P. aeruginosa, by the ME0329 complex, was similar to Ga-citrate and lower than what has been reported for Ga-ME0163

The surface charge of anti-bacterial coatings alters motility and biofilm architecture

Bacterial biofilms affect many areas of human activity including food processing, transportation, public infrastructure, and most importantly healthcare. This study addresses the prevention of biofilms and shows that the surface charge of an abiotic substrate influences bacterial motility as well as the morphology and physiology of the biofilm. Grafting-from polymerisation was used to create polymer brush surfaces with different characteristics, and the development of Pseudomonas aeruginosa biofilms was followed using confocal microscopy. Interestingly, two types of biofilms developed on these surfaces: mushroom structures with high levels of cyclic diguanylate (c-di-GMP) were found on negatively charged poly (3-sulphopropylmethacrylate) (SPM) and zwitterionic poly (2-(methacryloyloxy)ethyl)dimethyl-3-sulphoproyl) ammonium hydroxide) (MEDSAH), while flat biofilms developed on glass, positively charged poly (2-(methacryloyloxy)-ethyl trimethyl ammonium chloride) (METAC), protein-repellent poly oligo(ethylene glycol methyl ether methacrylate) (POEGMA) and hydrophobic polymethylmethacrylate (PMMA). The results show that of all the surfaces studied, overall the negatively charged polymer brushes were most efficient in reducing bacterial adhesion and biofilm formation. However, the increased level of regulatory c-di-GMP in mushroom structures suggests that bacteria are capable of a quick physiological response when exposed to surfaces with varying physicochemical characteristics enabling some bacterial colonization also on negatively charged surfaces

Surface analysis of bacterial systems using cryo-X-ray photoelectron spectroscopy

Surface analysis of biological systems using XPS often requires dehydration of the sample for it to be compatible with the ultrahigh vacuum of the spectrometer. However, if samples are frozen to liquid-nitrogen temperature prior to and during analysis, water can be retained in the sample and the organization of the sample surface should be preserved to a higher degree than in desiccated samples. This article presents recent developments of cryo-X-ray photoelectron spectroscopy (cryo-XPS) for analyses of hydrated biological samples at liquid nitrogen temperature. We describe experiments on bacterial cells, bacterial biofilms, and bacterial outer membrane vesicles using a variety of bacterial species. Differences and similarities in surface chemistry are monitored depending on growth in liquid culture, on culture plates, as well as in biofilms, and are discussed. Two data treatment methods providing decomposition of the C 1s spectra into lipid, polysaccharide, and peptide/peptidoglycan content are used and compared.Special Issue: SI</p

Diagnostics and management of tuberculosis and COVID-19 in a patient with pneumothorax (clinical case)

The spread of COVID-19 in countries with high and medium incidence of tuberculosis has led to an increased risk of COVID-19 and tuberculosis co-infection, introducing new diagnostic and therapeutic challenges for the clinician. Hereby we describe a first case where tuberculosis and COVID-19 were diagnosed concomitantly in a Russian patient with pneumothorax. We discuss the challenges associated with the diagnosis and treatment of tuberculosis during the COVID-19 pandemic

Do environmental pharmaceuticals affect the composition of bacterial communities in a freshwater stream? : A case study of the Knivsta river in the south of Sweden

Pharmaceutical substances present at low concentrations in the environment may cause effects on biological systems such as microbial consortia living on solid riverbed substrates. These consortia are an important part of the river ecosystem as they form part of the food chain. This case study aims to contribute to an increased understanding of how low levels of pharmaceuticals in freshwater streams may influence sessile bacterial consortia. An important point source for pharmaceutical release into the environment is treated household sewage water. In order to investigate what types of effects may occur, we collected water samples as well as riverbed substrates from a small stream in the south of Sweden, Knivstaån, upstream and downstream from a sewage treatment plant (STP). Data from these samples formed the base of this case study where we investigated both the presence of pharmaceuticals in the water and bacterial composition on riverbed substrates. In the water downstream from the STP, 19 different pharmaceuticals were detected at levels below 800 ng/dm3. The microbial composition was obtained from sequencing 16S rRNA genes directly from substrates as well as from cultivated isolates. The cultivated strains showed reduced species variability compared with the data obtained directly from the substrates. No systematic differences were observed following the sampling season. However, differences could be seen between samples upstream and downstream from the STP effluent. We further observed large similarities in bacterial composition on natural stones compared to sterile stones introduced into the river approximately two months prior to sampling, giving indications for future sampling methodology of biofilms