Phenol-soluble modulins (PSMs) are a family of small proteins, that carry out a variety of functions, including acting as toxins, assisting in biofilm formation, and colony spreading. PSMs are produced by Staphylococcus bacteria including Methicillin-resistant Staphylococcus aureus (MRSA), and Staphylococcus epidermidis. Many PSMs are encoded within the core genome and can play an important virulence factor. [1] PSMs were first discovered in S. epidermidis by Seymour Klebanoff and via hot-phenol extraction and were described as a pro-inflammatory complex of three peptides. [2] Since their initial discovery, numerous roles of PSMs have been identified. However, due in part to the small size of many PSMs, they have largely gone unnoticed until recent years.
Although PSMs are present in every Staphylococcal species, there is still diversity. Staphylococcus aureus encodes eight different PSMs, PSMα 1-4, PSMβ 1-2, PSMγ (Also known as δ-toxin in S. aureus), and PSM-mec. [3] While Staphylococcus epidermidis encodes one PSMα, PSMβ 1-2, PSMγ, and PSM-mec. [3] In addition S. epidermidis encodes two unique PSMs, PSMδ and PSMε. [3]
PSM-mec is one of the most widely encoded PSMs among Staphylococcal species, which may be in part due to PSM-mec being encoded on the mecI mobile genetic element. [3]
As the PSM classes are closely related there are many conserved aspects. However each PSM class plays a different role, as such there are some distinctive features for each. Generally PSMs are encoded on the core genome of staphylococcal species however some, such as PSM-mec, are encoded on mobile genetic elements. PSMs are generally separated into one of two classes α-type PSMs and β-type PSMs, which are based upon characteristics of the two most well studied PSMs PSMα and PSMβ.
PSMα forms an amphipathic α-helix structure that composes the entire length of the peptide. [2] These peptides are relatively short, being composed of only 20-25 amino acids. [2] With regards to charge, α-type PSMs generally have a neutral charge, but may also be slightly positive. [2]
PSMβ Are similar to PSMα in that they contain an amphipathic α-helix. [2] However, the helix does not compose the entirety of the peptide, instead covering only the C-terminus of the peptide. [2] PSMβ are generally larger than PSMα, being composed of 43-45 amino acids. [2] Unlike α-type PSMs, β-type PSMs usually possess a negative charge. [2]
PSMγ (also known as δ-Toxin) shares some homology with PSMα-3 encoded by S. aureus. [3]
PSMδ is encoded downstream of the PSMα gene in S. epidermidis. [3] In addition PSMδ shares some homology with PSMγ. [3]
Little work has been done to determine the structure of PSMε. However it is believed to play a role in both biofilm formation as well as inflammation. [3]
PSM-mec is encoded on the Staphylococcal Chromosomal Cassette methicillin resistance island (SCCmec) which encodes genes associated with methicillin resistance in different Staphylococcal species. [3] Little work has been done to determine the exact structure of PSM-mec.
PSM regulation in S. aureus is primarily controlled by the agr system. [2] The exact mechanism of regulation differs from other agr controlled toxins, which are controlled by the agr effector molecule RNAIII. PSMs, however, are controlled by direct binding of AgrA to the promoter region. [2] PSM-mec RNA has been implicated in the regulation of the agr system and as a result can influence the expression of other PSMs. [2] In addition to the agr system, SarA as well as LuxS have both been implicated in PSM control, with mutations in either system showing decreased levels of PSM production. [3] In addition the MgrA system has been shown to alter biofilm formation, via suppression of PSMs. [4] The environment S. aureus is exposed to has been demonstrated to play a role in PSM expression. In intracellular environments it has been shown that PSM production is increased. [2]
In addition to being the subject of regulation, PSMs have been shown to regulate other toxins such as S. aureus alpha toxin. [5]
PSMs were first described as a pro-inflammatory molecule. [2] This role has been repeatedly demonstrated to be true. PSMs are able to induce the production of a variety of cytokines as well as induce neutrophils to migrate to sites of infection. [3] PSMε in S. epidermidis is known to influence the production of IL-8. [3] PSMα in S. aureus has been shown to influence IL-17 levels during infection. [6]
In addition to their pro-inflammatory properties, PSMs have been shown to be directly sensed by circulating leucocytes through the formyl peptide receptor FPR2, thus driving a rapid, pathogen-specific attraction of neutrophiles to the site of infection, via an EGR1-dependent signalling pathway. [7]
In addition to their role in attracting neutrophils to sites of infection, PSMs can also influence the function of neutrophils. It has been demonstrated that secreted PSMs are able to induce Neutrophil Extracellular Trap release. [8] The PSMs also have been shown to decrease the number of persister cells within a population of S. aureus. [9]
MRSA production of PSMs is thought to be a possible cause of severe infections. [10] PSM production is higher in community-acquired MRSA (CA-MRSA) than in healthcare-associated MRSA (HA-MRSA), [11] and consequently CA-MRSA associated osteomyelitis [11] is more severe than HA-MRSA associated osteomyelitis.
Many PSMs have cytolytic activity and play a major role in the nonspecific lysing of host cells, including Polymorphonuclear Leukocytes (PMNs). [2] Lysis is carried out by integration of PSMs into membranes, in a nonspecific fashion, which results in disruption of the membrane. [2] Different PSMs are able to lyse cells with different affinities. PSMα, in S. aureus, and PSMδ, in S. epidermidis, are the most potent cytolysins. [2] While highly cytolytic PSMs, such as PSMα and PSMδ, are generally α-type PSMs the β-type PSMs tend to be less cytolytic. [2]
S. aureus is a non-motile bacteria, and must rely on alternative forms of spreading. PSMs have been implicated in assisting with colony spreading. [12] PSMα 1-4 have been shown to help S. aureus colonies spread on agar plates. [12] However, δ-Toxin, which is another α-class PSM, does not play a role in colony spreading. [12]
While the α-type PSMs are regarded as major cytolysins, both α-type and β-type PSMs are thought to play a role in biofilm formation. [2] The aggregation of α-type PSMs into fibrils is able to modulate S. aureus biofilm formation. [13] [ verification needed ]In vitro measurement of PSMβ expression in S. epidermidis has shown to be increased in biofilm as opposed to planktonic growth, suggesting a link between PSMβ and biofilm formation. [2] Altering the structure of PSMβ has been demonstrated to disrupt their ability to influence biofilm formation. [3]
Staphylococcus aureus is a gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive for catalase and nitrate reduction and is a facultative anaerobe, meaning that it can grow without oxygen. Although S. aureus usually acts as a commensal of the human microbiota, it can also become an opportunistic pathogen, being a common cause of skin infections including abscesses, respiratory infections such as sinusitis, and food poisoning. Pathogenic strains often promote infections by producing virulence factors such as potent protein toxins, and the expression of a cell-surface protein that binds and inactivates antibodies. S. aureus is one of the leading pathogens for deaths associated with antimicrobial resistance and the emergence of antibiotic-resistant strains, such as methicillin-resistant S. aureus (MRSA). The bacterium is a worldwide problem in clinical medicine. Despite much research and development, no vaccine for S. aureus has been approved.
Methicillin-resistant Staphylococcus aureus (MRSA) is a group of gram-positive bacteria that are genetically distinct from other strains of Staphylococcus aureus. MRSA is responsible for several difficult-to-treat infections in humans. It caused more than 100,000 deaths worldwide attributable to antimicrobial resistance in 2019.
Methicillin (USAN), also known as meticillin (INN), is a narrow-spectrum β-lactam antibiotic of the penicillin class.
Staphylococcus haemolyticus is a member of the coagulase-negative staphylococci (CoNS). It is part of the skin flora of humans, and its largest populations are usually found at the axillae, perineum, and inguinal areas. S. haemolyticus also colonizes primates and domestic animals. It is a well-known opportunistic pathogen, and is the second-most frequently isolated CoNS. Infections can be localized or systemic, and are often associated with the insertion of medical devices. The highly antibiotic-resistant phenotype and ability to form biofilms make S. haemolyticus a difficult pathogen to treat. Its most closely related species is Staphylococcus borealis.
Staphylococcus epidermidis is a Gram-positive bacterium, and one of over 40 species belonging to the genus Staphylococcus. It is part of the normal human microbiota, typically the skin microbiota, and less commonly the mucosal microbiota and also found in marine sponges. It is a facultative anaerobic bacteria. Although S. epidermidis is not usually pathogenic, patients with compromised immune systems are at risk of developing infection. These infections are generally hospital-acquired. S. epidermidis is a particular concern for people with catheters or other surgical implants because it is known to form biofilms that grow on these devices. Being part of the normal skin microbiota, S. epidermidis is a frequent contaminant of specimens sent to the diagnostic laboratory.
Panton–Valentine leukocidin (PVL) is a cytotoxin—one of the β-pore-forming toxins. The presence of PVL is associated with increased virulence of certain strains (isolates) of Staphylococcus aureus. It is present in the majority of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) isolates studied and is the cause of necrotic lesions involving the skin or mucosa, including necrotic hemorrhagic pneumonia. PVL creates pores in the membranes of infected cells. PVL is produced from the genetic material of a bacteriophage that infects Staphylococcus aureus, making it more virulent.
RNAIII is a stable 514 nt regulatory RNA transcribed by the P3 promoter of the Staphylococcus aureus quorum-sensing agr system ). It is the major effector of the agr regulon, which controls the expression of many S. aureus genes encoding exoproteins and cell wall associated proteins plus others encoding regulatory proteins The RNAIII transcript also encodes the 26 amino acid δ-haemolysin peptide (Hld). RNAIII contains many stem loops, most of which match the Shine-Dalgarno sequence involved in translation initiation of the regulated genes. Some of these interactions are inhibitory, others stimulatory; among the former is the regulatory protein Rot. In vitro, RNAIII is expressed post exponentially, inhibiting translation of the surface proteins, notably protein A, while stimulating that of the exoproteins, many of which are tissue-degrading enzymes or cytolysins. Among the latter is the important virulence factor, α-hemolysin (Hla), whose translation RNAIII activates by preventing the formation of an inhibitory foldback loop in the hla mRNA leader.
Lysostaphin is a Staphylococcus simulans metalloendopeptidase. It can function as a bacteriocin (antimicrobial) against Staphylococcus aureus.
A staphylococcal infection or staph infection is an infection caused by members of the Staphylococcus genus of bacteria.
mecA is a gene found in bacterial cells which allows them to be resistant to antibiotics such as methicillin, penicillin and other penicillin-like antibiotics.
'Staphylococcus aureus delta toxin is a toxin produced by Staphylococcus aureus. It has a wide spectrum of cytolytic activity.
Staphylococcus capitis is a coagulase-negative species (CoNS) of Staphylococcus. It is part of the normal flora of the skin of the human scalp, face, neck, scrotum, and ears and has been associated with prosthetic valve endocarditis, but is rarely associated with native valve infection.
Staphylococcus is a genus of Gram-positive bacteria in the family Staphylococcaceae from the order Bacillales. Under the microscope, they appear spherical (cocci), and form in grape-like clusters. Staphylococcus species are facultative anaerobic organisms.
Aureolysin is an extracellular metalloprotease expressed by Staphylococcus aureus. This protease is a major contributor to the bacterium's virulence, or ability to cause disease, by cleaving host factors of the innate immune system as well as regulating S. aureus secreted toxins and cell wall proteins. To catalyze its enzymatic activities, aureolysin requires zinc and calcium which it obtains from the extracellular environment within the host.
Staphylococcus schleiferi is a Gram-positive, cocci-shaped bacterium of the family Staphylococcaceae. It is facultatively anaerobic, coagulase-variable, and can be readily cultured on blood agar where the bacterium tends to form opaque, non-pigmented colonies and beta (β) hemolysis. There exists two subspecies under the species S. schleiferi: Staphylococcus schleiferi subsp. schleiferi and Staphylococcus schleiferi subsp. coagulans.
Staphylococcus pseudintermedius is a gram-positive spherically shaped bacterium of the genus Staphylococcus found worldwide. It is primarily a pathogen for domestic animals, but has been known to affect humans as well. S. pseudintermedius is an opportunistic pathogen that secretes immune-modulating virulence factors, has many adhesion factors, and the potential to create biofilms, all of which help to determine the pathogenicity of the bacterium. Diagnoses of S. pseudintermedius have traditionally been made using cytology, plating, and biochemical tests. More recently, molecular technologies like MALDI-TOF, DNA hybridization and PCR have become preferred over biochemical tests for their more rapid and accurate identifications. This includes the identification and diagnosis of antibiotic resistant strains.
The arginine catabolic mobile element (ACME) is a mobile genetic element of Staphylococcus bacterial species. This genetic element provides for several immune modulating functions, including resistance to polyamines which serve as a non-specific immune response both on intact skin and following the inflammatory response in wound healing. Diverse ACME are present in several species of Staphylococcus, including Staphylococcus epidermidis.
Staphopain A is a secreted cysteine protease produced by Staphylococcus aureus. It was first identified in the S. aureus V8 strain as a papain-like cysteine protease. The protease distinguishes itself from the other major proteases of S. aureus in its very broad specificity and its ability to degrade elastin.
Accessory gene regulator (agr) is a complex 5 gene locus that is a global regulator of virulence in Staphylococcus aureus. It encodes a two-component transcriptional quorum-sensing (QS) system activated by an autoinducing, thiolactone-containing cyclic peptide (AIP).
Kerry L. LaPlante is an American pharmacist, academic and researcher. She is the Dean at the University of Rhode Island College of Pharmacy. She is a Professor of Pharmacy and former department Chair of the Department of Pharmacy Practice at the University of Rhode Island, an adjunct professor of medicine at Brown University, an Infectious Diseases Pharmacotherapy Specialist, and the Director of the Rhode Island Infectious Diseases Fellowship and Research Programs at the Veterans Affairs Medical Center in Providence, Rhode Island.