Abstract:
The present invention relates to  Bartonella henselae  as a component of a pharmaceutical composition for the modulation of the angiogenesis; a nucleic acid molecule that is derived from the gene encoding the  Bartonella henselae  adhesin A protein (BadA), a vector comprising said nucleic acid molecule; a host containing said nucleic acid molecule or said vector; a (poly)peptide encoded by said nucleic acid molecule; a composition comprising  Bartonella henselae  bacteria; a composition comprising aforesaid (poly)peptide; a method for treating a human or animal being in need of the modulation of the angiogenesis, a method for detecting an infection by  Bartonella  in a human or animal being, as well as a method for immunizing a cat.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of copending International Patent Application PCT/EP/2004/012273 filed on Oct. 29, 2004 and designating the United States, which claims priority of German Patent Application DE 103 51 627.1 filed on Nov. 5, 2003, which is incorporated herein by reference. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to  Bartonella henselae  as a component of a pharmaceutical composition for the modulation of the angiogenesis; a nucleic acid molecule that is derived from the gene encoding the  Bartonella henselae  adhesin A protein (BadA), a vector comprising said nucleic acid molecule; a host containing said nucleic acid molecule or said vector; a (poly)peptide encoded by said nucleic acid molecule; a composition comprising  Bartonella henselae  bacteria; a composition comprising aforesaid (poly)peptide; a method for treating a human or animal being in need of the modulation of the angiogenesis, a method for detecting an infection by  Bartonella  in a human or animal being, as well as a method for immunizing a cat. 
     2. Related Prior Art 
     Angiogenesis or neovascularisation refers to a process in which under physiological conditions new blood vessels are sprouting out of the existing vascular system. Angiogenesis can, e.g., be observed during embryogenesis in the corpus luteum (menstruation). Furthermore, angiogenesis has a pathophysiological relevance, it can be observed during the wound healing, in diabetic retinopathy, haemangiomas, psoriasis, as well as in malignant tumors. In this connection, ischaemic diseases are especially relevant, which are very often characterized by a disorder of the angiogenesis. 
     Against this background especially in medicine and pharmacology there is a considerable need for pharmacological effective substances by which the angiogenesis can be modulated. 
     SUMMARY OF THE INVENTION 
     Therefore, the object of the present invention is to provide a substance for modulating the angiogenesis. Furthermore, such a substance should be provided that can easily and cost-effectively be obtained or prepared. 
     According to the invention this object is achieved by the usage of  Bartonella henselae  as a compound of a pharmaceutical composition for the modulation of the angiogenesis. 
     This object can also be realized by the following method, comprising the steps: (a) providing  Bartonella henselae  and (b) formulating  Bartonella henselae  into a pharmaceutically acceptable carrier. 
     The inventors could surprisingly demonstrate that incubating biological replicating material, such as HeLa cells, with  Bartonella henselae  results in an a manipulation of the genetic program of said biological material, that is responsible for the regulation of the angiogenesis. In other words, the inventors have succeeded in demonstrating that  Bartonella henselae  is a substance that is suitable for the targeted modulation of the angiogenesis. 
     The finding that a gram-negative bacterium of the genus  Bartonella , namely  Bartonella henselae , enables the modulation of the angiogenesis and has therewith a therapeutical capacity was especially surprising, since this bacterium is largely described in the art as a trigger for the induction of a number of different diseases:  Bartonella henselae  was detected in the blood of immunosuppressed patients, for example HIV patients. Such patients which were infected by  Bartonella henselae , show symptoms of the bacillary angiomatosis, bacillary peliosis (infestation of viscera), fever, bacteraemia and endocarditis. In immunocompetent hosts  Bartonella henselae  is the main pathogen that causes the so-called cat scratch disease (CSD). 
     It is also known that  Bartonella henselae  stimulates the production of growth factors or cytokines, for example of vascular endothelial growth factor (VEGF; cf. for this Kempf et al. (2001), “Evidence of a leading role for VEGF in  Bartonella henselae -induced endothelial cell proliferations”,  Cell. Microbiol.  3(9), 623-632; Resto-Ruiz et al. (2002), “Induction of a potentional paracrine angiogenetic loop between human THP-1 macrophages and human microvascular endothelial cells during  Bartonella henselae  infection”,  Infection and Immunity  70(8), 4564-4570. 
     However, there are no hints in the art, which demonstrate or even suggest a relation between  Bartonella henselae  and the modulation of the angiogenesis. 
     Within the scope of the invention modulation of the angiogenesis refers to every largely targeted manipulation of the angiogenesis in a human or animal organism or parts or organs thereof, respectively, by  Bartonella henselae  or by parts of this bacterium, such as the stimulation, induction or inhibition of the angiogenesis. 
     It is preferred if the entire bacterium is used for the modulation of the angiogenesis. 
     This means that according to this embodiment the angiogenesis-modulating activity is based on the whole bacterium, the latter, therefore, can be used as such as an effective agent without any further processing measures, for example by performing a targeted infection. This measure has the advantage that the whole bacterium is available in large amounts and can be cultivated and reproduced by means of well-established microbiological methods. 
     According to a preferred embodiment of the invention, for modulating the angiogenesis a genetically modified bacterium is used. 
     A genetically modified bacterium refers to such a  Bartonella henselae  bacterium that differs in its pheno- or genotype in some way from that of the corresponding wild type bacterium. This measure has the advantage, that on the one hand the angiogenesis-modulating activity of the bacterium can be altered by means of molecular biological methods in a targeted fashion, and on the other hand possible pathogenic factors can be simultaneously knocked-out in a targeted fashion. Methods for the genetic modification of the bacterium are well-known in the art; cf. for example Sambrook, J. and Russell, D. W. (2001), “Molecular Cloning—A Laboratory Manual”, Cold Spring Harbor Laboratory Press, New York, 3rd Edition. 
     According to the invention it is also preferred, if a killed bacterium is used for the modulation of the angiogenesis. 
     According to the invention a killed bacterium refers to such a bacterium that has lost its dividing activity and/or metabolic activity, however, such a bacterium is still able to modulate the angiogenesis. This measure has the advantage that such a  Bartonella henselae  bacterium is still in the position for presenting angiogenesis-modulating activity in biological material, as this was found by the inventors, however, it does not evolve any pathogenic activity. 
     According to a variation of the invention, for modulating the angiogenesis a peptide is used, that comprises a fragment of the adhesin A protein of  Bartonella henselae  (BadA). 
     This variation is also realized by the following method, comprising the steps: (a) Providing BadA and (b) formulating BadA into a pharmaceutically acceptable carrier. I.e., the  Bartonella henselae  bacterium is reduced to its BadA protein. 
     The inventors were able to identify a new protein referred to as  Bartonella henselae  adhesin A (BadA) as a crucial bacterial factor that is involved in the modulation of the angiogenesis. BadA is a bacterial protein having a molecular weight of 340 kD, and is encoded by a gene having the length of 9.3 kB. The DNA sequence of the BadA gene is presented in the attached sequence listing and referred to as SEQ ID No. 1. This protein is expressed at the bacterial surface of  Bartonella henselae , and is visible in the electron microscope due to its enormous size. 
     As the inventors have realized, within the scope of the present invention and according to this preferred embodiment, for modulating the angiogenesis a peptide fragment can be used that is characteristic for BadA, i.e. such a fragment that displays the biological activity of BadA, which is responsible for the modulation of the angiogenesis, as, e.g., a segment of the whole protein, that is responsible for the adhesion of the bacterium to the host cells or the endothelial tissue of the host. Segments of the BadA protein which do not contribute to the angiogenesis-modulating activity, such as protein domains which merely serve for anchoring the protein in the membrane can be neglected. It goes without saying, that within the scope of the invention for modulating the angiogenesis also the whole BadA protein can be used, as well as fusion proteins which comprise a corresponding fragment of BadA displaying angiogenesis-modulating activity. With the present invention also the usage of such peptides is encompassed, which comprise a fragment of BadA that is modified compared to the wild type BadA, for example due to modified or substituted amino acids, as long as by this measure the angiogenesis-modulating activity of BadA is not lost. 
     On account of the therapeutical relevance of the findings of the inventors, it is preferred according to the invention if the modulation of the angiogenesis in the afore-mentioned usages occurs within the frame of the treatment of an ischaemic disease. 
     Especially in ischaemic diseases, i.e. such diseases characterized by a decreased or interrupted blood circulation through an organ, a part of an organ or a tissue resulting from disordered arterial blood supply, a targeted modulation of the angiogenesis is envisaged in order to normalize the circulation, that is so far not possible in the art or merely in an unsatisfactory way. Here, the present invention gives remedy by activating or upregulating genetic factors, such as growth factors or cytokines, resulting in the induction of the angiogenesis in an affected patient. 
     This measure has the advantage that herewith especially ischaemic conditions are redressed or reduced, and aid can be given to affected patients in a targeted manner. The inventors were able to show that  Bartonella henselae  or BadA have a special angiogenesis-stimulating potential that results from an up-regulation of different genes inducing the angiogenesis in biological material, if said biological material is incubated together with  Bartonella henselae  or BadA for a certain time, or if cells are infected by  Bartonella henselae.    
     Very often especially in tumor diseases the angiogenesis should be manipulated in a targeted fashion in order to, e.g., modulate or inhibit the blood flow in tumors. Therefore, it is preferred according to the invention, if in the afore-explained usages the modulation of the angiogenesis occurs within the frame of the treatment of a tumor disease. Of course, while doing so further anti-carcinogenic measures can be performed, such as a chemotherapy. 
     In this connection on account of the present invention it is possible to analyze substances which are not known so far in view of their capacity to modulate the angiogenesis by screening these substances in an in vitro assay system. In such an assay system it can be studied whether such substances are competitive with  Bartonella henselae  or BadA, e.g. whether they have a similar, i.e. angiogenesis-stimulating activity, or whether they have an activity that is contradictory to that of  Bartonella henselae  or BadA, and, therefore, inhibit the angiogenesis. 
     Another subject of the present invention relates to a nucleic acid molecule encoding a (poly)peptide that is associated with the modulation of the angiogenesis, said nucleic acid molecule comprises a segment having the sequence SEQ ID No. 1. 
     The sequence SEQ ID No. 1 that is shown in  FIG. 7 , is the sequence of the gene encoding the bacterial adhesin A protein of  Bartonella henselae  (BadA) and has a size of 9.3 kB. According to the invention, the afore-described nucleic acid molecule also encompasses such a molecule that encodes the whole BadA protein but also such a molecule that encodes protein segments which display BadA activity, i.e. angiogenesis-modulating activity. Furthermore, according to the invention also such nucleic acid molecules are meant, which encode (poly)peptides derived from BadA and in which, e.g., different amino acids were replaced or chemically modified, as long as this (poly)peptide still displays BadA activity, i.e. angiogenesis-modulating activity. Furthermore, according to the invention this object also encompasses such a nucleic acid molecule that comprises at its 5′- and/or 3′-ends additional sequences which are independent from SEQ ID No. 1 and which, e.g., serve for the expression, replication, purification, etc. of the genetic information or the (poly)peptide, respectively. 
     Another object of the present invention is a vector that comprises the before-described nucleic acid molecule, i.e. a corresponding genetically modified element, such as a plasmid, virus, bacteriophage or a cosmid, that can be used for transferring and/or inserting the nucleic acid molecule into a host cell. A further object of the invention is a host, such as a bacterium, a cell or an organism, into which the before-described nucleic acid molecule or the vector comprising this nucleic acid molecule was introduced. Besides, the present invention relates to a (poly)peptide that is encoded by the before-described nucleic acid molecule. 
     Against this background the present invention also relates to a composition that comprises  Bartonella henselae  bacteria or the before-explained (poly)peptide that is derived from the  Bartonella henselae  adhesin A protein (BadA) or that corresponds to BadA. 
     In this composition the bacteria can either be present alive or deadened. Moreover, also genetically modified bacteria can be used in this connection. By means of both measures pathogenic factors can be eliminated, whereas the angiogenesis-modulating activity is conserved or is even enhanced. 
     These compositions are preferably pharmaceutical compositions for the modulation of the angiogenesis and comprise a pharmaceutically acceptable carrier as well as, if appropriate, further auxiliary agents. Such pharmaceutical auxiliary agents are well-known in the art; cf. for example A. Kibbe, “Handbook of Pharmaceutical Excipients”, American Pharmaceutical Association and Pharmaceutical Press, 3rd edition (2000). 
     Another object of the present invention is a method for detecting a  Bartonella  infection in a human or animal being, comprising the following steps: (a) providing a biological sample of a living being; (b) analyzing the biological sample for the existence of antibodies against the  Bartonella henselae  adhesin A protein (BadA), and (c) correlating a positive finding in step (b) with an infection by  Bartonella.    
     Up to now, in the art  Bartonella  infections are detected serologically under employment of an immunofluorescence assay. Therefor, for example monkey kidney epithelial cells are co-cultivated with  Bartonella . Subsequently, microscopic slides are covered with the cell lysate that contains whole bacteria and cell debris. These slides were incubated with a serum of a patient. If such a serum contains antibodies against  Bartonella , such antibodies will bind to the intact bacteria and could be visualized by means of a labeled secondary antibody (e.g. anti-human IgG) under fluorescence excitation. The manufacture of such antigen preparations and the performance of such immunofluorescence analyses are very costly, expensive and require special skilled staff and involve several potential sources of error. To the contrary, the before-explained method according to the invention can be easily handled, is reasonably practicable and produces correct results with a high liability. 
     Within the frame of this method, in the biological sample, e.g. in the blood serum, the presence of antibodies against the BadA protein or against fragments of this protein can be detected, i.e. by the usage of patient sera, for example within the frame of an immunoblot via the detection of specific antibodies in the serum, and it can be shown in an indirect way that in these patients an infection by  Bartonella  bacteria has been occurred in the past. 
     Another object of the present invention relates to a method for immunizing a cat against an infection by  Bartonella henselae  and/or BadA, comprising the steps: (a) providing a vaccinable solution containing  Bartonella henselae  and/or BadA, and (b) administering said solution to a cat. 
     The  Bartonella henselae  bacteria can be killed or genetically modified. Furthermore, the BadA protein can be altered or genetically modified as explained above in more detail. Step (b) can be repeated for several times until an activation of the immune system has taken place. 
     By this method it is ensured that cats as the main carrier of  Bartonella henselae  and causers of the cat scratch disease (CSD), will no longer be receptive for an infection by  Bartonella henselae  and, therefore, humans who are in contact with those cats are not endangered for becoming infected due to transmission of the bacterium from these cats. 
     It is to be understood that the features recited above and those yet to be explained below can be used not only in the respective combination indicated, but also in other combinations or in isolation, without departing from the scope of the present invention. 
     The present invention is now explained in more detail by means of embodiments, from which further advantages arise. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  the progress of an infection of HeLa cells by  Bartonella henselae , analyzed by confocal laser scanning microscopy; 
         FIG. 2  the induction of proangiogenetic host cell transcripts and proteins in HeLa cells after an infection by  Bartonella henselae;    
         FIG. 3  the activation of HIF-1α in HeLa cells after an infection by  Bartonella henselae;    
         FIG. 4  the activation of HIF-1α in BA-patients&#39; samples; 
         FIG. 5  the preservation of the viability of HeLa cells after an infection by  Bartonella henselae;    
         FIG. 6  the induction of proangiogenetic factors in HeLa cells after an infection by  Bartonella henselae  depending on BadA; 
         FIG. 7A-D  the nucleotide sequence SEQ ID No. 1 that is derived from BadA; 
         FIG. 8  the adhesion of  Bartonella henselae  depending on BadA, and 
         FIG. 9  the immunoreactivity of sera of CSD patients, a rabbit infected with viable  Bartonella henselae , and a mouse immunized with heat-killed  Bartonella henselae , for BadA. 
     
    
    
     DESCRIPTION OF PREFERRED EMBODIMENTS 
     Example 1 
     Induction of a Genetic Program that Modifies the Angiogenesis by  Bartonella henselae    
     The inventors have infected HeLa cells with  Bartonella henselae . 6 hours after the infection, these cells were compared to non-infected HeLa cells in a standard RNA microarray analysis (AFFYMETRIX MICROARRAY SUITE 5.0; AFFYMETRIX DATA MINING TOOL 3.0) in order to determine whether the infection results in an alteration of the genetic program of the cells. The infection itself was controlled by means of confocal laser scanning micros-copy. The result of such a microscopic analysis is shown in  FIG. 1 . 
     The left picture of the infected HeLa cells in  FIG. 1  reflects the situation 1 hour, the picture in the middle 3 hours, and the right picture 6 hours after infection. The light structures which are located in the cytoplasm and which can be clearly seen in the central and the right picture correspond to bacteria which were detected by means of FITC-conjugated antibodies which were directed against the bacterium. The analysis of these pictures revealed that 6 hours after the infection&gt;99% of the HeLa cells were infected. 
     The RNA microarray analysis showed that in the HeLa cells at least 7 genes were more than twofold up-regulated, which, as this has been described, are involved in the regulation of the angiogenesis and the vascularisation: Interleukin-8 (IL-8, 6,41-fold induction), Stanniocalcin-2 (STC2, 5,16-fold induction), Adrenomedullin (ADN, 3,88-fold induction), Ephrin A1 (EFNA1, 3,74-fold induction), Vascular Endothelial Growth Factor (VEGF, 3,54-fold induction), Insulin-like Growth Factor-Binding Protein-3 (IGFBP-3, 2,67-fold induction) and Endothelin 2 (ET-2, 2,13-fold induction). Except of IL-8 all of the analyzed induced genes are directly or indirectly regulated via the Hypoxia Inducible Factor-1 (HIF-1), the key transcription factor of the angiogenesis, suggesting that the main trigger for the induction of the genetic program by  Bartonella henselae  that modifies the angiogenesis, is HIF-1. 
     The results which were obtained from RNA microarray analysis were verified by means of a quantitative real-time PCR or a semi-quantitative RT PCR, and on a protein level by means of Western blotting. The result of such an experiment is shown in  FIG. 2 . 
     For this, HeLa cells were infected by  Bartonella henselae  ( B.h. ), the total RNA was extracted 6 h after the infection and was transcribed into cDNA. The gene induction was evaluated by means of real-time PCR (VEGF, IL-8) or RT PCR (ADM, IGFBP-3, HK2). In order to determine the level of secreted protein, cells were infected and the supernatants of the cell cultures were analyzed 48 h after the infection by ELISA [VEGF (VEGF 165 -ELISA-Kit, Quantikine, R &amp; D Systems, Wiesbaden); IL-8 (Schulte et al. (2000), “ Yersinia enterocolitica  invasin protein triggers IL-8 production in epithelial cells via activation of Rel p65-p65 homodimers”,  FASEB J  14, 1471-1484)] or RIA [ADM (RKD10-10, Phoenix Pharmaceuticals, Karlsruhe, Germany); IGFBP-3 (Blum et al. (1990), “A specific radioimmunoassay for the growth hormone (GH)-dependent somatomedin-binding protein: its use for diagnosis of GH deficiency”,  J Clin. Endocrinol. Metab  70, 1292-1298)]. For Western blotting [HK2 (antibody SC6521, Santa Cruz)] 8 h after the infection cell extracts were prepared. C: Control, non-infected cells. 
     Also, these results verify the findings of the inventors, that an incubation of biological material, or an infection of HeLa cells with  Bartonella henselae  result in an induction of a genetic program that modifies angiogenesis. The level of mRNA and of protein of all angiogenesis-modulating factors which have been analyzed, were clearly increased after the infection. 
     Example 2 
     Activation of HIF-1 by  Bartonella henselae    
     In the following, the inventors have examined whether the transcription factor HIF-1 is also be induced in the host cell after an infection by  Bartonella henselae  has taken place. The results of corresponding experiments are shown in  FIG. 3 . 
     Picture (a) shows the detection of HIF-1 protein in HeLa cells 4 h after the infection by means of immunofluorescent staining under the usage of monoclonal antibodies which are specifically directed against HIF-1α (MB100- 131, Novus Biologicals, Littleton, Colo., USA) and TRITC-labeled secondary antibodies (Dianova, Hamburg, Germany), (upper row). The nuclei and bacteria were stained by DAPI (lower row). The depicted bar corresponds to 20 μm. It can be seen that 4 h after the infection with  Bartonella henselae  in the infected HeLa cells HIF-1α-associated signals appear in the nucleus ( B.h. , central picture, light structures). This response can also be seen in hypoxia-treated cells (cf. Raleigh et al. (1998),  Cancer Res.  58, 3765-3768), (H, right picture). In contrast, in non-infected HeLa cells virtually no HIF-1α can be detected (C, left picture). 
     The induction of HIF-1α protein in the HeLa cells was also verified by means of Western blots which were performed 4 h after the infection. The so obtained results ( FIG. 3   b ) are consistent with those resulting from the immunofluorescence analysis. Here also a clear increase of the HIF-1α protein level can be observed in the HeLa cells 3 h after the infection by  Bartonella henselae , whereas in non-infected control cells virtually no HIF-1α protein could be detected (cf. lanes 3-6 compared to 1 and 2). 
     The activation of HIF-1α was also verified by means of electromobility shift assays (EMSA) under usage of nucleic extracts ( FIG. 3   c ). In competition experiments, nucleic extracts of  Bartonella henselae -infected HeLa cells were incubated with a labeled HIF-1α probe in the presence of a 100-fold excess of non-labeled competitor probe (comp.). It follows that the transcription factor HIF-1 is in fact present in the nucleus and can bind to the corresponding target sequences of the host cell DNA. 
     In transfection experiments in which a VEGF promoter luziferase reporter was used, that is specifically regulated by HIF-1 (cf. Ikeda et al., (1995),  J Biol. Chem.  270, 19761-19766) it turned out that the infection of HeLa cells by  Bartonella henselae  ( B.h. ) results in a VEGF gene transcription that is increased to a 3- to 4-fold level; by hypoxia (H) an 8- to 20-fold stimulation can be observed ( FIG. 3   d ). 
     By the results which are shown in  FIG. 3  arising from four independent methods it is demonstrated by the inventors, that by  Bartonella henselae  a modulation or activation of the angiogenesis occurs via an up-regulation of the HIF-1 transcription factor. 
     Example 3 
     Activation of HIF-1 in BA Biopsy Specimen 
     In order to analyze whether also in vivo in  Bartonella henselae -infected tissues a HIF-1 activation occurs, sections of histological verified BA (bacillary angiomatosis) or BP (bacillary peliosis) lesions were examined for HIF-1α. The result of a corresponding experiment is shown in  FIG. 4 . 
     Picture (a) shows the analysis of the skin of a non-affected control person, and in pictures (b) and (c) the analysis of two histologically verified BA patients&#39; samples are shown. For the detection of HIF-1α in the tissues a labeled antibody was used that is directed against HIF-1α (MB100-131, loc. cit.). It could be shown that in the patient samples (pictures (b), (c)) HIF-1α was very clearly present in the nuclei of histiocytes or macrophages which have infiltrated the BA lesions, whereas in the control tissue (picture (a)) the HIF-1α-associated signal is much weaker (see arrows). 
     These results prove that by an incubation or infection of biological material, such as for example HeLa cells, with  Bartonella henselae  a modulation of the angiogenesis via the induction of HIF-1 is not only possible in vitro, but also in vivo. 
     Example 4 
       Bartonella henselae -infected HeLa Cells are Viable 
     HeLa cells were infected by  Bartonella henselae  and by  Y. enterocolitica  and the cellular morphology and the cellular viability was evaluated 12, 24 and 48 h after the infection. The result of such an experiment is shown in  FIG. 5 . 
     Picture (a) shows the evaluation of a Giemsa staining and picture (b) the evaluation of a MTS assay (CELLTITER-96 AQ NEOUS ; Promega, Mannheim, Germany). The viability of non-infected control cells (C) was set to 100%. Each calculated value corre-sponds to the average out of three samples of each group. * indicates a significant difference compared to the control (p&lt;0.05). 
     It arises from this experiment that the infection of the HeLa cells by  Bartonella henselae  ( B.h. ) up to 45 h after the infection does not result in a decrease of the cellular viability (cf.  FIG. 3   a , central column;  FIG. 3   b , central lanes). To the contrary, the cellular viability was dramatically decreased after an infection by  Y. enterocoliticia  ( Y.e. ) (cf.  FIG. 3   a , right column,  FIG. 3   b , right lanes). 
     This experiment indicates the pharmacological tolerance or suitability of  Bartonella henselae  and its therapeutical potential as an active agent of a pharmaceutical composition. 
     Example 5 
     Induction of an Angiogenesis-modifying Genetic Program by the Adhesin A Protein of  Bartonella henselae  (BadA) 
     Since the before-shown experiments demonstrate that the incubation or infection of biological material, such as HeLa cells or tissues, by  Bartonella henselae  results in an up-regulation of angiogenesis-modifying genes, which are controlled by the key transcription factor of the angiogenesis HIF- 1, it was also analyzed by the inventors, whether a specific bacterial protein can be found that is responsible for this biological effect. In connection with this it was also tested, whether the surface protein of  Bartonella henselae , BadA, having a molecular weight of 340 kD and that has been detected by the inventors, is involved in the modulation of the angiogenesis or the up-regulation of angiogenesis-modulating host cell components, such as the Vascular Endothelial Growth Factor (VEGF), Interleukin-8 (IL-8), Insulin-like Growth Factor Binding Protein-3 (IGFBP-3). In these experiments two mutants of  Bartonella henselae  were used, which do not express the BadA protein (BadK mutants), as well as wild type  Bartonella henselae  as a control. With these  Bartonella henselae  bacteria HeLa cells were infected and cultivated, the cell culture supernatants were removed 8, 24, 48 and 72 h after the infection, centrifuged and frozen at −20° C. The VEGF concentration in the supernatants was determined by the usage of a human VEGF 165  ELISA Kit (cit. loc.), IL-8 was determined by means of ELISA, as described in Schulte et al. (cit. loc.). The IGFBP-3 that was secreted into the cell culture supernatant was measured under the usage of a specific RIA, cf. concerning this Blum et al. (cit. loc). The result of such an experiment is shown in  FIG. 6 . 
     This experiment shows that an infection of HeLa cells by the two BadA −  mutants (-♦- first mutant; -▴- second mutant) does not result in any increase of the production of angiogenesis-modulating factors, whereas the infection by wild type  Bartonella henselae  (-▪-) causes a clear increase of angiogenesis-modulating cytokines in the correspondingly infected HeLa cells. 
     In further experiments the BadA− mutants were complemented by the introduction of an expression vector that expresses functional BadA protein, i.e. the mutants were subsequently again in the condition to synthesize BadA and to insert it into the membrane. While performing the before-mentioned experiment, it could be demonstrated that such complemented BadA− mutants are again in the condition to stimulate the production of angiogenesis-modulating factors, such as VEGF (data not shown). 
     It follows that BadA is a crucial bacteria factor of  Bartonella henselae  that is responsible for modulating the angiogenesis and, therewith, is suitable as an active agent in a pharmaceutical composition for the modulation of the angiogenesis. 
     The DNA nucleotide sequence encoding the bacterial BadA protein is indicated as SEQ ID No. 1 and shown in  FIG. 7 . As usual, the presentation starts with the 5′-end that comprises the initiation codon (ATG), and extends to the 3′-end that comprises the stop codon (TAA). The last 111 nucleotides at the 3′-end encode the so-called membrane anchor domain that is responsible for insertion of the protein into the bacterial membrane. 
     Example 6 
     BadA as the Key Factor in the Adhesion of  Bartonella henselae  to Endothelial Cells 
     After that, the inventors have analyzed whether BadA is involved in the adhesion of  Bartonella henselae  to endothelial cells, among other things in order to get information about the possible mode of action of the modulation of the angiogenesis. 
     For this, endothelial cells were infected by the before-mentioned  Bartonella henselae  bacteria (wild type, two different BadA −  mutants) and 30 min after the infection the amount of adhering bacteria was determined. For doing this, the cell culture supernatants were carefully removed, the cells were thoroughly washed with Clicks (RPMI 1640 medium), lysed and the total amount of adhering bacteria was determined. The results of such an experiment are shown in  FIG. 8 . 
     In the upper illustrations as a control it is demonstrated by transmission electron microscope that wild type  Bartonella henselae  expresses, as expected, BadA on its surface (see arrows, left picture), whereas the two BadA −  mutants do not express any BadA (central and right picture). 
     Furthermore, it is shown by this experiment that a BadA −  mutation results in a dramatical decrease of the adhesion of the corresponding mutant to endothelial cells (lower picture; compare central and right column to left column). 
     The before-described observations concerning the adhesion of the wild type or genetically modified  Bartonella henselae  bacteria, were also verified by means of immunofluorescence analysis via laser scanning microscopy staining (data not shown). 
     In further experiments, the BadA −  mutants were complemented by the introduction of an expression vector that expresses functional BadA protein (cf. example 5). While performing these before-explained experiments it turned out that such complemented BadA −  mutants are again in the position to adhere to endothelial cells. It could also be demonstrated that BadA −  mutants, in contrast to  Bartonella henselae  wild type bacteria, were no more able to bind to fibronectin and collagen. This loss was recovered by the introduction of the above-mentioned BadA encoding expression vector into the mutants (data not shown). 
     These results indicate that the modulation of the angiogenesis by  Bartonella henselae  is mediated by the adhesion of BadA to the biological material, for example to the endothelial cells. 
     Example 7 
     BadA as a Diagnostic Marker for Infections by  Bartonella    
     In another experiment the inventors have analyzed whether antibodies directed against BadA can be found in human sera of patients who are affected by an infection with  Bartonella henselae , or of rabbits and mice infected with viable or heat-killed  Bartonella henselae.    
     For this wild type bacteria of  Bartonella henselae  and BadA −  mutants of  Bartonella henselae  were separated by electrophoresis and transferred onto a blotting membrane. The membrane was incubated with human sera which came from patients suffering from cat scratch disease (CSD), or from healthy control patients, or from infected rabbits and mice. The result of such an experiment is depicted in  FIG. 9 . 
     In the respective upper lanes wild type bacteria lysate (WT) was separated, whereas in the respective lower lanes BadA −  bacteria lysate (BadA − ) was separated, blotted and afterwards incubated with sera of CSD patients, sera of rabbits infected by viable  Bartonella henselae , or sera of mice infected by heat-killed  Bartonella henselae . In the lowest two lanes, wild type and BadA −  bacteria lysate were separated and incubated with serum of a healthy control person. 
     The arrow indicates the position of the separated BadA. It can be seen that by means of the sera that came from a CSD-affected patient (patient), or infected mice or rabbits, BadA protein is detected, consequently their immune systems have produced antibodies against the BadA protein, whereas in the human serum that came from the healthy control person (Kontr.) no antibodies against BadA are contained and therefore no immunoreactive band on the level of the BadA protein appears. Since the BadA −  mutants do not comprise any BadA protein no immunoreactive band on the level of the BadA protein can be found. 
     In total, seven out of eleven sera coming from CSD patients showed a reactivity against BadA, compared to one out of nine sera coming from healthy control persons. 
     These experiments demonstrate that BadA is a suitable diagnostic marker for identifying  Bartonella  infections.