VARIOUS ADHERENT-INVASIVE E. COLI (AIEC) AND NON-AIEC STRAINS ISOLATED FROM CROHN’S DISEASE PATIENTS GROW DIFFERENTLY WITH RUMINOCOCCUS GNAVUS PRE-DIGESTED MUCUS AND R. GNAVUS-RELEASED PRE-DIGESTED ILEAL AND COLONIC MUCUS MONOSACCHARIDES
Authors: Kashiwagi Saori , Dogan Belgin , Perez-Orozco Sebastian , Choudhury Biswa , Gray Simon , Winter Sebastian , Simpson Kenneth , Sartor R Balfour 
Published: January 2024

Abstract

BACKGROUND
Mucus-digesting Ruminococcus gnavus (R. gnavus), adherent-invasive E. coli (AIEC), and hydrogen sulfide (H2S) are enriched in active Crohn’s disease (CD) patients compared to healthy subjects. Dual colonization of R. gnavus and E. coli LF82 in ex-germ-free mice enhanced distal colitis and H2S production in cecal contents. R. gnavus pre-digestion of mucus enhanced the ileal CD isolate AIEC LF82 growth and H2S production in vitro. H2S enhanced LF82 adhesion and invasion both in vitro and in vivo along with related LF82 adhesion gene expression and Caco-2 cell expression of CEACAM6, a receptor for AIEC ligand FimH. Interactions between other CD-derived AIEC/non-AIEC and R. gnavus are unknown.

HYPOTHESIS
Different AIEC and non-AIEC may grow and produce H2S differently using mucus digested by R. gnavus, which releases mucus-derived monosaccharides and sulfur substrates.

METHODS
We studied CD-derived clinical isolates of AIEC 541-15 (phylotype A), 541-1 (B1), LF82 and NRG857c (B2) and non-AIEC T75 (A) and lab strain K12 (A). M9 minimal media was supplemented with porcine gastric mucin (PGM), ileal (MIM) and colonic (MCoM) mucus isolated from germ-free mice. We measured growth kinetics and H2S production by these AIEC and non-AIEC following culture with sterile supernatants of each mucin/mucus media precultured with or without R. gnavus, monosaccharides obtained by R. gnavus digestion of mucus, and several sulfur substrates in the gut added to M9 minimal media.

RESULTS
AIEC, especially LF82 (B2), grew better with ileal mucus aerobically and, to a lesser extent, anaerobically than non-AIEC strains, with even greater AIEC growth with R. gnavus pre-digested mucus (Fig.1). AIEC produced more H2S with R. gnavus-precultured mucus than with mucus alone. R. gnavus digestion of PGM released mucus monosaccharides (Fig.2A). AIEC strains grew differently with each monosaccharide constituent of R. gnavus pre-digested PGM. AIEC grew better than non-AIEC with each monosaccharide in aerobic conditions, but AIEC (B2) grew better than others in all monosaccharides in anaerobic conditions (Fig.2B). Amongst mucus-relevant sulfur substrates, L-cysteine was the only substrate to enhance E. coli H2S production by all AIEC and non-AIEC strains. All mucus-relevant sulfur substrates supported R. gnavus survival for 24 hrs, while H2S sustained R. gnavus for 48 hrs in minimum media.

CONCLUSIONS
AIEC grew better and produced more H2S with R. gnavus pre-digested mucus suggesting that co-existence of AIEC with R. gnavus mutually support each other and may explain why they are often observed together in active CD patients. In addition, enhanced AIEC growth with ileal vs. colonic mucus may explain why AIEC are frequently isolated from ileal CD patients. AIEC phylotype growth differences with mucus substrates may explain their persistence in the ileal mucosa.

Figure 1

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