当前位置: 首页 > 医学版 > 期刊论文 > 基础医学 > 感染与免疫杂志 > 2006年 > 第5期 > 正文
编号:11255549
Department of Microbiology and Molecular Genetics, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, ICPH Build
     Departments of Microbiology and Immunology, University of Louisville College of Medicine, Louisville, Kentucky 40292

    ABSTRACT

    The induction of virulence traits by Legionella pneumophila at the post-exponential phase has been proposed to be triggered by the stringent response mediated by RelA, which triggers RpoS. We show that L. pneumophila rpoS but not relA is required for early intracellular survival and replication within human monocyte-derived macrophages and Acanthamoeba polyphaga. In addition, L. pneumophila rpoS but not relA is required for expression of the pore-forming activity. We provide evidence that RpoS plays a role in the modulation of phagosome biogenesis and in adaptation to the phagosomal microenvironment. Thus, there is no functional link between the stringent response and RpoS in the pathogenesis of L. pneumophila.

    TEXT

    In aquatic environments, Legionella pneumophila replicates intracellularly within protozoa (11, 27). Upon transmission to humans, L. pneumophila replicates intracellularly within alveolar macrophages (26, 44). Ultrastructural and molecular studies have shown that intracellular replication of L. pneumophila in amoebae and macrophages exhibits similar features (1, 2, 39). After invasion of a eukaryotic host cell, L. pneumophila diverts its phagosome from the "default" endosomal-lysosomal pathway to establish an endoplasmic reticulum-derived replicative niche (18, 19, 34, 42, 45). The L. pneumophila Dot/Icm type IV secretion system has been shown to be essential for biogenesis of the Legionella-containing phagosome (LCP) in quiescent macrophages (38, 43). However, in gamma interferon-activated macrophages, the LCP fuses to lysosomes and the bacteria fail to replicate (35). Upon termination of intracellular replication, L. pneumophila disrupts the phagosomal membrane and continues to replicate in the cytoplasm prior to lysis of the plasma membrane and egress of the progeny (5, 22, 24, 25, 28, 46).

    The stringent response is initiated in response to various nutritional stresses, including starvation for amino acids, with subsequent accumulation of the stringent response alarmone ppGpp, which is synthesized by RelA (9). Expression of virulence traits by L. pneumophila has been shown to be triggered at the post-exponential (PE) phase and coincides with accumulation of ppGpp and expression of the stationary-phase sigma factor RpoS (8, 15, 16, 29, 41, 47). The ppGpp alarmone has been proposed to trigger two parallel signaling pathways in L. pneumophila, one of which is controlled by RpoS while the other is controlled by the LetA/S two-component regulatory system (6, 15, 29, 30). The two pathways coordinate the induction of several virulence traits at the PE phase (7, 14, 29). The roles of RpoS and RelA in intracellular infection by L. pneumophila have been controversial. Although L. pneumophila RpoS has been shown to be required for intracellular replication in both amoebae and primary mouse macrophages (7, 14, 29), it is dispensable for intracellular replication in the human macrophage-like cell line HL-60 (7, 15). A key role for ppGpp in expression of L. pneumophila virulence traits has been proposed based on expression of a plasmid-borne relA gene of Escherichia coli in L. pneumophila (7, 16). Based on these observations, a model of a signaling cascade at the PE phase has been proposed in which expression of virulence traits (including pore-forming activity/cytotoxicity, motility, and evasion of lysosomal fusion) is triggered by ppGpp synthesized by RelA in response to amino acid starvation (5, 8, 29, 33, 41). A relA mutant has not been utilized to test this proposed model (7, 16). However, Zusman et al. have shown that a relA mutant of L. pneumophila does not produce ppGpp but is not affected in intracellular replication in amoebae and HL-60 human macrophage-like cells (47). It is not known whether L. pneumophila rpoS and relA are required for intracellular replication in human primary macrophages. In addition, it is not documented whether there is a functional link between the stringent response and the virulence regulatory cascade regulated by RpoS in L. pneumophila pathogenesis.

    The virulent clinical isolate of L. pneumophila strain AA100, its isogenic dotA mutant, and their cultivation have been described previously (4, 46). Human monocyte-derived macrophages (hMDMs) were prepared as described previously (36, 37). U937 macrophage-like cells, hMDMs, and Acanthamoeba polyphaga were maintained as we described previously (4, 46). The growth kinetics of L. pneumophila strains in these host cells was determined by using a multiplicity of infection (MOI) of 10 followed by 1 h of gentamicin treatment, as we described previously (13, 23, 46). Transmission electron microscopy of infected amoebae and caspase-3 enzymatic activity assays were carried out as described previously (12, 28).

    The L. pneumophila rpoS and relA genes were amplified by PCR from the genomic DNA of the parental strain AA100 and were cloned individually into the pBC-sk+ plasmid to generate plasmids pBRO and pRL-4, respectively. Mutagenesis of the cloned rpoS gene was carried out using an EZ::TN insertion kit as described by the manufacturer (Epicentre Technologies, Madison, WI). The plasmid generated was designated pBRT. Mutagenesis of the cloned relA gene was carried out by inserting a gentamicin-resistant gene, and the plasmid generated was designated pRL-44. The rpoS mutant strain Lex100 and the relA mutant strain AA100relA– were generated by natural transformation using the pBRT and pRL-44 plasmids, respectively, as we described previously (40). The rpoS relA double-mutant strain Lex100relA– was generated from the rpoS mutant strain Lex100 by natural transformation using the pRL-44 plasmid. Insertion of the EZ::TN transposon and the gentamicin-resistant cassette within the chromosomal rpoS and relA genes, respectively, was confirmed by PCR and Southern blot analysis.

    L. pneumophila rpoS is essential for intracellular replication in amoebae and human monocyte-derived macrophages. L. pneumophila rpoS has been shown to be essential for induction of some PE phase-induced virulence traits such as evasion of lysosomal fusion and intracellular replication in mouse bone marrow-derived macrophages (7, 15). However, it has been shown that L. pneumophila RpoS is not required for intracellular replication in the human macrophage-like cell line HL-60 (15). Similarly, our data show that within U937 macrophages, the L. pneumophila rpoS mutant Lex100 replicated similarly to the parental strain AA100 (data not shown). The intracellular growth kinetics in hMDMs showed that by 24 h after infection, the rpoS mutant strain Lex100 was defective in intracellular replication, like the dotA mutant control (Fig. 1A). However, by 48 h after infection, the number of CFU of the rpoS mutant reached a level similar to those of the parental strain and the complemented strain Lex100/pBRO (Fig. 1A).

    A similar defect in early intracellular survival and replication of the rpoS mutant was also observed in A. polyphaga, and the defect was complemented by wild-type rpoS (Fig. 1C), consistent with previous observations (7, 15). However, compared to hMDMs, the defect of the rpoS mutant was more severe in this protozoan host, since intracellular replication was not detectable up to 48 h postinfection (Fig. 1). This prompted us to investigate the viability of the L. pneumophila rpoS mutant within the first 2 h after infection. Our data showed that the levels of intracellular survival of the rpoS mutant strain Lex100 in hMDMs and A. polyphaga were 10 to 20% of those of the parental strain AA100. Transmission electron microscopy studies revealed that by 24 h after infection, only 3% of the phagosomes harboring the rpoS mutant contained a few bacteria (Fig. 2). The majority of the Lex100-infected amoebae showed phagosomes with structures that are most likely remnants of degraded bacterial cells (Fig. 2). Although the intracellular bacterial numbers for the rpoS mutant were similar to those of the parental strain by 48 h, the mutant never recovered within amoebae. The phagosomes of the rpoS mutant that replicated after 24 h were not different from the wild-type strain phagosomes at 2 to 4 h (data not shown). Taking these findings together, we conclude that L. pneumophila rpoS is required for early survival and intracellular replication of L. pneumophila in hMDMs and amoebae. In addition, rpoS is essential for intracellular replication throughout the intracellular infection of A. polyphaga.

    RelA is dispensable for intracellular replication of L. pneumophila in hMDMs. In response to amino acid starvation upon entry into the PE phase, L. pneumophila accumulates the stringent response alarmone ppGpp (16, 47), which is thought to be the main signal that activates the sigma factor RpoS (7, 17, 29). The proposed role of the stringent response in the induction of L. pneumophila virulence traits is based on gratuitous expression of RelA of E. coli in L. pneumophila and not on relA mutagenesis (7, 16). Zusman et al. have shown that a relA mutant of L. pneumophila does not accumulate ppGpp upon entering into the PE phase, but the relA mutant is not affected in intracellular replication in amoebae and human HL-60 macrophages (47). Thus, there is disagreement on the involvement of the stringent response in triggering L. pneumophila virulence traits and on the proposed functional link between the stringent response and the RpoS signaling cascade. Therefore, we reevaluated the role of relA in intracellular replication of L. pneumophila in hMDMs. We generated a relA mutant and an rpoS relA double mutant and examined their intracellular growth kinetics in hMDMs. The data showed that both the AA100relA– strain and its complemented counterpart AA100relA–/pRL-4 exhibited intracellular replication patterns in hMDMs that were indistinguishable from that of parental strain AA100 (Fig. 1B). In addition, the pattern of intracellular replication of the rpoS relA double-mutant strain Lex100relA– was indistinguishable from that of the rpoS mutant strain Lex100 (Fig. 1A and B). This indicated that L. pneumophila RpoS functions independently of the RelA product in the ability of L. pneumophila to replicate intracellularly. Taking these findings together, we conclude that L. pneumophila rpoS but not relA is required for early survival and intracellular replication in hMDMs.

    L. pneumophila rpoS but not relA is required for of the pore-forming activity. Upon entering the PE phase, L. pneumophila expresses a pore-forming activity that facilitates the egress of L. pneumophila from the spent host cell (5, 22-24). To examine whether L. pneumophila rpoS and/or relA is required for the induction of the pore-forming activity, we carried out contact-dependent hemolysis of erythrocytes, as described previously (5, 20). The data showed that the rpoS mutant Lex100 was severely defective in its pore-forming activity, which was complemented by the wild-type rpoS gene (Fig. 3A). In contrast, both the AA100relA– mutant strain and its complemented strain AA100relA–/pRL-4 exhibited a pore-forming activity level similar to that of the parental strain AA100 (Fig. 3A). The rpoS relA double mutant Lex100relA– showed a pore-forming activity similar to that of the rpoS mutant strain Lex100. The pore-forming activity of the double mutant was complemented by the wild-type rpoS but not by relA (Fig. 3A). Our results indicated that L. pneumophila rpoS but not relA was required for the induction of the pore-forming activity upon entry into the PE phase. This further confirms the lack of a functional link between the stringent response and the RpoS-regulated signaling cascade in L. pneumophila pathogenesis.

    L. pneumophila rpoS is not required for the induction of caspase-3 activation in macrophages. Activation of caspase-3 by L. pneumophila is essential for evasion of the endosomal-lysosomal pathway and intracellular replication (28). To determine whether L. pneumophila RpoS is required for caspase-3 activation, we compared the levels of caspase-3 activation in macrophages infected by the parental strain AA100, the rpoS mutant Lex100, and its complemented strain Lex100/pBRO. Our data showed that unlike the dotA mutant, which is completely defective in activating caspase-3 (46), both Lex100 and Lex100/pBRO activate caspase-3 similarly to the parental strain AA100 (data not shown). Since RelA was dispensable for intracellular replication in hMDMs, the role of the relA gene in caspase-3 activation was not examined.

    Rescue of the rpoS mutant within a communal phagosome harboring the parental strain. The phagosome harboring the replication-defective L. pneumophila rpoS, dotA, and htrA mutants are trafficked through the endosomal-lysosomal degradation pathway (7, 32, 34). The defect of the dot/icm mutants in the modulation of the biogenesis of the LCP is rescued within communal phagosomes remodeled by the parental strain (10). In contrast, the htrA mutant is not rescued within communal phagosomes remodeled by the parental strain, which is due to its defect in adaptation to the phagosomal microenvironment (32). We examined whether the rpoS mutant can be rescued for its defect in intracellular replication within communal phagosomes remodeled by the parental strain. Monolayers of hMDMs were coinfected for 1 h by a green fluorescent protein (GFP)-expressing (21) mutant (rpoS, dotA, or htrA) and/or the DsRed-expressing (31) parental strain AA100 exactly as we described previously (32). Eleven hours after infection, the infected cells were fixed and examined by confocal microscopy. In control single infections, the parental strain AA100 showed replicative phagosomes with 20 to 40 bacteria/phagosome in 75% of infected hMDMs. Both the dotA and htrA mutants were found as single bacteria in most of the hMDMs infected with either mutant. In 65% of communal phagosomes harboring the parental strain and the dotA mutant, the dotA mutant replicated as efficiently as the wild type strain (Fig. 4). In 80% of communal phagosomes harboring the htrA mutant and the parental strain, the mutant failed to replicate (Fig. 4), while in the other 20% of communal phagosomes, the htrA mutant exhibited very weak replication (2 to 6 htrA bacteria/communal phagosome) (data not shown), consistent with previous observations (32). In contrast, the rpoS mutant replicated in 40% of communal phagosomes harboring the parental strain (Fig. 4). The number of rpoS mutant bacteria per communal phagosome was 10 to 20 organisms, which is significantly less (P < 0.01 by the Student t test) than that of the parental strain AA100 (20 to 40 CFU/communal phagosome) (Fig. 4). Our data indicate that L. pneumophila RpoS is involved in Dot/Icm-mediated remodeling of the LCP into a replicative niche and also in adaptation of L. pneumophila to the phagosomal microenvironment, which has been shown to be stressful (3).

    It has been proposed that the stringent response is the primary signal that triggers the expression of virulence traits of L. pneumophila at the PE phase, and some of these traits are regulated by RpoS (6, 29, 30). Expression of these virulence traits at the PE phase prior to egress of intracellular bacteria is essential in order for the progeny released to establish an intracellular proliferative niche within new susceptible host cells, and one of the traits essential for this step is evasion of lysosomal fusion and intracellular replication (7). Here we show that L. pneumophila rpoS but not relA is essential for early survival and intracellular replication in primary human macrophages and amoebae. This indicates that there is no functional link between RpoS and the stringent response in intracellular replication of L. pneumophila.

    Within mouse primary macrophages, the L. pneumophila rpoS mutant resides in a phagosome that acquires the late endosomal-lysosomal marker LAMP-1 (7, 34). Our data indicate that RpoS is involved in Dot/Icm-mediated remodeling of the LCP in hMDMs, as evidenced by rescue of the RpoS mutant for intracellular replication in communal phagosomes remodeled by the parental strain. However, within communal phagosomes, replication of the rpoS mutant is less robust than that of the parental strain or the dotA mutant. Our data suggest a modest role for RpoS in bacterial adaptation to the harsh phagosomal microenvironment (3).

    ACKNOWLEDGMENTS

    Y.A.K. is supported by Public Health Service award R01 AI43965 and the Commonwealth of Kentucky Research Challenge Trust Fund.

    REFERENCES

    1. Abu Kwaik, Y. 1998. Fatal attraction of mammalian cells to Legionella pneumophila. Mol. Microbiol. 30:689-696.

    2. Abu Kwaik, Y. 1996. The phagosome containing Legionella pneumophila within the protozoan Hartmanella vermiformis is surrounded by the rough endoplasmic reticulum. Appl. Environ. Microbiol. 62:2022-2028.

    3. Abu Kwaik, Y., B. I. Eisenstein, and N. C. Engleberg. 1993. Phenotypic modulation by Legionella pneumophila upon infection of macrophages. Infect. Immun. 61:1320-1329.

    4. Abu Kwaik, Y., and N. C. Engleberg. 1994. Cloning and molecular characterization of a Legionella pneumophila gene induced by intracellular infection and by various in vitro stress stimuli. Mol. Microbiol. 13:243-251.

    5. Alli, O. A. T., L.-Y. Gao, L. L. Pedersen, S. Zink, M. Radulic, M. Doric, and Y. Abu Kwaik. 2000. Temporal pore formation-mediated egress from macrophages and alveolar epithelial cells by Legionella pneumophila. Infect. Immun. 68:6431-6440.

    6. Bachman, M. A., and M. S. Swanson. 2004. The LetE protein enhances expression of multiple LetA/LetS-dependent transmission traits by Legionella pneumophila. Infect. Immun. 72:3284-3293.

    7. Bachman, M. A., and M. S. Swanson. 2001. RpoS co-operates with other factors to induce Legionella pneumophila virulence in the stationary phase. Mol. Microbiol. 40:1201-1214.

    8. Byrne, B., and M. S. Swanson. 1998. Expression of Legionella pneumophila virulence traits in response to growth conditions. Infect. Immun. 66:3029-3034.

    9. Chatterji, D., and A. K. Ojha. 2001. Revisiting the stringent response, ppGpp and starvation signaling. Curr. Opin. Microbiol. 4:160-165.

    10. Coers, J., C. Monahan, and C. R. Roy. 1999. Modulation of phagosome biogenesis by Legionella pneumophila creates an organelle permissive for intracellular growth. Nat. Cell Biol. 1:451-453.

    11. Fields, B. S. 1996. The molecular ecology of legionellae. Trends Microbiol. 4:286-290.

    12. Gao, L.-Y., O. S. Harb, and Y. Abu Kwaik. 1998. Identification of macrophage-specific infectivity loci (mil) of Legionella pneumophila that are not required for infectivity of protozoa. Infect. Immun. 66:883-892.

    13. Gao, L.-Y., O. S. Harb, and Y. Abu Kwaik. 1997. Utilization of similar mechanisms by Legionella pneumophila to parasitize two evolutionarily distant hosts, mammalian and protozoan cells. Infect. Immun. 65:4738-4746.

    14. Hales, L. M., and H. A. Shuman. 1999. Legionella pneumophila contains a type II general secretion pathway required for growth in amoebae as well as for secretion of the Msp protease. Infect. Immun. 67:3662-3666.

    15. Hales, L. M., and H. A. Shuman. 1999. The Legionella pneumophila rpoS gene is required for growth within Acanthamoeba castellanii. J. Bacteriol. 181:4879-4889.

    16. Hammer, B. K., and M. S. Swanson. 1999. Co-ordination of Legionella pneumophila virulence with entry into stationary phase by ppGpp. Mol. Microbiol. 33:721-731.

    17. Hammer, B. K., E. S. Tateda, and M. S. Swanson. 2002. A two-component regulator induces the transmission phenotype of stationary-phase Legionella pneumophila. Mol. Microbiol. 44:107-118.

    18. Horwitz, M. A. 1983. Formation of a novel phagosome by the Legionnaires' disease bacterium (Legionella pneumophila) in human monocytes. J. Exp. Med. 158:1319-1331.

    19. Horwitz, M. A. 1983. The Legionnaires' disease bacterium (Legionella pneumophila) inhibits phagosome-lysosome fusion in human monocytes. J. Exp. Med. 158:2108-2126.

    20. Kirby, J. E., J. P. Vogel, H. L. Andrews, and R. R. Isberg. 1998. Evidence for pore-forming ability by Legionella pneumophila. Mol. Microbiol. 27:323-336.

    21. Kohler, R., A. Bubert, W. Goebel, M. Steinert, J. Hacker, and B. Bubert. 2000. Expression and use of the green fluorescent protein as a reporter system in Legionella pneumophila. Mol. Gen. Genet. 262:1060-1069.

    22. Molmeret, M., and Y. Abu Kwaik. 2002. How does Legionella pneumophila exit the host cell Trends Microbiol. 10:258-260.

    23. Molmeret, M., O. A. T. Alli, M. Radulic, M. Susa, M. Doric, and Y. Abu Kwaik. 2002. The C-terminus of IcmT is essential for pore formation and for intracellular trafficking of Legionella pneumophila within Acanthamoeba polyphaga. Mol. Microbiol. 43:1139-1150.

    24. Molmeret, M., O. A. T. Alli, S. Zink, A. Flieger, N. P. Cianciotto, and Y. Abu Kwaik. 2002. icmT is essential for pore formation-mediated egress of Legionella pneumophila from mammalian and protozoan cells. Infect. Immun. 70:69-78.

    25. Molmeret, M., D. Bitar, L. Han, and Y. Abu Kwaik. 2004. Disruption of the phagosomal membrane and egress of Legionella pneumophila into the cytoplasm during the last stages of intracellular infection of macrophages and Acanthamoeba polyphaga. Infect. Immun. 72:4040-4051.

    26. Molmeret, M., D. M. Bitar, L. Han, and Y. A. Kwaik. 2004. Cell biology of the intracellular infection by Legionella pneumophila. Microbes Infect. 6:129-139.

    27. Molmeret, M., M. Horn, M. Wagner, M. Santic, and Y. Abu Kwaik. 2005. Amoebae as training grounds for intracellular bacterial pathogens. Appl. Environ. Microbiol. 71:20-28.

    28. Molmeret, M., S. D. Zink, L. Han, A. Abu-Zant, R. Asari, D. M. Bitar, and Y. Abu Kwaik. 2004. Activation of caspase-3 by the Dot/Icm virulence system is essential for arrested biogenesis of the Legionella-containing phagosome. Cell Microbiol. 6:33-48.

    29. Molofsky, A. B., and M. S. Swanson. 2004. Differentiate to thrive: lessons from the Legionella pneumophila life cycle. Mol. Microbiol. 53:29-40.

    30. Molofsky, A. B., and M. S. Swanson. 2003. Legionella pneumophila CsrA is a pivotal repressor of transmission traits and activator of replication. Mol. Microbiol. 50:445-461.

    31. Otto, G. P., M. Y. Wu, M. Clarke, H. Lu, O. R. Anderson, H. Hilbi, H. A. Shuman, and R. H. Kessin. 2004. Macroautophagy is dispensable for intracellular replication of Legionella pneumophila in Dictyostelium discoideum. Mol. Microbiol. 51:63-72.

    32. Pedersen, L. L., M. Radulic, M. Doric, and Y. Abu Kwaik. 2001. HtrA homologue of Legionella pneumophila: an indispensable element for intracellular infection of mammalian but not protozoan cells. Infect. Immun. 69:2569-2579.

    33. Rowbotham, T. J. 1986. Current views on the relationships between amoebae, legionellae and man. Isr. J. Med. Sci. 22:678-689.

    34. Roy, C. R., K. H. Berger, and R. R. Isberg. 1998. Legionella pneumophila DotA protein is required for early phagosome trafficking decisions that occur within minutes of bacterial uptake. Mol. Microbiol. 28:663-674.

    35. Santic, M., M. Molmeret, and Y. Abu Kwaik. 2005. Maturation of the Legionella pneumophila-containing phagosome into a phagolysosome within gamma interferon-activated macrophages. Infect. Immun. 73:3166-3171.

    36. Santic, M., M. Molmeret, and Y. Abu Kwaik. 2005. Modulation of biogenesis of the Francisella tularensis subsp. novicida-containing phagosome in quiescent human macrophages and its maturation into a phagolysosome upon activation by IFN-. Cell. Microbiol. 7:957-967.

    37. Santic, M., M. Molmeret, K. E. Klose, S. Jones, and Y. A. Kwaik. 2005. The Francisella tularensis pathogenicity island protein IglC and its regulator MglA are essential for modulating phagosome biogenesis and subsequent bacterial escape into the cytoplasm. Cell. Microbiol. 7:969-979.

    38. Segal, G., M. Purcell, and H. A. Shuman. 1998. Host cell killing and bacterial conjugation require overlapping sets of genes within a 22-kb region of the Legionella pneumophila chromosome. Proc. Natl. Acad. Sci. USA 95:1669-1674.

    39. Segal, G., and H. A. Shuman. 1999. Legionella pneumophila utilizes the same genes to multiply within Acanthamoeba castellanii and human macrophages. Infect. Immun. 67:2117-2124.

    40. Stone, B. J., and Y. Abu Kwaik. 1999. Natural competency for DNA uptake by Legionella pneumophila and its association with expression of type IV pili. J. Bacteriol. 181:1395-1402.

    41. Swanson, M. S., and B. K. Hammer. 2000. Legionella pneumophila pathogenesis: a fateful journey from amoebae to macrophages. Annu. Rev. Microbiol. 54:567-613.

    42. Swanson, M. S., and R. R. Isberg. 1995. Association of Legionella pneumophila with the macrophage endoplasmic reticulum. Infect. Immun. 63:3609-3620.

    43. Vogel, J. P., H. L. Andrews, S. K. Wong, and R. R. Isberg. 1998. Conjugative transfer by the virulence system of Legionella pneumophila. Science 279:873-876.

    44. Vogel, J. P., and R. R. Isberg. 1999. Cell biology of Legionella pneumophila. Curr. Opin. Microbiol. 2:30-34.

    45. Wiater, L. A., K. Dunn, F. R. Maxfield, and H. A. Shuman. 1998. Early events in phagosome establishment are required for intracellular survival of Legionella pneumophila. Infect. Immun. 66:4450-4460.

    46. Zink, S. D., L. Pedersen, N. P. Cianciotto, and Y. Abu Kwaik. 2002. The Dot/Icm type IV secretion system of Legionella pneumophila is essential for the induction of apoptosis in human macrophages. Infect. Immun. 70:1657-1663.

    47. Zusman, T., O. Gal-Mor, and G. Segal. 2002. Characterization of a Legionella pneumophila relA insertion mutant and roles of RelA and RpoS in virulence gene expression. J. Bacteriol. 184:67-75.(Alaeddin Abu-Zant, Rexfor)