Project Summary/Abstract
Scrub typhus is a life-threatening disease caused by Orientia tsutsugamushi, an LPS-negative bacterium. This
bacterium is highly infectious, replicating preferentially in phagocytes and endothelial cells, leaving one third of
world population at risk of infection. Scrub typhus vaccines are not yet available; information on host immune
recognition and disease pathogenesis is limited. Our recently developed mouse models of O. tsutsugamushi
Karp strain infection, which mimic severe infection in human patients, have revealed that excessive type 1, but
deficient type 2, immune responses result in acute vascular damage in multiple organs. Using the NanoString
technology, we examined more than 1,200 immune genes in inflamed tissues (lung, spleen, brain). We found a
significant/selective increase in transcripts of Mincle/Clec4e (a C-type lectin receptor) and STING (a DNA
sensor) during acute/lethal infection in mice and in infected primary phagocyte cultures. The underlying
hypothesis is that Mincle/STING pathway activation in O. tsutsugamushi-infected monocytes are critical for
effector T cell priming, and dysregulated Mincle/STING activation can lead to excessive type 1 inflammation
and acute tissue damage. Aim 1 will test whether sustained bacterial replication can initiate Mincle and STING
activation and trigger their downstream signaling pathways. Both mouse and human primary macrophages and
monocytes will be used for in vitro infection under various conditions with normal or attenuated expression of
Mincle or STING (via siRNA, pharmacological inhibitors, or genetic knockouts). Aim 2 will determine whether
Mincle/STING activation in dendritic cells can effectively prime/activate T effector cells and if Mincle/STING
contribute to dysregulated T-cell responses during Orientia infection. Dendritic cells from Mincle-/- and STING-/-
C57BL/6J mice will be infected and examined for priming naïve CD4 T cells in vitro and in vivo; knockout mice
will receive a non-lethal or lethal Orientia infection. The spectrum of innate and adaptive immune responses
will be evaluated at the single-cell and molecular levels and integrated with those from bacteriologic/pathologic
studies. While Mincle and STING ligands from certain human pathogens or damaged self-components are
reported, the roles of Mincle or STING during Orientia infection have never been explored. This study will
reveal, for the first time, how these innate sensors collectively contribute to host responses to an obligate
intracellular bacterium, which is poorly studied but has public health impact. The feasibility is justified by our
research expertise and BSL3 facilities. Discovery of the nature of initial immune activation/dysfunction will help
reveal signature host profiles for scrub typhus prognosis and potential avenues for pharmacological
intervention. This timely study will have broad implications for other intracellular pathogens.