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The genus Mycobacterium includes species ranging from harmless saprophytic organisms to major human pathogens. Well-known pathogenic species such as Mycobacterium tuberculosis, Mycobacterium marinum and Mycobacterium ulcerans belong to the subgroup of slow-growing mycobacteria (SGM). In contrast, the subgroup of rapid-growing mycobacteria (RGM) is characterized by their ability to form visible colonies in less than 7 days on agar medium. The RGM group comprises more than 180 species, mainly non-pathogenic saprophytic mycobacteria. Studies on RGM interactions with their hosts have mainly focused on Mycobacterium smegmatis and demonstrate that these mycobacteria are rapidly eliminated by the bactericidal action of macrophages.
Mycobacterium abscessus is one of the rare RGM that are pathogenic to humans and is responsible for a wide range of infections ranging from the skin and soft tissue infections to the pulmonary and disseminated infections. M. abscessus is considered, along with Mycobacterium avium, to be the main mycobacterial pathogen in cystic fibrosis patients1.
Various studies performed on M. abscessus indicate that this mycobacterium behaves like an intracellular pathogen, capable of surviving the bactericidal response of macrophages and fibroblasts in the lungs and skin, which is not usually observed in RGM2,3,4. M. abscessus genome analysis has identified metabolic pathways typically found in environmental microorganisms in contact with the soil, plants and aquatic environments, where free amoebae are often present5. They have also demonstrated that M. abscessus is endowed with several virulence genes not found in the saprophytic and non-pathogenic RGM, probably acquired by the horizontal gene transfer in a niche favorable to genetic exchange that might gather various amoeba resistant bacteria.
Experimentally, one of the first striking results was the observation of intracellular growth of M. abscessus in macrophages as well as for M. tuberculosis6. M. abscessus also resists the acidification of the phagosome, apoptosis and autophagy, three essential mechanisms of the cellular resistance to the infection2. It has even been shown that M. abscessus is able to establish an immediate communication between the phagosome and the cytosol, a more nutrient-rich environment that might favor bacterial multiplication2. Very little is known about the genomic advantages that M. abscessus possesses or has acquired to allow survival in an intracellular environment. Amoeba coculture is an efficient method that allowed the isolation of many new amoeba resistant bacteria as Mycobacterium massiliense7,8. An ability to multiply within amoebae was observed, in a model of aerosolization of M. abscessus in mice, which can confer an increased virulence to M. abscessus4. One hypothesis is that M. abscessus had developed genetic traits encountered within this environment to survive in phagocytic cells, which are different from other non-pathogenic RGM. These acquisitions might favor the ability to spread and its virulence in the human host.
This report describes tools and methods to highlight the genomic advantages conferred to M. abscessus to survive in the amoebae environment. For this purpose, the screening of M. abscessus transposon mutants is first described, on the Acanthamoeba castellanii type strain, which allows the identification of mutant's defective for intracellular growth. A second screening in macrophages is also reported, to confirm if this defect persists in the human host. Secondly, to understand which mechanisms are harnessed in M. abscessus to adapt to life in phagocytic cells and increase its virulence in the animal host, a method specifically adapted for M. abscessus was developed, after co-culture in the presence of amoebae that allowed the extraction of total RNA from intra-amoebal bacteria. As a consequence, a comprehensive view of M. abscessus genes that are required for an intracellular life was developed.