Abstract 153: Molecular Mimicry Between Malondialdehyde and Group A Streptococcus Contribute to the Natural Selection of Conserved Innate Immune Response

Innate immunity utilizes evolutionarily conserved pattern recognition receptors (PRRs) to provide an early and effective response against Pathogen-Associated Molecular Patterns (PAMPs) on microbial pathogens and/or against Danger Associated Molecular Patterns (DAMPs) on endogenous modified-self structures. Atherosclerosis is a chronic inflammatory disease in which lipid peroxidation is greatly increased leading to the generation of OxLDL, which contains a variety of proinflammatory oxidation-specific neoepitopes (OSE), such as phosphocholine (PC) containing oxidized phospholipids (OxPL). Our group has shown that OSEs are DAMPs, to which has evolved a concerted innate immune response mediated by PRRs. For example, CD36, CRP and IgM E06 all recognize the PC of OxPL, but also the PC on apoptotic cells as well as the PC on the cell wall of S. pneumonia (but not as part of a lipid). Accordingly, we postulated that both endogenous DAMPs and exogenous PAMPs provide natural selection for PPR responses to PC. Malondialdehyde (MDA) is another prominent OSE target of three different PRR’s: SR-A, CFH, and the IgM NAb E014. Thus, we hypothesized that EO14 should also recognize an epitope/mimotope on an infectious pathogen. We screened a pathogen library with E014 and discovered it avidly bound to group A streptococcus (GAS). Because it was known that CFH also bound to GAS, and specifically to protein M, the major virulence factor of GAS, we used GAS with and without protein M to show that E014 specifically bound to protein M. Using a series of recombinant protein M fragments, we identified a 125 aa sequence required for binding. Using a synthetic peptide array to generate 15 aa-length overlapping peptides, we identified a 24 aa mimitope that E014 bound. We subsequently showed immunological cross reactivity between GAS, Protein M, the mimotope, and MDA in vitro and in vivo in mice and humans. Further, compared to immunization of mice with protein M, immunization with MDA-LDL provided partial protection against lethal infection with GAS. These data support the hypothesis that OSE are important targets of innate immunity and both oxidative events and pathogens have contributed to the natural selection of potent, shared innate immune responses to oxidation-specific epitopes.