To investigate how Panton-Valentine leukocidin (PVL)-positive Staphylococcus aureus (PPSA) strains associate with specific bronchial lesions during community-acquired necrotizing pneumonia, we examined PPSA strains and PVL-negative S. aureus (PNSA) strains for their binding behavior to extracellular matrix (ECM) proteins, primary human airway epithelial cell (HAEC) cultures, and human airway mucosa damaged ex vivo. Compared with PNSA strains, PPSA strains exhibited increased affinity for damaged airway epithelium and especially for exposed basement membrane. PPSA strains, compared with PNSA strains, showed stronger affinity for type I and IV collagens and laminin, a property associated with the presence of the cna gene. PPSA and PNSA culture supernatants similarly damaged HAEC layers, whereas recombinant PVL had no effect, suggesting that an S. aureus exoprotein other than PVL might contribute to the observed airway epithelial damage. These results suggest that epithelial damage, possibly due to viral infection (which usually precedes necrotizing pneumonia) and/or to a non-PVL S. aureus exoproduct action, may permit binding of PPSA to exposed type I and IV collagens and laminin--the PVL cytotoxin being involved later during necrotizing pneumonia.
Copyright 2004 Infectious Diseases Society of America