Enterohemorrhagic Escherichia coli colonization of human colonic epithelium in vitro and ex vivo

Enterohemorrhagic E. coli (EHEC) are important foodborne pathogens causing gastroenteritis and more severe complications such as hemorrhagic colitis and hemolytic uremic syndrome. Pathology is most pronounced in the colon, but to date there is no direct clinical evidence showing EHEC binding to colonic epithelium in patients. In this study, we investigated EHEC adherence to the human colon by using in vitro organ culture (IVOC) of colonic biopsies and polarized T84 colon carcinoma cells. We showed for the first time that EHEC colonized human colonic biopsies by forming typical attaching/effacing (A/E) lesions which were dependent on EHEC type III secretion (T3S) and binding of the outer membrane protein intimin to the Translocated intimin receptor (Tir). A/E lesion formation was dependent on oxygen levels and suppressed under oxygen-rich culture conditions routinely used for IVOC. In contrast, EHEC adherence to polarized T84 cells occurred independently of T3S and intimin and did not involve Tir translocation into the host cell membrane. Neither colonization of biopsies nor T84 cells was significantly affected by expression of Shiga toxins. Our study suggests that EHEC colonize and form stable A/E lesions on the human colon which is likely to contribute to intestinal pathology during infection. Furthermore, care needs to be taken when using cell culture models as they might not reflect the in vivo situation.