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Comparative Life Cycle Transcriptomics Revises Genome Annotation and Links a Chromosome Duplication with Parasitism of Vertebrates


Leishmania are single-celled parasites that are transmitted between animal hosts by the bite of sand flies. Once inside their animal hosts they abandon their extracellular habit and invade cells of the immune system, called macrophages. This oscillation between hosts requires the parasite to be able to adapt to dramatically different environments. To help unravel the multitude of biochemical, ultrastructural and lifestyle differences that distinguish these specialised life cycle stages we characterised and contrasted the transcriptomes of insect and mammalian adapted forms. Using bioinformatic approaches we revised the genome annotation and discovered nearly 1,000 new genes that had not been described before. We found that over 3,000 genes change in their expression to facilitate the change in host environment including those involved in specifying cell shape, extracellular appearance and biochemistry. Furthermore we reveal that an ancient chromosome duplication shared by all Leishmania species may have contributed to the adaptation of these globally important parasites to parasitism of vertebrates.


Vyšlo v časopise: Comparative Life Cycle Transcriptomics Revises Genome Annotation and Links a Chromosome Duplication with Parasitism of Vertebrates. PLoS Pathog 11(10): e32767. doi:10.1371/journal.ppat.1005186
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.ppat.1005186

Souhrn

Leishmania are single-celled parasites that are transmitted between animal hosts by the bite of sand flies. Once inside their animal hosts they abandon their extracellular habit and invade cells of the immune system, called macrophages. This oscillation between hosts requires the parasite to be able to adapt to dramatically different environments. To help unravel the multitude of biochemical, ultrastructural and lifestyle differences that distinguish these specialised life cycle stages we characterised and contrasted the transcriptomes of insect and mammalian adapted forms. Using bioinformatic approaches we revised the genome annotation and discovered nearly 1,000 new genes that had not been described before. We found that over 3,000 genes change in their expression to facilitate the change in host environment including those involved in specifying cell shape, extracellular appearance and biochemistry. Furthermore we reveal that an ancient chromosome duplication shared by all Leishmania species may have contributed to the adaptation of these globally important parasites to parasitism of vertebrates.


Zdroje

1. Stuart K, Brun R, Croft S, Fairlamb A, Gurtler RE, et al. (2008) Kinetoplastids: related protozoan pathogens, different diseases. J Clin Invest 118: 1301–1310. doi: 10.1172/JCI33945 18382742

2. Jaskowska E, Butler C, Preston G, Kelly S (2015) Phytomonas: Trypanosomatids Adapted to Plant Environments. PLoS Pathog 11: e1004484. doi: 10.1371/journal.ppat.1004484 25607944

3. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD, et al. (2012) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380: 2197–2223. doi: 10.1016/S0140-6736(12)61689-4 23245608

4. Pace D (2014) Leishmaniasis. J Infect.

5. Alvar J, Velez ID, Bern C, Herrero M, Desjeux P, et al. (2012) Leishmaniasis worldwide and global estimates of its incidence. PLoS One 7: e35671. doi: 10.1371/journal.pone.0035671 22693548

6. Peacock CS, Seeger K, Harris D, Murphy L, Ruiz JC, et al. (2007) Comparative genomic analysis of three Leishmania species that cause diverse human disease. Nat Genet 39: 839–847. 17572675

7. Rogers MB, Hilley JD, Dickens NJ, Wilkes J, Bates PA, et al. (2011) Chromosome and gene copy number variation allow major structural change between species and strains of Leishmania. Genome Res 21: 2129–2142. doi: 10.1101/gr.122945.111 22038252

8. Downing T, Imamura H, Decuypere S, Clark TG, Coombs GH, et al. (2011) Whole genome sequencing of multiple Leishmania donovani clinical isolates provides insights into population structure and mechanisms of drug resistance. Genome Res 21: 2143–2156. doi: 10.1101/gr.123430.111 22038251

9. Mannaert A, Downing T, Imamura H, Dujardin JC (2012) Adaptive mechanisms in pathogens: universal aneuploidy in Leishmania. Trends Parasitol 28: 370–376. doi: 10.1016/j.pt.2012.06.003 22789456

10. Gluenz E, Hoog JL, Smith AE, Dawe HR, Shaw MK, et al. (2010) Beyond 9+0: noncanonical axoneme structures characterize sensory cilia from protists to humans. FASEB J 24: 3117–3121. doi: 10.1096/fj.09-151381 20371625

11. Wu Y, El Fakhry Y, Sereno D, Tamar S, Papadopoulou B (2000) A new developmentally regulated gene family in Leishmania amastigotes encoding a homolog of amastin surface proteins. Mol Biochem Parasitol 110: 345–357. 11071288

12. Opperdoes FR, Coombs GH (2007) Metabolism of Leishmania: proven and predicted. Trends Parasitol 23: 149–158. 17320480

13. McConville MJ, Naderer T (2011) Metabolic pathways required for the intracellular survival of Leishmania. Annu Rev Microbiol 65: 543–561. doi: 10.1146/annurev-micro-090110-102913 21721937

14. Paramchuk WJ, Ismail SO, Bhatia A, Gedamu L (1997) Cloning, characterization and overexpression of two iron superoxide dismutase cDNAs from Leishmania chagasi: role in pathogenesis. Mol Biochem Parasitol 90: 203–221. 9497044

15. Isnard A, Shio MT, Olivier M (2012) Impact of Leishmania metalloprotease GP63 on macrophage signaling. Front Cell Infect Microbiol 2: 72. doi: 10.3389/fcimb.2012.00072 22919663

16. Mottram JC, Coombs GH, Alexander J (2004) Cysteine peptidases as virulence factors of Leishmania. Curr Opin Microbiol 7: 375–381. 15358255

17. Huynh C, Sacks DL, Andrews NW (2006) A Leishmania amazonensis ZIP family iron transporter is essential for parasite replication within macrophage phagolysosomes. J Exp Med 203: 2363–2375. 17000865

18. Zhang WW, Matlashewski G (2001) Characterization of the A2-A2rel gene cluster in Leishmania donovani: involvement of A2 in visceralization during infection. Mol Microbiol 39: 935–948. 11251814

19. Pan AA (1984) Leishmania mexicana: serial cultivation of intracellular stages in a cell-free medium. Exp Parasitol 58: 72–80. 6745388

20. Bates PA, Robertson CD, Tetley L, Coombs GH (1992) Axenic cultivation and characterization of Leishmania mexicana amastigote-like forms. Parasitology 105 (Pt 2): 193–202. 1454417

21. Bates PA (1994) Complete developmental cycle of Leishmania mexicana in axenic culture. Parasitology 108 (Pt 1): 1–9. 8152848

22. Pescher P, Blisnick T, Bastin P, Spath GF (2011) Quantitative proteome profiling informs on phenotypic traits that adapt Leishmania donovani for axenic and intracellular proliferation. Cell Microbiol 13: 978–991. doi: 10.1111/j.1462-5822.2011.01593.x 21501362

23. Akopyants NS, Matlib RS, Bukanova EN, Smeds MR, Brownstein BH, et al. (2004) Expression profiling using random genomic DNA microarrays identifies differentially expressed genes associated with three major developmental stages of the protozoan parasite Leishmania major. Mol Biochem Parasitol 136: 71–86. 15138069

24. Holzer TR, McMaster WR, Forney JD (2006) Expression profiling by whole-genome interspecies microarray hybridization reveals differential gene expression in procyclic promastigotes, lesion-derived amastigotes, and axenic amastigotes in Leishmania mexicana. Mol Biochem Parasitol 146: 198–218. 16430978

25. Leifso K, Cohen-Freue G, Dogra N, Murray A, McMaster WR (2007) Genomic and proteomic expression analysis of Leishmania promastigote and amastigote life stages: the Leishmania genome is constitutively expressed. Mol Biochem Parasitol 152: 35–46. 17188763

26. Alcolea PJ, Alonso A, Gomez MJ, Moreno I, Dominguez M, et al. (2010) Transcriptomics throughout the life cycle of Leishmania infantum: high down-regulation rate in the amastigote stage. Int J Parasitol 40: 1497–1516. doi: 10.1016/j.ijpara.2010.05.013 20654620

27. Rochette A, Raymond F, Corbeil J, Ouellette M, Papadopoulou B (2009) Whole-genome comparative RNA expression profiling of axenic and intracellular amastigote forms of Leishmania infantum. Mol Biochem Parasitol 165: 32–47. doi: 10.1016/j.molbiopara.2008.12.012 19393160

28. McNicoll F, Drummelsmith J, Muller M, Madore E, Boilard N, et al. (2006) A combined proteomic and transcriptomic approach to the study of stage differentiation in Leishmania infantum. Proteomics 6: 3567–3581. 16705753

29. Lahav T, Sivam D, Volpin H, Ronen M, Tsigankov P, et al. (2011) Multiple levels of gene regulation mediate differentiation of the intracellular pathogen Leishmania. FASEB J 25: 515–525. doi: 10.1096/fj.10-157529 20952481

30. Rastrojo A, Carrasco-Ramiro F, Martin D, Crespillo A, Reguera RM, et al. (2013) The transcriptome of Leishmania major in the axenic promastigote stage: transcript annotation and relative expression levels by RNA-seq. BMC Genomics 14: 223. doi: 10.1186/1471-2164-14-223 23557257

31. Mittra B, Cortez M, Haydock A, Ramasamy G, Myler PJ, et al. (2013) Iron uptake controls the generation of Leishmania infective forms through regulation of ROS levels. J Exp Med 210: 401–416. doi: 10.1084/jem.20121368 23382545

32. Martin JL, Yates PA, Soysa R, Alfaro JF, Yang F, et al. (2014) Metabolic reprogramming during purine stress in the protozoan pathogen Leishmania donovani. PLoS Pathog 10: e1003938. doi: 10.1371/journal.ppat.1003938 24586154

33. Mishra KK, Holzer TR, Moore LL, LeBowitz JH (2003) A negative regulatory element controls mRNA abundance of the Leishmania mexicana Paraflagellar rod gene PFR2. Eukaryot Cell 2: 1009–1017. 14555483

34. Boucher N, Wu Y, Dumas C, Dube M, Sereno D, et al. (2002) A common mechanism of stage-regulated gene expression in Leishmania mediated by a conserved 3'-untranslated region element. J Biol Chem 277: 19511–19520. 11912202

35. David M, Gabdank I, Ben-David M, Zilka A, Orr I, et al. (2010) Preferential translation of Hsp83 in Leishmania requires a thermosensitive polypyrimidine-rich element in the 3' UTR and involves scanning of the 5' UTR. RNA 16: 364–374. doi: 10.1261/rna.1874710 20040590

36. Quijada L, Soto M, Alonso C, Requena JM (2000) Identification of a putative regulatory element in the 3'-untranslated region that controls expression of HSP70 in Leishmania infantum. Mol Biochem Parasitol 110: 79–91. 10989147

37. Murray A, Fu C, Habibi G, McMaster WR (2007) Regions in the 3' untranslated region confer stage-specific expression to the Leishmania mexicana a600-4 gene. Mol Biochem Parasitol 153: 125–132. 17433460

38. Wilhelm BT, Marguerat S, Watt S, Schubert F, Wood V, et al. (2008) Dynamic repertoire of a eukaryotic transcriptome surveyed at single-nucleotide resolution. Nature 453: 1239–1243. doi: 10.1038/nature07002 18488015

39. Sharma CM, Hoffmann S, Darfeuille F, Reignier J, Findeiss S, et al. (2010) The primary transcriptome of the major human pathogen Helicobacter pylori. Nature 464: 250–255. doi: 10.1038/nature08756 20164839

40. Otto TD, Wilinski D, Assefa S, Keane TM, Sarry LR, et al. (2010) New insights into the blood-stage transcriptome of Plasmodium falciparum using RNA-Seq. Mol Microbiol 76: 12–24. doi: 10.1111/j.1365-2958.2009.07026.x 20141604

41. Daines B, Wang H, Wang L, Li Y, Han Y, et al. (2011) The Drosophila melanogaster transcriptome by paired-end RNA sequencing. Genome Res 21: 315–324. doi: 10.1101/gr.107854.110 21177959

42. Kolev NG, Franklin JB, Carmi S, Shi H, Michaeli S, et al. (2010) The transcriptome of the human pathogen Trypanosoma brucei at single-nucleotide resolution. PLoS Pathog 6: e1001090. doi: 10.1371/journal.ppat.1001090 20838601

43. Westermann AJ, Gorski SA, Vogel J (2012) Dual RNA-seq of pathogen and host. Nat Rev Microbiol 10: 618–630. doi: 10.1038/nrmicro2852 22890146

44. Maretti-Mira AC, Bittner J, Oliveira-Neto MP, Liu M, Kang D, et al. (2012) Transcriptome patterns from primary cutaneous Leishmania braziliensis infections associate with eventual development of mucosal disease in humans. PLoS Negl Trop Dis 6: e1816. doi: 10.1371/journal.pntd.0001816 23029578

45. Bates PA (1993) Axenic culture of Leishmania amastigotes. Parasitol Today 9: 143–146. 15463739

46. Fiebig M, Gluenz E, Carrington M, Kelly S (2014) SLaP mapper: A webserver for identifying and quantifying spliced-leader addition and polyadenylation site usage in kinetoplastid genomes. Mol Biochem Parasitol 196: 71–74. doi: 10.1016/j.molbiopara.2014.07.012 25111964

47. Siegel TN, Hekstra DR, Wang X, Dewell S, Cross GA (2010) Genome-wide analysis of mRNA abundance in two life-cycle stages of Trypanosoma brucei and identification of splicing and polyadenylation sites. Nucleic Acids Res 38: 4946–4957. doi: 10.1093/nar/gkq237 20385579

48. Paape D, Lippuner C, Schmid M, Ackermann R, Barrios-Llerena ME, et al. (2008) Transgenic, fluorescent Leishmania mexicana allow direct analysis of the proteome of intracellular amastigotes. Mol Cell Proteomics 7: 1688–1701. doi: 10.1074/mcp.M700343-MCP200 18474515

49. Ericson M, Janes MA, Butter F, Mann M, Ullu E, et al. (2014) On the extent and role of the small proteome in the parasitic eukaryote Trypanosoma brucei. BMC Biol 12: 14. doi: 10.1186/1741-7007-12-14 24552149

50. Moore LL, Santrich C, LeBowitz JH (1996) Stage-specific expression of the Leishmania mexicana paraflagellar rod protein PFR-2. Mol Biochem Parasitol 80: 125–135. 8892290

51. Burchmore RJ, Landfear SM (1998) Differential regulation of multiple glucose transporter genes in Leishmania mexicana. J Biol Chem 273: 29118–29126. 9786920

52. Burchmore RJS, Rodriguez-Contreras D, McBride K, Barrett MP, Modi G, et al. (2003) Genetic characterization of glucose transporter function in Leishmania mexicana. Proceedings of the National Academy of Sciences of the United States of America 100: 3901–3906. 12651954

53. McNicoll F, Muller M, Cloutier S, Boilard N, Rochette A, et al. (2005) Distinct 3'-untranslated region elements regulate stage-specific mRNA accumulation and translation in Leishmania. J Biol Chem 280: 35238–35246. 16115874

54. Jackson AP (2007) Evolutionary consequences of a large duplication event in Trypanosoma brucei: chromosomes 4 and 8 are partial duplicons. BMC Genomics 8: 432. 18036214

55. Andrews SJ, Rothnagel JA (2014) Emerging evidence for functional peptides encoded by short open reading frames. Nat Rev Genet 15: 193–204. doi: 10.1038/nrg3520 24514441

56. Hobbs EC, Fontaine F, Yin X, Storz G (2011) An expanding universe of small proteins. Curr Opin Microbiol 14: 167–173. doi: 10.1016/j.mib.2011.01.007 21342783

57. Werner M, Feller A, Messenguy F, Pierard A (1987) The leader peptide of yeast gene CPA1 is essential for the translational repression of its expression. Cell 49: 805–813. 3555844

58. Calvo SE, Pagliarini DJ, Mootha VK (2009) Upstream open reading frames cause widespread reduction of protein expression and are polymorphic among humans. Proc Natl Acad Sci U S A 106: 7507–7512. doi: 10.1073/pnas.0810916106 19372376

59. Magny EG, Pueyo JI, Pearl FM, Cespedes MA, Niven JE, et al. (2013) Conserved regulation of cardiac calcium uptake by peptides encoded in small open reading frames. Science 341: 1116–1120. doi: 10.1126/science.1238802 23970561

60. Lopez D, Vlamakis H, Losick R, Kolter R (2009) Paracrine signaling in a bacterium. Genes Dev 23: 1631–1638. doi: 10.1101/gad.1813709 19605685

61. Savard J, Marques-Souza H, Aranda M, Tautz D (2006) A segmentation gene in Tribolium produces a polycistronic mRNA that codes for multiple conserved peptides. Cell 126: 559–569. 16901788

62. Cheng H, Chan WS, Li Z, Wang D, Liu S, et al. (2011) Small open reading frames: current prediction techniques and future prospect. Curr Protein Pept Sci 12: 503–507. 21787300

63. Dumas C, Chow C, Muller M, Papadopoulou B (2006) A novel class of developmentally regulated noncoding RNAs in Leishmania. Eukaryot Cell 5: 2033–2046. 17071827

64. Muller SA, Kohajda T, Findeiss S, Stadler PF, Washietl S, et al. (2010) Optimization of parameters for coverage of low molecular weight proteins. Anal Bioanal Chem 398: 2867–2881. doi: 10.1007/s00216-010-4093-x 20803007

65. Klein C, Aivaliotis M, Olsen JV, Falb M, Besir H, et al. (2007) The low molecular weight proteome of Halobacterium salinarum. J Proteome Res 6: 1510–1518. 17326674

66. Storz G, Wolf YI, Ramamurthi KS (2014) Small proteins can no longer be ignored. Annu Rev Biochem 83: 753–777. doi: 10.1146/annurev-biochem-070611-102400 24606146

67. Ramiro MJ, Hanke T, Taladriz S, Larraga V (2002) DNA polymerase beta mRNA determination by relative quantitative RT-PCR from Leishmania infantum intracellular amastigotes. Parasitol Res 88: 760–767. 12122435

68. Clayton CE (2014) Networks of gene expression regulation in Trypanosoma brucei. Mol Biochem Parasitol 195: 96–106. doi: 10.1016/j.molbiopara.2014.06.005 24995711

69. Holzer TR, Mishra KK, LeBowitz JH, Forney JD (2008) Coordinate regulation of a family of promastigote-enriched mRNAs by the 3'UTR PRE element in Leishmania mexicana. Mol Biochem Parasitol 157: 54–64. 18023890

70. Haile S, Dupe A, Papadopoulou B (2008) Deadenylation-independent stage-specific mRNA degradation in Leishmania. Nucleic Acids Res 36: 1634–1644. doi: 10.1093/nar/gkn019 18250085

71. Nilsson D, Gunasekera K, Mani J, Osteras M, Farinelli L, et al. (2010) Spliced leader trapping reveals widespread alternative splicing patterns in the highly dynamic transcriptome of Trypanosoma brucei. PLoS Pathog 6: e1001037. doi: 10.1371/journal.ppat.1001037 20700444

72. Rettig J, Wang Y, Schneider A, Ochsenreiter T (2012) Dual targeting of isoleucyl-tRNA synthetase in Trypanosoma brucei is mediated through alternative trans-splicing. Nucleic Acids Res 40: 1299–1306. doi: 10.1093/nar/gkr794 21976735

73. Kelly S, Kramer S, Schwede A, Maini PK, Gull K, et al. (2012) Genome organization is a major component of gene expression control in response to stress and during the cell division cycle in trypanosomes. Open Biol 2: 120033. doi: 10.1098/rsob.120033 22724062

74. Figarella K, Uzcategui NL, Zhou Y, LeFurgey A, Ouellette M, et al. (2007) Biochemical characterization of Leishmania major aquaglyceroporin LmAQP1: possible role in volume regulation and osmotaxis. Mol Microbiol 65: 1006–1017. 17640270

75. Marquis N, Gourbal B, Rosen BP, Mukhopadhyay R, Ouellette M (2005) Modulation in aquaglyceroporin AQP1 gene transcript levels in drug-resistant Leishmania. Mol Microbiol 57: 1690–1699. 16135234

76. Austyn JM, Gordon S (1981) F4/80, a monoclonal antibody directed specifically against the mouse macrophage. Eur J Immunol 11: 805–815. 7308288

77. Springer T, Galfre G, Secher DS, Milstein C (1979) Mac-1: a macrophage differentiation antigen identified by monoclonal antibody. Eur J Immunol 9: 301–306. 89034

78. Wheeler RJ, Gull K, Gluenz E (2012) Detailed interrogation of trypanosome cell biology via differential organelle staining and automated image analysis. BMC Biol 10: 1. doi: 10.1186/1741-7007-10-1 22214525

79. Robinson JT, Thorvaldsdottir H, Winckler W, Guttman M, Lander ES, et al. (2011) Integrative genomics viewer. Nat Biotechnol 29: 24–26. doi: 10.1038/nbt.1754 21221095

80. Thorvaldsdottir H, Robinson JT, Mesirov JP (2013) Integrative Genomics Viewer (IGV): high-performance genomics data visualization and exploration. Brief Bioinform 14: 178–192. doi: 10.1093/bib/bbs017 22517427

81. Trudgian DC, Thomas B, McGowan SJ, Kessler BM, Salek M, et al. (2010) CPFP: a central proteomics facilities pipeline. Bioinformatics 26: 1131–1132. doi: 10.1093/bioinformatics/btq081 20189941

82. Paape D, Barrios-Llerena ME, Le Bihan T, Mackay L, Aebischer T (2010) Gel free analysis of the proteome of intracellular Leishmania mexicana. Mol Biochem Parasitol 169: 108–114. doi: 10.1016/j.molbiopara.2009.10.009 19900490

83. Koenig T, Menze BH, Kirchner M, Monigatti F, Parker KC, et al. (2008) Robust prediction of the MASCOT score for an improved quality assessment in mass spectrometric proteomics. J Proteome Res 7: 3708–3717. doi: 10.1021/pr700859x 18707158

84. Trudgian DC, Ridlova G, Fischer R, Mackeen MM, Ternette N, et al. (2011) Comparative evaluation of label-free SINQ normalized spectral index quantitation in the central proteomics facilities pipeline. Proteomics 11: 2790–2797. doi: 10.1002/pmic.201000800 21656681

85. Hirsh AE, Fraser HB (2001) Protein dispensability and rate of evolution. Nature 411: 1046–1049. 11429604

86. Manna PT, Kelly S, Field MC (2013) Adaptin evolution in kinetoplastids and emergence of the variant surface glycoprotein coat in African trypanosomatids. Mol Phylogenet Evol 67: 123–128. doi: 10.1016/j.ympev.2013.01.002 23337175

87. Porcel BM, Denoeud F, Opperdoes F, Noel B, Madoui MA, et al. (2014) The streamlined genome of Phytomonas spp. relative to human pathogenic kinetoplastids reveals a parasite tailored for plants. PLoS Genet 10: e1004007. doi: 10.1371/journal.pgen.1004007 24516393

88. Bolger AM, Lohse M, Usadel B (2014) Trimmomatic: a flexible trimmer for Illumina sequence data. Bioinformatics 30: 2114–2120. doi: 10.1093/bioinformatics/btu170 24695404

89. Li B, Dewey CN (2011) RSEM: accurate transcript quantification from RNA-Seq data with or without a reference genome. BMC Bioinformatics 12: 323. doi: 10.1186/1471-2105-12-323 21816040

90. Love MI, Huber W, Anders S (2014) Moderated estimation of fold change and dispersion for RNA-seq data with DESeq2. bioRxiv.

91. Young MD, Wakefield MJ, Smyth GK, Oshlack A (2010) Gene ontology analysis for RNA-seq: accounting for selection bias. Genome Biol 11: R14. doi: 10.1186/gb-2010-11-2-r14 20132535

92. Emms D, Kelly S (2015) OrthoFinder: solving fundamental biases in whole genome comparisons dramatically improves orthologous gene group inference accuracy. Genome Biol. 16: 157. doi: 10.1186/s13059-015-0721-2 26243257

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