Humoral Immunity in the Gut Selectively Targets Phenotypically Virulent Attaching-and-Effacing Bacteria for Intraluminal Elimination

Virulence factors expressed by enteric bacteria are pivotal for pathogen colonization and induction of intestinal disease, but the mechanisms by which host immunity regulates pathogen virulence are largely unknown. Here we show that specific antibody responses are required for downregulation of virulence gene expression in Citrobacter rodentium, an enteric pathogen that models human infections with attaching-and-effacing bacteria. In the absence of antibodies against the pathogen, phenotypically virulent C. rodentium, accumulated and infected the epithelium and subsequently invaded the lamina propia, causing host lethality. IgG induced after infection recognized virulence factors and bound virulent bacteria within the intestinal lumen, leading to their engulfment by neutrophils, while phenotypically avirulent pathogens remained in the intestinal lumen and were eventually outcompeted by the microbiota. Thus, the interplay of the innate and adaptive immune system selectively targets virulent C. rodentium in the intestinal lumen to promote pathogen eradication and host survival. [Display omitted] •Enteric pathogens reside as phenotypically virulent and avirulent subpopulations•Enteric pathogen infection induces virulence-factor-specific IgG•Virulent pathogens, but not commensals or avirulent pathogens, are recognized by IgG•IgG-bound virulent bacteria are eliminated intraluminally by migrated neutrophils Kamada et al. demonstrate that humoral immunity elicits selective elimination of phenotypically virulent bacteria in the gut. Immunoglobulin recognizes virulent bacteria, which leads to their selective elimination by neutrophils in the intestinal lumen. Phenotypically avirulent bacteria that are not targeted by host immunity are outcompeted by the commensal microbiota.