CipA mediates complement resistance of Acinetobacter baumannii by formation of a Factor I-dependent quadripartite assemblage

Abstract

Multidrug-resistant Acinetobacter baumannii is known to be one of the leading pathogens that cause severe nosocomial infections. To overcome eradication by the innate immune system during infection, A. baumannii developed a number of immune evasion strategies. Previously, we identified CipA as a plasminogen-binding and complement-inhibitory protein. Here we show that CipA strongly inhibits all three complement activation pathways and interacts with key complement components C3, C3b, C4b, C5, Factor B, Factor D, and in particular Factor I. CipA also targets function of the C5 convertase as cleavage of C5 was impaired. Systematic screening of CipA variants identified two separate binding sites for C3b and a Factor I-interacting domain located at the C-terminus. Structure predictions using AlphaFold2 and binding analyses employing CipA variants lacking Factor I-binding capability confirmed that the orientation of the C-terminal domain is essential for the interaction with Factor I. Hence, our analyses point to a novel, Factor I-dependent mechanisms of complement inactivation mediated by CipA of A. baumannii. Recrutiment of Factor I by CipA initiates the assembly of a quadripartite complex following binding of either Factor H or C4b-binding protein to degrade C3b and C4b, respectively. Loss of Factor I binding in a CipA-deficient strain, or a strain producing a CipA variant lacking Factor I-binding capability, correlated with a higher susceptibility to human serum, indicating that recruitment of Factor I enables A. baumannii to resist complement-mediated killing. Significance StatementThe Gram-negative bacterium Acinetobacter baumannii causes severe nosocomial infections and has developed various immune evasion strategies to overcome complement. The mechanisms how Acinetobacter baumannii successfully circumvents complement-mediated bacteriolysis are still poorly understood. Here, we show that the plasminogen-binding and complement inhibitory protein CipA terminates all three complement activation pathways. We describe a novel mechanism by which CipA cleaves the key complement components C3b and C4b in the presence of Factor H and C4b-binding protein by formation of a novel Factor I-dependent quadripartite complex. CipA, which has recently been successfully used for vaccination approaches, might represent an attractive target for the development of novel therapeutic interventions to block disorders with excessive hyperinflammatory complement activation.