Previous Article | Next Article 
Journal of Clinical Microbiology, February 2004, p. 895-898, Vol. 42, No. 2
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.2.895-898.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
IS6110-Mediated Deletion Polymorphism in Isogenic Strains of Mycobacterium tuberculosis
S. L. Sampson,1 M. Richardson,2 P. D. van Helden,2 and R. M. Warren2*
Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts 02115,1
MRC Centre for Molecular and Cellular Biology, Department of Medical Biochemistry, Faculty of Health Sciences, Stellenbosch University, Tygerberg, Western Cape 7505, South Africa2
Received 5 September 2003/
Returned for modification 1 October 2003/
Accepted 23 October 2003

ABSTRACT
Previous studies have described IS
6110-mediated polymorphism
as an important driving force in
Mycobacterium tuberculosis genome evolution and have provided indirect evidence for IS
6110-driven
deletion events. This study provides the first description of
an IS
6110-mediated deletion event in truly isogenic strains.
We also provide further support for the hypothesis that the
region from Rv1754 to Rv1765 is a hot spot for IS
6110 insertion
and deletion events.

INTRODUCTION
The insertion sequence IS
6110 has been suggested to be an important
agent of
Mycobacterium tuberculosis genome variation. IS
6110 transposition events may disrupt open reading frames (
12) or
regulatory domains, and there has been much speculation regarding
the possible influence of these events on strain phenotype (
1,
8,
11,
19). In addition, insertion sequence-mediated deletion
events have been suggested to be an important mechanism driving
mycobacterial genome variation (
2). Homologous recombination
between directly repeated IS
6110 elements has been proposed
as a likely mechanism for genomic deletions in clinical isolates
(
5). This hypothesis is supported by the results of in silico
analysis of sequences flanking the 16 IS
6110 elements in the
M. tuberculosis H37Rv genome to identify the deletions RvD3,
RvD4, and RvD5 (
2). In this study and others, the absence of
3- to 4-bp repeats immediately flanking the point of IS
6110 insertion is interpreted to reflect homologous recombination
events between two directly repeated IS
6110 elements (
2,
5).
Similarly, analysis of sequences immediately flanking IS
6110 elements in a highly variable 20-kb region of the chromosome
provides further examples of deletions associated with the presence
of IS
6110 elements (
10). A recent study suggested that alternative
mechanisms may be involved in deletion events between inverted
IS
6110 elements (
13).
To our knowledge, no study to date has investigated IS6110-mediated deletion in isogenic strains to directly support the hypothesis of homologous recombination. A previous report of multilesional intrapatient strain genotyping described the isolation of two isogenic strains from a single patient, one of which had a single IS6110 band polymorphism (4). From a visual perspective and in the absence of chronology, it was not clear whether this difference was due to an insertion or deletion event. In this study, we utilized the unique availability of these isogenic strains to address this question.
Mycobacterium tuberculosis was cultured from the cadaver of a human immunodeficiency virus-negative 41-year-old female which, on autopsy, showed pulmonary scarring and miliary pulmonary involvement (4). Extrapulmonary tuberculosis was evident in the liver; kidneys; ovaries; and hilar, mediastinal, and iliac lymph nodes. M. tuberculosis was successfully cultured from a mediastinal lymph node (culture D7030), a hilar lymph node (culture D7031), and an abdominal lymph node (culture D7033). IS-3' DNA fingerprinting (15) showed that all cultures had identical banding patterns with the exception of D7031, which showed an additional hybridizing band at 2.4 kb (Fig. 1A), corresponding to the IS6110 insertion at position ISL7031.8, as determined by DNA sequencing (12). Similarly, the IS-5' probe showed identical banding patterns with the exception of an additional hybridizing band at 1.0 kb (Fig. 1B), corresponding to the same insertion. DNA fingerprinting with the polymorphic GC-rich repetitive sequence probe (16) and direct repeat (DRr) probe (9) showed identical banding patterns, demonstrating that these strains were genetic variants that had evolved within this individual, possibly as the result of an IS6110-mediated event (Fig. 1C and D).
To determine whether the observed banding pattern was indeed
IS
6110 mediated, PCR primers were designed from the H37Rv (
3)
and CDC1551 (
7) whole genome sequences to facilitate the amplification
of the region spanning the insertions at positions ISL7031.2
and ISL7031.8 (
12) (Fig.
2). PCR amplifications were performed
using the Expand Long Range PCR system (Roche), as previously
described (
13). Amplification of D7031 with the primer combination
PR3 and Del5R produced a product of 2.0 kb, while the primer
combination Del4R and Del6F yielded a product of 1.9 kb. In
addition, amplification with the primer combination PR3 and
Del6R yielded a product of approximately 8 kb, in accordance
with the 8.1-kb product that was predicted based on the CDC1551
sequence data (
7). This confirmed that the RvD2 region (
8) was
present in D7031 and flanked by two IS
6110 insertions at positions
ISL7031.2 and ISL7031.8 (Fig.
2). This structure had not been
previously observed, and it was in fact hypothesized that such
a structure would be unstable (
10). Interestingly, the Del4R
and Del6F amplification product was 3.6 kb shorter than predicted
(based on the CDC1551 genome sequence data), suggesting a possible
deletion event. DNA sequencing of this product demonstrated
the presence of an IS
6110 element with the 3' point of insertion
corresponding to chromosomal position 1989082 (numbered according
to H37Rv genome sequence), while the 5' point of insertion corresponded
to chromosomal position 1992737, 3,655 bp downstream (Fig.
2).
The triplet repeats flanking this insertion element were not
conserved. This suggests that a precursor strain existed wherein
an additional IS
6110 insertion (ISL7031.X [Fig.
2]) occurred
downstream of the IS
6110 insertion at position ISL7031.8, with
subsequent recombination between the IS
6110 elements leading
to the deletion of the 3,655-bp intervening region. Alternatively,
it is conceivable that a transpositionally mediated mechanism
(
14), such as deletion of target DNA on integration of ISL7031.8,
may have resulted in the structure observed here, although this
has not been previously reported in
M. tuberculosis.
PCR amplification of D7030 using the primer combination PR3
and Del5R and the primer combination Del4R and Del6F failed
to generate products. Amplification using PR3 and Del4R produced
a product of 2.1 kb, suggesting that the region between the
IS
6110 elements at position ISL7031.2 and ISL7031.8 had been
deleted from strain D7030. This was confirmed by sequence analysis
(Fig.
2). However, the sequence data demonstrated that this
deletion event was not mediated by the recombination of these
adjacent IS
6110 elements. The DNA sequence of the flanking region
showed that the insertion point corresponded to chromosomal
position 1992746, 9 bp downstream of ISL7031.8. In addition,
the 5' triplet repeat differed from that of ISL7031.8. Based
on this result, we hypothesize the existence of a second precursor
strain wherein an additional IS
6110 insertion (at position ISL7030.Y
[Fig.
2]) occurred in the region downstream of the insertion
at position ISL7031.8. Subsequently, recombination between the
IS
6110 elements at positions ISL7030.Y and ISL7031.2 may have
mediated the deletion event, resulting in the deletion of five
genes as well as the IS
6110 element inserted at position ISL7031.8.
Although other transpositionally mediated mechanisms may explain
the structure observed here, for reasons discussed previously
by Sampson et al. (
13) and others (
5), we favor the recombination-mediated
scenario. In combination, the recombination between IS
6110 elements
inserted at ISL7031.X and ISL7031.8 as well as the recombination
between ISL7030.Y and ISL7031.2 resulted in the overall deletion
of a 12.9-kb fragment.
In summary, this study provides the first description of an IS6110-mediated deletion event in truly isogenic strains. However, as Sampson et al. have previously observed (13), the mechanism of deletion was more complex than simple homologous recombination between directly repeated IS6110 elements. From the results of this study and others (10, 13), it is evident that this chromosomal region from Rv1754 to Rv1765 has undergone a number of deletion events during its evolutionary history. The frequency at which these domains are deleted together with the fact that the strains caused disease in the human host implies that this region may not be important to the overall virulence of M. tuberculosis.
The results presented here emphasize that this region, like the DR (18) and IS6110 preferential locus (6) regions of the M. tuberculosis genome, is a hot spot for IS6110 insertions (10), which consequently drives the high rate of deletion events observed here. This suggests that regions of preferential IS6110 integration loci may be in a state of flux due to the disruptive influence of IS6110 insertion as well as IS6110-mediated deletion and thereby confirms the importance of IS6110 in defining the architecture of the M. tuberculosis chromosome. If preferential integration loci are also preferential deletion regions (13), these findings suggest that some caution should be exercised when reconstructing evolutionary histories of strains based on deletion mapping. Depending on the sensitivity of the detection method, deletions offset by only a few base pairs may not be distinguished from one another, thereby leading to an overestimation of relatedness. In addition, deletions in different regions may be more or less informative, depending on whether the region is a deletion hot spot or not. Together, these factors may lead to inaccurate measures of phylogenetic distances.

ACKNOWLEDGMENTS
We thank the GlaxoSmithkline Action TB Initiative for supporting
this study.
We are grateful to D. G. du Plessis for providing the mycobacterial strains.

FOOTNOTES
* Corresponding author. Mailing address: MRC Centre for Molecular and Cellular Biology, Department of Medical Biochemistry, Stellenbosch University, P.O. Box 19063, Tygerberg 7505, South Africa. Phone: 27-21-9389482. Fax: 27-21-9317810. E-mail:
RW1{at}SUN.AC.ZA.


REFERENCES
1 - Behr, M. A., M. A. Wilson, W. P. Gill, H. Salamon, G. K. Schoolnik, S. Rane, and P. M. Small. 1999. Comparative genomics of BCG vaccines by whole-genome DNA microarray. Science 284:1520-1523.[Abstract/Free Full Text]
2 - Brosch, R., W. J. Philipp, E. Stavropoulos, M. J. Colston, S. T. Cole, and S. V. Gordon. 1999. Genomic analysis reveals variation between Mycobacterium tuberculosis H37Rv and the attenuated M. tuberculosis H37Ra strain. Infect. Immun. 67:5768-5774.[Abstract/Free Full Text]
3 - Cole, S. T., R. Brosch, J. Parkhill, T. Garnier, C. Churcher, D. Harris, S. V. Gordon, K. Eiglmeier, S. Gas, C. E. Barry III, F. Tekaia, K. Badcock, D. Basham, D. Brown, T. Chillingworth, R. Connor, R. Davies, K. Devlin, T. Feltwell, S. Gentles, N. Hamlin, S. Holroyd, T. Hornsby, K. Jagels, B. G. Barrell, et al. 1998. Deciphering the biology of Mycobacterium tuberculosis from the complete genome sequence. Nature 393:537-544.[CrossRef][Medline]
4 - du Plessis, D. G., R. Warren, M. Richardson, J. J. Joubert, and P. D. van Helden. 2001. Demonstration of reinfection and reactivation in HIV-negative autopsied cases of secondary tuberculosis: multilesional genotyping of Mycobacterium tuberculosis utilizing IS6110 and other repetitive element-based DNA fingerprinting. Tuberculosis 81:211-220.
5 - Fang, Z., C. Doig, D. T. Kenna, N. Smittipat, P. Palittapongarnpim, B. Watt, and K. J. Forbes. 1999. IS6110-mediated deletions of wild-type chromosomes of Mycobacterium tuberculosis. J. Bacteriol. 181:1014-1020.[Abstract/Free Full Text]
6 - Fang, Z., and K. J. Forbes. 1997. A Mycobacterium tuberculosis IS6110 preferential locus (ipl) for insertion into the genome. J. Clin. Microbiol. 35:479-481.[Abstract]
7 - Fleischmann, R. D., D. Alland, J. A. Eisen, L. Carpenter, O. White, J. Peterson, R. DeBoy, R. Dodson, M. Gwinn, D. Haft, E. Hickey, J. F. Kolonay, W. C. Nelson, L. A. Umayam, M. Ermolaeva, S. L. Salzberg, A. Delcher, T. Utterback, J. Weidman, H. Khouri, J. Gill, A. Mikula, W. Bishai, J. W. Jacobs, Jr., J. C. Venter, and C. M. Fraser. 2002. Whole-genome comparison of Mycobacterium tuberculosis clinical and laboratory strains. J. Bacteriol. 184:5479-5490.[Abstract/Free Full Text]
8 - Gordon, S. V., R. Brosch, A. Billault, T. Garnier, K. Eiglmeier, and S. T. Cole. 1999. Identification of variable regions in the genomes of tubercle bacilli using bacterial artificial chromosome arrays. Mol. Microbiol. 32:643-655.[CrossRef][Medline]
9 - Hermans, P. W., D. van Soolingen, E. M. Bik, P. E. de Haas, J. W. Dale, and J. D. van Embden. 1991. Insertion element IS987 from Mycobacterium bovis BCG is located in a hot-spot integration region for insertion elements in Mycobacterium tuberculosis complex strains. Infect. Immun. 59:2695-2705.[Abstract/Free Full Text]
10 - Ho, T. B., B. D. Robertson, G. M. Taylor, R. J. Shaw, and D. B. Young. 2000. Comparison of Mycobacterium tuberculosis genomes reveals frequent deletions in a 20 kb variable region in clinical isolates. Yeast 17:272-282.[CrossRef][Medline]
11 - Mahairas, G. G., P. J. Sabo, M. J. Hickey, D. C. Singh, and C. K. Stover. 1996. Molecular analysis of genetic differences between Mycobacterium bovis BCG and virulent M. bovis. J. Bacteriol. 178:1274-1282.[Abstract/Free Full Text]
12 - Sampson, S. L., R. M. Warren, M. Richardson, G. D. van der Spuy, and P. D. van Helden. 1999. Disruption of coding regions by IS6110 insertion in Mycobacterium tuberculosis. Tuber. Lung Dis. 79:349-359.[CrossRef][Medline]
13 - Sampson, S. L., R. M. Warren, M. Richardson, T. C. Victor, A. M. Jordaan, G. D. van der Spuy, and P. D. van Helden. 2003. IS6110-mediated deletion polymorphism in the direct repeat region of clinical isolates of Mycobacterium tuberculosis. J. Bacteriol. 185:2856-2866.[Abstract/Free Full Text]
14 - Sherratt, D. 1989. Tn3 and related transposable elements: site-specific recombination and transposition., p. 163-184. In D. E. Berg and M. M. Howe (ed.), Mobile DNA. ASM Press, Washington, D.C.
15 - van Embden, J. D., M. D. Cave, J. T. Crawford, J. W. Dale, K. D. Eisenach, B. Gicquel, P. Hermans, C. Martin, R. McAdam, and T. M. Shinnick. 1993. Strain identification of Mycobacterium tuberculosis by DNA fingerprinting: recommendations for a standardized methodology. J. Clin. Microbiol. 31:406-409.[Abstract/Free Full Text]
16 - Warren, R., M. Richardson, S. Sampson, J. H. Hauman, N. Beyers, P. R. Donald, and P. D. van Helden. 1996. Genotyping of Mycobacterium tuberculosis with additional markers enhances accuracy in epidemiological studies. J. Clin. Microbiol. 34:2219-2224.[Abstract]
17 - Warren, R. M., M. Richardson, S. L. Sampson, G. D. van der Spuy, W. Bourn, J. H. Hauman, H. Heersma, W. Hide, N. Beyers, and P. D. van Helden. 2001. Molecular evolution of Mycobacterium tuberculosis: phylogenetic reconstruction of clonal expansion. Tuberculosis 81:291-302.
18 - Warren, R. M., E. M. Streicher, S. L. Sampson, G. D. van der Spuy, M. Richardson, D. Nguyen, M. A. Behr, T. C. Victor, and P. D. van Helden. 2002. Microevolution of the direct repeat region of Mycobacterium tuberculosis: implications for interpretation of spoligotyping data. J. Clin. Microbiol. 40:4457-4465.[Abstract/Free Full Text]
19 - Zumarraga, M., F. Bigi, A. Alito, M. I. Romano, and A. Cataldi. 1999. A 12.7 kb fragment of the Mycobacterium tuberculosis genome is not present in Mycobacterium bovis. Microbiology 145:893-897.[Abstract/Free Full Text]
Journal of Clinical Microbiology, February 2004, p. 895-898, Vol. 42, No. 2
0095-1137/04/$08.00+0 DOI: 10.1128/JCM.42.2.895-898.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
This article has been cited by other articles:
-
Alland, D., Lacher, D. W., Hazbon, M. H., Motiwala, A. S., Qi, W., Fleischmann, R. D., Whittam, T. S.
(2007). Role of Large Sequence Polymorphisms (LSPs) in Generating Genomic Diversity among Clinical Isolates of Mycobacterium tuberculosis and the Utility of LSPs in Phylogenetic Analysis. J. Clin. Microbiol.
45: 39-46
[Abstract]
[Full Text]
-
Gopaul, K. K., Brown, T. J., Gibson, A. L., Yates, M. D., Drobniewski, F. A.
(2006). Progression Toward an Improved DNA Amplification-Based Typing Technique in the Study of Mycobacterium tuberculosis Epidemiology.. J. Clin. Microbiol.
44: 2492-2498
[Abstract]
[Full Text]
-
Tsolaki, A. G., Gagneux, S., Pym, A. S., Goguet de la Salmoniere, Y.-O. L., Kreiswirth, B. N., Van Soolingen, D., Small, P. M.
(2005). Genomic Deletions Classify the Beijing/W Strains as a Distinct Genetic Lineage of Mycobacterium tuberculosis. J. Clin. Microbiol.
43: 3185-3191
[Abstract]
[Full Text]