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Blood, 1 September 2006, Vol. 108, No. 5, pp. 1751-1757.
Prepublished online as a Blood First Edition Paper on May 30, 2006; DOI 10.1182/blood-2005-11-011932.
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Submitted November 21, 2005
Accepted April 17, 2006
Serum amyloid A is an innate immune opsonin for
Gram-negative bacteria
Chandrabala Shah, Ranjeeta Hari-Dass, and John Graham Raynes*
Immunology Unit, London School of Hygiene and Tropical Medicine
* Corresponding author; email: john.raynes{at}lshtm.ac.uk.
Serum amyloid A (SAA) is the major acute phase protein
in man and most mammals. Recently we demonstrated that
SAA binds to many Gram-negative bacteria including
Escherichia coli and Pseudomonas aeruginosa through
outer membrane protein A (OmpA) family members.
Therefore we investigated whether SAA altered the
response of innate phagocytic cells to bacteria. Both
the percentage of neutrophils containing E. coli and the
number of bacteria per neutrophil were greatly increased
by SAA-opsonisation, equivalent to that seen for serum.
In contrast no change was seen for Streptoccocus
pneumoniae, a bacteria that did not bind SAA. Neutrophil
reactive oxygen intermediate production in response to
bacteria was also increased by opsonisation with SAA.
SAA-opsonisation also increased phagocytosis of E.coli
by peripheral blood mononuclear cell derived
macrophages. These macrophages showed strong enhancement
of TNF- ; and IL-10 production in response to SAA-
opsonised E. coli and P. aeruginosa. SAA did not enhance
responses in the presence of bacteria to which it did
not bind. These effects of SAA occur at normal and acute
phase concentrations consistent with SAA binding
properties and a role in innate recognition. SAA
therefore represents a novel innate recognition protein
for Gram-negative bacteria.

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