Immunity

Most of our understanding of host immunity to P. mirabilis has been extrapolated from rodent models of ascending UTIs and from rheumatoid arthritis (RA) patients. Sera collected from mice transureth-rally challenged with P. mirabilis have been shown to react in vitro with purified lipopolysaccharide, flagella, outer membrane protein (OMP) and man-nose-resistant Proteus-like (MR/P) fimbriae. Partial immunity has also been observed following vaccination in mice. In one study, animals were preim-munized with P. mirabilis and cleared using ampicil-lin. After one week of a secondary challenge P. mirabilis colonization in the bladder and kidney was significantly decreased compared with an unvac-cinated group. Intramuscular injections of purified OMP has also been demonstrated to protect mice from P. mirabilis renal infection.

Serum from patients with active RA also react with P. mirabilis. The immunogenic response may be due to a hexamer peptide within hemolysin which has a high degree of similarity to the susceptibility sequences of HLA-DR1 and DR4. Future research is aimed at determining whether the production of antibodies against P. mirabilis hemolysin stimulates the autoimmune response observed in RA patients.

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