OMV components synergistically modulate the host immune response. The single most abundant immune stimulating component in OMVs is LPS. Munford et al. (1982) showed that purified LPS from bacteria and vesicular LPS have the highest biological activity, whereas bacteria-associated LPS is less active. In addition to LPS, OMVs contain immune-stimulating PAMPs such as outer membrane porins, flagellins and peptidoglycans (Renelli et al., 2004; Bauman & Kuehn, 2006). These immune activating ligands in Gram-negative pathogens interact with host cells and promote proinflammatory activities (Tufano et al., 1994; Galdiero et al., click here 1999; Ellis & Kuehn, 2010; Kulp

& Kuehn, 2010). However, whether the innate immune response induced by OMVs from different bacterial species stimulates the clearance of bacteria or enhances pathogen virulence remains to be determined. Klebsiella

pneumoniae OMVs did not induce direct cytotoxicity in HEp-2 or U937 cells, but induced a proinflammatory response in vitro. Neutropenic mice were inoculated intratracheally with 20 μg of K. pneumoniae OMVs to determine whether K. pneumoniae OMVs induced lung pathology in vivo. Immunocompromised mice were used, because K. pneumoniae usually infects critically ill or immunocompromised patients. As a control, 1 × 107 CFU of K. pneumoniae ATCC 13883 were inoculated. The control mice treated with PBS showed normal lung histology (Fig. 4a), whereas live bacteria induced pathological changes in lung tissues, including congestion, oedema, collapse of alveoli Ivacaftor in vitro and a mild lymphocytic infiltration (Fig. 4b). Klebsiella pneumoniae OMVs induced more severe pathological changes as compared with live bacterial

infection (Fig. 4c). These results suggest that K. pneumoniae OMVs can induce lung pathology in vivo. The present study demonstrated that K. pneumoniae OMVs induce the innate immune response in vitro and induce lung pathology in vivo. Klebsiella pneumoniae OMVs induced neither cytotoxicity in both HEp-2 and U937 cells in vitro nor cell death in lung tissues in vivo. Instead, K. pneumoniae until OMVs induced expression of proinflammatory cytokine genes. Proinflammatory cytokines, IL-1β and IL-8, function as a mediator of local inflammation and recruit neutrophils and monocytes to sites of infection. Inflammatory cell infiltration was not prominent in mice treated with K. pneumoniae OMVs, because neutropenic mice were used. However, pathological changes of lung tissues were seen following intratracheal inoculation of K. pneumoniae OMVs. These results suggest that K. pneumoniae OMVs induce a strong innate immune response. In conclusion, we have shown that K. pneumoniae OMVs serve as a strong immune modulator to induce an inflammatory response, but do not serve as a transport system for toxic elements to host cells. Our results extend the role of OMVs in the pathogenesis of K.