Molecular Mechanisms of Priming Innate Immunity by Small Extracellular Vesicles Released during Infection with Gram-negative Bacteria

Much still remains to understand about the underlying molecular mechanisms by which the trafficking of small extracellular vesicles (sEVs) modulates innate immune responses during infection with pathogenic Gram-negative bacteria. To address this significant gap in knowledge, we used two infection models to investigate innate immune regulation by the sEVs released from cells infected with either <i>Yersinia pestis</i> (Yp) or <i>Burkholderia thailandensis</i> (Bt), designated as EXi-Yp and EXi-Bt respectively. The EXi induced differentiation of naïve human monocytes to macrophages and triggered robust pro-inflammatory cytokine release, including release of IL-6, mirroring direct bacterial infection effects. Comprehensive cell signaling analyses revealed that the EXi modulate a small set of host signaling proteins, with p38 activation being primarily responsible for the observed protective effects. EXi-induced p38 activation leads to increased IL-6 release, which in turn is responsible for decreased bacterial survival within recipient immune cells that are subsequently infected. Consistent with the <i>in vitro</i> results, mice administered with EXi-Yp exhibited elevated serum IL-6 levels and were protected from Yp infection. Furthermore, using our microfluidic chip platform that allows functional interrogation of EV effects under physiologically relevant conditions, we have demonstrated that EXi exchange between Yp-infected cells and naive recipient monocytes leads to differentiation of the recipient cells to macrophages. Together, our findings reveal a largely unexplored aspect of innate immunity and provide a mechanistic model in which EXi prime local and distant naïve monocytes via p38-induced differentiation and IL-6 production to protect against infection with Gram-negative bacteria.