The delivery of TLR-3, TLR-7, and TLR-9 from the endoplasmic reticulum to the endosome relies on their interaction with a specific protein, UNC93B1, which is composed of 12 transmembrane domains. Mice lacking this protein have defects in signaling by these endosomal TLRs. Rare human mutations in UNC93B1 have been identified as causing susceptibility to herpes simplex encephalitis, similarly to TLR-3 deficiency, but do not impair immunity to many other viral pathogens, presumably because of the existence of other viral sensors, which are discussed later in this chapter.
3-6 TLR-4 recognizes bacterial lipopolysaccharide in association with the host accessory proteins MD-2 and CD14.
Not all mammalian TLRs bind their ligands so directly. TLR-4 is expressed by several types of immune-system cells, including dendritic cells and macrophages, and is important in sensing and responding to numerous bacterial infections. TLR-4 recognizes the LPS of Gram-negative bacteria by a mechanism that is partly direct and partly indirect. The systemic injection of LPS causes a collapse of the circulatory and respiratory systems, a condition known as shock. These dramatic effects of LPS are seen in humans as septic shock, which results from an uncontrolled systemic bacterial infection, or sepsis. In this case, LPS induces an overwhelming secretion of cytokines, particularly TNF-α (see Section 3-15), causing systemic vascular permeability, an undesirable effect of its normal role in containing local infections. Mutant mice lacking TLR-4 function are resistant to LPS-induced septic shock but are highly sensitive to LPS-bearing pathogens such as Salmonella typhimurium, a natural pathogen of mice. In fact, TLR-4 was identified as the receptor for LPS by positional cloning of its gene from the LPS-resistant C3H/HeJ mouse strain, which harbors a naturally occurring mutation in the cytoplasmic tail of TLR-4 that interferes with the receptor’s ability to signal. For this discovery, the 2011 Nobel Prize in Physiology or Medicine was partly awarded to Bruce Buetler.
LPS varies in composition among different bacteria but essentially consists of a polysaccharide core attached to an amphipathic lipid, lipid A, with a variable number of fatty-acid chains per molecule. To recognize LPS, the ectodomain of TLR-4 uses an accessory protein, MD-2. MD-2 initially binds to TLR-4 within the cell and is necessary both for the correct trafficking of TLR-4 to the cell surface and for the recognition of LPS. MD-2 associates with the central section of the curved ectodomain of TLR-4, binding off to one side as shown in Fig. 3.13. When the TLR4–MD-2 complex encounters LPS, five lipid chains of LPS bind to a deep hydrophobic pocket of MD-2, but not directly to TLR-4, while a sixth lipid chain remains exposed on the surface of MD-2. This last lipid chain and parts of the LPS polysaccharide backbone can then bind to the convex side of a second TLR-4 ectodomain, inducing TLR-4 dimerization that activates intracellular signaling pathways.
TLR-4 activation by LPS involves two other accessory proteins besides MD-2. While LPS is normally an integral component of the outer membrane of Gram-negative bacteria, during infections it can become detached from the membrane and be picked up by the host LPS-binding protein present in the blood and in extracellular fluid in tissues. LPS is transferred from LPS-binding protein to a second protein, CD14, which is present on the surface of macrophages, neutrophils, and dendritic cells. On its own, CD14 can act as a phagocytic receptor, but on macrophages and dendritic cells it also acts as an accessory protein for TLR-4.