Attachment of Streptococcus pneumoniae to human pharyngeal epithelial cells in vitro--mechanism of binding.

To colonize mucosal surfaces and to invade underlying tissues, bacteria need to bind to components of the mucosa. Unattached bacteria are transported away from the surface with the fluid flow. By binding to the nasopharyngeal mucosa, Streptococcus pneumoniae causing otitis media may persist at the site of infection. High binding capacity of the bacterium and increased receptivity of the epithelial cells for attaching bacteria may both contribute to the susceptibility of patients prone to otitis. Thus, epithelial cells from children with frequent episodes of otitis bind attaching bacteria more readily than do cells from age-matched controls. The binding mechanism probably involves bacterial surface proteins and epithelial cell surface glycoconjugate receptors. Evidence is presented that phosphorylcholine, a component of the bacterial surface, as well as epithelial cell receptor analogues, that is, natural or synthetic saccharides analogous to the lactoneoseries of glycolipids, inhibits pneumococcal attachment. Inhibition of bacterial binding in vivo may be a new approach to prophylaxis against otitis media.