A hallmark of L. monocytogenes pathogenesis is escape of the bacteria from maturing phagosomes into the cytoplasm where the bacteria replicate rapidly and progress to infect neighbouring cells. Phagosome escape is facilitated by listeriolysin O (LLO) in concert with other virulence factors, whose expression is controlled by the transcription factor PrfA. Control of L. monocytogenes by the infected host requires T-cell mediated adaptive immunity, in particular cytotoxic T cell activity. More recently, L. monocytogenes has been found to reside inside vacuoles when expressing low levels of LLO in mouse macrophages or during low-dose infection of human hepatocytes and trophoblasts. This been associated with slow/non-replication of the bacteria and chronic infection in vivo.
Here we report that functional inhibition of the master regulator of L. monocytogenes virulence gene expression, PrfA, prevents phagosomal escape of L. monocytogenes. Instead, the bacteria rapidly replicated inside LAMP1-/LC3- vacuoles, which required LLO activity and functional host cell mitochondria. In contrast to the non-degradative spacious Listeria-containing phagosomes described previously in macrophages, these novel Listeria replication vacuoles (LisRVs) acquired lysosomal proteases and acidified, which was associated with clearance of L. monocytogenes by infected cells in the absence of T cell contributions. Crystallography of the PrfA:inhibitor complex showed direct binding of the inhibitor to the PrfA activator site. Our data demonstrating that pharmacologic targeting of L. monocytogenes PrfA licences macrophages to eradicate the bacteria might be harnessed for the rational design of adjunct therapies supporting treatment of listeriosis in high-risk patients.