GBS hyaluronidase mediates immune suppression in a TLR2/4- and IL-10-dependent manner during pregnancy-associated infection

Bacterial infections remain a significant cause of adverse pregnancy outcomes. Ascending infection of group B streptococcus (GBS) or Streptococcus agalactiae from the lower genital tract to the amniotic cavity leads to fetal injury, preterm births, or stillbirths. Factors increasing the invasive potential of bacteria at the maternal-fetal interface are poorly understood. Previous studies have indicated that the GBS hyaluronidase (HylB) can enhance systemic infection by breaking down host hyaluronan into disaccharides that dampen protective TLR2 and TLR4 signaling. Here, we examined the importance of hyaluronan receptors such as TLR2, TLR4, and CD44 in defense against GBS infections during pregnancy. While HylB promoted ascending GBS infection in wild-type (WT) and CD44-deficient mice, surprisingly, mice lacking both TLR2 and TLR4 (TLR2/4) were able to curtail these infections. Interleukin-10 (IL-10) and IL-10-expressing macrophages were significantly increased in the uterine tissues of WT mice during infection with HylB-proficient GBS compared with those of TLR2/4-deficient mice, and this likely promotes immune suppression and GBS dissemination. Consistent with these observations, pregnant IL-10-deficient mice exhibited diminished GBS ascension and dissemination. Similarly, the administration of a blocking antibody against the IL-10 receptor (IL-10R) in WT mice diminished ascending GBS infection. Collectively, these observations indicate that HylB promotes immune suppression in a TLR2/4- and IL-10-dependent manner to enhance the invasive potential of GBS during pregnancy-associated infections. IMPORTANCE: Bacteria such as GBS can cause infections during pregnancy leading to preterm births, stillbirths, and neonatal infections. The interaction between host and bacterial factors during infections in the placenta is not fully understood. GBS secretes a hyaluronidase enzyme that is thought to digest host hyaluronan into immunosuppressive disaccharides that dampen TLR2/4 signaling, leading to increased bacterial dissemination and adverse outcomes. In this study, we show that GBS HylB mediates immune suppression and promotes bacterial infection during pregnancy that requires TLR2, TLR4, and IL-10. Understanding the interaction between host and bacterial factors can inform future therapeutic strategies to mitigate GBS infections.