New prophylactic and therapeutic treatments to combat pathogenic Enterohaemorrhagic Escherichia coli

Bacterial diarrhoeal diseases have significant influence on global human health, and are a leading cause of preventable death in the developing world. Enterohaemorrhagic Escherichia coli (EHEC), pathogenic strains of E. coli that carry potent toxins, have been associated with a high number of large-scale outbreaks caused by contaminated food and water sources. This pathotype produces diarrhoea and haemorrhagic colitis in infected humans, and in some patients leads to the development of haemolytic uremic syndrome (HUS), which can result in mortality and chronic kidney disease. A major obstacle to the treatment of EHEC infections is the increased risk of HUS development that is associated with antibiotic treatment, and rehydration and renal support are often the only options available. New treatments designed to prevent or clear E. coli infections and reduce symptoms of illness would therefore have large public health and economic impacts. The three main aims of this thesis were: to explore mouse models for pre-clinical evaluation in vivo of small compounds that inhibit a major EHEC colonisation factor, to assess the production and role of two proteins considered promising candidates for a broad-spectrum vaccine against pathogenic E. coli, and to investigate a novel compound that has recently been identified as a potential inhibitor of EHEC toxin production. As EHEC cannot be safely tested in humans due to the risk of HUS development, appropriate small animal models are required for in vivo testing of new drugs. A number of different mouse models have been developed to replicate different features of EHEC pathogenesis, several of which we investigated with a focus on colonisation mediated by the Type III Secretion System (T3SS), a needle-like structure that translocates bacterial proteins into host cells, resulting in a tight, intimate attachment between pathogen and host, aiding colonisation of the gastrointestinal tract. As E. coli models were found not to depend significantly on the T3SS for colonisation, the Citrobacter rodentium model, a natural mouse pathogen closely related to E. coli, was deemed the most suitable mouse model currently available for in vivo testing of T3SS-targeting compounds. Two bacterial proteins, EaeH (an outer membrane adhesin) and YghJ (a putative secreted lipoprotein), highly conserved surface-associated proteins recently identified as III protective antigens against E. coli infection of mice, were explored in order to determine their suitability as candidates for a human vaccine against pathogenic E. coli. We focused on the expression and function of these proteins in the EHEC O157:H7 EDL933 strain and the adherent-invasive E. coli (AIEC) LF82 strain. Although expression of EaeH by other E. coli pathotypes has recently been shown to be upregulated upon contact with host intestinal cells, no evidence of this upregulation could be demonstrated in our strains. Additionally, while YghJ was produced by the AIEC strain, it was not secreted by bacteria under conditions that other YghJ-expressing E. coli pathotypes do, despite the AIEC strain carrying all the genes required to encode the secretion system it is associated with. While our findings indicate that a vaccine that raises antibodies against EaeH and YghJ may have limited effect on the EHEC and AIEC strains we used, recent studies into these proteins in different E. coli pathogens have suggested they are still excellent candidates for a broadly effective vaccine against E. coli. Finally, we characterised a small lead compound, identified by high-throughput screening as a possible inhibitor of Shiga toxin expression. Shiga toxin production causes both the symptoms of illness and development of HUS, and thus reduction of toxin production, release, or binding to host receptors could therefore be an effective way to treat infections and decrease the risk of HUS. Inhibition of Shiga toxin production by this compound was confirmed, and was shown to be caused by an inhibitory effect on activation of the bacterial SOS response rather than on the Shiga toxin genes themselves. The bacterial target of this compound was identified as RecA, a major regulator of the SOS response, and we hypothesise that the compound binds covalently to its target, preventing oligomerisation of RecA into an activated filament. Altogether, the results presented here provide an improved understanding of these different approaches to combating EHEC infection, which will aid the development of safe and effective vaccines and anti-virulence treatments against EHEC.

Interaction techniques with novel multimodal feedback for addressing gesture-sensing systems

Users need to be able to address in-air gesture systems, which means finding where to perform gestures and how to direct them towards the intended system. This is necessary for input to be sensed correctly and without unintentionally affecting other systems. This thesis investigates novel interaction techniques which allow users to address gesture systems properly, helping them find where and how to gesture. It also investigates audio, tactile and interactive light displays for multimodal gesture feedback; these can be used by gesture systems with limited output capabilities (like mobile phones and small household controls), allowing the interaction techniques to be used by a variety of device types. It investigates tactile and interactive light displays in greater detail, as these are not as well understood as audio displays. Experiments 1 and 2 explored tactile feedback for gesture systems, comparing an ultrasound haptic display to wearable tactile displays at different body locations and investigating feedback designs. These experiments found that tactile feedback improves the user experience of gesturing by reassuring users that their movements are being sensed. Experiment 3 investigated interactive light displays for gesture systems, finding this novel display type effective for giving feedback and presenting information. It also found that interactive light feedback is enhanced by audio and tactile feedback. These feedback modalities were then used alongside audio feedback in two interaction techniques for addressing gesture systems: sensor strength feedback and rhythmic gestures. Sensor strength feedback is multimodal feedback that tells users how well they can be sensed, encouraging them to find where to gesture through active exploration. Experiment 4 found that they can do this with 51mm accuracy, with combinations of audio and interactive light feedback leading to the best performance. Rhythmic gestures are continuously repeated gesture movements which can be used to direct input. Experiment 5 investigated the usability of this technique, finding that users can match rhythmic gestures well and with ease. Finally, these interaction techniques were combined, resulting in a new single interaction for addressing gesture systems. Using this interaction, users could direct their input with rhythmic gestures while using the sensor strength feedback to find a good location for addressing the system. Experiment 6 studied the effectiveness and usability of this technique, as well as the design space for combining the two types of feedback. It found that this interaction was successful, with users matching 99.9% of rhythmic gestures, with 80mm accuracy from target points. The findings show that gesture systems could successfully use this interaction technique to allow users to address them. Novel design recommendations for using rhythmic gestures and sensor strength feedback were created, informed by the experiment findings.