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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Cell. Infect. Microbiol.</journal-id>
<journal-title>Frontiers in Cellular and Infection Microbiology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Cell. Infect. Microbiol.</abbrev-journal-title>
<issn pub-type="epub">2235-2988</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fcimb.2024.1523597</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Cellular and Infection Microbiology</subject>
<subj-group>
<subject>Review</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Breaking the cellular defense: the role of autophagy evasion in <italic>Francisella</italic> virulence</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Pavlik</surname>
<given-names>Pavla</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/501864"/>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/validation/"/>
<role content-type="https://credit.niso.org/contributor-roles/visualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Velecka</surname>
<given-names>Eva</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/2888492"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Spidlova</surname>
<given-names>Petra</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
<uri xlink:href="https://loop.frontiersin.org/people/501440"/>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/supervision/"/>
<role content-type="https://credit.niso.org/contributor-roles/validation/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
</contrib-group>
<aff id="aff1">
<sup>1</sup>
<institution>Department of Molecular Pathology and Biology, Military Faculty of Medicine, University of Defence</institution>, <addr-line>Hradec Kralove</addr-line>, <country>Czechia</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Institute of Organic Chemistry and Biochemistry, Czech Academy of Sciences</institution>, <addr-line>Prague</addr-line>, <country>Czechia</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Cristel Archambaud, INRAE Centre Jouy-en-Josas, France</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Audrey Chong, National Institute of Allergy and Infectious Diseases (NIH), United States</p>
<p>Stuart Cantlay, West Liberty University, United States</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Petra Spidlova, <email xlink:href="mailto:petra.spidlova@unob.cz">petra.spidlova@unob.cz</email>
</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>24</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="collection">
<year>2024</year>
</pub-date>
<volume>14</volume>
<elocation-id>1523597</elocation-id>
<history>
<date date-type="received">
<day>06</day>
<month>11</month>
<year>2024</year>
</date>
<date date-type="accepted">
<day>04</day>
<month>12</month>
<year>2024</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2024 Pavlik, Velecka and Spidlova</copyright-statement>
<copyright-year>2024</copyright-year>
<copyright-holder>Pavlik, Velecka and Spidlova</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<p>Many pathogens have evolved sophisticated strategies to evade autophagy, a crucial cellular defense mechanism that typically targets and degrades invading microorganisms. By subverting or inhibiting autophagy, these pathogens can create a more favorable environment for their replication and survival within the host. For instance, some bacteria secrete factors that block autophagosome formation, while others might escape from autophagosomes before degradation. These evasion tactics are critical for the pathogens&#x2019; ability to establish and maintain infections. Understanding the mechanisms by which pathogens avoid autophagy is crucial for developing new therapeutic strategies, as enhancing autophagy could bolster the host&#x2019;s immune response and aid in the elimination of pathogenic bacteria. <italic>Francisella tularensis</italic> can manipulate host cell pathways to prevent its detection and destruction by autophagy, thereby enhancing its virulence. Given the potential for <italic>F. tularensis</italic> to be used as a bioterrorism agent due to its high infectivity and ability to cause severe disease, research into how this pathogen evades autophagy is of critical importance. By unraveling these mechanisms, new therapeutic approaches could be developed to enhance autophagic responses and strengthen host defense against this and other similarly evasive pathogens.</p>
</abstract>
<abstract abstract-type="graphical">
<title>Graphical Abstract</title>
<p>
<graphic xlink:href="fcimb-14-1523597-g001.tif" position="anchor"/>
</p>
</abstract>
<kwd-group>
<kwd>
<italic>Francisella</italic>
</kwd>
<kwd>autophagy</kwd>
<kwd>virulence</kwd>
<kwd>bacterial pathogenesis</kwd>
<kwd>host-pathogen interaction</kwd>
</kwd-group>
<contract-num rid="cn001">DZRO-FVZ22-ZHN II</contract-num>
<contract-sponsor id="cn001">Ministerstvo Obrany &#x10c;esk&#xe9; Republiky<named-content content-type="fundref-id">10.13039/501100014911</named-content>
</contract-sponsor>
<counts>
<fig-count count="0"/>
<table-count count="1"/>
<equation-count count="0"/>
<ref-count count="128"/>
<page-count count="11"/>
<word-count count="5803"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-in-acceptance</meta-name>
<meta-value>Bacteria and Host</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<title>Introduction</title>
<p>
<italic>Francisella</italic> is a genus of gram-negative bacteria that includes the highly virulent species <italic>F. tularensis</italic>, known for causing tularemia in humans and other mammals. Researches have revealed that <italic>F. tularensis</italic> can evade the host&#x2019;s immune response by escaping the phagosome. Instead of being targeted for degradation, the bacterium can replicate within the host cell&#x2019;s cytoplasm, where it is protected from immune responses. One intriguing aspect of the interaction between <italic>F. tularensis</italic> and its host cells is its ability to dampen the host&#x2019;s cellular processes, including autophagy. The bacterium has developed mechanisms to manipulate the host cell&#x2019;s autophagy machinery promoting its intracellular survival. Studies have shown that <italic>F. tularensis</italic> can inhibit the fusion of autophagosomes with lysosomes, where the contents are typically degraded. By preventing this fusion, the bacterium can avoid destruction and create a favorable intracellular niche for replication. Understanding the interplay between <italic>F. tularensis</italic> and autophagy is crucial for developing more effective treatments and vaccines against tularemia.</p>
<sec id="s1_1">
<title>The basics of autophagy</title>
<p>Autophagy is a fundamental cellular process responsible for the degradation and recycling of cellular components. This mechanism is crucial for maintaining cellular homeostasis, responding to stress conditions, and survival during nutrient deprivation. Autophagy involves the formation of autophagosomes, double-membraned vesicles that engulf damaged organelles, misfolded proteins, and pathogens for degradation in the lysosomes (<xref ref-type="bibr" rid="B62">Levine and Kroemer, 2019</xref>).</p>
<p>The process is highly regulated and can be triggered by various cellular signals, including nutrient levels, growth factors, and intracellular energy status. The regulation of autophagy is mediated by a complex network of signaling pathways, with the mammalian target of rapamycin (mTOR) pathway playing a central role in inhibiting autophagy under nutrient-rich conditions. Conversely, activation of AMP-activated protein kinase (AMPK) promotes autophagy by inhibiting mTOR under nutrient scarcity (<xref ref-type="bibr" rid="B54">Kim et&#xa0;al., 2011</xref>).</p>
<p>Autophagy not only helps in the removal of cellular debris but also plays a crucial role in defense mechanisms against infections by degrading intracellular pathogens through a process known as xenophagy (<xref ref-type="bibr" rid="B33">Deretic et&#xa0;al., 2013</xref>). Nevertheless, some pathogens together with <italic>F. tularensis</italic> can affect host cellular processes, including autophagy, to their advantage.</p>
</sec>
<sec id="s1_2">
<title>Mechanisms and pathways</title>
<p>Autophagy is a cellular degradation process crucial for maintaining cellular homeostasis by removing damaged organelles and misfolded proteins. There are three primary types of autophagy: macroautophagy, microautophagy, and chaperone-mediated autophagy (CMA), each with distinct mechanisms and functions.</p>
<p>
<bold>Macroautophagy</bold> is the most extensively studied form of autophagy and involves the formation of double-membrane vesicles called autophagosomes. These vesicles engulf cytoplasmic material and then fuse with lysosomes, where the content is degraded and recycled. The process begins with the nucleation and expansion of the isolation membrane, which requires the expression of various autophagy-related proteins (ATGs). Key regulators of this pathway include the ULK1 complex, Beclin-1, and the ATG8/LC3 family proteins. This type of autophagy is highly regulated by nutrient availability and cellular stress, playing a critical role in cell survival during starvation and other stress conditions (<xref ref-type="bibr" rid="B120">Yamamoto and Matsui, 2024</xref>).</p>
<p>One of the primary roles of macroautophagy in host defense is the direct elimination of intracellular pathogens. This process, termed xenophagy, targets bacteria, viruses, and other pathogens for degradation. Xenophagy, also known as selective autophagy of pathogens, is a host defense mechanism where intracellular pathogens are recognized, sequestered within double-membraned autophagosomes, and subsequently degraded after fusion with lysosomes. This process is essential for maintaining cellular homeostasis and protecting the host from infections by targeting and eliminating invasive microbes such as bacteria, viruses, and parasites (<xref ref-type="bibr" rid="B124">Yuk et&#xa0;al., 2012</xref>). Xenophagy not only removes these pathogens but also facilitates antigen presentation, enhancing the adaptive immune response. The process of xenophagy begins with the recognition of intracellular pathogens through pattern recognition receptors (PRRs) that identify pathogen-associated molecular patterns (PAMPs). By delivering pathogen-derived antigens to major histocompatibility complex (MHC) molecules, autophagy enhances the presentation of these antigens to T cells. This process is critical for the immune system to recognize and respond to infections effectively (<xref ref-type="bibr" rid="B113">Van Kaer et&#xa0;al., 2019</xref>). Autophagy contributes to the presentation of viral antigens on MHC class II molecules, thus aiding in the activation of CD4+ T cells during viral infections (<xref ref-type="bibr" rid="B91">Schmid et&#xa0;al., 2007</xref>). Once recognized, adaptor proteins such as p62/SQSTM1 link the pathogen to autophagic machinery by binding to ubiquitinated microbial proteins and recruiting autophagy-related proteins like LC3 (<xref ref-type="bibr" rid="B126">Zheng et&#xa0;al., 2009</xref>). This recruitment ensures the encapsulation of the pathogen within autophagosomes. However, many pathogens have evolved sophisticated strategies to evade or manipulate xenophagy. Some escape recognition by autophagic receptors, while others inhibit autophagosome formation or prevent their fusion with lysosomes (<xref ref-type="bibr" rid="B68">Mao and Klionsky, 2016</xref>).</p>
<p>In addition to direct targeting pathogens, autophagy plays a significant role in modulating inflammatory responses. By degrading damaged organelles and excess proteins, autophagy prevents the accumulation of cellular debris that can trigger inflammation. Furthermore, autophagy regulates the production of pro-inflammatory cytokines, such as IL-1&#x3b2;, by controlling the activation of the inflammasome (<xref ref-type="bibr" rid="B44">Harris et&#xa0;al., 2011</xref>; <xref ref-type="bibr" rid="B24">Claude-Taupin et&#xa0;al., 2018</xref>; <xref ref-type="bibr" rid="B49">Iula et&#xa0;al., 2018</xref>).</p>
<p>
<bold>Microautophagy</bold> involves the direct engulfment of cytoplasmic material by the lysosome itself through invagination, protrusion, or septation of the lysosomal membrane. Unlike macroautophagy, this process does not require the formation of autophagosomes. Instead, the lysosomal membrane engulfs small portions of the cytoplasm, including organelles and proteins, which are then degraded within the lysosome. Microautophagy is less well understood than macroautophagy but is believed to be crucial for maintaining organelle size and number, as well as for responding to nutrient depletion (<xref ref-type="bibr" rid="B120">Yamamoto and Matsui, 2024</xref>).</p>
<p>
<bold>Chaperone-mediated autophagy (CMA)</bold> is distinct from both macroautophagy and microautophagy since it specifically targets soluble cytosolic proteins for degradation. This selectivity is mediated by chaperone proteins, particularly heat shock protein 70 (Hsp70), which recognize and bind to specific KFERQ-like motifs in the substrate proteins. These substrates are then translocated across the lysosomal membrane via the lysosomal-associated membrane protein 2A (LAMP-2A). CMA is involved in the degradation of long-lived proteins and plays a significant role in cellular quality control and stress response (<xref ref-type="bibr" rid="B76">Orenstein and Cuervo, 2010</xref>; <xref ref-type="bibr" rid="B51">Kaushik and Cuervo, 2018</xref>).</p>
</sec>
<sec id="s1_3">
<title>Pathogenic bacteria and their influence on autophagy</title>
<p>Some pathogenic bacteria inhibit autophagy to avoid degradation. They employ various strategies to overcome autophagy, such as inhibiting autophagosome formation, evading recognition, and preventing acidification. This section summarizes several bacterial pathogens and their effectors (see <xref ref-type="table" rid="T1">
<bold>Table&#xa0;1</bold>
</xref>).</p>
<table-wrap id="T1" position="float">
<label>Table&#xa0;1</label>
<caption>
<p>Bacteria and their effector proteins affecting autophagy.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="middle" align="center">Bacteria</th>
<th valign="middle" align="center">Effector proteins</th>
<th valign="middle" align="center">Positive/negative <break/>modulation of the autophagy</th>
<th valign="middle" align="center">References</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="middle" rowspan="3" align="center">
<italic>Salmonella</italic>
</td>
<td valign="top" align="left">SopB</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B107">Tattoli et&#xa0;al., 2012</xref>; <xref ref-type="bibr" rid="B18">Chatterjee et&#xa0;al., 2023</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">SsrB, SsaV, SseG, SseF, SseL, SpvB</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B70">Mesquita et&#xa0;al., 2012</xref>; <xref ref-type="bibr" rid="B39">Ganesan et&#xa0;al., 2017</xref>; <xref ref-type="bibr" rid="B38">Feng et&#xa0;al., 2018</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">CdtB, Type II L-asparaginase, SipD, &#x3b2;-OMP</td>
<td valign="middle" align="center">Positive</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B47">Hernandez et&#xa0;al., 2003</xref>; <xref ref-type="bibr" rid="B116">Williams et&#xa0;al., 2015</xref>; <xref ref-type="bibr" rid="B109">Torres et&#xa0;al., 2016</xref>; <xref ref-type="bibr" rid="B19">Chaudhary et&#xa0;al., 2018</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>Shigella</italic>
</td>
<td valign="top" align="left">IcsB</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B7">Baxt and Goldberg, 2014</xref>; <xref ref-type="bibr" rid="B4">Ashida et&#xa0;al., 2015</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="2" align="center">
<italic>Legionella</italic>
</td>
<td valign="top" align="left">RavZ, LpSp1, Lpg1137, Lpg2936, SidE, SdeA, SdeB, SdeC</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B31">Degtyar et&#xa0;al., 2009</xref>; <xref ref-type="bibr" rid="B23">Choy et&#xa0;al., 2012</xref>; <xref ref-type="bibr" rid="B11">Bhogaraju et&#xa0;al., 2016</xref>; <xref ref-type="bibr" rid="B88">Rolando et&#xa0;al., 2016</xref>; <xref ref-type="bibr" rid="B3">Arasaki et&#xa0;al., 2017</xref>; <xref ref-type="bibr" rid="B32">De Leon et&#xa0;al., 2017</xref>; <xref ref-type="bibr" rid="B81">Pinotsis and Waksman, 2017</xref>; <xref ref-type="bibr" rid="B1">Abd El Maksoud et&#xa0;al., 2019</xref>; <xref ref-type="bibr" rid="B75">Omotade and Roy, 2020</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">LegA9, SetA</td>
<td valign="middle" align="center">Positive</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B53">Khweek et&#xa0;al., 2013</xref>; <xref ref-type="bibr" rid="B8">Beck et&#xa0;al., 2020</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>Brucella</italic>
</td>
<td valign="top" align="left">BtpB, NyxA, NyxB</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B63">Li et&#xa0;al., 2022</xref>; <xref ref-type="bibr" rid="B66">Louche et&#xa0;al., 2023</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>Mycobacterium</italic>
</td>
<td valign="top" align="left">PknG, SapM, PE_PGRS20, PE_PGRS47, PtpA, ESAT-6, CFP-10</td>
<td valign="middle" align="center">Positive/Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B106">Tan et&#xa0;al., 2006</xref>; <xref ref-type="bibr" rid="B117">Wong et&#xa0;al., 2011</xref>; <xref ref-type="bibr" rid="B55">Kim et&#xa0;al., 2020</xref>; <xref ref-type="bibr" rid="B105">Strong et&#xa0;al., 2021</xref>; <xref ref-type="bibr" rid="B40">Ge et&#xa0;al., 2022</xref>; <xref ref-type="bibr" rid="B125">Zhang et&#xa0;al., 2024</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>Listeria</italic>
</td>
<td valign="top" align="left">PlcA, PlcB, ActA, LLO, InlK</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B96">Smith et&#xa0;al., 1995</xref>; <xref ref-type="bibr" rid="B92">Schnupf and Portnoy, 2007</xref>; <xref ref-type="bibr" rid="B121">Yoshikawa et&#xa0;al., 2009a</xref>, <xref ref-type="bibr" rid="B122">Yoshikawa et&#xa0;al., 2009b</xref>; <xref ref-type="bibr" rid="B34">Dortet et&#xa0;al., 2011</xref>, <xref ref-type="bibr" rid="B35">Dortet et&#xa0;al., 2012</xref>; <xref ref-type="bibr" rid="B71">Mitchell et&#xa0;al., 2015</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>Streptococcus</italic>
</td>
<td valign="top" align="left">SpyCEP, SpeB,</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B6">Barnett et&#xa0;al., 2013</xref>; <xref ref-type="bibr" rid="B10">Bergmann et&#xa0;al., 2022</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="2" align="center">
<italic>Yersinia</italic>
</td>
<td valign="top" align="left">YopB, YopD, YopJ (YopP), YopM, YopE, YopT, YopH, YpkA (YopO), YopK (YopQ)</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B93">Seabaugh and Anderson, 2024</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">Unknown plasmid-borne effectors</td>
<td valign="middle" align="center">Positive</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B61">Lemarignier and Pizarro-Cerd&#xe1;, 2020</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>Pseudomonas</italic>
</td>
<td valign="top" align="left">ExoS</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B86">Rao et&#xa0;al., 2021</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>Bacillus</italic>
</td>
<td valign="top" align="left">Edtx</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B94">Shahnazari et&#xa0;al., 2011</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="3" align="center">
<italic>Vibrio</italic>
</td>
<td valign="top" align="left">Ctx,</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B48">Huang and Brumell, 2014</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">VCC,</td>
<td valign="middle" align="center">Positive/Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B42">Gutierrez et&#xa0;al., 2007</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">MakA</td>
<td valign="middle" align="center">Positive/Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B27">Corkery et&#xa0;al., 2021</xref>; <xref ref-type="bibr" rid="B50">Jia et&#xa0;al., 2022</xref>)</td>
</tr>
<tr>
<td valign="middle" align="center">
<italic>Enterococcus</italic>
</td>
<td valign="top" align="left">LTA</td>
<td valign="middle" align="center">Positive</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B65">Lin et&#xa0;al., 2018</xref>)</td>
</tr>
<tr>
<td valign="middle" rowspan="3" align="center">
<italic>Francisella</italic>
</td>
<td valign="top" align="left">IglC</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B90">Santic et&#xa0;al., 2005</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">PdpC, PdpD</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B36">Eshraghi et&#xa0;al., 2016</xref>)</td>
</tr>
<tr>
<td valign="top" align="left">OpiA</td>
<td valign="middle" align="center">Negative</td>
<td valign="top" align="center">(<xref ref-type="bibr" rid="B60">Ledvina et&#xa0;al., 2018</xref>)</td>
</tr>
</tbody>
</table>
</table-wrap>
<p>For instance, <bold>
<italic>Salmonella enterica</italic> serovar Typhimurium</bold>, a common cause of foodborne illness, secretes effector proteins through its type III secretion system (T3SS) to inhibit autophagy. The bacterial effector protein SopB disrupts the formation of autophagosomes by interfering with the host cell&#x2019;s signaling pathways (<xref ref-type="bibr" rid="B107">Tattoli et&#xa0;al., 2012</xref>; <xref ref-type="bibr" rid="B18">Chatterjee et&#xa0;al., 2023</xref>). This inhibition allows <italic>Salmonella</italic> to reside within a modified vacuole, where it can replicate and evade host immune responses. Other studies have also confirmed that effectors of SPI-2 (<italic>Salmonella</italic> pathogenicity island 2) T3SS as well as <italic>Salmonella</italic> virulence plasmids are important for bacterium to escape phagocytosis (<xref ref-type="bibr" rid="B119">Wu et&#xa0;al., 2020</xref>). For example, SsrB and SsaV effector proteins are responsible for activating mTOR through disruption of AMPK signaling (<xref ref-type="bibr" rid="B39">Ganesan et&#xa0;al., 2017</xref>). Other effector proteins, SseG and SseF, block Rab1 activity in host cell, which results in reduction of autophagosome formation and effective bacterial replication in cytoplasm (<xref ref-type="bibr" rid="B38">Feng et&#xa0;al., 2018</xref>). SseL acts as a deubiquitinase, which removes ubiquitin markers from <italic>Salmonella</italic>-infected cells, thus enabling bacterial replication instead of autophagic degradation (<xref ref-type="bibr" rid="B70">Mesquita et&#xa0;al., 2012</xref>). On the other hand, there exist <italic>Salmonella&#xb4;s</italic> proteins that are involved in autophagy induction. L-asparaginase hydrolyzes the L-asparagine, thus T cells are not activated, which results in mTOR signaling inhibition and autophagy induction (<xref ref-type="bibr" rid="B109">Torres et&#xa0;al., 2016</xref>). Among other autophagy inducing proteins belong &#x3b2;-barrel outer membrane protein (&#x3b2;-OMP), <italic>Salmonella</italic> invasive protein D (SipD) and cytoskelethal distending toxin B (CdtB) (<xref ref-type="bibr" rid="B47">Hernandez et&#xa0;al., 2003</xref>; <xref ref-type="bibr" rid="B116">Williams et&#xa0;al., 2015</xref>; <xref ref-type="bibr" rid="B19">Chaudhary et&#xa0;al., 2018</xref>).</p>
<p>
<bold>
<italic>Shigella</italic>
</bold>, a genus of bacteria responsible for causing dysentery, has developed sophisticated mechanisms to evade and manipulate the host&#x2019;s immune responses, particularly autophagy (<xref ref-type="bibr" rid="B80">Phalipon and Sansonetti, 2007</xref>). <italic>Shigella</italic> can inhibit the formation of autophagosomes, the vesicles responsible for sequestering pathogens. This inhibition prevents the bacteria from being engulfed and degraded. <italic>Shigella</italic> achieves this through the secretion of effector proteins via its T3SS, which interfere with autophagy signaling pathways. Even if <italic>Shigella</italic> is initially captured by autophagosomes, it can escape before being degraded. The effector protein IcsB, secreted by <italic>Shigella</italic>, helps it evade autophagic recognition. IcsB interferes with the recruitment of autophagy-related proteins, such as ATG5, which are necessary for the formation of autophagosomes (<xref ref-type="bibr" rid="B7">Baxt and Goldberg, 2014</xref>; <xref ref-type="bibr" rid="B4">Ashida et&#xa0;al., 2015</xref>).</p>
<p>
<bold>
<italic>Legionella pneumophila</italic>
</bold>, the causative agent of Legionnaires&#x2019; disease, hijacks the autophagic machinery through the irreversibly inactivating ATG8 proteins to create a replicative niche known as the <italic>Legionella</italic>-containing vacuole (LCV). <italic>Legionella</italic> secretes many effector proteins (<xref ref-type="bibr" rid="B108">Thomas et&#xa0;al., 2020</xref>), such as RavZ, that modulate autophagy to divert autophagic vesicles away from the lysosomal degradation pathway, thereby creating a favorable environment for bacterial replication (<xref ref-type="bibr" rid="B23">Choy et&#xa0;al., 2012</xref>).</p>
<p>LpSpl, a <italic>Legionella</italic> effector, mimics the enzymatic activity of sphingosine-1-phosphate lyase 1 (SGPL1), a key regulator of sphingolipid metabolism. LpSpl&#x2019;s localization to mitochondria and the endoplasmic reticulum suggests a complex interplay with host metabolic pathways (<xref ref-type="bibr" rid="B31">Degtyar et&#xa0;al., 2009</xref>; <xref ref-type="bibr" rid="B88">Rolando et&#xa0;al., 2016</xref>). By reducing sphingosine levels, which are known to stimulate autophagy (<xref ref-type="bibr" rid="B29">Dall&#x2019;Armi et&#xa0;al., 2013</xref>), LpSpl inhibits autophagosome biogenesis. This inhibition is dependent on its enzymatic activity, as mutants lacking functional active sites do not affect autophagy (<xref ref-type="bibr" rid="B88">Rolando et&#xa0;al., 2016</xref>). Despite its ability to modulate autophagy, LpSpl does not significantly impact bacterial replication in macrophages or amoebae but is required for optimal replication in mouse models (<xref ref-type="bibr" rid="B88">Rolando et&#xa0;al., 2016</xref>).</p>
<p>Lpg1137, a serine protease, disrupts autophagosome biogenesis by degrading Syntaxin 17 (Stx17), a key SNARE protein (soluble N-ethylmaleimide-sensitive factor attachment protein receptors) involved in autophagosome-lysosome fusion and autophagy initiation (<xref ref-type="bibr" rid="B43">Hamasaki et&#xa0;al., 2013</xref>; <xref ref-type="bibr" rid="B58">Kumar et&#xa0;al., 2019</xref>). By cleaving Stx17, Lpg1137 prevents the formation of LC3- and ATG14-positive puncta, essential for autophagosome formation (<xref ref-type="bibr" rid="B3">Arasaki et&#xa0;al., 2017</xref>). Interestingly, bioinformatic analysis suggests Lpg1137 resembles mitochondrial SLC25 carrier proteins, though its exact mechanism requires further structural characterization (<xref ref-type="bibr" rid="B41">Gradowski and Paw&#x142;owski, 2017</xref>).</p>
<p>The effector Lpg2936 modulates host autophagy by inducing epigenetic changes in the promoter regions of key autophagy genes, such as ATG7 and LC3B. By methylating the GATC motif in these promoters, Lpg2936 suppresses autophagosome formation, indirectly promoting bacterial replication (<xref ref-type="bibr" rid="B1">Abd El Maksoud et&#xa0;al., 2019</xref>). While this highlights its role as a transcriptional regulator, its potential autophagy-independent roles remain under investigation (<xref ref-type="bibr" rid="B81">Pinotsis and Waksman, 2017</xref>).</p>
<p>In contrast to other effectors, LegA9 enhances the recruitment of SQSTM-1 to <italic>Legionella</italic>-containing vacuoles (LCVs), promoting their recognition for autophagic clearance (<xref ref-type="bibr" rid="B53">Khweek et&#xa0;al., 2013</xref>). However, this effector does not directly activate autophagy, and its role appears to be more relevant in alternative hosts, suggesting an evolutionary trade-off in mammalian infections (<xref ref-type="bibr" rid="B82">Price et&#xa0;al., 2020</xref>).</p>
<p>The SidE family of effectors (SidE, SdeA, SdeB, and SdeC) inhibits the recruitment of autophagy adapters such as SQSTM-1 to LCVs by generating unique ubiquitin linkages (<xref ref-type="bibr" rid="B11">Bhogaraju et&#xa0;al., 2016</xref>; <xref ref-type="bibr" rid="B75">Omotade and Roy, 2020</xref>). Furthermore, these effectors promote TFEB (transcription factor EB) nuclear translocation, which upregulates autophagy and lysosomal genes, suggesting a dual role in balancing nutrient acquisition and autophagy inhibition (<xref ref-type="bibr" rid="B32">De Leon et&#xa0;al., 2017</xref>). Temporal regulation appears essential, as SidE activity is blocked during co-expression with other <italic>Legionella</italic> effectors (<xref ref-type="bibr" rid="B32">De Leon et&#xa0;al., 2017</xref>).</p>
<p>SetA glucosylates TFEB, preventing its cytoplasmic retention and promoting its nuclear translocation, thereby inducing autophagic gene expression (<xref ref-type="bibr" rid="B8">Beck et&#xa0;al., 2020</xref>).</p>
<p>
<bold>
<italic>Brucella abortus</italic>
</bold>, a pathogen responsible for brucellosis, resides in a membrane-bound compartment called the <italic>Brucella</italic>-containing vacuole (BCV) upon entry into host cells (<xref ref-type="bibr" rid="B16">Celli, 2019</xref>). <italic>Brucella</italic> inhibits the fusion of intermediate BCVs with late endosomes and lysosomes, which are critical steps in the autophagic process. Despite preventing full fusion with lysosomes, BCVs acquire several markers of late endosomes, including Rab7, a small GTPase, and its effector Rab-interacting lysosomal protein (RILP). This interaction allows <italic>Brucella</italic> to manipulate the endocytic pathway while avoiding degradation (<xref ref-type="bibr" rid="B100">Starr et&#xa0;al., 2008</xref>). <italic>Brucella</italic> effector like BtpB interferes with the host&#x2019;s autophagic signaling pathways, allowing the bacteria to persist in a replication-permissive environment (<xref ref-type="bibr" rid="B63">Li et&#xa0;al., 2022</xref>). Interestingly, some bacteria can both inhibit and exploit autophagy at different stages of infection. The <italic>Brucella</italic> effector proteins NyxA and NyxB modulate host autophagy by targeting the SUMO-specific protease SENP3, which regulates autophagy-related protein de-SUMOylation. By disrupting SENP3 activity, NyxA and NyxB inhibit xenophagy, allowing <italic>Brucella</italic> to evade autophagic degradation and establish a replicative niche. This interference also dampens inflammatory responses associated with autophagy, promoting bacterial survival and persistence within host cells (<xref ref-type="bibr" rid="B66">Louche et&#xa0;al., 2023</xref>).</p>
<p>
<bold>
<italic>Mycobacterium tuberculosis</italic>
</bold>, the bacterium responsible for tuberculosis, initially inhibits autophagy to prevent its destruction within macrophages. However, during later stages of infection, <italic>M. tuberculosis</italic> can exploit the autophagic process to access nutrients and enhance its survival. This dual manipulation underscores the complexity of bacterial interactions with the autophagic machinery (<xref ref-type="bibr" rid="B15">Castillo et&#xa0;al., 2012</xref>). <italic>Mycobacterium</italic> can activate the mTOR pathway, a key negative regulator of autophagy. By maintaining mTOR activity, <italic>Mycobacterium</italic> prevents the initiation of autophagy, hindering the formation of autophagosomes (<xref ref-type="bibr" rid="B95">Singh and Subbian, 2018</xref>). This is crucial because the initiation of autophagy is dependent on the inhibition of mTOR, which normally suppresses the activity of the ULK1 complex, essential for the nucleation of autophagosomes (<xref ref-type="bibr" rid="B54">Kim et&#xa0;al., 2011</xref>). Bacterium secretes proteins such as PknG, a serine/threonine kinase, which inhibits the maturation of phagosomes. PknG prevents the acidification and fusion of Mtb-containing phagosomes with lysosomes, thereby blocking their transformation into autophagolysosomes where the bacteria would be degraded (<xref ref-type="bibr" rid="B40">Ge et&#xa0;al., 2022</xref>). <italic>Mycobacterium</italic> also secretes SapM, which interacts with the adaptor protein Raptor that is involved in the mTOR pathway. SapM causes the dephosphorylation of Raptor and this interaction results in mTORC1 hyperactivity, which in turn inhibits autophagy (<xref ref-type="bibr" rid="B125">Zhang et&#xa0;al., 2024</xref>). Mycobacterial proteins PE_PGRS20 and PE_PGRS47 have been shown to interact with host autophagy proteins. These interactions can modulate autophagic flux, ensuring that the autophagy process is altered in a way that favors bacterial survival rather than its degradation. These proteins interact directly with Ras-related protein Rab1A -&#xa0;a multifunctional regulator in the autophagy pathway (<xref ref-type="bibr" rid="B105">Strong et&#xa0;al., 2021</xref>). Phagosomal maturation through fusion with lysosomes relies, besides others, on vacuolar ATPase, which acidifies the phagosomal lumen by hydrolyzing ATP. <italic>Mycobacterium</italic> inhibits host vacuolar ATPase using mechanisms involving the mycobacterial secreted phosphatase PtpA that interacts with vacuolar ATPase to enhance bacterial survival and pathogenicity (<xref ref-type="bibr" rid="B117">Wong et&#xa0;al., 2011</xref>; <xref ref-type="bibr" rid="B55">Kim et&#xa0;al., 2020</xref>). Two mycobacterial proteins ESAT-6 and CFP-10 are also secreted and plays a critical role in preventing phagolysosomal fusion, thereby aiding in the intracellular survival of <italic>Mycobacterium</italic> (<xref ref-type="bibr" rid="B106">Tan et&#xa0;al., 2006</xref>). Interaction of <italic>Mycobacterium</italic> with host autophagy is very well described in (<xref ref-type="bibr" rid="B55">Kim et&#xa0;al., 2020</xref>).</p>
<p>
<bold>
<italic>Listeria monocytogenes</italic>
</bold>, a facultative intracellular pathogen, avoids autophagy by expressing two key determinants of pathogenesis: secreted phosphatidylinositol-specific phospholipases C (PlcA) (<xref ref-type="bibr" rid="B71">Mitchell et&#xa0;al., 2015</xref>), broad-range phospholipase C (PlcB) (<xref ref-type="bibr" rid="B96">Smith et&#xa0;al., 1995</xref>), a surface protein (ActA) (<xref ref-type="bibr" rid="B121">Yoshikawa et&#xa0;al., 2009a</xref>, <xref ref-type="bibr" rid="B122">Yoshikawa et&#xa0;al., 2009b</xref>) and pore-forming cytolysin listeriolysin O (LLO) (<xref ref-type="bibr" rid="B92">Schnupf and Portnoy, 2007</xref>). These factors allow the bacterium to escape from phagosomes, grow in the host cytosol, and evade the autophagic response (<xref ref-type="bibr" rid="B71">Mitchell et&#xa0;al., 2015</xref>, <xref ref-type="bibr" rid="B72">2018</xref>). In addition to these proteins, the surface-associated protein InlK, encoded by the <italic>lmo1290</italic> gene, has been identified to play a crucial role in <italic>Listeria&#x2019;s</italic> ability to evade autophagy (<xref ref-type="bibr" rid="B34">Dortet et&#xa0;al., 2011</xref>). A yeast two-hybrid assay revealed that major vault protein (MVP), a highly abundant component of the eukaryotic cytoplasm, is a potential interacting partner of InlK (<xref ref-type="bibr" rid="B34">Dortet et&#xa0;al., 2011</xref>). InlK recruits MVP to coat the surface of <italic>Listeria</italic> so that the bacterium can escape autophagic recognition (<xref ref-type="bibr" rid="B35">Dortet et&#xa0;al., 2012</xref>).</p>
<p>In the case of <bold>
<italic>Streptococcus</italic>
</bold>, SpyCEP (Streptococcal pyrogenic exotoxin B cleaving enzyme) and SpeB (Streptococcal cysteine protease B) are critical factors to evade the host&#x2019;s autophagic defenses, facilitating their survival and proliferation within host cells. SpyCEP is an interleukin-8 protease that is highly upregulated during invasive streptococcal infections. This protease cleaves and inactivates IL-8, a key chemokine involved in recruiting immune cells to the site of infection. By doing so, SpyCEP helps bacteria evade the immune response, including autophagy, which is a critical host defense mechanism (<xref ref-type="bibr" rid="B10">Bergmann et&#xa0;al., 2022</xref>). SpeB is a cysteine protease that is involved in the degradation of host cell proteins and immune modulators. SpeB degrades p62, NDP52, and NBR1. These proteins are essential components of the autophagy machinery, functioning as adaptors that help in recognizing and targeting bacteria for autophagic degradation. By degrading these adaptors, SpeB effectively inhibits the autophagic process within the host cell cytosol (<xref ref-type="bibr" rid="B6">Barnett et&#xa0;al., 2013</xref>).</p>
<p>The uptake of <bold>
<italic>Yersinia</italic>
</bold> by host cells triggers autophagy-related processes, but the specific pathways and outcomes vary depending on the cell type and <italic>Yersinia</italic> species. For example, <italic>Y. pseudotuberculosis</italic> has been shown to induce classical autophagy in macrophages and a variant called LC3-assisted phagocytosis in epithelial cells (<xref ref-type="bibr" rid="B73">Moreau et&#xa0;al., 2010</xref>). However, these autophagic processes do not effectively eliminate the bacteria; instead, they may support bacterial survival within host cells. The study of (<xref ref-type="bibr" rid="B64">Ligeon et&#xa0;al., 2014</xref>) found that a subset of intracellular <italic>Y. enterocolitica</italic> localizes to autophagosomal compartments within epithelial cells. Interestingly, the autophagy triggered by <italic>Y. enterocolitica</italic> did not eliminate the bacteria but rather supported their intracellular survival and multiplication. This process differed from LC3-assisted phagocytosis and resembled classical autophagy, involving core components of the autophagic machinery. The increased intracellular replication of <italic>Y. enterocolitica</italic> due to autophagy was also associated with enhanced extracellular release of the bacteria. These findings suggest that <italic>Y. enterocolitica</italic> may exploit the canonical macroautophagy pathway to promote its intracellular replication and eventual escape from infected epithelial cells (<xref ref-type="bibr" rid="B64">Ligeon et&#xa0;al., 2014</xref>; <xref ref-type="bibr" rid="B112">Valencia Lopez et&#xa0;al., 2019</xref>). <italic>Y. pestis</italic> has been shown to reside in phagosomes that acquire certain markers of late endosomes or lysosomes but do not undergo the typical acidification process. It was demonstrated that within naive macrophages, the vacuoles containing <italic>Yersinia</italic> fail to acidify. This lack of acidification is crucial for the bacteria&#x2019;s survival, as it prevents the activation of lysosomal enzymes that would otherwise degrade the pathogen (<xref ref-type="bibr" rid="B83">Pujol et&#xa0;al., 2009</xref>). <italic>Yersinia</italic> produces a variety of effector proteins that play critical roles in the bacterium&#x2019;s pathogenicity, particularly by disrupting host cell responses. These proteins&#x2014;YopB, YopD, YopJ (known as YopP in <italic>Y. enterocolitica</italic>), YopM, YopE, YopT, YopH, YpkA (referred to as YopO in <italic>Y. enterocolitica</italic>), and YopK (YopQ in <italic>Y. enterocolitica</italic>)&#x2014;interfere with the host&#x2019;s immune defenses. By targeting and inhibiting key cellular processes, these Yop proteins help <italic>Yersinia</italic> survive and proliferate within the host (<xref ref-type="bibr" rid="B93">Seabaugh and Anderson, 2024</xref>).</p>
<p>It has been demonstrated that <bold>
<italic>Pseudomonas aeruginosa</italic>
</bold> infection also leads to the induction of autophagy (<xref ref-type="bibr" rid="B123">Yuan et&#xa0;al., 2012</xref>) but the question has arisen if <italic>P. aeruginosa</italic>, an extracellular pathogen, could modulate autophagy for its own benefit. The study of (<xref ref-type="bibr" rid="B86">Rao et&#xa0;al., 2021</xref>) has revealed that this pathogen affects the host defense pathway using T3SS. This secretion system could be used for the injection of up to four cytotoxins produced by <italic>P. aeruginosa</italic> (<xref ref-type="bibr" rid="B46">Hauser, 2009</xref>). The only toxin among these secreted proteins, which could dampen autophagy, is ExoS. Its mode of action is inhibition of mTOR by ADP ribosylation of Ras and concurrently inhibition of the autophagy process through repression of Vps34 kinase activity (autophagy&#x2013;associated) via ADP ribosylation (<xref ref-type="bibr" rid="B86">Rao et&#xa0;al., 2021</xref>).</p>
<p>
<bold>
<italic>Bacillus anthracis</italic>
</bold> produces Edema toxin (Edtx), which is a cAMP-elevating and thus capable of inhibiting autophagy as well as cholera toxin (Ctx) from <bold>
<italic>Vibrio cholerae</italic>
</bold> (<xref ref-type="bibr" rid="B94">Shahnazari et&#xa0;al., 2011</xref>; <xref ref-type="bibr" rid="B48">Huang and Brumell, 2014</xref>). Apart from Ctx, <italic>V. cholerae</italic> produces several other toxins. The <italic>V. cholerae</italic> cytolysin (VCC) protein is a key virulence factor that can disrupt host cell membranes by forming transmembrane pores, leading to cell lysis or triggering various cellular stress signaling. VCC can induce an autophagic response that leads to incomplete or stalled autophagic flux. While autophagosomes are formed in response to VCC, their maturation into autolysosomes&#x2014;where degradation occurs&#x2014;may be impaired, resulting in an accumulation of autophagosomes without effective breakdown of their contents (<xref ref-type="bibr" rid="B42">Gutierrez et&#xa0;al., 2007</xref>). MakA (Motility-associated killing factor A) interacts with the cellular membrane, leading to pore formation and disruption of membrane integrity. MakA is taken up by host cells, leading to the formation of cholesterol-rich membrane aggregates in a pH-dependent manner in endolysosomes, which triggers a non-canonical autophagy pathway with unconventional LC3 lipidation on these membranes (<xref ref-type="bibr" rid="B27">Corkery et&#xa0;al., 2021</xref>; <xref ref-type="bibr" rid="B50">Jia et&#xa0;al., 2022</xref>).</p>
<p>
<bold>
<italic>Enterococcus faecalis</italic>
</bold>, a gram- positive opportunistic invasive bacterium and a member of human intestinum microbiota (<xref ref-type="bibr" rid="B56">Klare et&#xa0;al., 2001</xref>) has been shown to induce formation of autophagosomes in small intestinal epithelial cells (<xref ref-type="bibr" rid="B9">Benjamin et&#xa0;al., 2013</xref>). Conversely, studies by <xref ref-type="bibr" rid="B127">Zou and Shankar (2014)</xref> demonstrated that <italic>E. faecalis</italic> infection activates PI3K/Akt signaling pathway in host cell, potentially contributing to autophagy inhibition. Further, their research revealed that following internalization, the <italic>Enterococcus</italic>-containing vacuole (ECV) is a single-membrane organelle that resists acidification (<xref ref-type="bibr" rid="B128">Zou and Shankar, 2016</xref>). In contrast, <xref ref-type="bibr" rid="B65">Lin et&#xa0;al. (2018)</xref> suggested that <italic>E. faecalis</italic> lipoteichoic acid (LTA) efficiently activates macrophage autophagy. This activation is achieved by p-Akt and p-mTOR inhibition and the process is dependent on Beclin1.</p>
</sec>
</sec>
<sec id="s2">
<title>
<italic>Francisella tularensis</italic>
</title>
<sec id="s2_1">
<title>
<italic>Francisella</italic> species and pathogenesis</title>
<p>
<italic>F. tularensis</italic>, a causative agent of a potentially lethal zoonotic disease tularemia, is a gram-negative facultative intracellular bacterium (<xref ref-type="bibr" rid="B69">Maurin, 2020</xref>). With an extremely low infectious dose (fewer than 10 colony-forming units, CFU), it is considered one of the most infectious pathogens described (<xref ref-type="bibr" rid="B110">Travis et&#xa0;al., 2021</xref>). Therefore, due to its high virulence, and multiple transmission routes with easy dissemination, the U.S. Centers for Disease Control and Prevention (CDC) classifies it as a Tier 1 Select Agent with the potential to be used as a biological weapon (<xref ref-type="bibr" rid="B89">Rowe and Huntley, 2015</xref>).</p>
<p>Currently, three subspecies are distinguished based on their metabolic characteristics, and virulence differences, such as <italic>F. tularensis</italic>, subsp. <italic>tularensis</italic> (type A), <italic>F. tularensis</italic> subsp. <italic>holarctica</italic> (type B), and <italic>F. tularensis</italic> subsp. <italic>mediasiatica</italic>. However, only <italic>F. tularensis</italic> subsp. <italic>tularensis</italic> and <italic>holarctica</italic> are known to cause tularemia in healthy individuals (<xref ref-type="bibr" rid="B30">Degabriel et&#xa0;al., 2023</xref>). While the type A strain primarily occurs on the ground in North America, the type B strain is mainly found in countries across the Northern Hemisphere (<xref ref-type="bibr" rid="B89">Rowe and Huntley, 2015</xref>). Although direct human-to-human transmission has not been reported, transmission through solid organ transplantation occurred in the United States in 2017, resulting in the death of one recipient (<xref ref-type="bibr" rid="B74">Nelson et&#xa0;al., 2019</xref>).</p>
<p>The pathogenicity of <italic>F. tularensis</italic> is primarily attributed to its ability to replicate and survive within various eukaryotic cells, especially macrophages. Infections of other cells, such as dendritic cells, hepatocytes, neutrophils, or endothelial cells, have also been documented (<xref ref-type="bibr" rid="B13">Br&#xf6;ms et&#xa0;al., 2010</xref>; <xref ref-type="bibr" rid="B17">Celli and Zahrt, 2013</xref>). During infection, the pathogen is engulfed by the macrophage through an asymmetric pseudopod loop, a process known as a,looping phagocytosis&#x201d; (<xref ref-type="bibr" rid="B26">Clemens et&#xa0;al., 2004</xref>). Subsequently, the pathogen resides within a <italic>Francisella</italic>-containing vacuole (FCV), preventing phagolysosomal fusion and escaping into the nutrition-rich cytosol, where a massive replication occurs. Eventually, this process leads to cell apoptosis and infection of surrounding macrophages, thereby spreading the infection (<xref ref-type="bibr" rid="B79">Pechous et&#xa0;al., 2009</xref>; <xref ref-type="bibr" rid="B17">Celli and Zahrt, 2013</xref>; <xref ref-type="bibr" rid="B85">Ramakrishnan, 2017</xref>). The mechanisms of phagosome escape are not fully understood yet, but a gene cluster known as the <italic>Francisella</italic> pathogenicity island (FPI) has been identified as a key factor, encoding proteins essential for the constitution of the atypical type VI secretion system (T6SS) (<xref ref-type="bibr" rid="B25">Clemens et&#xa0;al., 2015</xref>; <xref ref-type="bibr" rid="B87">Rigard et&#xa0;al., 2016</xref>; <xref ref-type="bibr" rid="B99">Spidlova and Stulik, 2017</xref>). Interestingly, none of those proteins possess properties of cytolysins, pore-forming toxins, or hydrolytic enzymes, suggesting a novel bacterial escape mechanism (<xref ref-type="bibr" rid="B13">Br&#xf6;ms et&#xa0;al., 2010</xref>). In addition to FPI proteins, <italic>F. tularensis</italic> virulence is critically dependent on several other factors, including MglA, SspA, PigR (also known as FevR), ppGpp, (<xref ref-type="bibr" rid="B59">Lauriano et&#xa0;al., 2004</xref>; <xref ref-type="bibr" rid="B118">Wrench et&#xa0;al., 2013</xref>) and the HU protein (<xref ref-type="bibr" rid="B102">Stojkova et&#xa0;al., 2018</xref>, <xref ref-type="bibr" rid="B104">Stojkova et&#xa0;al., 2019</xref>; <xref ref-type="bibr" rid="B103">Stojkova and Spidlova, 2022</xref>). These proteins, along with various other transcription factors (<xref ref-type="bibr" rid="B98">Spidlova et&#xa0;al., 2020</xref>), play essential roles in regulating virulence gene expression and ensuring the pathogen&#x2019;s ability to survive and proliferate within the host. Their coordinated action is vital for the bacterium&#x2019;s pathogenicity and ability to evade host immune responses.</p>
</sec>
<sec id="s2_2">
<title>Molecular insights into <italic>Francisella</italic>-autophagy interaction</title>
<p>The role of autophagy in the host defense against members of the <italic>Francisella</italic> genus is controversial (<xref ref-type="bibr" rid="B84">Qi et&#xa0;al., 2016</xref>). Comparative studies indicate that the less virulent LVS genome has undergone significant rearrangements compared to fully virulent SchuS4 strain. These rearrangements include inversions and deletions, leading to differences in gene content and organization. For instance, certain genes present in SchuS4 are either absent or pseudogenized in LVS, potentially affecting pathogenicity (<xref ref-type="bibr" rid="B20">Chaudhuri et&#xa0;al., 2007</xref>). While both strains possess the FPI, variations in gene sequences and expression levels have been observed, which may account for differences in their virulence (<xref ref-type="bibr" rid="B37">Faron et&#xa0;al., 2013</xref>). The distinct immune response dynamics observed between SchuS4 and LVS strains highlight differential regulation of key cellular processes, including the induction or suppression of autophagy, which may significantly impact their pathogenic strategies and host interactions. At an early stage of infection, <italic>F. tularensis</italic> dampens the autophagy process. The reasons why are still unanswered but a few possible explanations exist: a) <italic>F. tularensis</italic> prefers replication in cytosol instead of phagosome, b) the delay could bring time to become resistant to the autophagolysosome&#x2019;s acidic environment. On the other hand, at late stages of infection, <italic>F. tularensis</italic> exploits autophagy to be hidden inside autophagosomes, which leads to suppression of proinflammatory cytokines production (<xref ref-type="bibr" rid="B28">Cremer et&#xa0;al., 2009</xref>). <italic>F. tularensis</italic> avoids autophagic degradation by escaping from the phagosome before it can be targeted by autophagic machinery. After being phagocytosed by host cells, <italic>F. tularensis</italic> rapidly escapes into the cytosol, thereby avoiding the lysosomal degradation pathway (<xref ref-type="bibr" rid="B21">Checroun et&#xa0;al., 2006</xref>). The bacterial factors that mediate this escape are crucial for avoiding recognition by the autophagy machinery. The study has shown that the IglC protein is essential for phagosomal escape and subsequent replication in the cytosol (<xref ref-type="bibr" rid="B90">Santic et&#xa0;al., 2005</xref>). PdpC and PdpD that were identified as T6SS effectors (<xref ref-type="bibr" rid="B36">Eshraghi et&#xa0;al., 2016</xref>) are required for phagosomal escape (<xref ref-type="bibr" rid="B67">Ludu et&#xa0;al., 2008</xref>; <xref ref-type="bibr" rid="B111">Uda et&#xa0;al., 2016</xref>) and OpiA, a phosphatidylinositol 3-kinase that is not encoded in FPI, is responsible for delaying phagosomal maturation (<xref ref-type="bibr" rid="B60">Ledvina et&#xa0;al., 2018</xref>). These effector proteins contribute to <italic>Francisella</italic> virulence (<xref ref-type="bibr" rid="B12">Brodmann et&#xa0;al., 2021</xref>). Similarly, many other studies have described various proteins that are necessary for the intracellular replication of <italic>F. tularensis</italic> inside the host cell (<xref ref-type="bibr" rid="B13">Br&#xf6;ms et&#xa0;al., 2010</xref>; <xref ref-type="bibr" rid="B5">Barel and Charbit, 2013</xref>; <xref ref-type="bibr" rid="B17">Celli and Zahrt, 2013</xref>; <xref ref-type="bibr" rid="B77">Ozanic et&#xa0;al., 2016</xref>; <xref ref-type="bibr" rid="B2">Alam et&#xa0;al., 2018</xref>; <xref ref-type="bibr" rid="B97">Spidlova et&#xa0;al., 2018</xref>; <xref ref-type="bibr" rid="B102">Stojkova et&#xa0;al., 2018</xref>). After <italic>F. tularensis</italic> enters the host cell (usually a macrophage), it is initially enclosed in a membrane-bound compartment known as the <italic>Francisella</italic>-containing vacuole. This is a phagosome-like structure formed during the phagocytosis process. Once <italic>F. tularensis</italic> escapes the FCV and replicates in the cytosol, the host cell may attempt to target the bacterium for destruction through autophagy, a process where cellular debris or pathogens are engulfed by autophagosomes (double-membrane structures) and delivered to lysosomes for degradation. <italic>F. tularensis</italic> interferes with the autophagy machinery by negative modulating the expression of autophagy-related genes and proteins, including BECN1, ATG5, ATG12, ATG16L2, ATG7, and ATG4a (<xref ref-type="bibr" rid="B28">Cremer et&#xa0;al., 2009</xref>). It is known that there exist two type of autophagy process: a) ATG5- dependent autophagy and b) ATG5-independent autophagy. In order to increase intracellular stocks of host amino acids, which may be utilized as a source of carbon, energy, and iron, <italic>F. tularensis</italic> induces ATG5-independent autophagy (<xref ref-type="bibr" rid="B101">Steele et&#xa0;al., 2013</xref>). It has been shown that WT strains of <italic>Francisella</italic> species are able to resist ATG5-dependent autophagy (<xref ref-type="bibr" rid="B22">Chong et&#xa0;al., 2012</xref>; <xref ref-type="bibr" rid="B14">Case et&#xa0;al., 2014</xref>). But it seems that the WT strains somehow exploit ATG5-dependent autophagy or responses to this pathway, as shown in an example of LVS. This strain proliferates less effectively in ATG5-deficient mice when compared to the WT mice (<xref ref-type="bibr" rid="B52">Kelava et&#xa0;al., 2020</xref>). Contrarily the mutant strains unable to replicate within the host or deficient in O-antigen synthesis are captured by ATG5-dependent autophagy (<xref ref-type="bibr" rid="B14">Case et&#xa0;al., 2014</xref>). Highly virulent strain <italic>F. tularensis</italic> subsp. <italic>tularensis</italic> SchuS4, which successfully avoids being recognized by the autophagic machinery, does not undergo ubiquitination (a critical step for autophagic targeting) in the cytosol and SchuS4 bacteria are not fully recognized by the key autophagy receptors p62/SQSTM1 and NBR1 (<xref ref-type="bibr" rid="B22">Chong et&#xa0;al., 2012</xref>), compared to the <italic>F. tularensis</italic> subsp. <italic>holarctica</italic> LVS that induces the recruitment of p62/SQSTM1 and LC3 already after 1 hour post infection (<xref ref-type="bibr" rid="B45">H&#xe4;rtlova et&#xa0;al., 2014</xref>). On the other hand, SchuS4 mutants that are not able to survive in the cytosol are tagged with ubiquitin and are subsequently captured into autophagosomes in a process dependent on ATG5, LC3, and p62/SQSTM1 (<xref ref-type="bibr" rid="B22">Chong et&#xa0;al., 2012</xref>). Tagging of bacteria by ubiquitin is a critical step for recognition in autophagic process and many bacteria can manipulate with this ubiquitination/deubiquitination system for their benefit (<xref ref-type="bibr" rid="B114">Vozandychova et&#xa0;al., 2021</xref>) and likewise <italic>F. tularensis</italic> that is able to suppress the activity of deubiquitinating enzymes and thus disrupt the homeostasis in ubiquitin cycle (<xref ref-type="bibr" rid="B115">Vozandychova et&#xa0;al., 2023</xref>). <italic>F. tularensis</italic> subsp. <italic>holarctica</italic> FSC200 downregulates the activity of USP10 enzyme in human macrophages 1 hour post infection, leading to the decreased amount/degradation of LC3, and thus repression of autophagy. USP10 normally removes ubiquitin molecule from the Beclin1 and LC3 (required for autophagosome formation) and thus these proteins are not degraded (because they are not tagged by ubiquitin). This suggests an active manipulation of the autophagy by <italic>F. tularensis</italic> specific strain (<xref ref-type="bibr" rid="B115">Vozandychova et&#xa0;al., 2023</xref>). <italic>Francisella&#x2019;s</italic> HU protein (<xref ref-type="bibr" rid="B104">Stojkova et&#xa0;al., 2019</xref>), a DNA-binding protein involved in pathogenesis and virulence (<xref ref-type="bibr" rid="B102">Stojkova et&#xa0;al., 2018</xref>), may play a regulatory role in host&#xb4;s response. It has already been shown in other pathogens that the bacterial HU protein is capable of binding host DNA (<xref ref-type="bibr" rid="B103">Stojkova and Spidlova, 2022</xref>). Since it has been demonstrated that <italic>F. tularensis</italic> HU protein is secreted into the medium (<xref ref-type="bibr" rid="B57">Konecna et&#xa0;al., 2010</xref>), we can speculate whether it enters the host cell, or even host nucleus where it could bind host DNA, because the <italic>F. tularensis</italic> HU protein&#xb4;s DNA binding motif that we identified in our previous study (<xref ref-type="bibr" rid="B78">Pavlik and Spidlova, 2022</xref>) can be found in the host genome (Genome Data Viewer, NCBI). By binding to the promoter regions or regulatory elements of these genes, HU protein could affect their transcription, thus modulating the expression of key components in the autophagy process.</p>
<p>The key question remains regarding the dual role of autophagy as both a defense mechanism and a resource exploited by <italic>Francisella</italic> species. For instance, the exploitation of autophagy by <italic>F. tularensis</italic> at different infection stages, such as its ability to evade recognition by suppressing ubiquitination or manipulating ATG5-independent pathways, represents not just a mechanistic insight but a potential focal point for therapeutic intervention. So far, we know only a few of bacterial effector proteins that are somehow included in affecting the process of autophagy and their exact mechanisms of action remain elusive. It is crucial to delve deeper into the molecular interactions between bacterial effector proteins and host proteins that regulate autophagy machinery. Uncovering these detailed mechanisms can guide future research toward the development of targeted inhibitors, offering new strategies to combat infections.</p>
</sec>
</sec>
<sec id="s3" sec-type="conclusions">
<title>Conclusion</title>
<p>The study of <italic>Francisella</italic> provides general insight into the fight against intracellular bacterial pathogens, as many of these organisms share similar strategies for avoiding autophagy. Understanding the molecular interplay between host autophagy and microbial evasion tactics may be the basis for the development of treatments not only against tularemia but also against a number of other infectious diseases. Additionally, the insights gained from <italic>F. tularensis</italic> research have the potential to extend beyond infectious diseases and offer new approaches to manipulate autophagy for therapeutic benefit in cancer, autoimmune diseases, and other conditions where autophagy plays a critical role. Once the molecular interactions between <italic>F. tularensis</italic> and the host autophagy machinery are better understood, novel regulators of autophagy may be identified. These could include host proteins that are modulated by <italic>F. tularensis</italic> to suppress autophagy or new bacterial factors that inhibit autophagic processes. Future research should focus on uncovering the molecular details of <italic>Francisella</italic>-host interactions, characterizing the role of host genetic factors in autophagy response, and developing novel drugs and vaccine strategies that can modulate autophagy.</p>
</sec>
</body>
<back>
<sec id="s4" sec-type="author-contributions">
<title>Author contributions</title>
<p>PP: Conceptualization, Validation, Visualization, Writing &#x2013; original draft, Writing &#x2013; review &amp; editing. EV: Writing &#x2013; original draft, Writing &#x2013; review &amp; editing. PS: Conceptualization, Investigation, Supervision, Validation, Writing &#x2013; original draft, Writing &#x2013; review &amp; editing.</p>
</sec>
<sec id="s5" sec-type="funding-information">
<title>Funding</title>
<p>The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. The work was supported by the Ministry of Defence of the Czech Republic &#x201c;Long Term Organization Development Plan 1011&#x201d; &#x2013; Healthcare Challenges of WMD II of the Military Faculty of Medicine Hradec Kralove, University of Defence, Czech Republic (Project No: DZRO-FVZ22-ZHN II).</p>
</sec>
<sec id="s6" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="s7" sec-type="ai-statement">
<title>Generative AI statement</title>
<p>The author(s) declare that no Generative AI was used in the creation of this manuscript.</p>
</sec>
<sec id="s8" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
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