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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.2025.1492008</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Cellular and Infection Microbiology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Roles of the <italic>rpoEc-chrR-chrA</italic> operon in superoxide tolerance and &#x3b2;-lactam susceptibility of <italic>Stenotrophomonas maltophilia</italic>
</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" equal-contrib="yes">
<name>
<surname>Ku</surname>
<given-names>Ren-Hsuan</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
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</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name>
<surname>Lu</surname>
<given-names>Hsu-Feng</given-names>
</name>
<xref ref-type="aff" rid="aff2">
<sup>2</sup>
</xref>
<xref ref-type="author-notes" rid="fn003">
<sup>&#x2020;</sup>
</xref>
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</contrib>
<contrib contrib-type="author">
<name>
<surname>Li</surname>
<given-names>Li-Hua</given-names>
</name>
<xref ref-type="aff" rid="aff3">
<sup>3</sup>
</xref>
<xref ref-type="aff" rid="aff4">
<sup>4</sup>
</xref>
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</contrib>
<contrib contrib-type="author">
<name>
<surname>Yeh</surname>
<given-names>Ting-Yu</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
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</contrib>
<contrib contrib-type="author">
<name>
<surname>Lin</surname>
<given-names>Yi-Tsung</given-names>
</name>
<xref ref-type="aff" rid="aff5">
<sup>5</sup>
</xref>
<xref ref-type="aff" rid="aff6">
<sup>6</sup>
</xref>
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</contrib>
<contrib contrib-type="author" corresp="yes">
<name>
<surname>Yang</surname>
<given-names>Tsuey-Ching</given-names>
</name>
<xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn001">
<sup>*</sup>
</xref>
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<aff id="aff1">
<sup>1</sup>
<institution>Department of Biotechnology and Laboratory Science in Medicine, National Yang Ming Chiao Tung University</institution>, <addr-line>Taipei</addr-line>, <country>Taiwan</country>
</aff>
<aff id="aff2">
<sup>2</sup>
<institution>Department of Medical Laboratory Science and Biotechnology, Asia University</institution>, <addr-line>Taichung</addr-line>, <country>Taiwan</country>
</aff>
<aff id="aff3">
<sup>3</sup>
<institution>Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital</institution>, <addr-line>Taipei</addr-line>, <country>Taiwan</country>
</aff>
<aff id="aff4">
<sup>4</sup>
<institution>School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University</institution>, <addr-line>Taipei</addr-line>, <country>Taiwan</country>
</aff>
<aff id="aff5">
<sup>5</sup>
<institution>Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital</institution>, <addr-line>Taipei</addr-line>, <country>Taiwan</country>
</aff>
<aff id="aff6">
<sup>6</sup>
<institution>School of Medicine, National Yang Ming Chiao Tung University</institution>, <addr-line>Taipei</addr-line>, <country>Taiwan</country>
</aff>
<author-notes>
<fn fn-type="edited-by">
<p>Edited by: Giancarlo Ripabelli, University of Molise, Italy</p>
</fn>
<fn fn-type="edited-by">
<p>Reviewed by: Bryan Troxell, AjaxBio, LLC, United States</p>
<p>Jananee Jaishankar, University of Texas Southwestern Medical Center, United States</p>
</fn>
<fn fn-type="corresp" id="fn001">
<p>*Correspondence: Tsuey-Ching Yang, <email xlink:href="mailto:tcyang@nycu.edu.tw">tcyang@nycu.edu.tw</email>
</p>
</fn>
<fn fn-type="equal" id="fn003">
<p>&#x2020;These authors have contributed equally to this work</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>04</day>
<month>02</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="collection">
<year>2025</year>
</pub-date>
<volume>15</volume>
<elocation-id>1492008</elocation-id>
<history>
<date date-type="received">
<day>06</day>
<month>09</month>
<year>2024</year>
</date>
<date date-type="accepted">
<day>17</day>
<month>01</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#xa9; 2025 Ku, Lu, Li, Yeh, Lin and Yang</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>Ku, Lu, Li, Yeh, Lin and Yang</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>
<sec>
<title>Introduction</title>
<p>The <italic>rpoE-chrR</italic> pair is a regulatory system used by photosynthetic microorganisms to overcome singlet oxygen stress. <italic>rpoE</italic> and <italic>chrR</italic> encode the sigma factor &#x3c3;<sup>E</sup> and anti-sigma factor ChrR, respectively. Stenotrophomonas maltophilia, an opportunistic pathogen, is a multidrug-resistant gram-negative bacterium. Although it is not a photosynthetic microorganism, a <italic>rpoE-chrR</italic> homolog (<italic>smlt2377-smlt2378</italic>) was found in the <italic>S. maltophilia</italic> genome. In this study, we aimed to assess the significance of &#x3c3;<sup>Ec</sup>-ChrR pair in oxidative stress alleviation and antibiotic susceptibility of <italic>S. maltophilia</italic> KJ.</p>
</sec>
<sec>
<title>Methods</title>
<p>Reverse transcription-polymerase chain reaction was used to validate the presence of operon. The contribution of <italic>rpoEc-chrR-chrA</italic> operon to oxidative stress alleviation and antibiotic susceptibility was evaluated using mutant constructs and stress-tolerance assays. RNA-seq transcriptome assay of wild-type KJ, KJ&#x394;ChrR (<italic>chrR</italic> mutant), and KJ&#x394;ChrR&#x394;RpoEc (<italic>chrR/rpoEc</italic> double mutant) was performed to reveal the &#x3c3;<sup>Ec</sup> regulon.</p>
</sec>
<sec>
<title>Results</title>
<p>The <italic>rpoEc-chrR</italic> pair and downstream chrA formed an operon. Inactivation of <italic>chrR</italic> upregulated the expression of <italic>rpoEc-chrR-chrA</italic> operon in an &#x3c3;<sup>Ec</sup>- and ChrA-dependent manner. &#x3c3;<sup>Ec</sup> activation contributed to superoxide tolerance and increased &#x3b2;-lactam susceptibility but did not affect the tolerance to singlet oxygen and hydrogen peroxide. Transcriptome analysis revealed that expression of the nine-gene cluster, <italic>smlt2375-smlt2367</italic>, was significantly upregulated in KJ&#x394;ChrR and reverted to the wild-type level in KJ&#x394;ChrR&#x394;RpoEc. <italic>smlt2375-smlt2367</italic> cluster was located upstream of the <italic>rpoEc-chrR-chrA</italic> operon and divergently transcribed, seeming to be involved in membrane lipid modification. Deletion of <italic>smlt2375-smlt2367</italic> cluster from the chromosome of KJ&#x394;ChrR reverted the superoxide tolerance and &#x3b2;-lactam susceptibility to the wild-type level.</p>
</sec>
<sec>
<title>Discussion</title>
<p>The <italic>rpoEc-chrR</italic> pair of <italic>S. maltophilia</italic> was involved in superoxide tolerance and &#x3b2;-lactam susceptibility. Notably, a novel regulatory circuit involving <italic>rpoEc-chrR-chrA</italic> operon and <italic>smlt2375-smlt2367</italic> cluster was revealed.</p>
</sec>
</abstract>
<kwd-group>
<kwd>
<italic>Stenotrophomonas maltophilia</italic>
</kwd>
<kwd>singlet oxygen</kwd>
<kwd>&#x3b2;-lactam susceptibility</kwd>
<kwd>oxidative stress</kwd>
<kwd>sigma factor</kwd>
</kwd-group>
<contract-num rid="cn001">NSTC 112-2320-B-A49-043-MY3</contract-num>
<contract-num rid="cn002">V112C-227</contract-num>
<contract-sponsor id="cn001">National Science and Technology Council<named-content content-type="fundref-id">10.13039/501100020950</named-content>
</contract-sponsor>
<contract-sponsor id="cn002">Taipei Veterans General Hospital<named-content content-type="fundref-id">10.13039/501100011912</named-content>
</contract-sponsor>
<counts>
<fig-count count="7"/>
<table-count count="1"/>
<equation-count count="0"/>
<ref-count count="52"/>
<page-count count="13"/>
<word-count count="5688"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-in-acceptance</meta-name>
<meta-value>Antibiotic Resistance and New Antimicrobial drugs</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec id="s1" sec-type="intro">
<label>1</label>
<title>Introduction</title>
<p>Pathogens frequently encounter various stressors imposed by host cells, such as iron depletion, reactive oxygen species (ROS), and envelope-damaging agents (<xref ref-type="bibr" rid="B46">Sun and Zhou, 2018</xref>). Bacteria have evolved various mechanisms to deal with such environmental stresses (<xref ref-type="bibr" rid="B34">Marles-Wright and Lewis, 2007</xref>). One mechanism involves the reversible association of different &#x3c3; factors with the bacterial core RNA polymerase (RNAP) to control the expression of discrete sets of genes in response to stress-related signals (<xref ref-type="bibr" rid="B18">Helmann, 2002</xref>).</p>
<p>RNAP is an essential transcriptional enzyme. Bacterial core RNAP has five subunits: &#x3b1;<sup>I</sup>, &#x3b1;<sup>II</sup>, &#x3b2;, &#x3b2;&#x2018;, and &#x3c9;. The sigma (&#x3c3;) factor binds to the core RNAP to form a holoenzyme. Sigma factor is a transcription initiation factor that facilitates the specific binding of RNAP to gene promoters. Bacteria usually have one housekeeping &#x3c3; factor (&#x3c3;<sup>D</sup>) and an array of alternative &#x3c3; factors possessing different promoter-recognition properties to regulate the subsets of genes necessary for survival under specific environmental conditions or stress responses (<xref ref-type="bibr" rid="B16">Gruber and Gross, 2003</xref>). The number of &#x3c3; factors varies among bacteria, possibly related to their habitat and metabolism. The sigma factors are classified into two distinct families: &#x3c3;<sup>70</sup> and &#x3c3;<sup>54</sup>. The &#x3c3;<sup>70</sup> family members are further divided into four groups: group 1 comprising primary factors and groups 2&#x2013;4 consisting of alternative factors with specialized functions (<xref ref-type="bibr" rid="B9">Davis et&#xa0;al., 2017</xref>).</p>
<p>Extracytoplasmic function (ECF) sigma factors, the largest and most diverse group of alternative sigma factors, belong to group 4 of the &#x3c3;<sup>70</sup> families (<xref ref-type="bibr" rid="B35">Mascher, 2023</xref>). Several mechanisms responsible for the regulation of ECF sigma factor activity have been described. In general, these activities are inhibited by anti-&#x3c3; factors. In response to stimuli, anti-&#x3c3; factors use diverse mechanisms to release &#x3c3; factors that then bind to the core enzyme and drive the transcription of an array of genes. The subset of genes regulated in this manner is referred to as the regulon. The genes encoding ECF &#x3c3; factor and anti-&#x3c3; factor are generally organized in an operon (<xref ref-type="bibr" rid="B38">Paget, 2015</xref>). The most representative model is the RpoE/RseA model of <italic>Escherichia coli</italic>. RseA, an anti-&#x3c3;<sup>E</sup> factor, is an integral cytoplasmic membrane protein with a C-terminal extracytoplasmic sensory domain and an N-terminal intracellular inhibitory domain that binds to cognate &#x3c3;<sup>E</sup> protein. Upon challenge with stimuli, RseA is subsequently hydrolyzed by a two-step intramembrane proteolysis, and &#x3c3;<sup>E</sup> is released to trigger the transcription of responsive genes (<xref ref-type="bibr" rid="B19">Ho and Ellermeier, 2012</xref>). In addition to the inner membrane anti-&#x3c3;<sup>E</sup> factor, an example of cytoplasmic anti-&#x3c3; factor is discovered in the phototrophic alpha-proteobacterium <italic>Rhodobacter sphaeroides</italic>. In this microorganism, &#x3c3;<sup>E</sup>-ChrR pair is a regulatory system to alleviate the singlet oxygen stress. Under unstressed conditions, &#x3c3;<sup>E</sup> binds to the anti-&#x3c3; factor ChrR, which maintains &#x3c3;<sup>E</sup> in an inactive state. Singlet oxygen acts as a signal that is sensed in an unidentified manner and leads to &#x3c3;<sup>E</sup> release, thereby inducing the expression of &#x3c3;<sup>E</sup> regulon to alleviate singlet oxygen stress (<xref ref-type="bibr" rid="B12">Donohue, 2019</xref>).</p>
<p>Singlet oxygen, one of the ROS, is the primary agent of photo-oxidative stress in photosynthetic microorganisms. In these microorganisms, singlet oxygen is generated by energy transfer from the excited pigments of the photosystems (<xref ref-type="bibr" rid="B43">Sharma et&#xa0;al., 2012</xref>). A singlet oxygen molecule can react with a wide range of cellular macromolecules to cause damage (<xref ref-type="bibr" rid="B48">Triantaphylides and Hayaux, 2009</xref>). Interestingly, singlet oxygen is also produced in non-photosynthetic microorganisms because cellular cofactors, such as flavins, rhodopsins, quinones, and porphyrins, serve as photosensitizers. To face the singlet oxygen stress, microorganisms have evolved several mechanisms to alleviate singlet oxygen-mediated stress, including quenchers (such as carotenoids) and scavengers (such as glutathione) (<xref ref-type="bibr" rid="B13">Glaeser et&#xa0;al., 2011</xref>).</p>
<p>
<italic>Stenotrophomonas maltophilia</italic> is a ubiquitous environmental bacterium that acts as an opportunistic pathogen causing various clinical conditions, mainly pulmonary and bloodstream infections (<xref ref-type="bibr" rid="B41">S&#xe1;nchez, 2015</xref>). From the external to the host environment, <italic>S. maltophilia</italic> is subjected to various stresses, including nutrient unavailability, oxidative stress, osmotic stress, and iron-depletion; therefore, it has evolved various mechanisms to adapt to the dynamic environment (<xref ref-type="bibr" rid="B21">Huang et&#xa0;al., 2014</xref>; <xref ref-type="bibr" rid="B31">Lin et&#xa0;al., 2014</xref>; <xref ref-type="bibr" rid="B51">Wu et&#xa0;al., 2018</xref>; <xref ref-type="bibr" rid="B24">Jair et&#xa0;al., 2019</xref>; <xref ref-type="bibr" rid="B20">Huang et&#xa0;al., 2019</xref>; <xref ref-type="bibr" rid="B27">Li et&#xa0;al., 2020a</xref>, <xref ref-type="bibr" rid="B28">2020</xref>; <xref ref-type="bibr" rid="B39">Pan et&#xa0;al., 2022</xref>; <xref ref-type="bibr" rid="B44">Shih et&#xa0;al., 2022</xref>; <xref ref-type="bibr" rid="B30">Liao et&#xa0;al., 2022</xref>). <italic>S. maltophilia</italic> is intrinsically resistant to several antibiotics as it possesses various determinants contributing to antibiotic resistance, such as &#x3b2;-lactamases, efflux pumps, and aminoglycoside-modifying enzymes (<xref ref-type="bibr" rid="B36">Mojica et&#xa0;al., 2022</xref>). These defense mechanisms make the treatment of <italic>S. maltophilia</italic> infections challenging. <italic>S. maltophilia</italic> is intrinsically resistant to most &#x3b2;-lactams due to the chromosomally encoded L1 and L2 &#x3b2;-lactamases. Among &#x3b2;-lactams, ceftazidime (CAZ) and ticarcillin-clavulanic acid are the only ones suitable for treating <italic>S. maltophilia</italic> infections. L1 and L2 &#x3b2;-lactamases inducible expression in <italic>S. maltophilia</italic> is linked to the disturbance of peptidoglycan (PG) homeostasis (<xref ref-type="bibr" rid="B36">Mojica et&#xa0;al., 2022</xref>), similar to AmpC expression in <italic>Enterobacter cloacea</italic>, <italic>Citrobacter freundii</italic>, and <italic>Pseudomonas aeruginosa</italic> (<xref ref-type="bibr" rid="B23">Jacoby, 2009</xref>). In addition to &#x3b2;-lactamase, non-&#x3b2;-lactamase-mediated &#x3b2;-lactam resistance in <italic>S. maltophilia</italic> has also been reported. For example, loss-of-function of PhoPQ two-component regulatory system increases the outer membrane permeability, which leads to increased &#x3b2;-lactam susceptibility of <italic>S. maltophilia</italic> (<xref ref-type="bibr" rid="B22">Huang et&#xa0;al., 2021</xref>).</p>
<p>Some stress-alleviation systems contribute to antibiotic resistance (<xref ref-type="bibr" rid="B45">Shin et&#xa0;al., 2020</xref>). We reported that the <italic>smeU1VWU2X</italic> operon, which encodes an RND-type efflux pump, not only alleviates menadione (MD)-mediated oxidative stress but also contributes to antibiotic resistance in <italic>S. maltophilia</italic> (<xref ref-type="bibr" rid="B51">Wu et&#xa0;al., 2018</xref>). Furthermore, formaldehyde detoxification system FadRACB&#xa0;participates in the alleviation of oxidative stress and fluoroquinolone resistance in <italic>S. maltophilia</italic> (<xref ref-type="bibr" rid="B28">Li et&#xa0;al., 2020b</xref>). A genome-wide survey revealed that <italic>S. maltophilia</italic> K279a harbors the <italic>rpoE-chrR</italic> pair (<xref ref-type="bibr" rid="B7">Crossman et&#xa0;al., 2008</xref>), although it is not a photosynthetic microorganism. This observation raised our curiosity about the significance of the <italic>rpoE-chrR</italic> system in <italic>S. maltophilia</italic>. In this study, we aimed to elucidate the role of the &#x3c3;<sup>E</sup>-ChrR pair of <italic>S. maltophilia</italic> in oxidative stress alleviation and antibiotic susceptibility.</p>
</sec>
<sec id="s2" sec-type="materials|methods">
<label>2</label>
<title>Materials and methods</title>
<sec id="s2_1">
<label>2.1</label>
<title>Bacterial strains, plasmids, and primers</title>
<p>The strains, plasmids and primers used in this study are shown in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S1</bold>
</xref>.</p>
</sec>
<sec id="s2_2">
<label>2.2</label>
<title>Reverse transcription-PCR and operon verification</title>
<p>DNA-free RNA was prepared from <italic>S. maltophilia</italic> KJ&#x394;ChrR cells and reverse transcribed into cDNA using the ChrA-C primer (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S1</bold>
</xref>). cDNA was used as the template for PCR using the primer sets of RpoEcQ-F/R, ChrRQ-F/R, and ChrAQ-F/R (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S1</bold>
</xref>). The ChrAQ-F/R primer sets were used as a control for DNA contamination check.</p>
</sec>
<sec id="s2_3">
<label>2.3</label>
<title>In-frame deletion mutation construction</title>
<p>In-frame deletion mutants were constructed using allelic replacement strategy as described previously (<xref ref-type="bibr" rid="B52">Yang et&#xa0;al., 2009</xref>). Two DNA fragments flanking the deleted region were amplified by PCR and subsequently cloned into pEX18Tc to generate p&#x394;RpoEc, p&#x394;ChrR, and p&#x394;ChrA. The primer sets used were RpoEcN-F/R and RpoEcC-F/R for p&#x394;RpoEc, RpoEcC-F/R and ChrRC-F/R for p&#x394;ChrR, as well as ChrRC-F/R and ChrAC-F/R for p&#x394;ChrA (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S1</bold>
</xref>). The resulting pEX18Tc-derived constructs were transported to <italic>S. maltophilia</italic> strain by conjugation. Transconjugants selection and mutants confirmation were performed as described previously (<xref ref-type="bibr" rid="B52">Yang et&#xa0;al., 2009</xref>). The double and triple mutants were constructed from the single mutant sequentially using the same protocol.</p>
</sec>
<sec id="s2_4">
<label>2.4</label>
<title>Singlet oxygen tolerance test</title>
<p>Tert-Butyl hydroperoxide (tBOOH) and Rose Bengal (RB) were used for the generation of single oxygen. The tBOOH reacts with peroxynitrite to generate singlet oxygen (<xref ref-type="bibr" rid="B11">Di Mascio et&#xa0;al., 1997</xref>). Rose Bengal is a UV/VIS absorbing molecule capable of absorbing and using light energy to excite oxygen to singlet oxygen (<xref ref-type="bibr" rid="B10">DeRosa and Crutchley, 2002</xref>). For cell viability, the logarithmic-phase bacterial cells tested of 2 &#xd7; 10<sup>5</sup> CFU/&#x3bc;L were 10-fold serially diluted. Five microliters of the bacterial suspension were spotted onto the LB agar with and without tBOOH or RB as indicated. For the RB test, two plates were prepared. One plate was covered with foil seal to create &#x201c;dark&#x201d; conditions in which little or no singlet oxygen is produced. The other plate was kept in the light, representing the singlet oxygen-stressed condition. After 18-h incubation at 37&#xb0;C, the bacterial viability was imaged. For growth curve, overnight culture was inoculated into LB broth with and without tBOOH or RB at an initial OD<sub>450</sub> of 0.15. Bacterial growth was monitored for 24&#xa0;h.</p>
</sec>
<sec id="s2_5">
<label>2.5</label>
<title>Menadione and antibiotic tolerance assay</title>
<p>For cell viability, the logarithmic-phase bacterial cells of 2&#xd7;10<sup>5</sup> CFU/&#x3bc;L were serially 10-fold diluted. Five microliter bacterial aliquot was spotted onto LB agar with and without MD or antibiotic as indicated. After a 24-h incubation at 37&#x2da;C, the cell viabilities were recorded. For growth curve, overnight culture was inoculated into LB broth with and without MD or antibiotic at an initial OD<sub>450</sub> of 0.15. Bacterial growth was monitored for 24&#xa0;h.</p>
</sec>
<sec id="s2_6">
<label>2.6</label>
<title>Construction of a <italic>rpoEc</italic> promoter&#x2013;<italic>xylE</italic> transcriptional fusion, pRpoEc<sub>xylE</sub>
</title>
<p>For the construction of a transcriptional fusion of the <italic>rpoEc</italic> promoter with a promoterless <italic>xylE</italic> gene, the 356-bp DNA segment upstream of <italic>rpoEc</italic> was PCR-amplified using <italic>rpoEcN-</italic>F/R primer pair (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S1</bold>
</xref>) and cloned into pXylE (<xref ref-type="bibr" rid="B6">Chen et&#xa0;al., 2011</xref>) to generate pRpoEc<sub>xylE</sub>.</p>
</sec>
<sec id="s2_7">
<label>2.7</label>
<title>Catechol-2,3-dioxygenase activity determination</title>
<p>C23O, encoded by <italic>xylE</italic>, can convert catechol to an intensely yellow products, which can be spectrophotometrically quantified. One unit of enzyme activity (Uc) was defined as the amount of enzyme that converts 1 nmol of catechol per minute. The specific activity (Uc/OD<sub>450</sub>) of the enzyme was defined as units per OD450 unit of cells. All data were reported from experiments performed in triplicate.</p>
</sec>
<sec id="s2_8">
<label>2.8</label>
<title>Transcriptome analysis</title>
<p>Overnight cultures of KJ, KJ&#x394;ChrR, and KJ&#x394;ChrR&#x394;RpoEc were inoculated into fresh LB broth at an initial OD<sub>450</sub> of 0.15. After 5-h culture at 37&#xb0;C, total RNA was prepared for RNAseq transcriptome analysis. RNA isolation, rRNA depletion, adapter-ligated cDNA library, and cDNA sequencing were carried out as described previously (<xref ref-type="bibr" rid="B50">Wu et&#xa0;al., 2022</xref>). The sequencing reads were mapped to the genome of K279a (<xref ref-type="bibr" rid="B7">Crossman et&#xa0;al., 2008</xref>). The total number of reads per gene was normalized by transcripts per kilobase million (TPM). The RNA-seq data have been deposited in GenBank under BioProject accession numbers SAMN41918898 for KJ, SAMN41918899 for KJ&#x394;ChrR, and SAMN41918900 for KJ&#x394;ChrR&#x394;RpoEc.</p>
</sec>
<sec id="s2_9">
<label>2.9</label>
<title>Quantitative real-time-PCR</title>
<p>RNA was isolated from logarithmical phase bacterial cells and converted to cDNA using the High Capacity cDNA Reverse Transcription Kit (Applied Biosystems) following the manufacturer&#x2019;s instructions. Real-time PCR was performed using the TaqMan Universal PCR Master Mix (Applied Biosystems) and an ABI Prism 7000 Sequence Detection System (Applied Biosystems). The primer sets used are listed in <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S1</bold>
</xref>. The 16S rRNA was used to normalize the gene expressions. Fold change was calculated using the &#x394;&#x394;<italic>C<sub>T</sub>
</italic> method (<xref ref-type="bibr" rid="B32">Livak and Schmittgen, 2001</xref>). Three biological replicates were performed.</p>
</sec>
</sec>
<sec id="s3" sec-type="results">
<label>3</label>
<title>Results</title>
<sec id="s3_1">
<label>3.1</label>
<title>Smlt2377/Smlt2378 is a &#x3c3;<sup>E</sup>/ChrR homolog in <italic>S. maltophilia</italic>
</title>
<p>The &#x3c3;<sup>E</sup>-ChrR pair homologs are distributed among &#x3b1;-proteobacteria and &#x3b3;-proteobacteria, such as <italic>R. sphaeroides</italic>, <italic>Vibrionaceae</italic>, and <italic>Pseudomonas</italic> (<xref ref-type="bibr" rid="B13">Glaeser et&#xa0;al., 2011</xref>). To identify the &#x3c3;<sup>E</sup>-ChrR homolog in <italic>S. maltophilia</italic>, we performed BLASTP analysis using <italic>P. aeruginosa</italic> ChrR (accession No. CRR21278) as the query. The search results revealed a single candidate, Smlt2378, showing 94% protein identity with <italic>P. aeruginosa</italic> ChrR (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1A</bold>
</xref>). Next, genomic organization surrounding <italic>smlt2378</italic> was surveyed. <italic>smlt2377</italic> encoded an ECF &#x3c3; factor, demonstrating that the &#x3c3;<sup>E</sup>-ChrR pair is conserved in <italic>S. maltophilia</italic>. Eleven base pairs downstream of <italic>smlt2378</italic> and in the same orientation, a third open reading frame of 693 bp (Smlt2379) was identified (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1B</bold>
</xref>). <italic>smlt2379</italic> encoded a 23.6-kDa cytoplasmic protein with an NAD(P)-binding domain that highly functioned as an oxidoreductase. Genomic organization strongly suggested the presence of the <italic>smlt2377-smlt2378-smlt2379</italic> operon, which was verified via reverse transcription-polymerase chain reaction (RT-PCR) (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1C</bold>
</xref>). Based on the results presented in this study, we designated <italic>smlt2377-smlt2378-smlt2379</italic> as <italic>rpoEc-chrR-chrA.</italic> Next, we examined the conservation of <italic>rpoEc-chrR-chrA</italic> operon in <italic>S. maltophilia</italic>. Among the 12 strains surveyed, all harbored this operon, indicating high conservation of the <italic>rpoEc-chrR-chrA</italic> operon in <italic>S. maltophilia</italic>. In&#xa0;addition, we also noticed that there are nine genes (<italic>smlt2375-smlt2367</italic>) located upstream of <italic>rpoEc-chrR-chrA</italic> operon and divergently transcribed (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1D</bold>
</xref>). This genomic organization highly suggested that the nine genes may form an operon and regulated by &#x3c3;<sup>Ec</sup>, which will be further expounded later.</p>
<fig id="f1" position="float">
<label>Figure&#xa0;1</label>
<caption>
<p>Characterization of <italic>rpoEc-chrR-chrA</italic> operon. <bold>(A)</bold> Protein sequences alignment of <italic>P. aeruginosa</italic> ChrR (accession No. CRR21278) and <italic>S. maltophilia</italic> ChrR (Smlt2378). Protein sequence alignment was carried out using Needleman-Wunsch global alignment. The same amino acid residues are marked in gray. <bold>(B)</bold> Genetic organization of <italic>rpoEc-chrR-chrA</italic> operon. The orientation of the genes is indicated by arrows. The small black arrow indicates the position of the ChrA-C primer used for reverse transcription. Solid bars labeled as 1-3 represent the positions of PCR amplicons correspondent with the labels in <bold>(C)</bold>. <bold>(C)</bold> Verification of <italic>rpoEc-chrR-chrA</italic> operon. Overnight culture of <italic>S. maltophilia</italic> KJ&#x394;ChrR was inoculated into fresh LB with an initial OD<sub>450</sub> of 0.15 and grown for 5&#xa0;h. The cDNAs were obtained by reverse transcription using the primer ChrA-C. cDNA (100 ng) was used as the template for PCR. The PCR amplicons were separated by agarose gel electrophoresis and stained with ethidium bromide. Lane 1, PCR amplicon generated by RpoEcQ-F and RpoEcQ-R; lane 2, PCR amplicon generated by ChrRQ-F and ChrRQ-R; lane 3, PCR amplicon generated by ChrAQ-F and ChrAQ-R. The ChrAQ-F/R primers were used as a control for DNA contamination check. <bold>(D)</bold> Genetic organization of <italic>rpoEc-chrR-chrA</italic> operon and the divergently transcribed nine genes, <italic>smlt2375-smlt2367</italic>.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1492008-g001.tif"/>
</fig>
</sec>
<sec id="s3_2">
<label>3.2</label>
<title>
<italic>rpoEc-chrR-chrA</italic> operon barely contributes to singlet oxygen tolerance</title>
<p>To characterize <italic>rpoEc-chrR-chrA</italic> operon, its genes were deleted from <italic>S. maltophilia</italic> KJ, either alone or in combination, to yield KJ&#x394;RpoEc, KJ&#x394;ChrR, KJ&#x394;ChrA, KJ&#x394;ChrR&#x394;RpoEc, KJ&#x394;ChrR&#x394;ChrA, KJ&#x394;RpoEc&#x394;ChrA, and KJ&#x394;RpoEc&#x394;ChrR&#x394;ChrA (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S1</bold>
</xref>). These mutants exhibited no observable growth defects on LB agar (<xref ref-type="fig" rid="f2">
<bold>Figure&#xa0;2A</bold>
</xref>) or broth (data not shown).</p>
<fig id="f2" position="float">
<label>Figure&#xa0;2</label>
<caption>
<p>Role of <italic>chrEc-chrR-chrA</italic> operon in singlet oxygen tolerance. <bold>(A)</bold> tBOOH test. For cell viability, the logarithmic-phase bacterial cells tested of 2 &#xd7; 10<sup>5</sup> CFU/&#x3bc;L were 10-fold serially diluted. Five microliters of bacterial suspension were spotted onto the LB plates with and without 500 &#x3bc;M tBOOH. After 18-h incubation at 37&#xb0;C, the bacterial viability was imaged. For growth curve, overnight culture was inoculated into LB broth with 300 &#x3bc;M tBOOH at an initial OD<sub>450</sub> of 0.15. Bacterial growth was monitored for 24&#xa0;h. The image and graph are representatives of at least three replicated experiments. <bold>(B)</bold> RB test. For cell viability, the logarithmic-phase bacterial cells tested of 2 &#xd7; 10<sup>5</sup> CFU/&#x3bc;L were 10-fold serially diluted. Five microliters of bacterial suspension were spotted onto two LB plates with 300 nM RB. One plate was covered with foil to create &#x201c;dark&#x201d; condition. The other plate was kept in the light. After 18-h incubation at 37&#xb0;C, the bacterial viability was imaged. For growth curve, overnight culture was inoculated into LB broth with 200 nM RB at an initial OD<sub>450</sub> of 0.15. Both dark and light culture conditions were prepared. Dash and solid lines indicate the cultures in the dark and light, respectively. Bacterial growth was monitored for 24&#xa0;h. The image and graph are representatives of at least three replicated experiments.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1492008-g002.tif"/>
</fig>
<p>A study on &#x3c3;<sup>E</sup>-ChrR pair of <italic>R. sphaeroides</italic> indicated its contribution to the singlet oxygen stress response (<xref ref-type="bibr" rid="B1">Anthony et&#xa0;al., 2004</xref>). We were interested in understanding whether the <italic>rpoEc</italic>-<italic>chrR</italic>-<italic>chrA</italic> operon played a role in the alleviation of singlet oxygen stress. Rose Bengal (RB) and tert-butyl hydroperoxide (tBOOH) methods were used to evaluate singlet oxygen tolerance (<xref ref-type="bibr" rid="B11">Di Mascio et&#xa0;al., 1997</xref>; <xref ref-type="bibr" rid="B3">Brahmachari and Karmakar, 2020</xref>). All the mutants tested displayed almost comparable viability to wild-type KJ in RB- and tBOOH-containing LB agar or broth (<xref ref-type="fig" rid="f2">
<bold>Figures&#xa0;2A, B</bold>
</xref>), indicating that <italic>rpoEc-chrR-chrA</italic> hardly contributes to singlet oxygen alleviation in our assay.</p>
</sec>
<sec id="s3_3">
<label>3.3</label>
<title>
<italic>rpoEc-chrR-chrA</italic> operon contributes to superoxide tolerance</title>
<p>Involvement of the <italic>rpoE<sub>C</sub>-chrR-chrA</italic> operon in superoxide tolerance was assessed using an MD tolerance assay. Inactivation of <italic>chrR</italic> increased bacterial tolerance to MD, and complementation of KJ&#x394;ChrR with a plasmid containing <italic>chrR</italic> reversed MD tolerance to wild-type levels (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3A</bold>
</xref>). Furthermore, further inactivation of <italic>rpoEc</italic> or <italic>chrA</italic> in KJ&#x394;ChrR partially restored MD tolerance (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3A</bold>
</xref>). Thus, &#x3c3;<sup>Ec</sup> activation increases MD tolerance, and ChrA is involved in this regulatory circuit.</p>
<fig id="f3" position="float">
<label>Figure&#xa0;3</label>
<caption>
<p>Role of <italic>chrEc-chrR-chrA</italic> operon in MD and H<sub>2</sub>O<sub>2</sub> tolerance <bold>(A)</bold> Role of <italic>rpoEc-chrR-chrA</italic> operon in MD tolerance. For cell viability, the logarithmic-phase bacterial cells of 2&#xa0;&#xd7;&#xa0;10<sup>5</sup>&#xa0;CFU/&#x3bc;L were 10-fold serially diluted. Bacterial aliquot (5&#x2009;&#x3bc;L) was spotted onto LB agars without and with 50&#x2009;&#x3bc;g/mL MD. After a 24-h incubation at 37&#xb0;C, the growth of bacterial cells was observed. For growth curve, overnight culture was inoculated into LB broth with 20 &#x3bc;g/mL MD at an initial OD<sub>450</sub> of 0.15. Bacterial growth was monitored for 24&#xa0;h. The image and graph are representatives of at least three replicated experiments. <bold>(B)</bold> Role of <italic>rpoEc-chrR-chrA</italic> operon in H<sub>2</sub>O<sub>2</sub> tolerance. The bacterial cell suspension tested was spread onto LB agar. A sterile filter paper disc with 15&#x2009;&#x3bc;L 10% H<sub>2</sub>O<sub>2</sub> was placed on the agar. The growth inhibition zone was measured after a 24-h incubation at 37&#xb0;C. Bars represent the average values from three independent experiments. Error bars represent the standard deviation for triplicates.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1492008-g003.tif"/>
</fig>
<p>Next, we investigated the role of <italic>rpoE<sub>C</sub>-chrR-chrA</italic> operon in H<sub>2</sub>O<sub>2</sub> tolerance. All tested strains exhibited comparable H<sub>2</sub>O<sub>2</sub> susceptibilities (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3B</bold>
</xref>), tentatively ruling out the contribution of <italic>rpoE<sub>C</sub>-chrR-chrA</italic> operon to H<sub>2</sub>O<sub>2</sub> tolerance.</p>
</sec>
<sec id="s3_4">
<label>3.4</label>
<title>
<italic>rpoEc-chrR-chrA</italic> operon contributes to CAZ susceptibility</title>
<p>
<italic>S. maltophilia</italic> is intrinsically resistant to various antibiotics (<xref ref-type="bibr" rid="B7">Crossman et&#xa0;al., 2008</xref>). Clinically, CAZ and fluoroquinolones are the choices for the treatment of <italic>S. maltophilia</italic> infection. Stress alleviation systems can cross-protect bacteria from antibiotics (<xref ref-type="bibr" rid="B45">Shin et&#xa0;al., 2020</xref>). Therefore, we assessed the involvement of <italic>rpoEc-chrR-chrA</italic> operon in susceptibility to CAZ and levofloxacin (LEV) susceptibility. The viabilities of wild-type KJ and its derived mutants in MH agar or broth containing CAZ and LEV were assessed. Of the three single-deletion mutants, KJ&#x394;ChrR showed compromised viability in a medium containing CAZ, and viability was restored by ChrR complementation (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4</bold>
</xref>). Furthermore, KJ&#x394;ChrR&#x394;RpoEc and KJ&#x394;ChrR&#x394;ChrA displayed viability almost comparable to wild-type KJ (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4</bold>
</xref>). Collectively, <italic>&#x394;chrR</italic>-mediated <italic>rpoEc</italic> and <italic>chrA</italic> upregulation contributed to an increase in CAZ susceptibility. With respect to LEV susceptibility, all <italic>rpoEc-chrR-chrA</italic> operon-associated mutants displayed viability comparable to wild-type KJ (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4</bold>
</xref>), tentatively ruling out the involvement of <italic>rpoEc-chrR-chrA</italic> operon in LEV susceptibility.</p>
<fig id="f4" position="float">
<label>Figure&#xa0;4</label>
<caption>
<p>Role of <italic>rpoEc-chrR-chrA</italic> operon in antibiotic susceptibility. For cell viability, the logarithmic-phase bacterial cells (2&#xa0;&#xd7;&#xa0;10<sup>5</sup>&#xa0;CFU/&#x3bc;L) were 10-fold serially diluted. Bacterial aliquot (5&#x2009;&#x3bc;L) was spotted onto MH agars without and with 120 &#x3bc;g/mL CAZ or 0.25 &#x3bc;g/mL LEV. After a 24-h incubation at 37&#xb0;C, the growth of bacterial cells was observed. For growth curve, overnight culture was inoculated into MH broth with 200 &#x3bc;g/mL CAZ at an initial OD<sub>450</sub> of 0.15. Bacterial growth was monitored for 24&#xa0;h. The image and graph are representatives of at least three replicated experiments.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1492008-g004.tif"/>
</fig>
<p>The mechanisms responsible for CAZ susceptibility in <italic>S. maltophilia</italic> can be attributed to &#x3b2;-lactamase-mediated and non-&#x3b2;-lactamase-mediated mechanisms (<xref ref-type="bibr" rid="B22">Huang et&#xa0;al., 2021</xref>). To assess whether &#x3b2;-lactamase is involved in the <italic>&#x394;chrR</italic>-mediated CAZ susceptibility increase, CAZ-induced &#x3b2;-lactamase activities of KJ, KJ&#x394;ChrR, KJ&#x394;ChrR&#x394;RpoEc, and KJ&#x394;ChrR&#x394;ChrA were determined. All mutants tested displayed comparable CAZ-induced &#x3b2;-lactamase activities with wild-type KJ (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure S1</bold>
</xref>), indicating that &#x3c3;<sup>Ec</sup> activation-mediated increase of &#x3b2;-lactam susceptibility is irrelated to &#x3b2;-lactamase activity.</p>
</sec>
<sec id="s3_5">
<label>3.5</label>
<title>Regulation of <italic>rpoEc-chrR-chrA</italic> operon expression</title>
<p>We constructed a <italic>P<sub>rpoEc</sub>
</italic> and <italic>xylE</italic> transcriptional fusion construct, pRpoEc<sub>xylE</sub> (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S1</bold>
</xref>), to assess the expression of <italic>rpoEc-chrR-chrA</italic> operon by C23O determination. Plasmid pRpoEc<sub>xylE</sub> was transformed into the wild-type and its derived <italic>rpoEc-chrR-chrA</italic> operon<italic>-</italic>associated mutants (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S1</bold>
</xref>) to assess the autoregulation circuit. KJ(pRpoEc<sub>xylE</sub>) exhibited moderate C23O activity, supporting the intrinsic expression of <italic>rpoEc-chrR-chrA</italic> operon. Compared to that of wild-type KJ, the promoter activity of <italic>rpoEc-chrR-chrA</italic> operon was significantly increased in KJ&#x394;ChrR and reverted to wild-type levels in KJ&#x394;ChrR&#x394;RpoEc and KJ&#x394;ChrR&#x394;ChrA (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5</bold>
</xref>). These results are consistent with the previous understanding of &#x3c3;<sup>E</sup>-ChrR system that ChrR functions as an anti-&#x3c3;<sup>E</sup> and &#x3c3;<sup>E</sup> imposes autoregulation on its own expression (<xref ref-type="bibr" rid="B12">Donohue, 2019</xref>). A more interesting finding is that ChrA played a positive role in <italic>&#x394;chrR</italic>-mediated <italic>rpoEc</italic> upregulation (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5</bold>
</xref>). To further clarify this, the promoter activity of <italic>rpoEc-chrR-chrA</italic> operon in KJ&#x394;ChrA was assessed. KJ&#x394;ChrA(pRpoEc<sub>xylE</sub>) displayed lower C23O activity than KJ(pRpoEc<sub>xylE</sub>) (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5</bold>
</xref>), supporting that ChrA plays a positive role in regulating the transcriptional expression of <italic>rpoEc-chrR-chrA</italic> operon.</p>
<fig id="f5" position="float">
<label>Figure&#xa0;5</label>
<caption>
<p>Regulation of <italic>rpoEc-chrR-chrA</italic> operon expression. Overnight cultures of bacterial cells tested were subcultured into fresh LB broth with an initial OD<sub>450</sub> of 0.15. After 5-h culture, the C23O activity was measured. One unit of C23O activity (Uc) was defined as the amount of C23O that converted 1 nmol of catechol per min. The C23O specific activity was expressed as Uc/OD<sub>450</sub>. Bars represent the average values from three independent experiments. Error bars indicate the standard deviations for three triplicate samples. A two-sided Welch&#x2019;s <italic>t</italic>-test and Bonferroni&#x2019;s correction were used to determine statistical significance. *<italic>P &lt;</italic>0.01.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1492008-g005.tif"/>
</fig>
<p>Given the contribution of <italic>rpoEc-chrR-chrA</italic> operon to MD tolerance (<xref ref-type="fig" rid="f3">
<bold>Figure&#xa0;3A</bold>
</xref>) and CAZ susceptibility (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4</bold>
</xref>), we wondered whether MD and CAZ were the stimuli that induced the expression of <italic>rpoEc-chrR-chrA</italic> operon. The C23O activity expressed by KJ(pRpoEc<sub>xylE</sub>) under MD and CAZ challenges was determined. MD- and CAZ-treated KJ(pRpoEc<sub>xylE</sub>) exhibited C23O activity comparable to the untreated counterpart (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure S2</bold>
</xref>), indicating that MD and CAZ are not the stimuli that activate &#x3c3;<sup>Ec</sup>.</p>
</sec>
<sec id="s3_6">
<label>3.6</label>
<title>
<italic>smlt2375-smlt2367</italic> genes upregulation contributes to &#x3c3;<sup>Ec</sup> activation-mediated increase in MD tolerance and CAZ susceptibility</title>
<p>To elucidate the mechanism underlying the &#x3c3;<sup>Ec</sup> activation-mediated increase in MD tolerance and CAZ susceptibility, RNA-seq transcriptome analysis of wild-type KJ, KJ&#x394;ChrR, and KJ&#x394;ChrR&#x394;RpoEc was performed once. Differentially expressed genes (DEGs) were considered significant if the change in transcripts per kilobase million (TPM) between KJ and KJ&#x394;ChrR was greater than three-fold. Twenty-four DEGs were revealed (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S2</bold>
</xref>). Of them, 23 genes were upregulated and one was downregulated in KJ&#x394;ChrR (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S2</bold>
</xref>). Furthermore, the TPM values of the 24 DEGs in KJ&#x394;ChrR&#x394;RpoEc were significantly reverted (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S2</bold>
</xref>), indicating that these 24 genes were members of the ChrR-&#x3c3;<sup>E</sup> regulatory circuit. To validate the transcriptome data, we performed qRT-PCR to probe the genes <italic>rpoEc</italic>, <italic>smlt2373</italic>, <italic>smlt2382</italic>, <italic>cytB</italic>, <italic>L1</italic>, and <italic>L2</italic>. The results supported the reliability of the transcriptome results (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure S3</bold>
</xref>). By inputting the 500-base region upstream of the 24 DEGs into the motif search program MEME (<xref ref-type="bibr" rid="B2">Bailey et&#xa0;al., 2009</xref>), we generated a putative consensus DNA-binding motif of &#x3c3;<sup>Ec</sup> (&#x3c3;<sup>Ec</sup> box) (<xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6A</bold>
</xref>). <xref ref-type="fig" rid="f6">
<bold>Figure&#xa0;6B</bold>
</xref> shows the putative &#x3c3;<sup>Ec</sup> box located upstream of <italic>rpoEc a</italic>nd <italic>smlt2375</italic>.</p>
<fig id="f6" position="float">
<label>Figure&#xa0;6</label>
<caption>
<p>In <italic>silico</italic> analysis of putative &#x3c3;<sup>Ec</sup> box of <italic>S. maltophilia</italic> KJ. <bold>(A)</bold> Sequence logo of the putative &#x3c3;<sup>Ec</sup> box of <italic>S. maltophilia</italic>. Identification of putative &#x3c3;<sup>Ec</sup> box was performed using HEME program. The inputs included the 500-base region upstream from the 24 DEGs revealed by transcriptome analysis of KJ and KJ&#x394;ChrR. <bold>(B)</bold> The intergenic region of <italic>rpoEc</italic> and <italic>smlt2375</italic>, and the putative &#x3c3;<sup>Ec</sup> box. <italic>rpoEc</italic> and <italic>smlt2375</italic> code &#x3c3;<sup>Ec</sup> and a hypothetical protein, respectively. The start codon for <italic>smlt2375</italic> and <italic>rpoEc</italic> are highlighted in blue and green, respectively. The putative &#x3c3;<sup>Ec</sup> box of <italic>rpoEc</italic> and <italic>smlt2375</italic> are highlighted in yellow.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1492008-g006.tif"/>
</fig>
<p>As &#x3b2;-lactam resistance of <italic>S. maltophilia</italic> is strongly linked to PG homeostasis and &#x3b2;-lactamase induction (<xref ref-type="bibr" rid="B22">Huang et&#xa0;al., 2021</xref>), we checked the TPM values of L1, L2, and 37 known PG homeostasis-associated genes. No significant DEGs were identified among the 39 genes (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S3</bold>
</xref>). &#x3b2;-lactamase activity and transcriptome analyses (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Figure S1</bold>
</xref>, <xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S3</bold>
</xref>) suggested the involvement of a non-&#x3b2;-lactamase mechanism in the &#x3c3;<sup>Ec</sup> activation-mediated increase in &#x3b2;-lactam susceptibility.</p>
<p>Among the identified DEGs (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S2</bold>
</xref>), a nine-gene cluster, <italic>smlt2375-smlt2367</italic>, was the most significantly upregulated (<xref ref-type="table" rid="T1">
<bold>Table&#xa0;1</bold>
</xref>). The nine genes were located upstream of <italic>rpoEc-chrR-chrA</italic> operon and divergently transcribed (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1</bold>
</xref>). Furthermore, these genes were simultaneously upregulated in KJ&#x394;ChrR but significantly reverted in KJ&#x394;ChrR&#x394;RpoEc (<xref ref-type="table" rid="T1">
<bold>Table&#xa0;1</bold>
</xref>). These observations strongly suggest that these nine genes form an operon regulated by &#x3c3;<sup>Ec</sup>. The annotations and locations of the proteins encoded by <italic>smlt2375-smlt2367</italic> cluster are summarized in <xref ref-type="table" rid="T1">
<bold>Table&#xa0;1</bold>
</xref>. The nine-gene cluster appeared to be involved in membrane lipid modification as it encoded a fatty acid desaturase (Smlt2374), an oxidoreductase (Smlt2373), two cyclopropane-fatty-acyl phospholipid synthase (CFA synthases) (Smlt2371 and Smlt2368), and five hypothetical proteins (<xref ref-type="table" rid="T1">
<bold>Table&#xa0;1</bold>
</xref>). To investigate the role of the nine-gene upregulation in <italic>&#x394;chrR</italic>-mediated increase in MD tolerance and CAZ susceptibility, a nine-gene deletion mutant was constructed in wild-type KJ and KJ&#x394;ChrR, yielding KJ&#x394;Cfa9 and KJ&#x394;ChrR&#x394;Cfa9, respectively (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S1</bold>
</xref>). KJ&#x394;Cfa9 and wild-type KJ showed comparable MD tolerance and CAZ susceptibility; however, compared to those in KJ&#x394;ChrR, MD tolerance and CAZ susceptibility were almost reverted to wild-type levels in KJ&#x394;ChrR&#x394;Cfa9 (<xref ref-type="fig" rid="f3">
<bold>Figures&#xa0;3A</bold>
</xref>, <xref ref-type="fig" rid="f4">
<bold>4</bold>
</xref>), indicating that <italic>smlt2375-smlt2367</italic> genes upregulation contributes to <italic>&#x394;chrR</italic>-mediated increase in MD tolerance and CAZ susceptibility.</p>
<table-wrap id="T1" position="float">
<label>Table&#xa0;1</label>
<caption>
<p>Transcripts Per Kilobase Million (TPM) values of selected genes in KJ, KJ&#x394;ChrR, and KJ&#x394;ChrR&#x394;RpoEc, revealed by transcriptome analysis.</p>
</caption>
<table frame="hsides">
<thead>
<tr>
<th valign="middle" rowspan="2" align="left">Smlt</th>
<th valign="middle" colspan="2" align="center">Protein</th>
<th valign="middle" colspan="3" align="center">TPM<xref ref-type="table-fn" rid="fnT1_1">
<sup>a</sup>
</xref> (Fold change relative to KJ<xref ref-type="table-fn" rid="fnT1_2">
<sup>b</sup>
</xref>)</th>
</tr>
<tr>
<th valign="middle" align="center">Annotation</th>
<th valign="middle" align="center">Location</th>
<th valign="middle" align="center">KJ</th>
<th valign="middle" align="center">&#x394;ChrR</th>
<th valign="middle" align="center">&#x394;ChrR&#x394;RpoEc</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="middle" align="left" style="">2367</td>
<td valign="middle" align="left" style="">lipocalin family protein</td>
<td valign="middle" align="left" style="">periplasm</td>
<td valign="middle" align="left" style="">17.33 (1)</td>
<td valign="middle" align="left" style="">2867.37 (+165.47)</td>
<td valign="middle" align="left" style="">7.20 (-2.40)</td>
</tr>
<tr>
<td valign="middle" align="left" style="">2368</td>
<td valign="middle" align="left" style="">CfaS1, cyclopropane-fatty-acyl-phospholipid synthase</td>
<td valign="middle" align="left" style="">cytosol</td>
<td valign="middle" align="left" style="">16.22 (1)</td>
<td valign="middle" align="left" style="">3352.29 (+206.67)</td>
<td valign="middle" align="left" style="">3.37 (-4.81)</td>
</tr>
<tr>
<td valign="middle" align="left" style="">2369</td>
<td valign="middle" align="left" style="">hypothetical protein</td>
<td valign="middle" align="left" style="">inner membrane</td>
<td valign="middle" align="left" style="">2.93 (1)</td>
<td valign="middle" align="left" style="">576.64 (+196.86)</td>
<td valign="middle" align="left" style="">1.00 (-2.93)</td>
</tr>
<tr>
<td valign="middle" align="left" style="">2370</td>
<td valign="middle" align="left" style="">hypothetical protein</td>
<td valign="middle" align="left" style="">inner membrane</td>
<td valign="middle" align="left" style="">2.55 (1)</td>
<td valign="middle" align="left" style="">532.77 (+208.58)</td>
<td valign="middle" align="left" style="">0.80 (-3.18)</td>
</tr>
<tr>
<td valign="middle" align="left" style="">2371</td>
<td valign="middle" align="left" style="">CfaS2, cyclopropane-fatty-acyl-phospholipid synthase</td>
<td valign="middle" align="left" style="">cytosol</td>
<td valign="middle" align="left" style="">4.81 (1)</td>
<td valign="middle" align="left" style="">1413.76 (+293.67)</td>
<td valign="middle" align="left" style="">1.13 (-4.25)</td>
</tr>
<tr>
<td valign="middle" align="left" style="">2372</td>
<td valign="middle" align="left" style="">hypothetical protein</td>
<td valign="middle" align="left" style="">cytosol</td>
<td valign="middle" align="left" style="">5.48 (1)</td>
<td valign="middle" align="left" style="">1459.26 (+266.45)</td>
<td valign="middle" align="left" style="">0.81 (-6.76)</td>
</tr>
<tr>
<td valign="middle" align="left" style="">2373</td>
<td valign="middle" align="left" style="">FAD-dependent oxidoreductase</td>
<td valign="middle" align="left" style="">cytosol</td>
<td valign="middle" align="left" style="">4.90 (1)</td>
<td valign="middle" align="left" style="">1535.77 (+313.29)</td>
<td valign="middle" align="left" style="">0.74 (-6.62)</td>
</tr>
<tr>
<td valign="middle" align="left" style="">2374</td>
<td valign="middle" align="left" style="">acyl-CoA desaturase</td>
<td valign="middle" align="left" style="">inner membrane</td>
<td valign="middle" align="left" style="">4.12 (1)</td>
<td valign="middle" align="left" style="">2088.48 (+506.88)</td>
<td valign="middle" align="left" style="">2.13 (-1.93)</td>
</tr>
<tr>
<td valign="middle" align="left" style="">2375</td>
<td valign="middle" align="left" style="">hypothetical protein</td>
<td valign="middle" align="left" style="">periplasm</td>
<td valign="middle" align="left" style="">1.07 (1)</td>
<td valign="middle" align="left" style="">743.80 (+697.41)</td>
<td valign="middle" align="left" style="">0.78 (-1.37)</td>
</tr>
<tr>
<td valign="middle" align="left" style="">2377</td>
<td valign="middle" align="left" style="">&#x3c3;<sup>Ec</sup>
</td>
<td valign="middle" align="left" style="">cytosol</td>
<td valign="middle" align="left" style="">35.09 (1)</td>
<td valign="middle" align="left" style="">1587.08 (+45.23)</td>
<td valign="middle" align="left" style="">17.94 (-1.95)</td>
</tr>
<tr>
<td valign="middle" align="left" style="">2378</td>
<td valign="middle" align="left" style="">ChrR</td>
<td valign="middle" align="left" style="">inner membrane</td>
<td valign="middle" align="left" style="">24.66 (1)</td>
<td valign="middle" align="left" style="">800.91 (+32.47)</td>
<td valign="middle" align="left" style="">9.56 (-2.57)</td>
</tr>
<tr>
<td valign="middle" align="left" style="">2379</td>
<td valign="middle" align="left" style="">ChrA, Oxidoreductase</td>
<td valign="middle" align="left" style="">cytosol</td>
<td valign="middle" align="left" style="">49.87 (1)</td>
<td valign="middle" align="left" style="">940.68 (+18.86)</td>
<td valign="middle" align="left" style="">26.16 (-1.90)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="fnT1_1">
<label>a</label>
<p>TPM, Transcripts Per Kilobase Million.</p>
</fn>
<fn id="fnT1_2">
<label>b</label>
<p>Negative fold changes represent genes that were significantly downregulated compared to wild-type KJ, whereas positive fold changes represent upregulation compared to wild-type KJ.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</sec>
</sec>
<sec id="s4" sec-type="discussion">
<label>4</label>
<title>Discussion</title>
<p>&#x3c3;<sup>E</sup>-ChrR system was first reported in photosynthetic microorganisms, such as <italic>R. sphaeroides</italic>, due to its role in the alleviation of stress induced by singlet oxygen, which is an inevitable by-product of photosynthesis (<xref ref-type="bibr" rid="B1">Anthony et&#xa0;al., 2004</xref>). Later, a core &#x3c3;<sup>E</sup>-ChrR regulon was discovered in non-photosynthetic &#x3b1;- and &#x3b3;-proteobacteria, such as <italic>Azospirillum brasilense</italic>, <italic>Caulobacter crescentus</italic>, <italic>Shewanella oneidensis</italic>, <italic>Pseudomonas syringae</italic> pv. tomato, and <italic>Vibrio cholerae</italic> (<xref ref-type="bibr" rid="B17">Gupta et&#xa0;al., 2013</xref>; <xref ref-type="bibr" rid="B33">Louren&#xe7;o and Gomes, 2009</xref>; <xref ref-type="bibr" rid="B8">Dai et&#xa0;al., 2015</xref>; <xref ref-type="bibr" rid="B4">Butcher et&#xa0;al., 2017</xref>; <xref ref-type="bibr" rid="B47">Tardu et&#xa0;al., 2017</xref>). These known &#x3c3;<sup>E</sup>-ChrR regulons are involved in the alleviation of singlet oxygen stress. In this study, we revealed that <italic>rpoEc-chrR-chrA</italic> operon was not involved in singlet oxygen stress alleviation but contributed to superoxide tolerance and CAZ susceptibility in <italic>S. maltophilia</italic> (<xref ref-type="fig" rid="f2">
<bold>Figures&#xa0;2</bold>
</xref>, <xref ref-type="fig" rid="f3">
<bold>3A</bold>
</xref>, <xref ref-type="fig" rid="f4">
<bold>4</bold>
</xref>). A similar function was shown earlier in <italic>A. brasilense</italic> Sp245, in which the <italic>rpoE2-chrR2</italic> system is involved in superoxide and antibiotic tolerance (<xref ref-type="bibr" rid="B17">Gupta et&#xa0;al., 2013</xref>). Sigma E2 activation in <italic>A. brasilens</italic> Sp245 confers resistance to &#x3b2;-lactam and nalidixic acid (<xref ref-type="bibr" rid="B17">Gupta et&#xa0;al., 2013</xref>); however, &#x3c3;<sup>Ec</sup> activation increases the &#x3b2;-lactam susceptibility of <italic>S. maltophilia</italic> (<xref ref-type="fig" rid="f4">
<bold>Figure&#xa0;4</bold>
</xref>).</p>
<p>The <italic>rpoE-chrR</italic> system is an effector of singlet oxygen stress, and both genes are generally organized into an operon in bacteria. Unlike the two-gene <italic>rpoE-chrR</italic> operon, <italic>rpoEc</italic> and <italic>chrR</italic> of <italic>S. maltophilia</italic> are located in the three-gene <italic>rpoEc-chrR-chrA</italic> operon (<xref ref-type="fig" rid="f1">
<bold>Figure&#xa0;1A</bold>
</xref>). Similarly, a three-gene <italic>rpoE-chrR-VC2303</italic> operon is observed in <italic>V. cholerae</italic> (<xref ref-type="bibr" rid="B47">Tardu et&#xa0;al., 2017</xref>). The protein encoded by <italic>VC2303</italic> is annotated as a hypothetical protein and its significance in the RpoE-ChrR system has not characterized. In this study, we verified that ChrA of <italic>S. maltophilia</italic> plays a positive role in the expression of <italic>rpoEc</italic> regulon (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5</bold>
</xref>). To consider the underlying mechanism responsible for ChrA function, the <italic>rsbV-rsbW-sigB-rsbX</italic> operon of <italic>Bacillus subtilis</italic> provides some ideas. <italic>sigB</italic>, <italic>rsbW</italic>, and <italic>rsbV</italic> encode the sigma factor &#x3c3;<sup>B</sup>, anti-&#x3c3;<sup>B</sup> (RsbW), and anti-anti-&#x3c3;<sup>B</sup> (RsbV), respectively (<xref ref-type="bibr" rid="B26">Kazmierczak et&#xa0;al., 2005</xref>). Similar to most ECF &#x3c3; factors, &#x3c3;<sup>B</sup> autoregulates the <italic>rsbV-rsbW-sigB-rsbX</italic> operon expression. RsbX plays a negative role in &#x3c3;<sup>B</sup> activity through its phosphatase activity (<xref ref-type="bibr" rid="B49">Voelker et&#xa0;al., 1997</xref>). Here, inactivation of <italic>chrA</italic> decreased the expression of <italic>rpoEc-chrR-chrA</italic> operon (<xref ref-type="fig" rid="f5">
<bold>Figure&#xa0;5</bold>
</xref>). As ChrA is predicted to be a cytoplasmic protein with an NAD(P)-binding domain that functions as an oxidoreductase, we speculated that ChrA plays a positive role in modulating &#x3c3;<sup>Ec</sup>&#xa0;activity and this modulation may be oxidoreductase activity involved.</p>
<p>Transcriptome analysis revealed the genes regulated by <italic>rpoEc-chrR</italic> pair. Among the DEGs (<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Table S2</bold>
</xref>), three upregulated gene clusters and a downregulated gene attracted our attention, that is, <italic>smlt2375-smlt2367</italic>, <italic>smlt2382-smlt2380</italic>, <italic>yceA-cybB-yceB</italic> operon (<italic>smlt3627-smlt3629</italic>), and <italic>smlt0227</italic>. <italic>smlt2375-smlt2367</italic> gene cluster was the most upregulated in KJ&#x394;ChrR. Because of the presence of a fatty acid desaturase gene (<italic>smlt2374</italic>) and two CFA synthase genes (<italic>smlt2371</italic> and <italic>smlt2368</italic>), <italic>smlt2375</italic>-<italic>smlt2367</italic> gene cluster may be involved in membrane lipid modification. CFA synthase catalyzes the modification of the acyl chains of membrane phospholipids through the methylation of unsaturated fatty acyl chains to generate cyclopropane-fatty-acyl-phospholipid (CFA) (<xref ref-type="bibr" rid="B15">Grogan and Cronan, 1997</xref>). Modification of membrane lipids by CFA synthase can alter the biophysical properties of membranes and protect cells against drastic environmental perturbations such as oxidative stress, high ionic strength, and acid stress (<xref ref-type="bibr" rid="B14">Grogan and Cronan, 1986</xref>, <xref ref-type="bibr" rid="B15">1997</xref>; <xref ref-type="bibr" rid="B47">Tardu et&#xa0;al., 2017</xref>; <xref ref-type="bibr" rid="B5">Chang and Cronan, 1999</xref>; <xref ref-type="bibr" rid="B25">Jiang et&#xa0;al., 2019</xref>). Membrane lipid modification also modulates membrane permeability and fluidity, thereby altering bacterial susceptibility to antibiotics and antimicrobial peptides (<xref ref-type="bibr" rid="B42">Schmidt et&#xa0;al., 2018</xref>). Integrating our finding that &#x3b2;-lactamase activity is not the critical factor responsible for &#x3c3;<sup>Ec</sup> activation-mediated increase of &#x3b2;-lactam susceptibility. Therefore, we speculated that the upregulation of <italic>smlt2375-smlt2367</italic> cluster in KJ&#x394;ChrR may alter membrane properties against MD-mediated oxidative stress and increase membrane permeability to CAZ, which increases MD tolerance and CAZ susceptibility. <italic>smlt2382-smlt2380</italic> gene cluster is located downstream of <italic>rpoEc-chrR-chrA</italic> operon and divergently transcribed. The proteins encoded by <italic>smlt2382-smlt2380</italic> are the members of a two-component regulatory system, including sensor kinase, response regulator, and hybrid sensor kinase/response regulator, respectively. Thus, a regulatory interconnect between <italic>rpoEc-chrR-chrA</italic> operon and <italic>smlt2382-smlt2380</italic> gene cluster highly exists. Furthermore, <italic>yceA-cybB-yceB</italic> operon is the member of <italic>rpoEc</italic> regulon. The contribution of <italic>yceA-cybB-yceB</italic> operon to MD tolerance has been reported recently (<xref ref-type="bibr" rid="B29">Liao et&#xa0;al., 2023</xref>). Therefore, the <italic>smlt2375-smlt2367</italic> cluster upregulation may&#xa0;not be the sole factor leading to MD tolerance increase in KJ&#x394;ChrR. The contribution of <italic>yceA-cybB-yceB</italic> operon upregulation cannot be ignored. <italic>smlt0227</italic> is the sole downregulated DEG in KJ&#x394;ChrR. The protein encoded by <italic>smlt0227</italic> is annotated as a major facilitator superfamily (MFS) transporter. MFS transporter plays a crucial role in a multitude of physiological processes and its involvement in stress tolerance and antibiotic susceptibility has been widely reported (<xref ref-type="bibr" rid="B40">Pao et&#xa0;al., 1998</xref>; <xref ref-type="bibr" rid="B37">Nag and Mehra, 2021</xref>).</p>
<p>Promoter activity and transcriptome assay revealed that <italic>rpoEc-chrR-chrA</italic> operon exhibited moderate expression, indicating that <italic>rpoEc-chrR-chrA</italic> operon was transcribed by &#x3c3;<sup>D</sup>-driven RNAP in logarithmically grown KJ cells. Under these conditions, translated &#x3c3;<sup>Ec</sup> was sequestered via ChrR binding (<xref ref-type="fig" rid="f7">
<bold>Figure&#xa0;7A</bold>
</xref>). In the presence of stimuli, &#x3c3;<sup>Ec</sup> was released from ChrR and activated the expression of &#x3c3;<sup>Ec</sup> regulon. In this study, KJ&#x394;ChrR mimicked the concept of &#x3c3;<sup>Ec</sup> activation. A positive autoregulation was observed in the <italic>rpoEc-chrR-chrA</italic> operon and ChrA played a positive role in this regulatory circuit. Furthermore, activated &#x3c3;<sup>Ec</sup> upregulated the expression of <italic>smlt2375-smlt2367</italic> gene cluster, thus increasing the MD tolerance and CAZ susceptibility (<xref ref-type="fig" rid="f7">
<bold>Figure&#xa0;7B</bold>
</xref>).</p>
<fig id="f7" position="float">
<label>Figure&#xa0;7</label>
<caption>
<p>The proposed model for &#x3c3;<sup>Ec</sup> activation-mediated increase in MD tolerance and CAZ susceptibility. In the wild-type KJ, <italic>rpoEc-chrR-chrA</italic> operon is moderately expressed via &#x3c3;<sup>D</sup>-driven RNA polymerase. The &#x3c3;<sup>Ec</sup> protein is sequestered by ChrR <bold>(A)</bold>. In the <italic>chrR</italic> mutant, the free form &#x3c3;<sup>Ec</sup> and core RNA polymerase (RNAP) form a holoenzyme, which drives the expression of &#x3c3;<sup>Ec</sup> regulon, including <italic>rpoEc-chrR-chrA</italic> operon and <italic>smlt2375-smlt2367</italic> cluster. ChrA protein plays a positive role in the transcriptional-level expression of &#x3c3;<sup>E</sup> regulon. The upregulation of <italic>smlt2375-smlt2367</italic> cluster contributes to the &#x3c3;<sup>Ec</sup> activation-mediated increase in MD tolerance and CAZ susceptibility <bold>(B)</bold>.</p>
</caption>
<graphic mimetype="image" mime-subtype="tiff" xlink:href="fcimb-15-1492008-g007.tif"/>
</fig>
</sec>
</body>
<back>
<sec id="s5" sec-type="data-availability">
<title>Data availability statement</title>
<p>The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found in the article/<xref ref-type="supplementary-material" rid="SM1">
<bold>Supplementary Material</bold>
</xref>.</p>
</sec>
<sec id="s6" sec-type="author-contributions">
<title>Author contributions</title>
<p>R-HK: Formal analysis, Funding acquisition, Methodology, Validation, Writing &#x2013; original draft, Writing &#x2013; review &amp; editing. H-FL: Conceptualization, Data curation, Resources, Writing &#x2013; original draft, Writing &#x2013; review &amp; editing. L-HL: Conceptualization, Data curation, Funding acquisition, Methodology, Writing &#x2013; original draft, Writing &#x2013; review &amp; editing. T-YY: Methodology, Software, Writing &#x2013; original draft, Writing &#x2013; review &amp; editing. Y-TL: Resources, Writing &#x2013; original draft, Writing &#x2013; review &amp; editing. T-CY: Conceptualization, Formal analysis, Funding acquisition, Project administration, Validation, Writing &#x2013; original draft, Writing &#x2013; review &amp; editing.</p>
</sec>
<sec id="s7" sec-type="funding-information">
<title>Funding</title>
<p>The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This project has received funding from the National Science and Technology Council of Taiwan (grant numbers MOST 111-2320-B-A49-025-MY3 and NSTC 112-2320-B-A49-043-MY3), the Taipei Veterans General Hospital (V112C-227 &amp; V113C-225), and the Professor Tsuei-Chu Mong Merit Scholarship (grant number 412260001).</p>
</sec>
<sec id="s8" 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="s9" 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>
<sec id="s10" sec-type="supplementary-material">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fcimb.2025.1492008/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fcimb.2025.1492008/full#supplementary-material</ext-link>
</p>
<supplementary-material xlink:href="DataSheet1.docx" id="SM1" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document"/>
</sec>
<ref-list>
<title>References</title>
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