Streptococcus agalactiae (Group B Streptococcus, GBS) is the most common neonatal
pathogen capable of causing devastating disease in newborns, yet healthy adults are largely
unaffected. The cellular and molecular mechanisms for neonatal susceptibility to GBS
pneumonia and sepsis are incompletely understood. Here we optimized a mouse model of
GBS pneumonia to test the role of alveolar macrophage (AM) maturation in host
vulnerability to severe disease. Compared with juvenile and adult mice, neonatal mice
infected with GBS had increased mortality and persistence of lung injury. In addition,
neonatal mice were defective in GBS phagocytosis and killing. AM depletion and disruption
of AM differentiation in Csf2-/- mice both impaired GBS clearance. AM engage the heavily
sialylated GBS capsule via the cell surface Siglec receptors Sialoadhesin (Sn) and Siglec-E.
Newborn AM expressed significantly lower levels of Sn, although both newborn and adult
AM expressed Siglec-E. Sn is exclusively expressed by CD11b lo and CD11b hi AM, while
Siglec-E is more commonly expressed by lung myeloid cells. AM Sn expression decreased
after GBS infection in both adults and neonates, this decrease seemed to be mediated by the
GBS Sia-Siglec-E ligation. The GBS Sia mutant, neuA, failed to decrease Sn expression in
either adults or neonates. Cell surface protein expression of Sn also decreased at 24 h after
GBS infection in the WT neonates, however, Sig-E-/- neonates maintained surface expression
of Sn at 24 h of infection. We propose that a developmental delay in Sn expression on AM
may prevent effective killing and clearing of GBS from the newborn lung. Next we
investigated the impact host Sia could have on AM development and responsiveness to
infection. While the fetal lung lacks expression of 2-3 Sia in the lung, the major sialylated
glycoprotein in the urine, Tamm-Horsfall Protein (THP), was found in the fetal lung. THP-/-
neonates, at PND1, 2, and 8 all showed decreased expression of Siglec-E, and higher
expression of Siglec-F at PND2. We hypothesize that the developing fetus aspirates amniotic
fluid, of which a major component is fetal urine containing THP, into the lung during
gestation bringing a source of Sia into the lungs and regulates fetal AM development and
suppresses inflammatory activity.