Jane E Koehler, MD

Professor

Research in my laboratory is focused on defining the clinical spectrum, microbiology, and molecular pathogenesis of the emerging pathogen Bartonella. Our research encompasses both translational and basic investigation. B. henselae and B. quintana are fastidious, gram-negative bacteria that cause bacillary angiomatosis lesions, which are unique, potentially lethal, vascular proliferative lesions affecting HIV-infected patients. Relapsing and/or persistent bloodstream infection is a more frequent manifestation of Bartonella infection. We are investigating the molecular mechanisms associated with two virulence phenotypes of Bartonella: relapsing and persistent bloodstream infection; and hemin (iron)-regulation of gene expression. Finally, we are characterizing the mechanisms involved in differential transcription of virulence genes in the two environmental niches encountered by Bartonella, e.g., in the gut of the poikilothermic body louse vector, and in the bloodstream of the homeothermic mammalian host.

1) Mechanisms of Persistent Bloodstream Infection
Bartonellae can persist in the bloodstream of some mammalian hosts indefinitely (even years in humans) and reach levels of 106 cfu/ml blood, often with minimal apparent systemic effects. Our animal model made possible the analysis of serial Bartonella bloodstream isolates, to detect sequential alteration(s) in surface structural components of Bartonella that confer the ability to adapt and persist in the host. We evaluated outer membrane proteins (OMP) from blood isolates over time as infection persisted/relapsed, and observed a family of three OMP that were present in the inoculum strain, but which were absent in later bloodstream isolates from the same animal.

We determined that these variably-expressed OMP (Vomp) are chromosomally encoded by four tandemly arranged, highly homologous genes that undergo phase variation, gene duplication or deletion, and high frequency recombination. The Vomp are members of the newly described family of trimeric autotransporter adhesins and are associated with several critical virulence properties, including host cell adhesion and autoaggregation. Each Vomp binds a different, unique substrate; binding specificity is determined by the major variable sequence at the tip of each Vomp adhesin. We are currently investigating the Vomp architecture (homotrimeric vs. heterotrimeric) on the surface of Bartonella, and the mechanisms involved in transport of the Vomp to the bacterial surface. The Vomp are essential virulence factors (the vomp null mutant is avirulent in vivo), and understanding the function and structure of the Vomp will provide important clues about the interactions between the host and Bartonella, including the mechanisms of persistence in the human bloodstream.

2) Regulation of Virulence Gene Expression by Environmental Cues
A second research emphasis in my laboratory is the regulation of virulence gene expression by environmental cues. BQ is a Gram-negative bacillus that occupies two very disparate niches: the bloodstream of the homeothermic human reservoir (37°C, very low hemin/Fe level), and the gut of the poikilothermic body louse arthropod vector (28°C, toxic hemin level). The ability of BQ to survive in the body louse is essential for transmission from the body louse vector to humans, the only known host. We identified genes that are up regulated only at the lower temperature of the body louse, including several genes that control iron acquisition by Bartonella.

a) Virtually all bacteria protect themselves from environmental stressors by activating a general stress response (GSR). After BQ is taken up during a blood meal, the bacterium utilizes a unique system of transcriptional regulation to survive the decreased temperature (28°C) and heme-toxic (10 mM) gut in the body louse. We identified an alternative RNA polymerase sigma subunit that is central to the Bartonella GSR that is elicited at body louse temperature. The mechanism of GSR activation has been studied at the molecular level in a collaboration between the SSGCID at U WA. In collaboration with Dr. John Clark at UMass, we also began studying the regulation of BQ gene expression in wild type lice from a colony that can be fed a blood meal spiked with BQ wild type and mutant strains. This has enabled us to identify the signal cascade that activates the GSR after uptake of BQ into the body louse, as well as to identify genes that are critical for BQ survival in the arthropod host. Studying BQ virulence gene expression and regulation in the body louse enables us to define critical interactions between arthropod vector and bacterium that ultimately could provide targets for interrupting the transmission cycle to humans.

b) Iron is an essential growth factor for virtually all bacteria, and the ability to acquire iron from the environment governs potential virulence and pathogenicity in many bacterial organisms (e.g., iron influences the expression of the diphtheria toxin by Corynebacterium diphtheriae). Acquisition of iron and expression of many virulence factors are under transcriptional regulation by the fur gene product, the ferric uptake regulation (Fur) protein, and its homodimeric complex. At sufficient intracellular iron levels, the co-repressors Fur and Fe2+ bind a consensus sequence in the promoter region of genes regulated by Fur, controlling expression of genes encoding iron-scavenging proteins and toxins. Bartonella is a hemophilic bacterium that is not free-living but is restricted to two alternate niches: the iron-rich gut of obligately hematophagous arthropods, or the severely iron-restricted bloodstream of mammals. Iron availability provides a signal to Bartonella indicating which niche (arthropod vector or mammalian reservoir) it occupies, and it is probable that the Fur protein is responsible for global regulation of genes required in each specific host environment. These studies will enable us to characterize the vector- and host-induced responses that facilitate the infection and persistence of Bartonella in humans.
Education
Research Post-Doc Fellow, 1992 - Infectious Diseases, University of California, San Francisco
Clinical Fellow, 1988 - Infectious Diseases, University of California, San Francisco
Intern and Resident, 1987 - Internal Medicine, University of California, San Francisco
M.D., 1984 - School of Medicine, George Washington University
M.A., 1978 - Microbiology and Immunology, University of California, Berkeley
A.B., - Biology, Vassar College
Honors and Awards
  • Elected Fellow, Infectious Diseases Society of America, 2012
  • Essential Core Teaching Award for Outstanding Lecture, UCSF School of Medicine Class of 2014, 2012
  • Walter E. Stamm Mentor Award, Infectious Diseases Society of America, 2011
  • Smadel Lecturer (named scientific award lecture), Infectious Diseases Society of America, 2008
  • Chancellor’s Award for the Advancement of Women, UCSF, 2008
  • Clinical Scientist Award in Translational Research, Burroughs Wellcome Fund, 2003-2008
  • Fellow, Executive Leadership in Academic Medicine (ELAM), Executive Leadership in Academic Medicine (ELAM), 2002-2003
  • Ann Sullivan Baker Visiting Professorship, Massachusetts General Hospital, Harvard Medical School, 2001
  • Elected Member, American Society for Clinical Investigation, American Society for Clinical Investigation, 1997
  • Pew Scholar in the Biomedical Sciences, Pew Biomedical Scholars Program, 1994-1998
  • ICAAC Young Investigator Award, American Society for Microbiology, 1994
  • Marilyn Coward Memorial Inaugural Lecturer, American Society for Microbiology, No CA, 1993
  • Hyman R. Posin Prize in Neurology, George Washington University School of Medicine, 1984
  • Scholarship Achievement Citation, American Medical Women's Association, 1984
  • Graduation with Distinction, George Washington University School of Medicine, 1984
  • Huron W. Lawson Award in Obstetrics and Gynecology, George Washington University School of Medicine, 1984
  • Alpha Omega Alpha Honor Medical Society, Junior Year Initiate, Alpha Omega Alpha Honor Medical Society, George Washington University School of Medicine, 1983
Websites
Publications
  1. Dietz BW, Winston LG, Koehler JE, Margaretten M. Copycat. 2021. PMID: 34731540


  2. Wang C, Zhang H, Fu J, Wang M, Cai Y, Ding T, Jiang J, Koehler JE, Liu X, Yuan C. Bartonella type IV secretion effector BepC induces stress fiber formation through activation of GEF-H1. 2021. PMID: 33508039


  3. Wang C, Fu J, Wang M, Cai Y, Hua X, Du Y, Yang Z, Li Y, Wang Z, Sheng H, Yin N, Liu X, Koehler JE, Yuan C. Bartonella quintana type IV secretion effector BepE-induced selective autophagy by conjugation with K63 polyubiquitin chain. 2018. PMID: 30463105


  4. Kim JH, Previte DJ, Yoon KS, Murenzi E, Koehler JE, Pittendrigh BR, Lee SH, Clark JM. Comparison of the proliferation and excretion of Bartonella quintana between body and head lice following oral challenge. 2017. PMID: 28105732


  5. Lee SA, Plett SK, Luetkemeyer AF, Borgo GM, Ohliger MA, Conrad MB, Cookson BT, Sengupta DJ, Koehler JE. Bartonella quintana Aortitis in a Man with AIDS, Diagnosed by Needle Biopsy and 16S rRNA Gene Amplification. 2015. PMID: 26063867


  6. Chomel BB, Kasten RW, Stuckey MJ, Breitschwerdt EB, Maggi RG, Henn JB, Koehler JE, Chang CC. Experimental infection of cats with Afipia felis and various Bartonella species or subspecies. 2014. PMID: 24972870


  7. Previte D, Olds BP, Yoon K, Sun W, Muir W, Paige KN, Lee SH, Clark J, Koehler JE, Pittendrigh BR. Differential gene expression in laboratory strains of human head and body lice when challenged with Bartonella quintana, a pathogenic bacterium. 2014. PMID: 24404961


  8. Abromaitis S, Nelson CS, Previte D, Yoon KS, Clark JM, DeRisi JL, Koehler JE. Bartonella quintana deploys host and vector temperature-specific transcriptomes. 2013. PMID: 23554923


  9. Doyon JB, Sutton DA, Theodore P, Dhillon G, Jones KD, Thompson EH, Fu J, Wickes BL, Koehler JE, Schwartz BS. Rasamsonia argillacea pulmonary and aortic graft infection in an immune-competent patient. 2012. PMID: 23241382


  10. Vigil A, Ortega R, Jain A, Nakajima-Sasaki R, Tan X, Chomel BB, Kasten RW, Koehler JE, Felgner PL. Identification of the feline humoral immune response to Bartonella henselae infection by protein microarray. 2010. PMID: 20625509


  11. Chomel BB, Henn JB, Kasten RW, Nieto NC, Foley J, Papageorgiou S, Allen C, Koehler JE. Dogs are more permissive than cats or guinea pigs to experimental infection with a human isolate of Bartonella rochalimae. 2009. PMID: 19272295


  12. Bouchouicha R, Durand B, Monteil M, Chomel BB, Berrich M, Arvand M, Birtles RJ, Breitschwerdt EB, Koehler JE, Maggi R, Maruyama S, Kasten R, Petit E, Boulouis HJ, Haddad N. Molecular epidemiology of feline and human Bartonella henselae isolates. 2009. PMID: 19402978


  13. Chomel BB, Boulouis HJ, Breitschwerdt EB, Kasten RW, Vayssier-Taussat M, Birtles RJ, Koehler JE, Dehio C. Ecological fitness and strategies of adaptation of Bartonella species to their hosts and vectors. 2009. PMID: 19284965


  14. Henn JB, Gabriel MW, Kasten RW, Brown RN, Koehler JE, MacDonald KA, Kittleson MD, Thomas WP, Chomel BB. Infective endocarditis in a dog and the phylogenetic relationship of the associated "Bartonella rochalimae" strain with isolates from dogs, gray foxes, and a human. 2008. PMID: 19109472


  15. Lipton BA, Hopkins SG, Koehler JE, DiGiacomo RF. A survey of veterinarian involvement in zoonotic disease prevention practices. 2008. PMID: 19180714


  16. Eremeeva ME, Gerns HL, Lydy SL, Goo JS, Ryan ET, Mathew SS, Ferraro MJ, Holden JM, Nicholson WL, Dasch GA, Koehler JE. Bacteremia, fever, and splenomegaly caused by a newly recognized bartonella species. 2007. PMID: 17554119


  17. Boonjakuakul JK, Gerns HL, Chen YT, Hicks LD, Minnick MF, Dixon SE, Hall SC, Koehler JE. Proteomic and immunoblot analyses of Bartonella quintana total membrane proteins identify antigens recognized by sera from infected patients. 2007. PMID: 17307937


  18. Zhang P, Chomel BB, Schau MK, Goo JS, Droz S, Kelminson KL, George SS, Lerche NW, Koehler JE. A family of variably expressed outer-membrane proteins (Vomp) mediates adhesion and autoaggregation in Bartonella quintana. 2004. PMID: 15347808


  19. Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D. Recommendations for treatment of human infections caused by Bartonella species. 2004. PMID: 15155180


  20. Koehler JE, Sanchez MA, Tye S, Garrido-Rowland CS, Chen FM, Maurer T, Cooper JL, Olson JG, Reingold AL, Hadley WK, Regnery RR, Tappero JW. Prevalence of Bartonella infection among human immunodeficiency virus-infected patients with fever. 2003. PMID: 12905141


  21. Koehler, J.E. and D.A. Relman. HIV Clinical Manual (Singh, N., R.W. Shafer and S. Swindells, Eds) 2003. PMID:


  22. Park SY, Kelminson KL, Lee AK, Zhang P, Warner RE, Rehkopf DH, Calderwood SB, Koehler JE. Identification, characterization, and functional analysis of a gene encoding the ferric uptake regulation protein in Bartonella species. 2001. PMID: 11544240


  23. Cunningham ET, Koehler JE. Ocular bartonellosis. 2000. PMID: 11020414


  24. Jane E. Koehler. Bartonella Species. 2000. PMID:


  25. Matar GM, Koehler JE, Malcolm G, Lambert-Fair MA, Tappero J, Hunter SB, Swaminathan B. Identification of Bartonella species directly in clinical specimens by PCR-restriction fragment length polymorphism analysis of a 16S rRNA gene fragment. 1999. PMID: 10565929


  26. Warren K, Goldstein E, Hung VS, Koehler JE, Richardson W. Use of retinal biopsy to diagnose Bartonella (formerly Rochalimaea) henselae retinitis in an HIV-infected patient. 1998. PMID: 9682711


  27. Spach DH, Koehler JE. Bartonella-associated infections. 1998. PMID: 9494835


  28. Koehler JE, Sanchez MA, Garrido CS, Whitfeld MJ, Chen FM, Berger TG, Rodriguez-Barradas MC, LeBoit PE, Tappero JW. Molecular epidemiology of bartonella infections in patients with bacillary angiomatosis-peliosis. 1997. PMID: 9407154


  29. Jane E. Koehler. Bartonella: an Emerging Human Pathogen. 1997. PMID:


  30. Whitfeld MJ, Kaveh S, Koehler JE, Mead P, Berger TG. Bacillary angiomatosis associated with myositis in a patient infected with human immunodeficiency virus. 1997. PMID: 9145727


  31. Abbott RC, Chomel BB, Kasten RW, Floyd-Hawkins KA, Kikuchi Y, Koehler JE, Pedersen NC. Experimental and natural infection with Bartonella henselae in domestic cats. 1997. PMID: 9023040


  32. Long SR, Whitfeld MJ, Eades C, Koehler JE, Korn AP, Zaloudek CJ. Bacillary angiomatosis of the cervix and vulva in a patient with AIDS. 1996. PMID: 8841262


  33. Chomel BB, Kasten RW, Floyd-Hawkins K, Chi B, Yamamoto K, Roberts-Wilson J, Gurfield AN, Abbott RC, Pedersen NC, Koehler JE. Experimental transmission of Bartonella henselae by the cat flea. 1996. PMID: 8818889


  34. Mohle-Boetani JC, Koehler JE, Berger TG, LeBoit PE, Kemper CA, Reingold AL, Plikaytis BD, Wenger JD, Tappero JW. Bacillary angiomatosis and bacillary peliosis in patients infected with human immunodeficiency virus: clinical characteristics in a case-control study. 1996. PMID: 8722933


  35. Koehler JE. Bartonella infections. 1996. PMID: 8718458


  36. Chomel BB, Abbott RC, Kasten RW, Floyd-Hawkins KA, Kass PH, Glaser CA, Pedersen NC, Koehler JE. Bartonella henselae prevalence in domestic cats in California: risk factors and association between bacteremia and antibody titers. 1995. PMID: 7494043


  37. Rodriguez-Barradas MC, Hamill RJ, Houston ED, Georghiou PR, Clarridge JE, Regnery RL, Koehler JE. Genomic fingerprinting of Bartonella species by repetitive element PCR for distinguishing species and isolates. 1995. PMID: 7615711


  38. Koehler, J.E. and J.W. Tappero. AIDS Commentary: Bacillary angiomatosis 1995. PMID:


  39. Jane E. Koehler, Carol A. Glaser, Jordan W. Tappero. Rochalimaea henselae Infection: A New Zoonosis With the Domestic Cat as Reservoir. 1994. PMID:


  40. Koehler JE, Glaser CA, Tappero JW. Rochalimaea henselae infection. A new zoonosis with the domestic cat as reservoir. 1994. PMID: 8301768


  41. Tappero JW, Koehler JE. Rochalimaea infections. 1993. PMID: 8357124


  42. Tappero JW, Koehler JE, Berger TG, Cockerell CJ, Lee TH, Busch MP, Stites DP, Mohle-Boetani J, Reingold AL, LeBoit PE. Bacillary angiomatosis and bacillary splenitis in immunocompetent adults. 1993. PMID: 8430982


  43. Christiansen G, Pedersen LB, Koehler JE, Lundemose AG, Birkelund S. Interaction between the Chlamydia trachomatis histone H1-like protein (Hc1) and DNA. 1993. PMID: 8449885


  44. Tappero JW, Mohle-Boetani J, Koehler JE, Swaminathan B, Berger TG, LeBoit PE, Smith LL, Wenger JD, Pinner RW, Kemper CA. The epidemiology of bacillary angiomatosis and bacillary peliosis. 1993. PMID: 8423659


  45. Berger TG, Koehler JE. Bacillary angiomatosis. 1993. PMID: 8217903


  46. Koehler JE, Quinn FD, Berger TG, LeBoit PE, Tappero JW. Isolation of Rochalimaea species from cutaneous and osseous lesions of bacillary angiomatosis. 1992. PMID: 1435899


  47. Law PY, Nicksic TD, O'Rourke MA, Koehler JE, Herz A, Loh HH. Potentiation of opiate action in neuroblastoma N18TG2 cells by lipid incorporation. 1982. PMID: 6285174