Molecular mechanisms of persistence of adherent-invasive Escherichia coli in the host organism

Adherent–invasive Escherichia coli (AIEC), which have acquired the ability to adhere to and penetrate epithelial cells, survive and replicate within macrophages, and provoke inflammation, are attracting particular attention from researchers due to their role in the pathogenesis of Crohn’s disease (CD), a severe chronic inflammatory disease of the gastrointestinal tract. AIEC represent a phylogenetically diverse group of bacteria that lack the genetic determinants characteristic of pathogenic E. coli and possess unique metabolic plasticity, allowing them to adapt to various conditions. Currently, one of the key research questions is whether AIEC trigger CD or simply adapt to existing inflammation, exploiting it to survive and replicate in the face of reduced mucosal immunity and impaired intestinal epithelial barrier function. Of particular interest is the study of the mechanisms and causes of the transformation of commensal E. coli into the pathogenic AIEC phenotype.

The aim of this review is to systematize and analyze scientific data on the key molecular mechanisms that ensure successful colonization of the human intestine by AIEC. This paper examines in detail the strategies of AIEC to overcome the mucus layer, the mechanisms of adhesion and invasion, their ability to survive and replicate in macrophages, their metabolic plasticity that enables the utilization of alternative carbon sources, their ability to form biofilms, and their resistance to antibiotics and antimicrobial peptides. For this study, we used review and experimental articles available in full format in the PubMed database, using the keyword “adherent–invasive Escherichia coli” (AIEC). Articles dating back to 1998, when the first publications on AIEC appeared, were used as a filter.

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