Pseudomonas aeruginosa (
P. aeruginosa), rod-shaped gram-negative bacteria, can cause acute infections in humans (
1). These bacteria are multidrug resistant pathogens recognized for their ubiquity, their intrinsically advanced antibiotic resistance mechanisms and association with serious infections in hospitalized patients, such as ventilator-associated pneumonia and various sepsis syndromes (
1-
3).
Pseudomonas aeruginosa produces a broad spectrum of virulence factors, the expression levels of which are firmly adjusted (
4). The key to this adjustment is quorum sensing (QS), a ubiquitous cell density-dependent cell-to-cell communication system (
4-
6).In
P. aeruginosa, similar to other bacteria, QS controls formation of biofilm, virulence factors secretion and DNA exchange (
7-
9). It has been shown that the growth of biofilm is the main bacterial property and plays a critical role in infections (
10,
11).
On the other hand, numerous infections require the formation of bacterial biofilms, which are communities of bacterial that proliferate and fix on surfaces and are hidden by exopolymers (
12).
It must be noted that after formation, it is difficult to eradicate the biofilm and this becomes a principle of secondary infection (
4,
13).
Furthermore, bacteria hidden in biofilms are more resistant against antibiotics. Therefore, in this condition, treatment of infections often fails (
14,
15).
Gram-negative bacteria, such as
P. aeruginosa, produce and release N-acyl Homoserine Lactones (AHLs) by QS. Suitable concentrations of AHLs then bind to specific receptors and make dimers or polymers of the activated receptor-AHL complex which, in turn, acts as transcriptional modifiers of target genes in the QS region (
16,
17).
Hence, the expression of virulence genes and induction of biofilm formation, through a cascade of regulatory events, is coordinated by AHLs (
4,
18). Therefore, the QS system plays a crucial role in organizing infections and enhancing resistance to antibiotics (
6,
15).
Discovery and development of drugs that inhibit the QS system cause a major innovation in the eradication of antibiotic resistant bacteria (
19,
20). It has been found that some QS Inhibitors (QSIs) like patulin, a mycotoxin produced by a variety of molds, make
P. aeruginosa more susceptible to tobramycin, an aminoglycoside antibiotic (
21-
23).
It must not be forgotten that
P. aeruginosa cell-to-cell signaling is not limited to AHLs. Two distinct, yet related QS circuits, have been identified in
P. aeruginosa. Both of these systems are genetically similar in that they consist of genes encoding transcriptional activator proteins (lasR and rhlR) as well as genes responsible for the production of AHL signaling molecules (lasI and rhlI) (
24,
25).
In the QS systems, the intercellular signals for the las and rhl are N-(3-oxododecanoyl)-L-homoserine lactone (3-oxo-C12-HSL) and N-(butanoyl)-L-homoserine lactone (C4-HSL) (
26). It has been shown that these signals regulate hundreds of genes, indicating 4% to 12% of the
P. aeruginosa genome (
27,
28).
Furthermore, 3-oxo-C12-HSL and C4-HSL, 2 bacterial cell-to-cell signals, are essential for the production of various extracellular virulence factors and the development of a differentiated biofilm in
P. aeruginosa (
29,
30).
It has been reported that
P. aeruginosa produces another signal molecule, 2-heptyl-3-hydroxy-4-quinolone, which has been determined as the
pseudomonas quinolone signal (PQS), a unique cell-to-cell signal (
30,
31). Furthermore, PQS was shown to control the expression of lasB, which encodes for LasB elastase, a major virulence factor (
32,
33). Moreover, the
P. aeruginosa las and rhl QS systems were interfering in the synthesis and bioactivity of PQS, respectively (
31).
Transcriptome analysis studies have shown that PQS directly and indirectly activates 92 and 143 genes, respectively (
34,
35).
For this purpose, PQS binds to and activates PqsR (a LysR-type transcriptional regulator), and subsequently induces the expression of the pqsABCDE operon (
36,
37). The pqsABCD genes of this operon are required for PQS synthesis, yet, the function of the pqsE gene is not clear (
38-
41). It has been reported that the pqsE gene is required for the production of several PQS-controlled virulence factors (
42). Furthermore, it has been suggested that the regulatory activity of PqsE is unrelated to PqsR and PQS, yet, related to the rhl QS system (
31,
42).