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Stamatiou R, Vasilaki A, Tzini D, Deskata K, Zacharouli K, Ioannou M, Sgantzos M, Zakynthinos E, Makris D. Colistin Effects on Emphysematous Lung in an LPS-Sepsis Model. Antibiotics (Basel) 2023; 12:1731. [PMID: 38136765 PMCID: PMC10740909 DOI: 10.3390/antibiotics12121731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Emphysema is prevalent in various respiratory diseases like Chronic Obstructive Pulmonary Disease (COPD) and cystic fibrosis. Colistin and vasoconstrictive drugs are crucial for treating these patients when diagnosed with sepsis in the ICU. This study examines colistin impact in ether-induced emphysematous septic and non-septic animals, focusing on lung pathophysiology and inflammatory responses, including IL-1β, TNF-α, AMPK, caspase-3, cyclin-D1, and colistin levels in lung tissue. All animals exhibited significant emphysematous changes, accentuated by LPS-induced septic conditions, validating the emphysema model and highlighting the exacerbating effect of sepsis on lung pathology. Colistin, alone or with vasoconstrictive drugs, stimulated immune responses through increased inflammatory cell infiltration and the presence of lymphocytes, indicating potential immunomodulatory effects. Vasoconstriction did not alter the effects of colistin or sepsis but correlated with increased colistin levels in the lungs of septic animals. These observations suggest a potential interplay between vasoconstrictive drugs and colistin distribution/metabolism, leading to enhanced local concentrations of colistin in the lung microenvironment. The findings suggest the need for further investigations to optimize colistin and vasoconstrictive drug delivery in critically ill patients with lung pathologies. Understanding these complexities may guide more effective management of inflammatory responses and lung pathologies in these critical conditions.
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Affiliation(s)
- Rodopi Stamatiou
- Physiology Laboratory, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece
| | - Anna Vasilaki
- Pharmacology Laboratory, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece; (A.V.)
| | - Dimitra Tzini
- Pharmacology Laboratory, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece; (A.V.)
| | - Konstantina Deskata
- Intensive Care Unit, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece (E.Z.); (D.M.)
| | - Konstantina Zacharouli
- Pathology Department, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece (M.I.)
| | - Maria Ioannou
- Pathology Department, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece (M.I.)
| | - Markos Sgantzos
- Anatomy Department, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece;
| | - Epaminondas Zakynthinos
- Intensive Care Unit, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece (E.Z.); (D.M.)
| | - Demosthenes Makris
- Intensive Care Unit, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41500 Larissa, Greece (E.Z.); (D.M.)
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Mousavi SR, Lotfi H, Salmanizadeh S, Feizbakhshan S, Khosravian F, Sajjadi MS, Komachali SR, Beni FA, Torkan B, Kazemi M, Sami R, Salehi M. An experimental in silico study on COVID‐19: Response of neutrophil‐related genes to antibiotics. Health Sci Rep 2022; 5:e548. [PMID: 35284643 PMCID: PMC8900978 DOI: 10.1002/hsr2.548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/14/2022] [Accepted: 02/11/2022] [Indexed: 12/23/2022] Open
Abstract
Background and Aims All components of the immune system are involved in alleviating severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Further research is required to provide detailed insights into COVID‐19‐related immune compartments and pathways. In addition, a significant percentage of hospitalized COVID‐19 patients suspect bacterial infections and antimicrobial resistance occurs following antibiotics treatment. The aim of this study was to evaluate the possible effects of antibiotics on the response of neutrophil‐related genes in SARS‐CoV‐2 patients by an experimental in silico study. Methods The two data sets GSE1739 and GSE21802 including 10 SARS positive patients and 35 influenza A (H1N1) patients were analyzed, respectively. Differentially expressed genes (DEGs) between these two data sets were determined by GEO2R analysis and the Venn diagram online tool. After determining the hub genes involved in immune responses, the expression of these genes in 30 COVID‐19 patients and 30 healthy individuals was analyzed by real‐time polymerase chain reaction (PCR). All patients received antibiotics, including levofloxacin, colistin, meropenem, and ceftazidime. Results GEO2R analysis detected 240 and 120 DEGs in GSE21802 and GSE1739, respectively. Twenty DEGs were considered as enriched hub genes involved in immune processes such as neutrophil degranulation, neutrophil activation, and antimicrobial humoral response. The central nodes were attributed to the genes of neutrophil elastase (ELANE), arginase 1 (ARG‐1), lipocalin 2 (LCN2), and defensin 4 (DEFA4). Compared to the healthy subjects, the expression of LCN2 and DEFA4 were significantly reduced in COVID‐19 patients. However, no significant differences were observed in the ELANE and AGR‐1 levels between COVID‐19 subjects and the control group. Conclusions Activation and degranulation of neutrophils were observed mainly in SARS, and H1N1 infection processes and antibiotics administration could affect neutrophil activity during viral infection. It can be suggested that antibiotics can decrease inflammation by restoring the expression of neutrophil‐related genes in COVID‐19 patients.
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Affiliation(s)
- Seyyed R. Mousavi
- Cellular, Molecular and Genetics Research Center Isfahan University of Medical Sciences Isfahan Iran
- Medical Genetics Research Center of Genome Isfahan University of Medical Sciences Isfahan Iran
| | - Hajie Lotfi
- Cellular and Molecular Research Center Qazvin University of Medical Sciences Qazvin Iran
| | - Sharareh Salmanizadeh
- Cellular, Molecular and Genetics Research Center Isfahan University of Medical Sciences Isfahan Iran
- Medical Genetics Research Center of Genome Isfahan University of Medical Sciences Isfahan Iran
| | - Sara Feizbakhshan
- Cellular, Molecular and Genetics Research Center Isfahan University of Medical Sciences Isfahan Iran
- Medical Genetics Research Center of Genome Isfahan University of Medical Sciences Isfahan Iran
| | - Farinaz Khosravian
- Cellular, Molecular and Genetics Research Center Isfahan University of Medical Sciences Isfahan Iran
- Medical Genetics Research Center of Genome Isfahan University of Medical Sciences Isfahan Iran
| | - Maryam S. Sajjadi
- Medical Genetics Laboratory Alzahra University Hospital Isfahan University of Medical Sciences Isfahan Iran
| | - Sajad R. Komachali
- Cellular, Molecular and Genetics Research Center Isfahan University of Medical Sciences Isfahan Iran
- Medical Genetics Research Center of Genome Isfahan University of Medical Sciences Isfahan Iran
| | - Faeze A. Beni
- Cellular, Molecular and Genetics Research Center Isfahan University of Medical Sciences Isfahan Iran
- Medical Genetics Research Center of Genome Isfahan University of Medical Sciences Isfahan Iran
- Department of Genetics and Molecular Biology Isfahan University of Medical Sciences Isfahan Iran
| | - Banafshe Torkan
- Cellular, Molecular and Genetics Research Center Isfahan University of Medical Sciences Isfahan Iran
- Medical Genetics Research Center of Genome Isfahan University of Medical Sciences Isfahan Iran
| | - Mohammad Kazemi
- Department of Genetics and Molecular Biology Isfahan University of Medical Sciences Isfahan Iran
| | - Ramin Sami
- Department of Pulmonology Isfahan University of Medical Sciences Isfahan Iran
| | - Mansoor Salehi
- Cellular, Molecular and Genetics Research Center Isfahan University of Medical Sciences Isfahan Iran
- Medical Genetics Research Center of Genome Isfahan University of Medical Sciences Isfahan Iran
- Department of Genetics and Molecular Biology Isfahan University of Medical Sciences Isfahan Iran
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ZnO-loaded DNA nanogels as neutrophil extracellular trap-like structures in the treatment of mouse peritonitis. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 131:112484. [PMID: 34857270 DOI: 10.1016/j.msec.2021.112484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 02/06/2023]
Abstract
Neutrophil extracellular traps (NETs) are chromatin-based structures that are released from neutrophils during infections and prevent microbes from spreading in the body through efficient degradation of their composition. Based on this chromatin-driven strategy of capturing and killing bacteria, we designed NET-like structures using DNA and ZnO nanoparticles (NPs). DNA was first purified from kiwifruit and treated with HCl to increase hydroxyl groups in the opened-deoxylribose form. The carboxyl groups of citric acid were then thermally crosslinked with said hydroxyl and primary amine groups in DNA, forming DNA-HCl nanogels (NGs). ZnO NPs were then used as positively charged granule enzymes, adsorbed onto the DNA-HCl NG, obtaining ZnO/DNA-HCl NGs (with NET biomimicry). In an anti-inflammatory assay, ZnO/DNA-HCl NGs significantly inhibited TNF-α, IL-6, iNOS and COX-2 expression in LPS-stimulated Raw264.7 cells. Moreover, the ZnO/DNA-HCl NGs markedly alleviated clinical symptoms in LPS-induced mouse peritonitis. Finally, ZnO/DNA-HCl NGs suppressed E. coli from entering circulation in septic mice while prolonging their survival. Our results suggest that the ZnO/DNA-HCl NGs, which mimic NET-like structures in the blocking of bacteria-inducted inflammation, may be a potential therapeutic strategy for bacterial infections.
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Tegge W, Guerra G, Höltke A, Schiller L, Beutling U, Harmrolfs K, Gröbe L, Wullenkord H, Xu C, Weich H, Brönstrup M. Selective Bacterial Targeting and Infection-Triggered Release of Antibiotic Colistin Conjugates. Angew Chem Int Ed Engl 2021; 60:17989-17997. [PMID: 34097810 PMCID: PMC8456958 DOI: 10.1002/anie.202104921] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/28/2021] [Indexed: 12/18/2022]
Abstract
In order to render potent, but toxic antibiotics more selective, we have explored a novel conjugation strategy that includes drug accumulation followed by infection-triggered release of the drug. Bacterial targeting was achieved using a modified fragment of the human antimicrobial peptide ubiquicidin, as demonstrated by fluorophore-tagged variants. To limit the release of the effector colistin only to infection-related situations, we introduced a linker that was cleaved by neutrophil elastase (NE), an enzyme secreted by neutrophil granulocytes at infection sites. The linker carried an optimized sequence of amino acids that was required to assure sufficient cleavage efficiency. The antibacterial activity of five regioisomeric conjugates prepared by total synthesis was masked, but was released upon exposure to recombinant NE when the linker was attached to amino acids at the 1- or the 3-position of colistin. A proof-of-concept was achieved in co-cultures of primary human neutrophils and Escherichia coli that induced the secretion of NE, the release of free colistin, and an antibacterial efficacy that was equal to that of free colistin.
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Affiliation(s)
- Werner Tegge
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Giulia Guerra
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Alexander Höltke
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Lauritz Schiller
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Ulrike Beutling
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Kirsten Harmrolfs
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Lothar Gröbe
- Flow Cytometry and Cell Sorting PlatformHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Hannah Wullenkord
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Chunfa Xu
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Herbert Weich
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
| | - Mark Brönstrup
- Department of Chemical BiologyHelmholtz Centre for Infection ResearchInhoffenstrasse 738124BraunschweigGermany
- German Center for Infection Research (DZIF), SiteHannover-BraunschweigGermany
- Center of Biomolecular Drug Research (BMWZ)Leibniz Universität30167HannoverGermany
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5
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Tegge W, Guerra G, Höltke A, Schiller L, Beutling U, Harmrolfs K, Gröbe L, Wullenkord H, Xu C, Weich H, Brönstrup M. Zielgerichtete bakterielle Lokalisation und infektionsinduzierte Freisetzung von antibiotischen Colistin‐Konjugaten. Angew Chem Int Ed Engl 2021. [DOI: 10.1002/ange.202104921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Werner Tegge
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Giulia Guerra
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Alexander Höltke
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Lauritz Schiller
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Ulrike Beutling
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Kirsten Harmrolfs
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Lothar Gröbe
- Flow Cytometry and Cell Sorting Platform Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Hannah Wullenkord
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Chunfa Xu
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Herbert Weich
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
| | - Mark Brönstrup
- Abteilung für Chemische Biologie Helmholtz-Zentrum für Infektionsforschung Inhoffenstraße 7 38124 Braunschweig Deutschland
- Deutsches Zentrum für Infektionsforschung (DZIF), Standort Hannover-Braunschweig Deutschland
- Biomolekulares Wirkstoffzentrum (BMWZ) Leibniz Universität 30167 Hannover Deutschland
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Zhang W, Zhou Y, Li D, Ma T. Near-infrared fluorescent probe with large stokes shift for detecting Human Neutrophil elastase in living cells. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2021; 252:119533. [PMID: 33581578 DOI: 10.1016/j.saa.2021.119533] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/05/2021] [Accepted: 01/22/2021] [Indexed: 06/12/2023]
Abstract
Human Neutrophil elastase (HNE) plays a great role in immune responses and inflammation, and is associated closely with lung cancer and acute lung injury (ALI). Accurate detection of its activity is imperative to understand its biological function and diagnosing the disease states through monitoring the dynamic changes. Herein, we report a new NIR fluorescent probe (F-1) with large Stokes shift (182 nm). Probe F-1 featured high sensitivity (LOD ~ 5.6 ng/mL), good selectivity, low toxicity and a bright NIR emission triggered by HNE. Moreover, F-1 was successfully applied as an indicator to track the HNE in the A549 cells. Thus, F-1 may be an excellent tool for detecting enzymatic activity for preclinical applications and NE related diseases.
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Affiliation(s)
- Wenda Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou 450052, Henan, China.
| | - Yubing Zhou
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou 450052, Henan, China
| | - Duolu Li
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou 450052, Henan, China
| | - Ting Ma
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450001, China.
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Selective toxicity of antibacterial agents-still a valid concept or do we miss chances and ignore risks? Infection 2020; 49:29-56. [PMID: 33367978 PMCID: PMC7851017 DOI: 10.1007/s15010-020-01536-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/04/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Selective toxicity antibacteribiotics is considered to be due to interactions with targets either being unique to bacteria or being characterized by a dichotomy between pro- and eukaryotic pathways with high affinities of agents to bacterial- rather than eukaryotic targets. However, the theory of selective toxicity oversimplifies the complex modes of action of antibiotics in pro- and eukaryotes. METHODS AND OBJECTIVE This review summarizes data describing multiple modes of action of antibiotics in eukaryotes. RESULTS Aminoglycosides, macrolides, oxazolidinones, chloramphenicol, clindamycin, tetracyclines, glycylcyclines, fluoroquinolones, rifampicin, bedaquillin, ß-lactams inhibited mitochondrial translation either due to binding to mitosomes, inhibition of mitochondrial RNA-polymerase-, topoisomerase 2ß-, ATP-synthesis, transporter activities. Oxazolidinones, tetracyclines, vancomycin, ß-lactams, bacitracin, isoniazid, nitroxoline inhibited matrix-metalloproteinases (MMP) due to chelation with zinc and calcium, whereas fluoroquinols fluoroquinolones and chloramphenicol chelated with these cations, too, but increased MMP activities. MMP-inhibition supported clinical efficacies of ß-lactams and daptomycin in skin-infections, and of macrolides, tetracyclines in respiratory-diseases. Chelation may have contributed to neuroprotection by ß-lactams and fluoroquinolones. Aminoglycosides, macrolides, chloramphenicol, oxazolidins oxazolidinones, tetracyclines caused read-through of premature stop codons. Several additional targets for antibiotics in human cells have been identified like interaction of fluoroquinolones with DNA damage repair in eukaryotes, or inhibition of mucin overproduction by oxazolidinones. CONCLUSION The effects of antibiotics on eukaryotes are due to identical mechanisms as their antibacterial activities because of structural and functional homologies of pro- and eukaryotic targets, so that the effects of antibiotics on mammals are integral parts of their overall mechanisms of action.
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Hakeam HA, Almohaizeie AM. Hypotension Following Treatment with Aerosolized Colistin in a Patient with Multidrug-Resistant Pseudomonas aeruginosa. Ann Pharmacother 2016; 40:1677-80. [PMID: 16896020 DOI: 10.1345/aph.1h019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objective: To report a case of a man who developed temporary hypotension after aerosolized colistin administration. Case Summary: A 62-year-old Arab male was admitted to the intensive care unit for respiratory failure and septic shock. Simultaneous therapy using intravenous and aerosolized colistin was initiated for the management of multidrug-resistant Pseudomonas aeruginosa. A significant but transient drop in blood pressure occurred when aerosolized colistin was introduced. However, when it was stopped, but intravenous administration was continued, no hypotension was observed. Moreover, the combined use of aerosolized amikacin with intravenous colistin did not significantly affect blood pressure. Discussion: It is widely accepted that aerosolization allows safe administration of colistin in the absence of significant systemic adverse effects. However, in our patient, hypotension was observed with aerosolized colistin, but not with the systemic formulation. The lack of adverse effects with administration of aerosolized amikacin in this patient demonstrates the safety of the aerosolization technique. Use of the Naranjo scale indicated a probable relationship between hypotension and aerosolized colistin administration. Conclusions: This case suggests that hypotension may be induced with administration of aerosolized colistin. Although this effect is rare, clinicians should be aware that hypotension may develop in critically ill patients following aerosolized colistin treatment.
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Affiliation(s)
- Hakeam A Hakeam
- Pharmacy Services Department, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
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Luo G, Spellberg B, Gebremariam T, Bolaris M, Lee H, Fu Y, French SW, Ibrahim AS. Diabetic murine models for Acinetobacter baumannii infection. J Antimicrob Chemother 2012; 67:1439-45. [PMID: 22389456 DOI: 10.1093/jac/dks050] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Extremely drug-resistant (XDR; i.e. resistant to all antibiotics except colistin or tigecycline) Acinetobacter baumannii has emerged as one of the most common and highly antibiotic-resistant causes of infection. Diabetes is a risk factor for acquisition of and worse outcomes from A. baumannii infection. We sought to develop diabetic mouse models of A. baumannii bacteraemia and pneumonia and validate these models by comparing the efficacy of antibiotic treatment in these models with the established neutropenic mouse models. METHODS Diabetic or neutropenic mice were infected via intravenous inoculation or inhalation in an aerosol chamber with an XDR A. baumannii. Treatment with colistin started 24 h after infection and continued daily for 7 days. Survival served as the primary endpoint while tissue bacterial burden and histopathological examination served as secondary endpoints. RESULTS Lethal infection was achieved for the neutropenic and diabetic mice when infected intravenously or via inhalation. Neutropenic mice were more susceptible to infection than diabetic mice in the pneumonia model and equally susceptible in the bacteraemia model. Both models of bacteraemia were sensitive enough to detect virulence differences among different clinical strains of A. baumannii. In the pneumonia model, colistin treatment was effective in improving survival, reducing lung bacterial burden and histologically resolving the infection compared with placebo only in diabetic mice. CONCLUSIONS We developed novel models of A. baumannii bacteraemia and pneumonia in diabetic mice. These models can be used to study mechanisms of infection, develop immunotherapeutic strategies and evaluate drug efficacies against highly lethal A. baumannii infections.
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Affiliation(s)
- Guanpingsheng Luo
- Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA 90502, USA
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Antoniu SA, Cojocaru I. Inhaled colistin for lower respiratory tract infections. Expert Opin Drug Deliv 2012; 9:333-42. [DOI: 10.1517/17425247.2012.660480] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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In vitro inhibition of neutrophil elastase activity by inhaled anti-Pseudomonas antibiotics used in cystic fibrosis patients. Mediators Inflamm 2010; 2010:809591. [PMID: 20634941 PMCID: PMC2903981 DOI: 10.1155/2010/809591] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Revised: 03/18/2010] [Accepted: 04/11/2010] [Indexed: 11/26/2022] Open
Abstract
Background. Inhaled antibiotics are commonly used in the treatment of cystic fibrosis lung disease. A previous study suggested neutrophil elastase activation by colistin in vitro. Here, we investigated direct effects of the commonly used antibiotics colistin and tobramycin on neutrophil elastase activity. Methods. Neutrophil elastase was measured spectrophotometrically. The antibiotics colistin and tobramycin were added in different concentrations with or without the addition of albumin. Results. Generally, neutrophil elastase activity was lower in the absence of albumin compared to its presence. Both antibiotics, colistin and tobramycin, had inhibitory effects on neutrophil elastase activity except for high concentrations of colistin when albumin was absent. Conclusions. Our results suggest inhibitory effects of colistin and tobramycin in vitro. There was a clear dependency of neutrophil elastase measurements on the presence of albumin. Clinical studies are needed to investigate potential direct effects of inhaled antibiotics on neutrophil elastase activity in cystic fibrosis airways.
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Ilowite J, Spiegler P, Kessler H. Pharmacological treatment options for bronchiectasis: focus on antimicrobial and anti-inflammatory agents. Drugs 2009; 69:407-19. [PMID: 19323585 DOI: 10.2165/00003495-200969040-00002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Patients with bronchiectasis experience tenacious mucus, recurrent infectious exacerbations, and progressive worsening of symptoms and obstruction over time. Treatment is aimed at trying to break the cycle of infection and progressive airway destruction. Antibacterial treatment is targeted towards likely organisms or tailored to the results of sputum culture. Inhaled antibacterial therapy may offer the advantage of increased local concentration of medication, while minimizing systemic adverse effects; however, to date, studies have been equivocal in this disorder. Macrolides, in addition to their antibacterial properties, have unique anti-inflammatory properties, which may make them useful in this disorder. Other mucoactive and anti-inflammatory agents, such as inhaled corticosteroids, mannitol and hypertonic saline, may also prove useful in this disease, but further studies are needed.
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Affiliation(s)
- Jonathan Ilowite
- Winthrop University Hospital, State University Hospital of New York at Stony Brook, Mineola, New York 11501, USA.
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Broughton-Head VJ, Shur J, Carroll MP, Smith JR, Shute JK. Unfractionated heparin reduces the elasticity of sputum from patients with cystic fibrosis. Am J Physiol Lung Cell Mol Physiol 2007; 293:L1240-9. [PMID: 17827252 DOI: 10.1152/ajplung.00206.2007] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Mucus obstruction of the airway in patients with cystic fibrosis (CF) reduces lung function, invites infection, and limits delivery of inhaled drugs including gene therapy vectors to target cells. Not all patients respond to presently available mucolytics, and new approaches are needed. Our objectives were to investigate the in vitro effects of unfractionated heparin (UFH) on the morphology and rheology of sputum and the effect of UFH on diffusion of 200-nm nanospheres through sputum from adult CF patients. Confocal laser scanning microscopy was used to image fluorescently stained actin and DNA components of CF sputum, and atomic force microscopy was used to image isolated DNA networks. The viscoelasticity of CF sputum was measured using dynamic oscillatory rheometry. Nanosphere diffusion was measured through CF sputum using a Boyden chamber-based assay. Actin-DNA bundles in CF sputum were disaggregated by UFH at concentrations of 0.1–10 mg/ml, and UFH enhanced the endonuclease activity in sputum from patients on dornase alfa therapy. UFH significantly reduced the elasticity and yield stress, but not the viscosity, of CF sputum from patients not receiving dornase alfa therapy. Heparin dose-dependently significantly increased the diffusion of nanospheres through CF sputum from patients not on dornase alfa therapy from 10.5 ± 2.5% at baseline to 36.9 ± 4.4% at 10 mg/ml but was more potent, with maximal effect at 0.1 mg/ml, in patients who were on dornase alfa therapy. Thus the mucoactive properties of UFH indicate its potential as a new therapeutic approach in patients with cystic fibrosis.
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Abstract
Macrolide antibiotics are known for their efficacy in treating acute airway infections, but just as importantly, they are also effective anti-inflammatory agents. Their anti-inflammatory properties have been studied most thoroughly in chronic inflammatory airway diseases, particularly diffuse panbronchiolitis (DPB). Erythromycin, azithromycin, clarithromycin, and roxithromycin inhibit chemotaxis and infiltration of neutrophils into the airway and, subsequently, decrease mucus secretion. Mucus formation, a significant cause of morbidity and mortality in patients with chronic airway inflammation, is directly inhibited by macrolides and suppressed by decreased inflammation in the airway. The mechanisms of action for the anti-inflammatory properties of the macrolides are still being investigated, but they are clearly multifactorial. Macrolides inhibit the production of many proinflammatory cytokines, such as interleukin (IL)-1, IL-6, IL-8, and tumor necrosis factor-alpha, perhaps by suppressing the transcription factor nuclear factor-kappaB or activator protein-1. Inhibition of cytokine production has been seen in vitro and also in bronchoalveolar lavage fluid, which contains less IL-8 and fewer neutrophils after treatment with macrolides. Macrolides also inhibit formation of leukotriene B4, which attracts neutrophils, and inhibit the release of superoxide anion by neutrophils that may be present in the airway. An important aspect of inflammation is extravasation of neutrophils into the tissues. Macrolides block formation of adhesion molecules necessary for neutrophil migration. Together, these anti-inflammatory effects result in improved pulmonary functions and fewer airway infections. In patients with DPB, the anti-inflammatory effects lead to a significant increase in survival. Further work is needed to characterize the clinical benefits of macrolides in patients with other chronic inflammatory airway diseases.
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Affiliation(s)
- Jun Tamaoki
- First Department of Medicine, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shiinjuku, Tokyo, Japan
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Hermsen ED, Sullivan CJ, Rotschafer JC. Polymyxins: pharmacology, pharmacokinetics, pharmacodynamics, and clinical applications. Infect Dis Clin North Am 2004; 17:545-62. [PMID: 14711076 DOI: 10.1016/s0891-5520(03)00058-8] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Although the polymyxins seem attractive because of their unique structure and mechanism of action, relatively little is known about this group of antibiotics. Much of the available information is from a different era of medical practice when the manipulation of dosing strategies, or optimization of pharmacodynamic parameters, was not commonplace. Moreover, the more recent information that is available is limited in scope with regards to patient populations and microorganisms.
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Affiliation(s)
- Elizabeth D Hermsen
- Experimental and Clinical Pharmacology, University of Minnesota College of Pharmacy, Weaver-Densford Hall 7-170, 308 Harvard Street SE, Minneapolis, MN 55455, USA
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