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阿托伐他汀治疗在肺炎克雷伯菌诱导的小鼠革兰氏阴性菌肺炎模型中为亚胺培南提供了额外的益处。

Treatment with Atorvastatin Provides Additional Benefits to Imipenem in a Model of Gram-Negative Pneumonia Induced by Klebsiella pneumoniae in Mice.

机构信息

Laboratório de Interação Micro-organismo/Hospedeiro, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Laboratório de Imunofarmacologia, Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

Antimicrob Agents Chemother. 2018 Apr 26;62(5). doi: 10.1128/AAC.00764-17. Print 2018 May.

Abstract

The clinical pathogen is a relevant cause of nosocomial infections, and resistance to current treatment with carbapenem antibiotics is becoming a significant problem. Statins are inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) used for controlling plasma cholesterol levels. There is clinical evidence showing other effects of statins, including decrease of lung inflammation. In the current study, we show that pretreatment with atorvastatin markedly attenuated lung injury, which was correlated with a reduction in the cellular influx into the alveolar space and lungs and downmodulation of the production of proinflammatory mediators in the initial phase of infection in C57BL/6 mice with However, atorvastatin did not alter the number of bacteria in the lungs and blood of infected mice, despite decreasing local inflammatory response. Interestingly, mice that received combined treatment with atorvastatin and imipenem displayed better survival than mice treated with vehicle, atorvastatin, or imipenem alone. These findings suggest that atorvastatin could be an adjuvant in host-directed therapies for multidrug-resistant , based on its powerful pleiotropic immunomodulatory effects. Together with antimicrobial approaches, combination therapy with anti-inflammatory compounds could improve the efficiency of therapy during acute lung infections.

摘要

临床病原体是导致医院获得性感染的相关原因,而对当前碳青霉烯类抗生素治疗的耐药性正成为一个重大问题。他汀类药物是 3-羟基-3-甲基戊二酰辅酶 A(HMG-CoA)的抑制剂,用于控制血浆胆固醇水平。有临床证据表明他汀类药物具有其他作用,包括减轻肺部炎症。在本研究中,我们表明,在感染初始阶段用阿托伐他汀预处理可显著减轻肺损伤,这与细胞向肺泡空间和肺部的细胞内流减少以及促炎介质的产生下调相关。然而,阿托伐他汀并未改变感染小鼠肺部和血液中的细菌数量,尽管其降低了局部炎症反应。有趣的是,与单独使用 vehicle、阿托伐他汀或亚胺培南相比,接受阿托伐他汀和亚胺培南联合治疗的小鼠的存活率更高。这些发现表明,基于其强大的多效免疫调节作用,阿托伐他汀可能成为针对多药耐药菌的宿主导向治疗的辅助药物。联合使用抗炎化合物的联合治疗可能会提高急性肺部感染期间治疗的效率。

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