Koo Jenny, Escajadillo Tamara, Zhang Liangfang, Nizet Victor, Lawrence Shelley M
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States.
Collaborative to Halt Antibiotic-Resistant Microbes (CHARM), Division of Host-Microbe Systems and Therapeutics, Department of Pediatrics, University of California, San Diego, La Jolla, CA, United States.
Front Pediatr. 2019 Nov 1;7:410. doi: 10.3389/fped.2019.00410. eCollection 2019.
Group B (GBS) emerged as a leading cause of invasive infectious disease in neonates in the 1970s, but has recently been identified as an escalating public health threat in non-pregnant adults, particularly those of advanced aged or underlying medical conditions. GBS infection can rapidly develop into life-threatening disease despite prompt administration of effective antibiotics and initiation of state-of-the-art intensive care protocols and technologies due to deleterious bacterial virulence factors, such as the GBS pore-forming toxin β-hemolysin/cytolysin (β-H/C). β-H/C is known to have noxious effects on a wide range of host cells and tissues, including lung epithelial cell injury, blood brain barrier weakening, and immune cell apoptosis. Neonatal and adult survivors of GBS infection are at a high risk for substantial long-term health issues and neurologic disabilities due to perturbations in organ systems caused by bacterial- and host- mediated inflammatory stressors. Previously engineered anti-virulence inhibitors, such as monoclonal antibodies and small molecular inhibitors, generally require customized design for each different pathogenic toxin and do not target deleterious host pro-inflammatory responses that may cause organ injury, septic shock, or death. By simply wrapping donor red blood cells (RBCs) around polymeric cores, we have created biomimetic "nanosponges." Because nanoparticles retain the same repertoire of cell membrane receptors as their host cell, they offer non-specific and all-purpose toxin decoy strategies with a broad ability to sequester and neutralize various bacterial toxins and host pro-inflammatory chemokines and cytokines to attenuate the course of infectious disease. This proof-of-concept study successfully demonstrated that intervention with nanosponges reduced the hemolytic activity of live GBS and stabilized β-H/C in a dose-dependent manner. Nanosponge treatment also decreased lung epithelial and macrophage cell death following exposure to live GBS bacteria and stabilized β-H/C, improved neutrophil killing of GBS, and diminished GBS-induced macrophage IL-1β production. Our results, therefore, suggest biomimetic nanosponges provide a titratable detoxification therapy that may provide a first-in-class treatment option for GBS infection by sequestering and inhibiting β-H/C activity.
B组链球菌(GBS)在20世纪70年代成为新生儿侵袭性传染病的主要病因,但最近已被确认为非妊娠成人中不断升级的公共卫生威胁,尤其是那些高龄或有基础疾病的人。尽管及时使用有效的抗生素并启动最先进的重症监护方案和技术,但由于有害的细菌毒力因子,如GBS成孔毒素β-溶血素/细胞毒素(β-H/C),GBS感染仍可迅速发展为危及生命的疾病。已知β-H/C对多种宿主细胞和组织具有有害作用,包括肺上皮细胞损伤、血脑屏障减弱和免疫细胞凋亡。由于细菌和宿主介导的炎症应激源导致器官系统紊乱,GBS感染的新生儿和成人幸存者面临着严重长期健康问题和神经残疾的高风险。以前设计的抗毒力抑制剂,如单克隆抗体和小分子抑制剂,通常需要针对每种不同的致病毒素进行定制设计,并且不针对可能导致器官损伤、感染性休克或死亡的有害宿主促炎反应。通过简单地将供体红细胞(RBC)包裹在聚合物核心周围,我们创造了仿生“纳米海绵”。由于纳米颗粒保留了与其宿主细胞相同的细胞膜受体库,它们提供了非特异性和通用的毒素诱饵策略,具有广泛的能力来隔离和中和各种细菌毒素以及宿主促炎趋化因子和细胞因子,从而减轻传染病的病程。这项概念验证研究成功证明,用纳米海绵进行干预可降低活GBS的溶血活性,并以剂量依赖的方式稳定β-H/C。纳米海绵治疗还减少了暴露于活GBS细菌后的肺上皮细胞和巨噬细胞死亡,并稳定了β-H/C,改善了中性粒细胞对GBS的杀伤作用,并减少了GBS诱导的巨噬细胞IL-1β产生。因此,我们的结果表明,仿生纳米海绵提供了一种可滴定的解毒疗法,通过隔离和抑制β-H/C活性,可能为GBS感染提供一流的治疗选择。