Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, United States of America.
PLoS Pathog. 2022 Feb 10;18(2):e1010240. doi: 10.1371/journal.ppat.1010240. eCollection 2022 Feb.
Staphylococcus aureus bacteremia (SAB) remains a clinically challenging infection despite extensive investigation. Repurposing medications approved for other indications is appealing as clinical safety profiles have already been established. Ticagrelor, a reversible adenosine diphosphate receptor antagonist that prevents platelet aggregation, is indicated for patients suffering from acute coronary syndrome (ACS). However, some clinical data suggest that patients treated with ticagrelor are less likely to have poor outcomes due to S. aureus infection. There are several potential mechanisms by which ticagrelor may affect S. aureus virulence. These include direct antibacterial activity, up-regulation of the innate immune system through boosting platelet-mediated S. aureus killing, and prevention of S. aureus adhesion to host tissues. In this Pearl, we review the clinical data surrounding ticagrelor and infection as well as explore the evidence surrounding these proposed mechanisms of action. While more evidence is needed before antiplatelet medications formally become part of the arsenal against S. aureus infection, these potential mechanisms represent exciting pathways to target in the host/pathogen interface.
金黄色葡萄球菌菌血症（SAB）尽管经过广泛研究，但仍然是一种具有临床挑战性的感染。重新利用已批准用于其他适应症的药物很有吸引力，因为已经确定了临床安全性概况。替格瑞洛是一种可逆的二磷酸腺苷受体拮抗剂，可防止血小板聚集，适用于患有急性冠脉综合征（ACS）的患者。然而，一些临床数据表明，接受替格瑞洛治疗的患者因金黄色葡萄球菌感染而出现不良后果的可能性较小。替格瑞洛可能通过几种潜在机制影响金黄色葡萄球菌的毒力。这些机制包括直接的抗菌活性、通过增强血小板介导的金黄色葡萄球菌杀伤作用来上调先天免疫系统，以及防止金黄色葡萄球菌黏附到宿主组织。在这篇珍珠文章中，我们回顾了围绕替格瑞洛和感染的临床数据，并探讨了这些拟议作用机制的证据。虽然在抗血小板药物正式成为金黄色葡萄球菌感染的治疗方法之前，还需要更多的证据，但这些潜在的机制代表了在宿主/病原体界面上的一个令人兴奋的靶向途径。
