Pathogenesis of Pf Bacteriophages in Pseudomonas Cystic Fibrosis lung Infections

Pf 噬菌体在假单胞菌囊性纤维化肺部感染中的发病机制

• 批准号: 10463594
• 负责人: Carlos Milla
• 金额: $ 41.95万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-01 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10463594
• 关键词: Adhesives; Adult; Affect; Aminoglycosides; Antibiotic Resistance; Antibiotics; Antibodies; Antibody Response; Architecture; Aztreonam; Bacteria; Bacterial Infections; Bacteriophages; Cell physiology; Characteristics; Charge; Chronic; Ciliary epithelium; Clinical; Crystallization; Cystic Fibrosis; Cystic Fibrosis Transmembrane Conductance Regulator; Cystic Fibrosis sputum; Data; Development; Diffusion; Disease; Disease Progression; Effectiveness; Elastases; Electrostatics; Entropy; Epithelial; Extracellular Matrix; Immune response; Immunity; Impairment; In Vitro; Infection; Inflammatory; Inhalation; Ion Transport; Ions; Light; Liquid substance; Longitudinal Studies; Lung; Lung Transplantation; Lung infections; Mediating; Meropenem; Microbial Biofilms; Movement; Mucociliary Clearance; Mucous body substance; Outcome; Pathogenesis; Pathogenicity; Patients; Phagocytes; Phagocytosis; Polymers; Polysaccharides; Production; Pseudomonas; Pseudomonas aeruginosa; Pseudomonas aeruginosa infection; Pulmonary Cystic Fibrosis; Reporting; Role; Sampling; Sputum; Suggestion; Surface; Testing; Therapeutic Intervention; Time; Tobramycin; Translations; Virulence; Virulence Factors; Virus; Work; antibiotic tolerance; base; chronic infection; cohort; crystallinity; cystic fibrosis patients; cytokine; experimental study; extracellular; human pathogen; immune clearance; in vitro Model; infection burden; liquid crystal; microbial; mortality; neutrophil; new therapeutic target; novel; pathogenic bacteria; pediatric patients; prevent; pulmonary function; resistance mutation; resistant strain; response; treatment strategy

Project Summary Pseudomonas aeruginosa (Pa) is a major human pathogen whose virulence is predicated on its ability to form biofilms - slimy layers of polysaccharides and bacteria that confer resistance to antibiotics and immune clearance. Pa biofilms are particularly problematic in Cystic Fibrosis (CF), where they are a major cause of mortality. We have uncovered novel roles for Pf bacteriophages in chronic biofilm infections. We recently reported that Pf phages produced by Pa organize host and microbial polymers present in sputum into a liquid crystal. This crystalline architecture makes CF sputum more viscous and more adhesive. It also traps antibiotics like tobramycin and prevents them from reaching the bacteria living within. Along with these effects on biofilm formation and function, Pf phages directly interfere with host immunity. Purified Pf phage inhibits phagocytosis and hampers the ability to clear bacterial infections. In preliminary work with a cohort of Pa infected CF patients, we found associations between Pf phage and Pa lung infection burden, chronicity of Pa infection, declines in pulmonary function during exacerbation, and antibiotic resistance to anti- Pseudomonal antibiotics. Given the high abundance of Pf in CF sputum we also postulate that Pf liquid crystals may affect host mucociliary clearance by attachment and impairment of the epithelial ciliary brush function. In light of these exciting preliminary data, we hypothesize that Pf phage cause worse clinical outcomes in CF by disrupting bacterial clearance mechanisms and promoting bacterial tolerance to antibiotics. We will test this hypothesis in experiments with the following aims: In Aim 1 we will determine how Pf phage impacts cell function in the airways. Our hypothesis is that Pf phage interferes with phagocytosis, impairs mucus transport and disrupts the function of the ciliary brush. To test this, we will conduct a number of in vitro experiments to investigate the mechanisms of Pf pathogenecity. In Aim 2 we will elucidate how Pf phage production drives Pa antibiotic tolerance. Our hypothesis is that the liquid crystalline organization of Pa biofilms prevents diffusion of antibiotics and promotes the emergence of resistant strains. To test this, we will assess how Pf phage-mediated sequestration impacts the bioactivity of antibiotics and the emergence of antibiotic resistant Pa isolates over time. In Aim 3 we will characterize how Pf phage impacts clinical outcomes in CF patients. Our hypothesis is that higher Pf phage titers are associated with crystalline sputum and worse clinical outcomes. To test this, we will perform longitudinal studies to determine how Pa colonization influences pulmonary function and the occurrence of exacerbations. We will also investigate in CF patients for the presence of antibody responses directed at Pf and correlate their presence with clinical outcomes. This proposal represents a bold and radically unconventional approach to Pa biofilm infections and CF pathobiology. If successful, this work will identify a novel therapeutic target in CF and other settings where Pa biofilm infections cause disease.

项目摘要 铜绿假单胞菌（Pseudomonasaeruginosa，Pa）是一种主要的人类病原菌，其毒力取决于其形成 生物膜-多糖和细菌的粘液层，赋予抗生素和免疫抵抗力 间隙PA生物膜在囊性纤维化（CF）中是特别成问题的，其中它们是囊性纤维化的主要原因。 mortality.我们已经发现了Pf噬菌体在慢性生物膜感染中的新作用。我们最近 报道，由Pa产生的Pf β将痰中存在的宿主和微生物聚合物组织成液体 水晶这种晶体结构使CF痰液更粘稠和更具粘性。它还能捕获抗生素 比如妥布霉素，阻止它们到达细菌体内。 沿着这些对生物膜形成和功能的影响，Pf β直接干扰宿主免疫。纯化 Pf噬菌体抑制吞噬作用并阻碍清除细菌感染的能力。在初步工作中， 在Pa感染的CF患者的队列中，我们发现Pf噬菌体和Pa肺部感染负荷之间的关联， Pa感染的慢性化，加重期间肺功能下降，以及抗- 假单胞菌抗生素。鉴于CF痰液中Pf的高丰度，我们还假设Pf液晶 可能通过附着和损害上皮纤毛刷功能而影响宿主粘膜纤毛清除。 根据这些令人兴奋的初步数据，我们假设Pf噬菌体通过以下方式导致CF的临床结局更差： 破坏细菌清除机制并促进细菌对抗生素的耐受性。我们将测试这个 假设在实验中具有以下目的： 在目标1中，我们将确定Pf噬菌体如何影响气道中的细胞功能。我们的假设是Pf噬菌体 干扰吞噬作用、损害粘液运输并扰乱睫毛刷的功能。为了验证这个， 我们将进行大量的体外实验来研究Pf致病的机制。 在目标2中，我们将阐明Pf噬菌体生产如何驱动Pa抗生素耐受性。我们的假设是 Pa生物膜的液晶组织防止抗生素的扩散并促进 耐药菌株为了测试这一点，我们将评估Pf噬菌体介导的螯合如何影响Pf噬菌体的生物活性。 随着时间的推移，抗生素和抗生素耐药性Pa分离株的出现。 在目标3中，我们将描述Pf噬菌体如何影响CF患者的临床结果。我们的假设是 较高的Pf噬菌体滴度与结晶痰和较差的临床结果相关。为了验证这一点，我们 进行纵向研究，以确定Pa定植如何影响肺功能和 病情加重我们还将调查CF患者中是否存在针对Pf的抗体应答 并将它们的存在与临床结果相关联。 该提案代表了一种大胆的和根本上非传统的方法，以Pa生物膜感染和CF 病理生物学如果成功，这项工作将确定一个新的治疗目标，在CF和其他设置，其中Pa 生物膜感染引起疾病。