Low-Dose Nitric Oxide as Targeted Anti-biofilm Adjunctive Therapy to Treat Chronic Pseudomonas aeruginosa Infection in Cystic Fibrosis
File(s)2017 Howlin et al Molecular Therapy.pdf (3.08 MB)
Published version
Author(s)
Type
Journal Article
Abstract
Despite aggressive antibiotic therapy, bronchopulmonary colonization by Pseudomonas aeruginosa causes persistent morbidity and mortality in cystic fibrosis (CF). Chronic P. aeruginosa infection in the CF lung is associated with structured, antibiotic-tolerant bacterial aggregates known as biofilms. We have demonstrated the effects of non-bactericidal, low-dose nitric oxide (NO), a signaling molecule that induces biofilm dispersal, as a novel adjunctive therapy for P. aeruginosa biofilm infection in CF in an ex vivo model and a proof-of-concept double-blind clinical trial. Submicromolar NO concentrations alone caused disruption of biofilms within ex vivo CF sputum and a statistically significant decrease in ex vivo biofilm tolerance to tobramycin and tobramycin combined with ceftazidime. In the 12-patient randomized clinical trial, 10 ppm NO inhalation caused significant reduction in P. aeruginosa biofilm aggregates compared with placebo across 7 days of treatment. Our results suggest a benefit of using low-dose NO as adjunctive therapy to enhance the efficacy of antibiotics used to treat acute P. aeruginosa exacerbations in CF. Strategies to induce the disruption of biofilms have the potential to overcome biofilm-associated antibiotic tolerance in CF and other biofilm-related diseases.
Date Issued
2017-07-24
Date Acceptance
2017-06-24
Citation
MOLECULAR THERAPY, 2017, 25 (9), pp.2104-2116
ISSN
1525-0016
Publisher
CELL PRESS
Start Page
2104
End Page
2116
Journal / Book Title
MOLECULAR THERAPY
Volume
25
Issue
9
Copyright Statement
© 2017 The Authors. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000410462600013&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Biotechnology & Applied Microbiology
Genetics & Heredity
Medicine, Research & Experimental
Research & Experimental Medicine
IN-SITU HYBRIDIZATION
BACTERIAL BIOFILMS
POLYMORPHONUCLEAR LEUKOCYTES
ANTIBIOTIC SUSCEPTIBILITIES
SILICA NANOPARTICLES
CLINICAL-SAMPLES
LUNG INFECTIONS
MIDDLE-EAR
SPUTUM
ADULTS
Pseudomonas aeruginosa
cystic fibrosis
nitric oxide
06 Biological Sciences
10 Technology
11 Medical And Health Sciences
Biotechnology
Publication Status
Published