1
|
Schwarz C, Wimmer E, Holz F, Grehn C, Staab D, Eschenhagen PN. Antibiotic Therapy for Pulmonary Exacerbations in Cystic Fibrosis-A Single-Centre Prospective Observational Study. Antibiotics (Basel) 2023; 12:antibiotics12040734. [PMID: 37107096 PMCID: PMC10135273 DOI: 10.3390/antibiotics12040734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/30/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
People with cystic fibrosis experience bronchopulmonary exacerbations, leading to lung damage, lung function decline, increased mortality, and a poor health-related quality of life. To date, there are still open questions regarding the rationale for antibiotic use and the optimal duration of antibiotic therapy. This prospective single-center study (DRKS00012924) analyzes exacerbation treatment over 28 days in 96 pediatric and adult people with cystic fibrosis who started oral and/or intravenous antibiotic therapy in an inpatient or outpatient setting after clinician diagnosis of bronchopulmonary exacerbation. Biomarkers of exacerbation were examined in terms of their ability to predict response to treatment and the need for antibiotic therapy. The mean duration of antibiotic therapy was 14 days. Inpatient treatment was associated with a poorer health status, but no significant difference was found in the modified Fuchs exacerbation score between inpatients and outpatients. A significant increase of in-hospital FEV1, home spirometry FEV1, and body-mass index and a significant decrease of the modified Fuchs symptom score, C-reactive protein, and 8 out of the 12 domain scores of the revised cystic fibrosis questionnaire were demonstrated after 28 days. However, a trend towards a FEV1 decline in the inpatient group on day 28 could be demonstrated, while FEV1 was maintained in the outpatient group. Correlation analyses of changes between baseline and day 28 show a strong positive correlation between home spirometry and in-hospital FEV1, strong negative correlations between FEV1 and the modified Fuchs exacerbation score and between FEV1 and C-reactive protein, and a moderately negative correlation between FEV1 and the three domains of the revised cystic fibrosis questionnaire. Responders and non-responders to antibiotic therapy were defined in terms of FEV1 improvement after therapy. A higher baseline C-reactive protein, a greater decrease in C-reactive protein, a higher baseline modified Fuchs exacerbation score, and a greater decrease in the score after 28 days could be found in the responder group, while other baseline and follow-up parameters like FEV1 showed no significant differences. Our data show that the modified Fuchs exacerbation score is applicable in a clinical setting and can detect acute exacerbations regardless of health status. Home spirometry is a useful tool for outpatient exacerbation management. A change in C-reactive protein and a modified Fuchs score change are suitable follow-up markers of exacerbation due to their strong correlation with FEV1. Further studies are needed to assess which patients would benefit from a longer duration of antibiotic therapy. C-reactive protein at exacerbation onset and C-reactive protein decline during and after therapy better predict antibiotic therapy success than FEV1 at therapy onset, while the modified Fuchs score indicates exacerbation regardless of the need for antibiotic therapy, suggesting that antibiotic therapy is only part of exacerbation management.
Collapse
Affiliation(s)
- Carsten Schwarz
- Cystic Fibrosis Center, Clinic Westbrandenburg, 14467 Potsdam, Germany
- Department of Education and Research, HMU Health and Medical University Potsdam, 14471 Potsdam, Germany
| | - Eliana Wimmer
- Paediatric Practice at Traveplatz, Dr. Kilger, Dr. Kabelitz, Dr. Shetty, 10247 Berlin, Germany
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany
| | - Frederik Holz
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany
| | - Claudia Grehn
- BIH Berlin Institute of Health, Charité University Medicine Berlin, 13353 Berlin, Germany
| | - Doris Staab
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany
| | - Patience Ndidi Eschenhagen
- Cystic Fibrosis Center, Clinic Westbrandenburg, 14467 Potsdam, Germany
- Department of Education and Research, HMU Health and Medical University Potsdam, 14471 Potsdam, Germany
| |
Collapse
|
2
|
Boecker D, Zhang Z, Breves R, Herth F, Kramer A, Bulitta C. Antimicrobial efficacy, mode of action and in vivo use of hypochlorous acid (HOCl) for prevention or therapeutic support of infections. GMS HYGIENE AND INFECTION CONTROL 2023; 18:Doc07. [PMID: 37034111 PMCID: PMC10073986 DOI: 10.3205/dgkh000433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
The objective is to provide a comprehensive overview of the rapidly developing field of the current state of research on in vivo use of hypochlorous acid (HOCl) to aid infection prevention and control, including naso-pharyngeal, alveolar, topical, and systemic HOCl applications. Also, examples are provided of dedicated applications in COVID-19. A brief background of HOCl's biological and chemical specifics and its physiological role in the innate immune system is provided to understand the effect of in vivo applications in the context of the body's own physiological defense mechanisms.
Collapse
Affiliation(s)
- Dirk Boecker
- TOTO Consulting LLC, San Jose CA, USA
- *To whom correspondence should be addressed: Dirk Boecker, TOTO Consulting LLC, San Jose CA, USA, E-mail:
| | - Zhentian Zhang
- Institute for Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | | | - Felix Herth
- Thoraxklinik, University of Heidelberg, Heidelberg, Germany
| | - Axel Kramer
- Institut of Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Clemens Bulitta
- Institut für Medizintechnik, Ostbayerische Technische Hochschule (OTH) Amberg-Weiden, Amberg-Weiden, Germany
| |
Collapse
|
3
|
Baroni L, Abreu-Filho PG, Pereira LM, Nagl M, Yatsuda AP. Recombinant actin-depolymerizing factor of the apicomplexan Neospora caninum (NcADF) is susceptible to oxidation. Front Cell Infect Microbiol 2022; 12:952720. [PMID: 36601306 PMCID: PMC9806845 DOI: 10.3389/fcimb.2022.952720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/21/2022] [Indexed: 12/24/2022] Open
Abstract
Neospora caninum is a member of Apicomplexa Phylum and the causative agent of neosporosis, a disease responsible for abortions in cattle. Apicomplexan parasites have a limited set of actin-binding proteins conducting the regulation of the dynamics of nonconventional actin. The parasite actin-based motility is implicated in the parasite invasion process in the host cell. Once no commercial strategy for the neosporosis control is available, the interference in the parasite actin function may result in novel drug targets. Actin-depolymerization factor (ADF) is a member of the ADF/cofilin family, primarily known for its function in actin severing and depolymerization. ADF/cofilins are versatile proteins modulated by different mechanisms, including reduction and oxidation. In apicomplexan parasites, the mechanisms involved in the modulation of ADF function are barely explored and the effects of oxidation in the protein are unknown so far. In this study, we used the oxidants N-chlorotaurine (NCT) and H2O2 to investigate the susceptibility of the recombinant N. caninum ADF (NcADF) to oxidation. After exposing the protein to either NCT or H2O2, the dimerization status and cysteine residue oxidation were determined. Also, the interference of NcADF oxidation in the interaction with actin was assessed. The treatment of the recombinant protein with oxidants reversibly induced the production of dimers, indicating that disulfide bonds between NcADF cysteine residues were formed. In addition, the exposure of NcADF to NCT resulted in more efficient oxidation of the cysteine residues compared to H2O2. Finally, the oxidation of NcADF by NCT reduced the ability of actin-binding and altered the function of NcADF in actin polymerization. Altogether, our results clearly show that recombinant NcADF is sensitive to redox conditions, indicating that the function of this protein in cellular processes involving actin dynamics may be modulated by oxidation.
Collapse
Affiliation(s)
- Luciana Baroni
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Péricles Gama Abreu-Filho
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Luiz Miguel Pereira
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil
| | - Markus Nagl
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Ana Patricia Yatsuda
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil,*Correspondence: Ana Patricia Yatsuda,
| |
Collapse
|
4
|
Murashevych B, Stepanskyi D, Toropin V, Mironenko A, Maslak H, Burmistrov K, Teteriuk N. Virucidal properties of new multifunctional fibrous N-halamine-immobilized styrene-divinylbenzene copolymers. J BIOACT COMPAT POL 2022. [DOI: 10.1177/08839115221121852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Virucidal properties of N-chlorosulfonamides immobilized on fibrous styrene-divinylbenzene copolymers have been studied. Corresponding materials with different functional group structures and chlorine content have been synthesized on FIBAN polymer carriers in the form of staple fibers and non-woven fabrics. The study has been conducted in general accordance with EN 14476 standard on poliovirus type-1 and adenovirus type-5. It has been found that all tested samples exhibit pronounced virucidal activity: regardless of the carrier polymer form, sodium N-chlorosulfonamides inactivated both viruses in less than 30 s, and N,N-dichlorosulfonamides—in 30–60 s. The main mechanism of action of these materials, obviously, consists in the emission of active chlorine from the functional group into the treated medium under the action of the amino groups of virus fragments and cell culture. Considering the previously described antimicrobial and reparative properties of such materials, as well as their satisfactory physical and mechanical properties, the synthesized polymers are promising for the creation of medical devices with increased resistance to microbial contamination, such as protective masks, filter elements, long-acting wound dressings, and others.
Collapse
Affiliation(s)
- Bohdan Murashevych
- Department of Biochemistry and Medical Chemistry, Dnipro State Medical University, Dnipro, Ukraine
| | - Dmytro Stepanskyi
- Department of Microbiology, Virology, Immunology and Epidemiology, Dnipro State Medical University, Dnipro, Ukraine
| | - Volodymyr Toropin
- Department of Pharmacy and Technology of Organic Substances, Ukrainian State University of Chemical Technology, Dnipro, Ukraine
| | - Alla Mironenko
- Department of Respiratory and Other Viral Infections, L.V. Gromashevsky Institute of Epidemiology and Infectious Diseases, Kyiv, Ukraine
| | - Hanna Maslak
- Department of Biochemistry and Medical Chemistry, Dnipro State Medical University, Dnipro, Ukraine
| | - Konstantin Burmistrov
- Department of Pharmacy and Technology of Organic Substances, Ukrainian State University of Chemical Technology, Dnipro, Ukraine
| | - Nataliia Teteriuk
- Department of Respiratory and Other Viral Infections, L.V. Gromashevsky Institute of Epidemiology and Infectious Diseases, Kyiv, Ukraine
| |
Collapse
|
5
|
Comparative Fungicidal Activities of N-Chlorotaurine and Conventional Antiseptics against Candida spp. Isolated from Vulvovaginal Candidiasis. J Fungi (Basel) 2022; 8:jof8070682. [PMID: 35887439 PMCID: PMC9322802 DOI: 10.3390/jof8070682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/01/2022] [Accepted: 06/09/2022] [Indexed: 02/01/2023] Open
Abstract
N-chlorotaurine (NCT), the N-chloro derivative of the amino acid taurine, is a long-lived oxidant produced by stimulated human leucocytes. NCT has antimicrobial activities which are generally enhanced in the presence of organic material. The aim of this study was to investigate fungicidal effects of NCT and conventional antiseptics against Candida isolated from vulvovaginal candidiasis (VVC). Chlorhexidine (CHX, 1.6%), octenidine dihydrochloride (OCT, 0.08%), povidone iodine (PVP-I, 8%), boric acid (8%), and NCT (0.1% (5.5 mM)) were evaluated against forty-four Candida isolates, according to European Standard methods, at 30, 60, 90, and 120 min and 24 h in the presence of skim milk as an organic material. CHX, OCT, and PVP-I showed rapid fungicidal activity against all Candida isolates with 5–6 log10 reduction of viable counts after 30 min, whereas boric acid and NCT needed 1 h against Candida albicans and 2 h against non-albicans Candida for a significant 3 log10 reduction. NCT showed fungicidal activity (defined as ≥4 log10 reduction) against C. albicans within 90 min and C. non–albicans within 24 h. Based upon all presently available data, including our results, NCT could be used as a new agent for treatment of local fungal infections such as VVC.
Collapse
|