Enhanced killing of group B streptococci in vitro by penicillin and opsonophagocytosis with intravenous immunoglobulin

Antibacterial properties of Pseudomonas aeruginosa immunotype 1 lipopolysaccharide-specific monoclonal antibody (MAb) in a murine thigh infection model: combined effects of MAb and ceftazidime

A murine monoclonal antibody (MAb) specific for the Pseudomonas aeruginosa immunotype 1 (It-1) lipopolysaccharide (LPS) O-side chain was evaluated in terms of its in vitro bactericidal opsonophagocytic activity and in vivo bacterial killing in a mouse thigh infection model. An immunoglobulin (Ig) G2a MAb Ld3-2F2, specific for It-1 LPS, mediated in vitro complement-dependent opsonophagocytic killing at a concentration of 10 microg/ml. MAb-mediated, complement-dependent killing also occurred in the absence of neutrophils at serum concentrations in excess of 20%. A remarkable synergy was observed in opsonophagocytic assays between MAb Ld3-2F2 (0.5 microg/ml) and ceftazidime (1/4 MIC). The administration of MAb Ld3-2F2 at a level of 1 microg resulted in a significant decrease in the number of bacteria in the thigh muscles of normal mice, while 100 microg of the same MAb was required for one log of reduction in the number of bacteria at the same site in neutropenic mice. The combined therapy with MAb Ld3-2F2 and ceftazidime provided a significant reduction in the density of bacteria in the thigh muscle at 9 hr post-infection in normal and neutropenic mice as compared with those after treatment alone or with no treatment (P< 0.01). These favorable in vitro and in vivo interactions of an LPS-specific IgG MAb and ceftazidime strongly support their potential for use in therapy, combined with an LPS-reactive MAb and parenteral antipseudomonas beta-lactam antibiotics in the therapy of systemic Pseudomonas infections in normal and neutropenic hosts.

Flow cytometric analysis of group B streptococci phagocytosis and oxidative burst in human neutrophils and monocytes

Group B streptococci (GBS) are a major cause of meningitis and septicemia in neonates and numerous invasive diseases in adults. Host defense against GBS infections relies upon phagocytosis and killing by phagocytic cells. To better understand the importance of this defense mechanism a flow cytometric assay was developed to study phagocytosis and oxidative burst of leukocytes stimulated by bacteria. GBS labeled with fluorescein isothiocyanate were used for phagocytosis experiments and the extracellular fluorescence was quenched by ethidium bromide to differentiate intracellular from extracellular bacteria. The intracellular oxidative burst was determined by using 2',7'-dichlorofluorescein diacetate to measure hydrogen peroxide production and hydroethidine for superoxide anion production. We found that for GBS serotypes Ia, Ib/c, II, and III phagocytosis was greater in neutrophils than monocytes. Hydrogen peroxide production and superoxide anion production were also greater for neutrophils than monocytes in all serotypes tested. A comparison of seven type III strains revealed greater phagocytosis and superoxide anion production by neutrophils than monocytes but no difference in hydrogen peroxide production. Therefore, monocytes react similarly as neutrophils in response to GBS but at a reduced level. This methodology of measuring both phagocytosis of GBS and oxidative burst simultaneously in neutrophils and monocytes should be very useful in further studies on the importance of factors such as complement and IgG receptors for the killing of bacteria.

Salicylate-enhanced exposure of Klebsiella pneumoniae subcapsular components

The capsular polysaccharide (CPS) of Klebsiella pneumoniae is an important virulence factor. Salicylate, which inhibits CPS production, was used to expose subcapsular antigens and components that may play an important role in host defense. Salicylate treatment greatly increased phagocytosis of five O1 serotypes by human polymorphonuclear leukocytes with normal rabbit serum and rabbit antisera against purified O1 lipopolysaccharide (O1LPS) as opsonins (p < 0.01 or < 0.05). Similar results were obtained with rabbit antiserum against a non-encapsulated isogenic strain. To further determine how salicylate increases susceptibility to phagocytosis, the binding of monoclonal antibodies against O1LPS or the LPS core and the binding of complement component C3b were measured by ELISA. The data indicate that salicylate reduced the barrier of CPS in serotypes O1:K1, O1:K10, and O1:K16 and unmasked subcapsular antigenic components in serotypes O1:K2 and O1:K66 so that bound opsonins could react with receptors on phagocytes. Serum bactericidal assays supported this conclusion. Therefore, decapsulating agents such as salicylate accentuate phagocytosis of K. pneumoniae by making subcapsular antigens and components accessible to immune and nonimmune host defences and vaccination with subcapsular antigens may exhibit optimal protection against lethal infection when combined with salicylate therapy.

Salicylate or bismuth salts enhance opsonophagocytosis of Klebsiella pneumoniae

After treatment of encapsulated Klebsiella pneumoniae with salicylate or bismuth compounds, phagocytic uptake by human peripheral white blood cells or rat alveolar macrophages was assessed. Without salicylate pretreatment of bacteria, a 30-60% net increase in viable bacteria resulted in phagocytic assays after a 1 hour incubation. With salicylate pretreatment, dose-related decreases in bacterial counts were seen, achieving a maximal reduction of 60% with 240 microM salicylate pretreatment. Bacterial variants producing less capsule were more serum sensitive and more readily phagocytosed. Micrographs of Giemsa-stained cells revealed phagocytic uptake of multiple bacteria after salicylate pretreatment, but virtually no uptake of untreated bacteria. Opsonization with polyclonal antiserum decreased bacterial cell counts by 20% without and by 90% with salicylate pretreatment of bacteria. Pretreatment of bacteria with bismuth salts also enhanced opsonophagocytosis of encapsulated bacteria. Thus, agents known to reduce capsule expression in K. pneumoniae also enhance phagocytic uptake of bacteria.