Critical care medicine in AJRCCM 2002

Effect of polymyxin B on gram-negative bacterial infection during pregnancy

OBJECTIVE

Polymyxin B (PB) is a naturally occurring cationic cyclic decapeptide which is highly bactericidal to Gram-negative bacteria. The objective of this study was to investigate the effect of PB on the viability of developing embryos during pregnancy and to validate its protective effect on the embryotoxic effect of Gram-negative bacterial lipopolysaccharide (LPS).

MATERIAL AND METHODS

Animals were injected intraperitoneally (i.p.) with PB (5-100 μg/animal), (Minimum effective dose) MD of LPS and MD of LPS+PB (5-100 μg/animal) on day 0.5 of pregnancy. The percentage of normal gestational sacs and histopathologic analysis were assessed.

RESULTS

PB treatment of pregnant females disturbs the pregnancy in a dose dependent manner and increases the substantial risk of congenital abnormalities in the growing fetuses of the mother. However, PB does not show any adverse effect on implantation of embryos. The embryotoxic effect of LPS can be prevented completely by 25 μg PB/animal; however other lower and higher doses of PB were not able to protect against the effect of LPS on pregnancy.

CONCLUSIONS

Our results demonstrate that PB has the ability to protect the LPS-induced pregnancy loss but may not be recommended as a safe drug for the treatment of a mother suffering from Gram-negative bacterial infection during pregnancy.

Lipopolysaccharide alters the vaginal electrical resistance in cycling and pregnant mice

PROBLEM

Lipopolysaccharide (LPS) has been postulated to exert harmful biologic effects during pregnancy. The objective of present investigation is to measure the vaginal electrical resistance (VER) in LPS-treated normal cycling and pregnant female mice.

METHOD OF STUDY

Minimum dose (MD) of LPS (250 microg/kg body weight) was injected in pregnant female mice through i.p. route on day 0.5 of pregnancy. VER was measured during different phases of reproductive cycle in female mice, which were pre-exposed to LPS and in untreated cycling female mice. VER was also measured in control pregnant female mice (saline-treated mice) through whole pregnancy and LPS-treated female mice in early stages of pregnancy.

RESULTS

Vaginal electrical resistance was significantly higher during proestrous or early estrous stage as compared with any other stages of reproductive cycle in mouse. One peak of VER was observed during peri-implantation period of pregnancy in control female mice. The significant differences in the pattern of VER were found between LPS-treated and control female mice during peri-implantation period of pregnancy, and between cycling female mice, which were pre-exposed to LPS and untreated cycling female mice during proestrus.

CONCLUSION

The presented results demonstrate, for the first time, that LPS exposure during pregnancy may be determined by measuring VER in mothers without any adverse effect on ongoing pregnancy and may help in refining the assisted reproduction techniques.

Cathelicidin Peptide Sheep Myeloid Antimicrobial Peptide-29 Prevents Endotoxin-induced Mortality in Rat Models of Septic Shock

The present study was designed to investigate the antiendotoxin activity and therapeutic efficacy of sheep myeloid antimicrobial peptide (SMAP)-29, a cathelicidin-derived peptide. The in vitro ability of SMAP-29 to bind LPS from Escherichia coli 0111:B4 was determined using a sensitive limulus chromogenic assay. Two rat models of septic shock were performed: (1) rats were injected intraperitoneally with 1 mg E. coli 0111:B4 LPS and (2) intraabdominal sepsis was induced via cecal ligation and single puncture. All animals were randomized to receive parenterally isotonic sodium chloride solution, 1 mg/kg SMAP-29, 1 mg/kg polymyxin B or 20 mg/kg imipenem. The main outcome measures were: abdominal exudate and plasma bacterial growth, plasma endotoxin and tumor necrosis factor-alpha concentrations, and lethality. The in vitro study showed that SMAP-29 completely inhibited the LPS procoagulant activity at approximately 10 microM peptide concentration. The in vivo experiments showed that all compounds reduced the lethality when compared with control animals. SMAP-29 achieved a substantial decrease in endotoxin and tumor necrosis factor-alpha plasma concentrations when compared with imipenem and saline treatment and exhibited a slightly lower antimicrobial activity than imipenem. No statistically significant differences were noted between SMAP-29 and polymyxin B. SMAP-29, because of its double antiendotoxin and antimicrobial activities, could be an interesting compound for septic shock treatment.