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Fraser-Pitt DJ, Dolan SK, Toledo-Aparicio D, Hunt JG, Smith DW, Lacy-Roberts N, Nupe Hewage PS, Stoyanova TN, Manson E, McClean K, Inglis NF, Mercer DK, O'Neil DA. Cysteamine Inhibits Glycine Utilisation and Disrupts Virulence in Pseudomonas aeruginosa. Front Cell Infect Microbiol 2021; 11:718213. [PMID: 34631600 PMCID: PMC8494450 DOI: 10.3389/fcimb.2021.718213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/11/2021] [Indexed: 11/13/2022] Open
Abstract
Pseudomonas aeruginosa is a major opportunistic human pathogen which employs a myriad of virulence factors. In people with cystic fibrosis (CF) P. aeruginosa frequently colonises the lungs and becomes a chronic infection that evolves to become less virulent over time, but often adapts to favour persistence in the host with alginate-producing mucoid, slow-growing, and antibiotic resistant phenotypes emerging. Cysteamine is an endogenous aminothiol which has been shown to prevent biofilm formation, reduce phenazine production, and potentiate antibiotic activity against P. aeruginosa, and has been investigated in clinical trials as an adjunct therapy for pulmonary exacerbations of CF. Here we demonstrate (for the first time in a prokaryote) that cysteamine prevents glycine utilisation by P. aeruginosa in common with previously reported activity blocking the glycine cleavage system in human cells. Despite the clear inhibition of glycine metabolism, cysteamine also inhibits hydrogen cyanide (HCN) production by P. aeruginosa, suggesting a direct interference in the regulation of virulence factor synthesis. Cysteamine impaired chemotaxis, lowered pyocyanin, pyoverdine and exopolysaccharide production, and reduced the toxicity of P. aeruginosa secreted factors in a Galleria mellonella infection model. Thus, cysteamine has additional potent anti-virulence properties targeting P. aeruginosa, further supporting its therapeutic potential in CF and other infections.
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Affiliation(s)
| | - Stephen K Dolan
- Department of Biochemistry, University of Cambridge, Cambridge, United Kingdom
| | | | | | | | | | - Piumi Sara Nupe Hewage
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, United Kingdom
| | - Teodora N Stoyanova
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, United Kingdom
| | - Erin Manson
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Kevin McClean
- Proteomics Facility Services, Moredun Research Institute, Penicuik, United Kingdom
| | - Neil F Inglis
- Proteomics Facility Services, Moredun Research Institute, Penicuik, United Kingdom
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Devereux G, Wrolstad D, Bourke SJ, Daines CL, Doe S, Dougherty R, Franco R, Innes A, Kopp BT, Lascano J, Layish D, MacGregor G, Murray L, Peckham D, Lucidi V, Lovie E, Robertson J, Fraser-Pitt DJ, O'Neil DA. Oral cysteamine as an adjunct treatment in cystic fibrosis pulmonary exacerbations: An exploratory randomized clinical trial. PLoS One 2020; 15:e0242945. [PMID: 33370348 PMCID: PMC7769283 DOI: 10.1371/journal.pone.0242945] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/03/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Emerging data suggests a possible role for cysteamine as an adjunct treatment for pulmonary exacerbations of cystic fibrosis (CF) that continue to be a major clinical challenge. There are no studies investigating the use of cysteamine in pulmonary exacerbations of CF. This exploratory randomized clinical trial was conducted to answer the question: In future pivotal trials of cysteamine as an adjunct treatment in pulmonary exacerbations of CF, which candidate cysteamine dosing regimens should be tested and which are the most appropriate, clinically meaningful outcome measures to employ as endpoints? METHODS AND FINDINGS Multicentre double-blind randomized clinical trial. Adults experiencing a pulmonary exacerbation of CF being treated with standard care that included aminoglycoside therapy were randomized equally to a concomitant 14-day course of placebo, or one of 5 dosing regimens of cysteamine. Outcomes were recorded on days 0, 7, 14 and 21 and included sputum bacterial load and the patient reported outcome measures (PROMs): Chronic Respiratory Infection Symptom Score (CRISS), the Cystic Fibrosis Questionnaire-Revised (CFQ-R); FEV1, blood leukocyte count, and inflammatory markers. Eighty nine participants in fifteen US and EU centres were randomized, 78 completed the 14-day treatment period. Cysteamine had no significant effect on sputum bacterial load, however technical difficulties limited interpretation. The most consistent findings were for cysteamine 450mg twice daily that had effects additional to that observed with placebo, with improved symptoms, CRISS additional 9.85 points (95% CI 0.02, 19.7) p = 0.05, reduced blood leukocyte count by 2.46x109 /l (95% CI 0.11, 4.80), p = 0.041 and reduced CRP by geometric mean 2.57 nmol/l (95% CI 0.15, 0.99), p = 0.049. CONCLUSION In this exploratory study cysteamine appeared to be safe and well-tolerated. Future pivotal trials investigating the utility of cysteamine in pulmonary exacerbations of CF need to include the cysteamine 450mg doses and CRISS and blood leukocyte count as outcome measures. CLINICAL TRIAL REGISTRATION NCT03000348; www.clinicaltrials.gov.
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Affiliation(s)
- Graham Devereux
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Danielle Wrolstad
- Precision for Medicine, Oncology and Rare Disease, Carlsbad, CA, United States of America
| | | | - Cori L. Daines
- Banner University of Arizona Medical Center, Tucson, Arizona, United States of America
| | - Simon Doe
- Royal Victoria Infirmary, Newcastle, United Kingdom
| | - Ryan Dougherty
- San Francisco Critical Care Medical Group California Pacific Medical Center, San Francisco, United States of America
| | - Rose Franco
- The Medical College of Wisconsin/Froedtert Hospital, Milwaukee, Wisconsin, United States of America
| | | | - Benjamin T. Kopp
- Nationwide Children's Hospital, Columbus, OH, United States of America
| | - Jorge Lascano
- University of Florida, Gainesville, Florida, United States of America
| | - Daniel Layish
- Central Florida Pulmonary Group, Orlando, Florida, United States of America
| | | | | | | | - Vincenzina Lucidi
- Ospedale Padiatrico Bambino Gesu Centro Fibrosi Cistica, Rome, Italy
| | - Emma Lovie
- NovaBiotics Ltd, Aberdeen, United Kingdom
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Fraser-Pitt DJ, Cameron P, McNeilly TN, Boyd A, Manson EDT, Smith DGE. Phosphorylation of the epidermal growth factor receptor (EGFR) is essential for interleukin-8 release from intestinal epithelial cells in response to challenge with Escherichia coli O157 : H7 flagellin. Microbiology (Reading) 2011; 157:2339-2347. [PMID: 21546588 DOI: 10.1099/mic.0.047670-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Enterohaemorrhagic Escherichia coli O157 : H7 is a major foodborne and environmental pathogen responsible for both sporadic cases and outbreaks of food poisoning, which can lead to serious sequelae, such as haemolytic uraemic syndrome. The structural subunit of E. coli O157 : H7 flagella is flagellin, which is both the antigenic determinant of the H7 serotype, an important factor in colonization, and an immunomodulatory protein that has been determined to be a major pro-inflammatory component through the instigation of host cell signalling pathways. Flagellin has highly conserved N- and C-terminal regions that are recognized by the host cell pattern recognition receptor Toll-like receptor (TLR) 5. Activation of this receptor triggers cell signalling cascades, which are known to activate host cell kinases and transcription factors that respond with the production of inflammatory mediators such as the chemokine interleukin-8 (IL-8), although the exact components of this pathway are not yet fully characterized. We demonstrate that E. coli O157 : H7-derived flagellin induces rapid phosphorylation of the epidermal growth factor receptor (EGFR), as an early event in intestinal epithelial cell signalling, and that this is required for the release of the pro-inflammatory cytokine IL-8.
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Affiliation(s)
- Douglas J Fraser-Pitt
- Biomedical Sciences and Microbiology Group, School of Life, Sport and Social Sciences, Faculty of Health, Life and Social Sciences, Sighthill Campus, Edinburgh Napier University, Edinburgh EH11 4BN, UK
| | - Pamela Cameron
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik, Midlothian EH26 0PZ, UK
| | - Tom N McNeilly
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik, Midlothian EH26 0PZ, UK
| | - Amanda Boyd
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik, Midlothian EH26 0PZ, UK
| | - Erin D T Manson
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik, Midlothian EH26 0PZ, UK
| | - David G E Smith
- Institute for Comparative Medicine, Faculty of Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, UK.,Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik, Midlothian EH26 0PZ, UK
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