Relative contribution of Prevotella intermedia and Pseudomonas aeruginosa to lung pathology in airways of patients with cystic fibrosis

Martina Ulrich, Isabelle Beer, Peter Braitmaier, Michaela Dierkes, Florian Kummer, Bernhard Krismer, Ulrike Schumacher, Ute Gräpler-Mainka, Joachim Riethmüller, Peter Østrup Jensen, Thomas Bjarnsholt, Niels Høiby, Gabriel Bellon, Gerd Döring

60 Citations (Scopus)

Abstract

Background: Patients with cystic fibrosis (CF) with Pseudomonas aeruginosa lung infections produce endobronchial mucus plugs allowing growth of obligate anaerobes including Prevotella spp. Whether obligate anaerobes contribute to the pathophysiology of CF lung disease is unknown. Methods: The virulence of Prevotella intermedia and Ps aeruginosa was investigated in vitro and in mice, antibodies against P intermedia in CF sera were assessed and a culture-independent detection method for P intermedia/P nigrescens in CF sputum was tested. Results: P intermedia reached cell numbers of >10 5->107 colony-forming units (CFU)/ml sputum. The majority of patients with CF (16/17; 94.1%) produced antibodies against two immunoreactive antigens of P intermedia. Culture supernatant fluids, collected from 10 9 P intermedia cells, were more cytotoxic to respiratory epithelial cells in vitro and inflammatory in mouse lungs than respective fluids from anaerobically grown Ps aeruginosa, while fluids from aerobically grown Ps aeruginosa had the highest cytotoxicity and inflammation. Both pathological effects were largely reduced when culture supernatant fluids from 107 cells of either species were used. P intermedia cells (∼10 6CFU/lung) did not induce mortality in the agar beads lung infection mouse model, while Ps aeruginosa cells caused death in 30% of mice due to rapid multiplication. A P intermedia/P nigrescens-specific PNA probe was significantly more sensitive than culture-dependent diagnostic assays to detect these strict anaerobes. Conclusion: Ps aeruginosa and P intermedia become significantly virulent in vitro and in vivo when cell numbers exceed 108 CFU/lung.

Original languageEnglish
JournalThorax
Volume65
Issue number11
Pages (from-to)978-984
Number of pages7
ISSN0040-6376
DOIs
Publication statusPublished - 1 Nov 2010

Keywords

  • Animals
  • Antibodies, Bacterial
  • Bacteroidaceae Infections
  • Bronchoalveolar Lavage Fluid
  • Cells, Cultured
  • Colony Count, Microbial
  • Cystic Fibrosis
  • Humans
  • Lung
  • Mice
  • Mice, Inbred C57BL
  • Opportunistic Infections
  • Prevotella intermedia
  • Pseudomonas Infections
  • Pseudomonas aeruginosa
  • Respiratory Tract Infections
  • Sputum
  • Virulence

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