Targeting iron uptake to control Pseudomonas aeruginosa infections in cystic fibrosis

Eur Respir J. 2013 Dec;42(6):1723-36. doi: 10.1183/09031936.00124012. Epub 2012 Nov 8.

Abstract

The aerobic Gram-negative bacterium Pseudomonas aeruginosa is an opportunistic pathogen responsible for life-threatening acute and chronic infections in humans. As part of chronic infection P. aeruginosa forms biofilms, which shield the encased bacteria from host immune clearance and provide an impermeable and protective barrier against currently available antimicrobial agents. P. aeruginosa has an absolute requirement for iron for infection success. By influencing cell-cell communication (quorum sensing) and virulence factor expression, iron is a powerful regulator of P. aeruginosa behaviour. Consequently, the imposed perturbation of iron acquisition systems has been proposed as a novel therapeutic approach to the treatment of P. aeruginosa biofilm infection. In this review, we explore the influence of iron availability on P. aeruginosa infection in the lungs of the people with the autosomal recessive condition cystic fibrosis as an archetypal model of chronic P. aeruginosa biofilm infection. Novel therapeutics aimed at disrupting P. aeruginosa are discussed, with an emphasis placed on identifying the barriers that need to be overcome in order to translate these promising in vitro agents into effective therapies in human pulmonary infections.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Infective Agents / therapeutic use
  • Biofilms
  • Chelating Agents / chemistry
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / microbiology*
  • Gene Expression Regulation, Bacterial
  • Homeostasis
  • Humans
  • Iron / chemistry
  • Iron / pharmacokinetics*
  • Lactoferrin / chemistry
  • Lung / microbiology
  • Pseudomonas Infections / microbiology
  • Pseudomonas Infections / prevention & control*
  • Pseudomonas aeruginosa*
  • Quorum Sensing / genetics
  • Respiratory Tract Infections / microbiology
  • Respiratory Tract Infections / prevention & control
  • Thiocyanates / chemistry

Substances

  • Anti-Infective Agents
  • Chelating Agents
  • Thiocyanates
  • hypothiocyanite ion
  • Iron
  • Lactoferrin