Targeting Alpha Toxin To Mitigate Its Lethal Toxicity in Ferret and Rabbit Models of Staphylococcus aureus Necrotizing Pneumonia

Antimicrob Agents Chemother. 2017 Mar 24;61(4):e02456-16. doi: 10.1128/AAC.02456-16. Print 2017 Apr.

Abstract

The role broad-spectrum antibiotics play in the spread of antimicrobial resistance, coupled with their effect on the healthy microbiome, has led to advances in pathogen-specific approaches for the prevention or treatment of serious bacterial infections. One approach in clinical testing is passive immunization with a monoclonal antibody (MAb) targeting alpha toxin for the prevention or treatment of Staphylococcus aureus pneumonia. Passive immunization with the human anti-alpha toxin MAb, MEDI4893*, has been shown to improve disease outcome in murine S. aureus pneumonia models. The species specificity of some S. aureus toxins necessitates testing anti-S. aureus therapeutics in alternate species. We developed a necrotizing pneumonia model in ferrets and utilized an existing rabbit pneumonia model to characterize MEDI4893* protective activity in species other than mice. MEDI4893* prophylaxis reduced disease severity in ferret and rabbit pneumonia models against both community-associated methicillin-resistant S. aureus (MRSA) and hospital-associated MRSA strains. In addition, adjunctive treatment of MEDI4893* with either vancomycin or linezolid provided enhanced protection in rabbits relative to the antibiotics alone. These results confirm that MEDI4893 is a promising candidate for immunotherapy against S. aureus pneumonia.

Keywords: Staphylococcus aureus; alpha toxin; antibacterial; antibiotic; hemolysins; monoclonal antibodies.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Antibodies, Monoclonal / immunology
  • Ferrets
  • Hemolysin Proteins / metabolism
  • Methicillin-Resistant Staphylococcus aureus / physiology
  • Pneumonia, Necrotizing / drug therapy*
  • Pneumonia, Necrotizing / microbiology
  • Pneumonia, Staphylococcal
  • Rabbits
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / physiology*

Substances

  • Anti-Bacterial Agents
  • Antibodies, Monoclonal
  • Hemolysin Proteins