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JEM: Nox2-derived oxidative stress results in inefficacy of antibiotics against post-influenza S. aureus pneumonia

tetano

Editor, Senior Moderator
Published August 15, 2016
The Rockefeller University Press, doi: 10.1084/jem.20150514 ? 2016 Sun et al.
    • Article

[h=1]Nox2-derived oxidative stress results in inefficacy of antibiotics against post-influenza S. aureus pneumonia[/h]
  • [SUP]1[/SUP]Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68198
  • [SUP]2[/SUP]Center for Immunology and Microbial Disease, Albany Medical College, Albany, NY 12208
  • Correspondence to Keer Sun: Keer.sun{at}unmc.edu

[h=2]Abstract[/h] Clinical post-influenza Staphylococcus aureus pneumonia is characterized by extensive lung inflammation associated with severe morbidity and mortality even after appropriate antibiotic treatment. In this study, we show that antibiotics rescue nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 (Nox2)?deficient mice but fail to fully protect WT animals from influenza and S. aureus coinfection. Further experiments indicate that the inefficacy of antibiotics against coinfection is attributable to oxidative stress?associated inflammatory lung injury. However, Nox2-induced lung damage during coinfection was not associated with aggravated inflammatory cytokine response or cell infiltration but rather caused by reduced survival of myeloid cells. Specifically, oxidative stress increased necrotic death of inflammatory cells, thereby resulting in lethal damage to surrounding tissue. Collectively, our results demonstrate that influenza infection disrupts the delicate balance between Nox2-dependent antibacterial immunity and inflammation. This disruption leads to not only increased susceptibility to S. aureus infection, but also extensive lung damage. Importantly, we show that combination treatment of antibiotic and NADPH oxidase inhibitor significantly improved animal survival from coinfection. These findings suggest that treatment strategies that target both bacteria and oxidative stress will significantly benefit patients with influenza-complicated S. aureus pneumonia.

http://jem.rupress.org/content/early/2016/08/08/jem.20150514
 
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