Exploring the therapeutic potential of staphylococcal phage formulations: Current challenges and applications in phage therapy

Unconstrained consumption of antibiotics throughout the expanse of the 21st century has resulted in increased antimicrobial resistance (AMR) among bacterial pathogens, a transpiring predicament affecting the public healthcare sector. The upsurge of multidrug-resistant pathogens, including Staphylococcus aureus, synchronously with the breakdown of the conventional antibiotic pipeline has led to the exploration of alternate strategies. Phage therapy applications have thus gained immense prominence among the scientific community to conquer this notorious pathogen associated with wide-ranging clinical manifestations, especially in immunosuppressed individuals. In this direction, a plethora of phage formulations like topical solutions, medicated dressings impregnated with phages, liposomal entrapments, etc., have been considered as an effective and upcoming strategy. Owing to the synergistic effect of phages with other antibacterial agents, they can be easily exploited for biomedical application. This review primarily focuses on the therapeutic implications of S. aureus phages in the biotechnological and medical arena. Through this review article, we have also discussed the current status and the incurring challenges in phage therapy.     

噬菌体疗法在疾病中的应用进展

随着耐药菌在世界范围内不断传播,应用噬菌体作为有效的抗生素替代疗法重新受到研究者的关注。另一方面,人体微生物群与宿主健康的相互作用研究不断深入,靶向调控微生物群来影响人体健康成为多项研究的关注焦点,利用噬菌体靶向降低与疾病发展正相关的特征性细菌的丰度,成为肿瘤、酒精性肝病及糖尿病等非感染性疾病更精准的预防或辅助治疗策略。本文对噬菌体疗法在感染性和非感染性疾病中的应用进展进行了综述。     

噬菌体对黏质沙雷菌感染 BA LB／c小鼠的保护作用

本文旨在观察噬菌体对黏质沙雷菌感染小鼠的治疗作用,为噬菌体疗法应用于细菌性感染提供依据。以黏质沙雷菌为宿主菌,采用双层琼脂噬斑法从污水中分离和纯化裂解性噬菌体。将最小致死量的黏质沙雷菌经腹腔感染BALB／c小鼠后,立即腹腔注射不同剂量的噬菌体,观察动物的生存率并确定噬菌体的保护剂量。在动物感染后的不同时间（0、20、40、60和180 min ）观察噬菌体疗法对动物存活率的影响。将噬菌体和细菌同时或分别注射动物后,分析噬菌体在动物体内的药代动力学。结果显示,经噬斑法从污水中分离出1株裂解性噬菌体（命名为φSM9‐3Y ）,电镜观察发现该噬菌体属有尾噬菌体目肌尾噬菌体科。动物腹腔感染黏质沙雷菌并立即给予噬菌体后发现,当噬菌体的保护剂量为108 PFU／ml时,动物的存活率为100％。动物感染后40和60 min给予噬菌体（1010 PFU／ml）治疗,动物的存活率为60％。药代动力学表明,将噬菌体和细菌同时注入动物体内,在6 h内噬菌体的滴度维持在1010 PFU／ml。结果提示,噬菌体对黏质沙雷菌所致动物腹腔内感染的治疗是有效的,提示针对细菌性感染的噬菌体疗法具有潜在的应用价值。     

Relationship between capsular types 5 and 8 and phage types in Staphylococcus aureus isolates from cow, goat and ewe milk

Abstract In order to check the relationship between capsular polysaccharide (CP) type 5 and 8 and certain phage patterns, previously described in human Staphylococcus aureus clinical isolates, we typed 100 CP types 5 and 8 S. aureus strains isolated from cow, goat and ewe milk, with the human set of phages. The proportion of typable strains was much less than that found with human strains. The association between CP types 5 and 8 and phage patterns reported for human isolates was only partially confirmed and an original correlation between susceptibility to group III phages and CP type 5 was found.     

Optimal bacteriophage mutation rates for phage therapy

The mutability of bacteriophages offers a particular advantage in the treatment of bacterial infections not afforded by other antimicrobial therapies. When phage-resistant bacteria emerge, mutation may generate phage capable of exploiting and thus limiting population expansion among these emergent types. However, while mutation potentially generates beneficial variants, it also contributes to a genetic load of deleterious mutations. Here, we model the influence of varying phage mutation rate on the efficacy of phage therapy. All else being equal, phage types with historical mutation rates of approximately 0.1 deleterious mutations per genome per generation offer a reasonable balance between beneficial mutational diversity and deleterious mutational load. We determine that increasing phage inoculum density can undesirably increase the peak density of a mutant bacterial class by limiting the in situ production of mutant phage variants. For phage populations with minimal genetic load, engineering mutation rate increases beyond the mutation-selection balance optimum may provide even greater protection against emergent bacterial types, but only with very weak selective coefficients for de novo deleterious mutations (below approximately 0.01). Increases to the mutation rate beyond the optimal value at mutation-selection balance may therefore prove generally undesirable.     

Structural protein analysis of the polyvalent staphylococcal bacteriophage 812

Phage 812 is a polyvalent phage with a very broad host range in the genus Staphylococcus, which makes it a suitable candidate for phage therapy of staphylococcal infections. This proteomic study, combining the results of both 1-DE and 2-DE followed by PMF, led to the identification of 24 virion proteins. Twenty new proteins, not yet identified by proteome analysis of closely related staphylococcal phages K and G1 were identified using this approach. Fifteen proteins were assigned unambiguously to the head-tail genome module; the remaining nine proteins are encoded by genes of the left or right arms of the phage genome. As expected, the most abundant proteins in the electrophoretic patterns are the major capsid protein, the major tail sheath protein and proteins identical to ORF 50 and ORF 95 of phage K, although their function is only putative. Identification of these 20 new proteins contributes substantially to a detailed characterization of phage virions, knowledge of which is necessary for rational phage therapy.     

The role of grancalcin in adhesion of neutrophils

Grancalcin is a protein specifically expressed in neutrophils and monocytes/macrophages. The function of grancalcin has not been identified. Grancalcin-deficient neutrophils were previously demonstrated to exert normal recruitment to the inflamed site, NADPH oxidase activation, extracellular release of secondary granules, apoptosis and activation-induced Ca2+ flux. In this study we analyzed granule numbers in resting and activated grancalcin-deficient neutrophils, their phagocytic activity and adherence to extracellular matrix proteins. Results revealed normal phagocytosis and degranulation of grancalcin-deficient neutrophils, while their adhesion to fibronectin was decreased by 60%. Consistently, the processes associated with neutrophil adhesion, such as formation of focal adhesion complexes and spreading, were also impaired in grancalcin-deficient neutrophils by 89 and 38%, respectively. In contrast, adherence to other extracellular matrix proteins: collagen, laminin and vitronectin, was not significantly altered. We thus report for the first time a function of grancalcin.     

Effect of blood serum, caffeine and heparin on in vitro phagocytosis of frozen-thawed bull sperm by neutrophils derived from the peripheral blood of cows

Although polymorphonuclear leukocytes (PMNs) are recruited into the uterine lumen to phagocytize sperm, factors controlling the phagocytotic ability of PMNs in cattle are not well documented. The objective was to determine the effects of blood serum, caffeine, and heparin on chemotaxis of PMNs for sperm and phagocytosis of sperm by PMNs in cows. Polymorphonuclear leukocytes were obtained (centrifugation) from a cow's peripheral blood. In Experiment 1, the chemotactic activity of PMNs increased (P < 0.01) when fresh serum was included in the medium (1226 cells/mm² in serum vs. 1110 cells/mm² in BSA), regardless of the presence of sperm, whereas heat-inactivated serum (1099 cells/mm²) did not affect their activity (P = 0.65). Phagocytosis of live and dead sperm by PMNs both increased (P < 0.01) in the presence of fresh serum (incidences of 54.5 and 48.0%, respectively), but stimulation was decreased (P < 0.01) by supplementation of the medium with ≥1 mM caffeine (20.6-30.3%). Serum-stimulated chemotactic activity of PMNs (1218 cells/mm²) was also decreased (P < 0.01) in the presence of caffeine (1090 cells/mm²). Furthermore, supplementation of PMNs with heparin in the presence of serum decreased (P < 0.01) both phagocytotic (from 43.8% to 21.5-31.7%) and chemotactic activities of PMNs (from 1124 to 1048-1108 cells/mm²). We inferred that opsonization in the presence of active complement stimulated phagocytotic and chemotactic activities of PMNs, and that both caffeine and heparin decreased serum-stimulated phagocytotic and chemotactic activities of PMNs.     

两株新的金黄色葡萄球菌烈性噬菌体的生物学特性和基因组学研究

以金黄色葡萄球菌为宿主菌,从奶牛场废水样品中分离到两株烈性噬菌体,分别命名为phiSA_BS1和phiSA_BS2。电子显微镜观察显示其头部呈多面体对称,有伸缩性尾部。对这两株噬菌体的一步生长曲线、温度耐受性和pH耐受性进行研究,发现两者均裂解3株金黄色葡萄球菌,但不能裂解1株表皮葡萄球菌。进一步分析它们的全基因组序列,发现phiSA_BS1基因组大小为 142 978 bp,GC含量为 29.80%,预测到201个开放读码框(open reading frame,ORF),未预测到tRNA基因;phiSA_BS2基因组大小为 149 230 bp,GC含量为 29.61%,预测到210个ORF和1个tRNA基因。系统发育分析表明,这两株噬菌体同属肌尾噬菌体科,属于新的金黄色葡萄球菌噬菌体,可能为治疗金黄色葡萄球菌相关的奶牛乳腺炎提供新的方法。     

A cell permeant peptide containing the cytoplasmic tail sequence of Fc receptor type IIA reduces calcium signaling and phagolysosome formation in neutrophils

Receptors for the Fc domain of IgG mediate target recognition, signal transduction, and effector functions including antibody-dependent cytolysis, phagocytosis, and phagolysosome formation. To better understand FcR-mediated functions and to identify potential therapeutic strategies, we employed cell-penetrating (“Trojan”) peptides to deliver “wild-type” (LTL) or modified (AAA) FcγRIIA tail sequences to the neutrophil’s cytoplasm. The Trojan-LTL peptide appeared to label the endoplasmic reticulum whereas the Trojan-AAA peptide distributed throughout the cytoplasm. The Trojan-LTL peptide, but not the Trojan-AAA peptide, decreased Ca²⁺ signaling at the phagosome and reduced phagolysosome formation. These studies suggest that FcγRIIA’s tail can act as a peptide decoy thereby blunting FcγRIIA-mediated processes, which, in turn, suggests a possible route in managing inflammatory tissue damage.     

The capsular turnover product of Staphylococcus aureus strain Smith

Abstract The capsular polysaccharide released from the bacterial surface by cell wall turnover during growth exhibited less size heterogeneity and a higher average molecular mass than the polysaccharide extracted from the cell by treatment with lysostaphin or low pH. Treatment of turnover polysaccharide, radiolabelled by growth of the bacteria in the presence of N-acetyl-[³H]-glucosamine, with muramidase B from Chalaropsis released a low molecular weight product chromatographically identical to the peptidoglycan degradation products released from the peptidoglycan-teichoic acid complex by the same treatment. It is concluded that some or all of the capsular polysaccharide released into the culture fluid during growth is derived from peptidoglycan-linked capsular material, solubilised by cell wall turnover.     

Characteristics of Staphylococcus aureus, isolated from airways of cystic fibrosis patients, and their small colony variants

The colonization of respiratory tract by Staphylococcus aureus is a frequent feature of cystic fibrosis (CF), especially in pediatric patients. The formation of small colony variants (SCVs), which produce reduced amounts of alpha-toxin, is one of the proposed ways of staphylococcal accommodation in an intracellular niche. The aim of the present study was to compare some properties of S. aureus SCVs and their parent strains. A site-directed S. aureus hemB mutant and parent strain 8325-4 were included in the study (control pair). Normal and SCV strain pairs from CF patients as well as control strains were tested for the susceptibility to defensins, killing activity of professional phagocytes and adhesion to A549 cell line. Because S. aureus are exposed to many cationic proteins in the host, we challenged a clinical isolate with minimal subinhibitory concentration (subMIC) of protamine and found that hemin and menadione auxotrophic SCVs emerged. SCVs were more resistant than normal strains to protamine but not to dermaseptin. The susceptibility to the bactericidal activity of magainin was the same for normal and SCV strains. The protamine resistance of normal as well as SCVs was strongly enhanced by high salt concentration. The adhesion of some SCVs to A549 cells was higher than adhesion of parental strains. However, the number of adherent bacteria (SCVs) was diminished in the presence of hemin for hemin auxotrophs. The uptake of SCVs by granulocytes was lower than ingestion of normal strains, but SCVs were killed with equal or greater potency. SCVs are adapted to intracellular survival and persistence in the host under certain circumstances. The ability to form a variant subpopulation affords S. aureus additional survival options.     

Synonymous codon usage in forty staphylococcal phages identifies the factors controlling codon usage variation and the phages suitable for phage therapy

The immergence and dissemination of multidrug-resistant strains of Staphylococcus aureus in recent years have expedited the research on the discovery of novel anti-staphylococcal agents promptly. Bacteriophages have long been showing tremendous potentialities in curing the infections caused by various pathogenic bacteria including S. aureus. Thus far, only a few virulent bacteriophages, which do not carry any toxin-encoding gene but are capable of eradicating staphylococcal infections, were reported. Based on the codon usage analysis of sixteen S. aureus phages, previously three phages were suggested to be useful as the anti-staphylococcal agents. To search for additional S. aureus phages suitable for phage therapy, relative synonymous codon usage bias has been investigated in the protein-coding genes of forty new staphylococcal phages. All phages appeared to carry A and T ending codons. Several factors such as mutational pressure, translational selection and gene length seemed to be responsible for the codon usage variation in the phages. Codon usage indeed varied phage to phage. Of the phages, phages G1, Twort, 66 and Sap-2 may be extremely lytic in nature as majority of their genes possess high translational efficiency, indicating that these phages may be employed in curing staphylococcal infections.     

Simultaneous measurement by flow cytometry of phagocytosis and metabolic burst induced in phagocytic cells in whole blood by Borrelia burgdorferi

Abstract This paper describes the interactions between a strain of Borrelia burgdorferi and phagocytic cells, measured in whole blood, by a two-color flow cytometric method, which allowed the simultaneous quantification of both the phagocytosis rate and the oxidative burst activation. The data obtained indicated that: a) phagocytosis and metabolic activation increased as a function of spirochete concentration; b) the number of ingesting cells peaked within 10 min but activation followed later, and did not involve all the phagocytosing cells; c) opsonization of borreliae with a patient's serum enhanced the two cellular activities, mostly phagocytosis. The intensity of such functions was lower than those found for Staphylococcus aureus . The flow cytometric assay of phagocytosis interactions with Borrelia burgdorferi assessed in whole blood represents an experimental approach which simulates the physiological conditions in nature.     

产生葡激酶的溶原性转换噬菌体的研究——Ⅰ.转换噬菌体的分离及宿主双溶原性的检出

从葡激酶阳性菌株66分离到两株噬菌体即α及β,α有转换葡激酶产生的能力,β则无。用去溶原方法由菌株66得到葡激酶阴性66SAK~-,由该菌株诱导得到噬菌体β。证明菌株66为带有两个前噬菌体的双溶原菌。在该菌株经过诱导后,得到的裂解液中,不能转换的噬菌体β多于转换噬菌体α。     

5-氨基酮戊酸光动力疗法对不同疾病来源的耐甲氧西林金黄色葡萄球菌的体外杀伤作用

光动力疗法(photodynamic therapy,PDT)利用光敏剂与光源反应后产生的活性氧,破坏细菌组分,进而致细菌死亡。其多靶位杀伤特性在治疗耐甲氧西林金黄色葡萄球菌(methicillin-resistant Staphylococcus aureus,MRSA)感染方面有应用前景,但相关研究尚处于起步阶段。本研究MRSA菌株取自烧伤、急性咽炎、鼻窦炎和肺炎4类临床常见MRSA感染性疾病患者,使用5-氨基酮戊酸(5-aminolevulinic acid,ALA)光敏剂、发光二极管光源,于体外检测ALA介导的PDT(ALA-PDT)对MRSA菌株的杀伤作用。结果显示,经5mmol/L ALA孵育1h后,给予360J/cm~2强光[(633±10)nm]照射1h,ALA-PDT对MRSA菌株具有1.80log_(10)cfu的有效杀伤作用。结果提示,在相同实验条件和参数下,ALA-PDT对上述4种疾病来源的MRSA菌株体外杀伤作用无统计学差异。     

乳酸杆菌细胞裂解物对金黄色葡萄球菌、大肠埃希菌的抑制作用

目的探讨乳杆菌DM8909裂解物在体内外对金黄色葡萄球菌、大肠埃希菌的抑制作用。方法通过对乳杆菌超声波破碎制成裂解物,分别用乳杆菌裂解物原液、裂解物稀释液、发酵上清液、乳杆菌活菌制剂进行体内、体外实验,观察乳杆菌各成分对金黄色葡萄球菌、大肠埃希菌的抑制作用。结果德氏乳酸杆菌裂解物对金黄色葡萄球菌、大肠埃希菌的抑制作用与乳杆菌活菌制剂的抑制作用相近。结论德氏乳酸杆菌裂解物在体内外对金黄色葡萄球菌、大肠埃希菌均有较强的抑制作用。     

CIN85 modulates the down-regulation of Fc gammaRIIa expression and function by c-Cbl in a PKC-dependent manner in human neutrophils

We previously described a non-classical mechanism that arrests FcγRIIa signaling in human neutrophils once engaged by immune complexes or opsonized pathogens. The engagement of FcγRIIa leads to its ubiquitination by the ubiquitin ligase c-Cbl and degradation by the proteasome. Herein, we further examined some of the events regulating this novel pathway. The adaptor protein CIN85 was described in other systems to be involved in the regulation of the c-Cbl-dependent pathway. We found that CIN85 is expressed in human neutrophils and that it translocates like c-Cbl from the cytosol to the plasma membrane following receptor cross-linking. CIN85 was also recruited to the same subset of high density detergent-resistant membrane fractions in which stimulated FcγRIIa partitioned with c-Cbl. The integrity of these microdomains is essential to the FcγRIIa degradation process because the cholesterol-depleting agent methyl-β-cyclodextrin inhibits this event. Silencing the expression of CIN85 by siRNA in dibutyryl cyclic AMP-differentiated PLB 985 cells prevented FcγRIIa degradation and increased IgG-mediated phagocytosis. Confocal microscopy revealed that the presence of CIN85 is essential to the proper sorting of FcγRIIa during endocytosis. We also provide direct evidence that CIN85 is a substrate of serine/threonine kinase PKCs. Classical PKCs positively regulate FcγRIIa ubiquitination and degradation because these events were inhibited by Gö6976, a classical PKC inhibitor. We conclude that the ubiquitination and degradation of stimulated FcγRIIa mediated by c-Cbl are positively regulated by the adaptor protein CIN85 in a PKC-dependent manner and that these events contribute to the termination of FcγRIIa signaling.