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What Can Go Wrong When Applying Immune Modulation Therapies to Target Persistent Bacterial Infections
Sofiya Micheva-Viteva1, Elizabeth Hong-Geller1
1Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM 87545, USA.
Abstract:
Antibiotics can treat the acute phase of a disease, but often do not completely clear the etiologic agent, allowing the pathogen to establish persistent infection that can revive the disease in a frustrating recurrence of infection. The mechanisms that control chronic bacterial infections are complex and involve pathogen adaptations that favor survival from both host immune responses and antibiotic bactericidal activity. Often, the causative agents of persistent infections are not drug-resistant species. Instead, bacterial persister cells temporarily enter a physiological state that is refractory to different classes of antibiotics. Supplemental therapies that potentiate antibiotic bactericidal efficiency and/or immune clearance of persistent pathogenic species may greatly improve the outcome of infectious disease. Here, we discuss the various outcomes in experimental studies in which a mega-dose of the energy-boosting vitamin B3 (nicotinamide) was applied in murine models of chronic infection to stimulate immune clearance of chronic infection or as an immune prophylactic treatment against the highly infectious pathogen, Burkholderia pseudomallei. It is our intent to raise awareness of the risks associated with immune modulation therapies. There is great variance in host immune responses to pathogenic bacteria. Each immune modulation approach needs to be tailored to a well-characterized host-pathogen interaction.
Insights
Vitamin B3 (nicotinamide) may help clear persistent bacterial infections by boosting the immune system. However, immune modulation therapies require careful consideration of host-pathogen interactions.
Area of Science:
- Infectious Diseases
- Microbiology
- Immunology
Background:
- Antibiotics often fail to eradicate pathogens, leading to persistent infections and disease recurrence.
- Bacterial persister cells, not necessarily drug-resistant, survive antibiotics and host immunity.
- Chronic infections involve complex pathogen adaptations and host immune responses.
Purpose of the Study:
- To investigate the efficacy of high-dose vitamin B3 (nicotinamide) in clearing chronic bacterial infections.
- To evaluate nicotinamide as an immune prophylactic treatment against *Burkholderia pseudomallei*.
- To highlight the risks and need for tailored immune modulation therapies.
Main Methods:
- Experimental studies using murine models of chronic infection.
- Administration of mega-doses of vitamin B3 (nicotinamide).
- Assessment of immune clearance and prophylactic effects against *Burkholderia pseudomallei*.
Main Results:
- Discusses various outcomes from experimental studies using nicotinamide in murine models.
- Nicotinamide was tested for immune clearance and prophylactic treatment.
- Highlights variance in host immune responses to pathogens.
Conclusions:
- Supplemental therapies, like vitamin B3, may enhance antibiotic efficacy and immune clearance of persistent pathogens.
- Immune modulation therapies require careful tailoring to specific host-pathogen interactions.
- Awareness of risks associated with immune modulation is crucial for effective infectious disease management.
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