Macrophage-Produced Peroxynitrite Induces Antibiotic Tolerance and Supersedes Intrinsic Mechanisms of Persister

Jenna E Beam1, Nikki J Wagner1, John C Shook1

  • 1Department of Microbiology and Immunology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA.

Insights

Host immune cells, specifically macrophages, induce antibiotic tolerance in Staphylococcus aureus via peroxynitrite. This finding suggests targeting host responses could resensitize bacteria to antibiotics.

Area of Science:

  • Microbiology
  • Immunology
  • Infectious Diseases

Background:

  • Staphylococcus aureus is a major cause of persistent human infections.
  • Antibiotic tolerance in persister cells contributes to treatment failures.
  • Macrophages are a key host niche during S. aureus bacteremia.

Purpose of the Study:

  • To identify the host-derived factors mediating antibiotic tolerance in S. aureus within macrophages.
  • To investigate the role of oxidative burst products in S. aureus antibiotic tolerance.
  • To determine if host-induced tolerance overrides bacterial persister formation mechanisms.

Main Methods:

  • Exposure of S. aureus clinical isolates to activated macrophages.
  • Analysis of bacterial antibiotic tolerance following host cell internalization.
  • Identification of host-derived reactive nitrogen species involved in tolerance.

Main Results:

  • Host-derived peroxynitrite, a product of superoxide and nitric oxide, is the primary mediator of S. aureus antibiotic tolerance within macrophages.
  • All tested S. aureus clinical isolates showed similar enrichment for antibiotic tolerance after macrophage internalization, irrespective of in vitro persister levels.
  • Host interaction significantly enhances S. aureus antibiotic tolerance, potentially masking intrinsic bacterial persister formation strategies.

Conclusions:

  • Bacterial interaction with the host immune environment, particularly macrophages, is critical for inducing antibiotic tolerance.
  • Peroxynitrite generated by host macrophages is a key factor driving S. aureus antibiotic tolerance.
  • Modulating host immune responses may offer novel therapeutic strategies to overcome antibiotic tolerance in S. aureus infections.

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