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Fighting Staphylococcus aureus infections with light and photoimmunoconjugates
Mafalda Bispo, Andrea Anaya-Sanchez, Sabrina Suhani, Elisa J. M. Raineri, Marina López-Álvarez, Marjolein Heuker, Wiktor Szymański, Francisco Romero Pastrana, Girbe Buist, Alexander R. Horswill, Kevin P. Francis, Gooitzen M. van Dam, Marleen van Oosten, Jan Maarten van Dijl
Mafalda Bispo, Andrea Anaya-Sanchez, Sabrina Suhani, Elisa J. M. Raineri, Marina López-Álvarez, Marjolein Heuker, Wiktor Szymański, Francisco Romero Pastrana, Girbe Buist, Alexander R. Horswill, Kevin P. Francis, Gooitzen M. van Dam, Marleen van Oosten, Jan Maarten van Dijl
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Resource and Technical Advance Microbiology Therapeutics

Fighting Staphylococcus aureus infections with light and photoimmunoconjugates

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Abstract

Infections caused by multidrug-resistant Staphylococcus aureus, especially methicillin-resistant S. aureus (MRSA), are responsible for high mortality and morbidity worldwide. Resistant lineages were previously confined to hospitals but are now also causing infections among healthy individuals in the community. It is therefore imperative to explore therapeutic avenues that are less prone to raise drug resistance compared with today’s antibiotics. An opportunity to achieve this ambitious goal could be provided by targeted antimicrobial photodynamic therapy (aPDT), which relies on the combination of a bacteria-specific targeting agent and light-induced generation of ROS by an appropriate photosensitizer. Here, we conjugated the near-infrared photosensitizer IRDye700DX to a fully human mAb, specific for the invariantly expressed staphylococcal antigen immunodominant staphylococcal antigen A (IsaA). The resulting immunoconjugate 1D9-700DX was characterized biochemically and in preclinical infection models. As demonstrated in vitro, in vivo, and in a human postmortem orthopedic implant infection model, targeted aPDT with 1D9-700DX is highly effective. Importantly, combined with the nontoxic aPDT-enhancing agent potassium iodide, 1D9-700DX overcomes the antioxidant properties of human plasma and fully eradicates high titers of MRSA. We show that the developed immunoconjugate 1D9-700DX targets MRSA and kills it upon illumination with red light, without causing collateral damage to human cells.

Authors

Mafalda Bispo, Andrea Anaya-Sanchez, Sabrina Suhani, Elisa J. M. Raineri, Marina López-Álvarez, Marjolein Heuker, Wiktor Szymański, Francisco Romero Pastrana, Girbe Buist, Alexander R. Horswill, Kevin P. Francis, Gooitzen M. van Dam, Marleen van Oosten, Jan Maarten van Dijl

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Figure 4

aPDT of S. aureus infection in G. mellonella.

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aPDT of S. aureus infection in G. mellonella.
Larvae were infected with ...
Larvae were infected with CA-MRSA USA300 D15-GFP, HA-MRSA USA300 D17-GFP, or CA-MRSA AH4807 grown to midexponential phase. For the P+L+ groups, 40 mg.kg–1 of 1D9-700DX (P+) were injected in the G. mellonella larvae at 90 minutes after bacterial inoculation. Thirty minutes after injection of the photosensitizer, red light treatment (L+) was performed at a radiant exposure of 4.5 J.cm–2 (45 seconds irradiation, 100 mW.cm–2). The P–L– group neither received the immunoconjugate nor light exposure. (A, C, and E) G. mellonella survival was monitored at 24, 48, and 72 hours after treatment. (B, D, and F) Persistence of S. aureus in the hemolymph. Bacterial quantification (CFU/mL) in the hemolymph of 3 surviving larvae was determined at 0, 24, 48, and 72 hours after treatment. Data are presented as mean ± SEM of 2 (E and F) and 3 (A–D) independent experiments with groups of 10 larvae (n = 10). Gehan-Breslow-Wilcoxon and 2-way ANOVA tests with subsequent Šidák multiple-comparison tests were used for statistical analysis of survival curves and bacterial persistence in the larvae hemolymph, respectively. Significant differences compared with the negative control group (P–L–) are marked as follows: *P < 0.03; **P < 0.002; ***P < 0.0002; ****P < 0.0001.

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