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2014 ; 2
(1
): 21
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Neutrophil extracellular traps in the host defense against sepsis induced by
Burkholderia pseudomallei (melioidosis)
#MMPMID26215706
de Jong HK
; Koh GC
; Achouiti A
; van der Meer AJ
; Bulder I
; Stephan F
; Roelofs JJ
; Day NP
; Peacock SJ
; Zeerleder S
; Wiersinga WJ
Intensive Care Med Exp
2014[Dec]; 2
(1
): 21
PMID26215706
show ga
BACKGROUND: Neutrophil extracellular traps (NETs) are a central player in the
host response to bacteria: neutrophils release extracellular DNA (nucleosomes)
and neutrophil elastase to entrap and kill bacteria. We studied the role of NETs
in Burkholderia pseudomallei infection (melioidosis), an important cause of
Gram-negative sepsis in Southeast Asia. METHODS: In a prospective observational
study, circulating nucleosomes and neutrophil elastase were assayed in 44
patients with Gram-negative sepsis caused by B. pseudomallei (melioidosis) and 82
controls. Functional assays included human neutrophil stimulation and killing
assays and a murine model of B. pseudomallei infection in which NET function was
compromised using DNase. Specified pathogen-free 8- to 12-week-old C57BL/6 mice
were sacrificed post-infection to assess bacterial loads, inflammation, and
pathology. RESULTS: Nucleosome and neutrophil elastase levels were markedly
elevated in patients compared to controls. NETs killed B. pseudomallei
effectively, and neutrophils stimulated with B. pseudomallei showed increased
elastase and DNA release in a time- and dose-dependent matter. In mice, NET
disruption with intravenous DNase administration resulted in decreased nucleosome
levels. Although DNase treatment of mice resulted in diminished liver
inflammation, no differences were observed in bacterial dissemination or systemic
inflammation. CONCLUSION: B. pseudomallei is a potent inducer of NETosis which
was reflected by greatly increased levels of NET-related components in
melioidosis patients. Although NETs exhibited antibacterial activity against B.
pseudomallei, NET formation did not protect against bacterial dissemination and
inflammation during B. pseudomallei-induced sepsis.