Vancomycin-resistant enterococci exploit antibiotic-induced innate immune deficits

Nature. 2008 Oct 9;455(7214):804-7. doi: 10.1038/nature07250. Epub 2008 Aug 24.

Abstract

Infection with antibiotic-resistant bacteria, such as vancomycin-resistant Enterococcus (VRE), is a dangerous and costly complication of broad-spectrum antibiotic therapy. How antibiotic-mediated elimination of commensal bacteria promotes infection by antibiotic-resistant bacteria is a fertile area for speculation with few defined mechanisms. Here we demonstrate that antibiotic treatment of mice notably downregulates intestinal expression of RegIIIgamma (also known as Reg3g), a secreted C-type lectin that kills Gram-positive bacteria, including VRE. Downregulation of RegIIIgamma markedly decreases in vivo killing of VRE in the intestine of antibiotic-treated mice. Stimulation of intestinal Toll-like receptor 4 by oral administration of lipopolysaccharide re-induces RegIIIgamma, thereby boosting innate immune resistance of antibiotic-treated mice against VRE. Compromised mucosal innate immune defence, as induced by broad-spectrum antibiotic therapy, can be corrected by selectively stimulating mucosal epithelial Toll-like receptors, providing a potential therapeutic approach to reduce colonization and infection by antibiotic-resistant microbes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Down-Regulation / drug effects
  • Enterococcus / drug effects*
  • Enterococcus / immunology
  • Enterococcus / physiology*
  • Immunity, Innate / drug effects*
  • Immunity, Innate / immunology*
  • Intestinal Mucosa / metabolism
  • Intestines / drug effects
  • Intestines / immunology
  • Intestines / microbiology
  • Lipopolysaccharides / pharmacology
  • Mice
  • Myeloid Differentiation Factor 88 / deficiency
  • Myeloid Differentiation Factor 88 / genetics
  • Myeloid Differentiation Factor 88 / metabolism
  • Pancreatitis-Associated Proteins
  • Proteins / metabolism
  • Signal Transduction
  • Toll-Like Receptor 4 / immunology
  • Toll-Like Receptor 4 / metabolism
  • Vancomycin / metabolism
  • Vancomycin / pharmacology*
  • Vancomycin Resistance*

Substances

  • Lipopolysaccharides
  • Myd88 protein, mouse
  • Myeloid Differentiation Factor 88
  • Pancreatitis-Associated Proteins
  • Proteins
  • Reg3g protein, mouse
  • Toll-Like Receptor 4
  • Vancomycin