Sang Sun Yoon
1, Ray Coakley
2, Gee W. Lau
3, Sergei V. Lymar
4, Benjamin Gaston
5, Ahmet C. Karabulut
1, Robert F. Hennigan
6, Sung-Hei Hwang
1, Garry Buettner
7, Michael J Schurr
8, Joel E. Mortensen
9, Jane L. Burns
10, David Speert
11, Richard C. Boucher
2, Daniel J. Hassett
12* 1 Department of Molecular Genetics, Biochemistry, and Microbiology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
2 Cystic Fibrosis Pulmonary Research and Treatment Center and Department of Pulmonary Biology, University of North Carolina, Chapel Hill, North Carolina, USA.
3 Pulmonary Biology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
4 Department of Chemistry, Brookhaven National Laboratory, Upton, New York, USA.
5 Department of Cell Biology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. ,Department of Pediatric Critical Care, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
6 Department of Pharmacology and Biological Chemistry, Mount Sinai School of Medicine, New York, New York, USA.
7 Department of Chemistry, University of Iowa, Iowa City, Iowa, USA.
8 Department of Microbiology, Tulane University, New Orleans, Louisiana, USA.
9 Department of Molecular Genetics, Biochemistry, and Microbiology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
10 Department of Molecular Genetics, Biochemistry, and Microbiology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. Department of Molecular Genetics, Biochemistry, and Microbiology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
11 Department of Pedriatrics, University of British Columbia, Vancouver, British Columbia, Canada.
12 Department of Molecular Genetics, Biochemistry, and Microbiology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, Ohio 45267-0524, USA. Phone: (513) 558-1154; Fax: (513) 558-8474
Received for publication February 8, 2005, and accepted in revised form November 29, 2005
Abstract
Mucoid, mucA mutant Pseudomonas aeruginosa cause chronic lung infections in cystic fibrosis (CF) patients and are refractory to phagocytosis and antibiotics. Here we show that mucoid bacteria perish during anaerobic exposure to 15 mM nitrite (NO2-) at pH 6.5, which mimics CF airway mucus. Killing required a pH lower than 7, implicating formation of nitrous acid (HNO2) and NO, that adds NO equivalents to cellular molecules. Eighty-seven percent of CF isolates possessed mucA mutations and were killed by HNO2 (3-log reduction in 4 days). Furthermore, antibiotic-resistant strains determined were also equally sensitive to HNO2. More importantly, HNO2 killed mucoid bacteria (a) in anaerobic biofilms; (b) in vitro in ultrasupernatants of airway secretions derived from explanted CF patient lungs; and (c) in mouse lungs in vivo in a pH-dependent fashion, with no organisms remaining after daily exposure to HNO2 for 16 days. HNO2 at these levels of acidity and NO2- also had no adverse effects on cultured human airway epithelia in vitro. In summary, selective killing by HNO2 may provide novel insights into the important clinical goal of eradicating mucoid P. aeruginosa from the CF airways.