Azithromycin Maintains Airway Epithelial Integrity During Pseudomonas aeruginosa Infection.

Am J Respir Cell Mol Biol. 2009 Apr 16. [Epub ahead of print]

Azithromycin Maintains Airway Epithelial Integrity During Pseudomonas aeruginosa Infection.

Halldorsson S, Gudjonsson T, Gottfredsson M, Singh PK, Gudmundsson GH, Baldursson O.

University of Iceland, Institute of Biology, Reykjavik, Iceland; Biomedical Center, University of Iceland, Reykjavik, Iceland.

Tight junctions (TJs) play a key role in maintaining bronchial epithelial integrity, including apical-basolateral polarity and paracellular trafficking. Patients with chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF) often suffer from chronic infections by the opportunistic Gram-negative bacterium Pseudomonas aeruginosa, which produces multiple virulence factors including rhamnolipids. The macrolide antibiotic azithromycin (AZM) has been shown to improve lung function in CF patients without reducing the bacterial count within the lung. However, the mechanism of this effect is still debated. It has previously been shown that AZM increased transepithelial electrical resistance (TER) in a bronchial epithelial cell line. In this study we used an air-liquid interface model of human airway epithelia and measured TER, changes in TJ expression and architecture following exposure to live P. aeruginosa PAO1, and PAO1-Deltarhl which is a PAO1 mutant lacking rhlA and rhlB, which encode key enzymes for rhamnolipid production. In addition, the cells were challenged with bacterial culture medium conditioned by these strains, purified rhamnolipids or synthetic 3O-C12-HSL. Virulence factors secreted by P. aeruginosa reduced TER and caused TJ rearrangement in the bronchial epithelium, exposing the epithelium to further bacterial infiltration. Pretreatment of the bronchial epithelium with AZM attenuated this effect and facilitated epithelial recovery. These data suggest that AZM protects the bronchial epithelium during P. aeruginosa infection independent of antimicrobial activity, and could explain in part the beneficial results seen in clinical trials of CF patients.

PMID: 19372247 [PubMed - as supplied by publisher]