Southampton research has shown that nitric oxide can greatly improve the effects of antibiotics in tackling the chronic lung infections endured by cystic fibrosis patients.
Cystic fibrosis (CF) is a genetic disease that affects around one in every 2500 children born in the UK, causing early death due to excessive build-up of sticky mucus in the lungs and problems associated with this.
CF patients often suffer from lung infections by the bacteria Pseudomonas aeruginosa, causing exacerbations – a sudden worsening of the patient’s health and symptoms. Tackling these infections with antibiotics is challenging, because these bacteria produce a protective biofilm slime that shields them from the antibiotics.
New research from the NIHR Southampton Biomedical Research Centre has shown that low doses of nitrogen oxide (NO) gas can greatly improve the action of antibiotics in CF infections, by breaking up the biofilm layer covering the bacteria.
After tests in the lab using mucus samples from CF patients, the researchers conducted a pilot study involving 12 CF patients. They found those receiving low doses of NO gas for 5-7 days alongside a course of antibiotics had less biofilm in their mucus samples than those who only had antibiotics.
Based on these initial results, published in the journal Molecular Therapy, the researchers suggest that NO treatment alongside antibiotics could help more CF patients survive severe P. aeruginosa infections.
Before such a treatment is made widely available, however, the researchers seek to find the best way of delivering the NO to the patients’ lungs – inhaled as a gas, for example, or by developing new antibiotics that release NO when they come into contact with bacteria in the lungs.
Fighting antibiotic resistance
The research provides a much-needed new front in tackling antibiotic resistant bacteria, which can emerge due to chronic use of antibiotics enabling them to evolve ways of dealing with the drug.
These bacteria, often named ‘superbugs’, cannot be killed with commonly used antibiotics and threaten to turn the clock back to a time when infections associated with surgery, disease or births were untreatable and deadly.
By allowing shorter courses and lower doses of antibiotics to be used, NO treatment could help fight the rise of antibiotic resistant bacteria by targeting superbugs that produce biofilms.