Inhalation with fucose and galactose for treatment of Pseudomonas aeruginosa in cystic fibrosis patients.
BACKGROUND
Colonisation of cystic fibrosis (CF) lungs with Pseudomonas aeruginosa is facilitated by two lectins, which bind to the sugar coat of the surface lining epithelia and stop the cilia beating.


OBJECTIVE
We hypothesized that P. aeruginosa lung infection should be cleared by inhalation of fucose and galactose, which compete for the sugar binding site of the two lectins and thus inhibit the binding of P. aeruginosa.


METHODS
11 adult CF patients with chronic infection with P. aeruginosa were treated twice daily with inhalation of a fucose/galactose solution for 21 days (4 patients only received inhalation, 7 patients received inhalation and intravenous antibiotics). Microbial counts of P. aeruginosa, lung function measurements, and inflammatory markers were determined before and after treatment.


RESULTS
The sugar inhalation was well tolerated and no adverse side effects were observed. Inhalation alone as well as combined therapy (inhalation and antibiotics) significantly decreased P. aeruginosa in sputum (P < 0.05). Both therapies also significantly reduced TNFalpha expression in sputum and peripheral blood cells (P < 0.05). No change in lung function measurements was observed.


CONCLUSIONS
Inhalation of simple sugars is a safe and effective measure to reduce the P. aeruginosa counts in CF patients. This may provide an alternative therapeutical approach to treat infection with P. aeruginosa.
Hauber
Hans-Peter
HP
Department of Medicine, Medical Clinic, Research Center Borstel, Borstel, Germany. hphauber@fz-borstel.de
Schulz
Maria
M
Pforte
Almuth
A
Mack
Dietrich
D
Zabel
Peter
P
Schumacher
Udo
U
D000280:Administration, Inhalation; D000328:Adult; D000617:Aminoglycosides / Q000008:administration & dosage / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D002452:Cell Count; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use; D003550:Cystic Fibrosis / Q000150:complications*; D004359:Drug Therapy, Combination; D005260:Female; D005643:Fucose / Q000008:administration & dosage / Q000627:therapeutic use*; D005690:Galactose / Q000008:administration & dosage / Q000627:therapeutic use*; D015870:Gene Expression / Q000187:drug effects; D006801:Humans; D007132:Immunoglobulin Isotypes / Q000097:blood; D007963:Leukocytes, Mononuclear / Q000166:cytology / Q000378:metabolism; D008111:Liver Function Tests; D008297:Male; D009504:Neutrophils / Q000166:cytology; D011552:Pseudomonas Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000302:isolation & purification; D012129:Respiratory Function Tests; D013183:Sputum / Q000166:cytology / Q000378:metabolism / Q000382:microbiology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000235:genetics
D000617:Aminoglycosides; D002511:Cephalosporins; D007132:Immunoglobulin Isotypes; D014409:Tumor Necrosis Factor-alpha; D005643:Fucose; D002097:C-Reactive Protein; D005690:Galactose