Antimicrobial Peptide P60.4Ac-Containing Creams and Gel for Eradication of Methicillin-Resistant Staphylococcus aureus from Cultured Skin and Airway Epithelial Surfaces.
We previously found the LL-37-derived peptide P60.4Ac to be effective against methicillin-resistant Staphylococcus aureus (MRSA) on human epidermal models (EMs). The goal of this study was to identify the preferred carrier for this peptide for topical application on skin and mucosal surfaces. We prepared P60.4Ac in three formulations, i.e., a water-in-oil cream with lanolin (Softisan 649), an oil-in-water cream with polyethylene glycol hexadecyl ether (Cetomacrogol), and a hydroxypropyl methylcellulose (hypromellose) 4000 gel. We tested the antimicrobial efficacy of the peptide in these formulations against mupirocin-resistant and -sensitive MRSA strains on EMs and bronchial epithelial models (BEMs). The cytotoxic effects of formulated P60.4Ac on these models were determined using histology and WST-1 and lactate dehydrogenase assays. Moreover, we assessed the stability of the peptide in these formulations with storage for up to 3 months. Killing of MRSA by P60.4Ac in the two creams was less effective than that by P60.4Ac in the hypromellose gel. In agreement with those findings, P60.4Ac in the hypromellose gel was highly effective in eradicating the two MRSA strains from EMs. We found that even 0.1% (wt/wt) P60.4Ac in the hypromellose gel killed >99% of the viable planktonic bacteria and >85% of the biofilm-associated bacteria on EMs. Hypromellose gels containing 0.1% and 0.5% (wt/wt) P60.4Ac effectively reduced the numbers of viable MRSA cells from BEMs by >90%. No cytotoxic effects of P60.4Ac in the hypromellose gel with up to 2% (wt/wt) P60.4Ac on keratinocytes in EMs and in the hypromellose gel with up to 0.5% (wt/wt) P60.4Ac on epithelial cells in BEMs were observed. High-performance liquid chromatography analysis showed that P60.4Ac was stable in the Softisan cream and the hypromellose gel but not in the Cetomacrogol cream. We conclude that P60.4Ac formulated in hypromellose gel is both stable and highly effective in eradicating MRSA from colonized EMs and BEMs.
Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands.
Elisabeth M
EM
Haisma
Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands.
Anikó
A
Göblyös
Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.
Bep
B
Ravensbergen
Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands.
Alwin E
AE
Adriaans
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Robert A
RA
Cordfunke
Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.
Jasmijn
J
Schrumpf
Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands.
Ronald W A L
RW
Limpens
Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands.
Kirsten J M
KJ
Schimmel
Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands.
Jan
J
den Hartigh
Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands.
Pieter S
PS
Hiemstra
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
Jan Wouter
JW
Drijfhout
Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands.
Abdoelwaheb
A
El Ghalbzouri
Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands p.h.nibbering@lumc.nl.
Peter H
PH
Nibbering
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000890:Anti-Infective Agents / Q000494:pharmacology; D001980:Bronchi / Q000166:cytology; D002478:Cells, Cultured; D020285:Cryoelectron Microscopy; D004848:Epithelium / Q000382:microbiology*; D006801:Humans; D066298:In Vitro Techniques; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000472:pathogenicity; D016712:Mupirocin / Q000494:pharmacology; D010455:Peptides / Q000494:pharmacology*; D012867:Skin / Q000382:microbiology*
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D010455:Peptides; D016712:Mupirocin