A NEW and somewhat unusual treatment pathway for antibiotic-resistant bacteria and infectious diseases is showing promise for patients and health care providers.
Researchers from the University of Birmingham and Newcastle University in the UK found that removing antibodies from the bloodstream reduced the effects of chronic infections, the requirement for days spent in hospital, and the use of antibiotics.
In the study, the team identified two patients with bronchiectasis who suffered with chronic Pseudomonas aeruginosa infections that were resistant to many antibiotics: a 64-year-old man, diagnosed with bronchiectasis aged 15, and a 69-year-old woman who had bronchiectasis from childhood.
Bronchiectasis is a disease that leads to permanent enlargement of the airways in the lung and often affects patients beyond the age at which lung transplantation is possible.
Chronic P. aeruginosa lung infections commonly occur in patients suffering from bronchiectasis.
The common bacterium can cause disease and is known as a multi drug-resistant pathogen, recognised for its advanced antibiotic-resistance mechanisms and association with serious illnesses.
Ian Henderson, director of the Institute of Microbiology and Infection at the University of Birmingham, said the two patients had an excess of a particular antibody in the bloodstream.
Unlike the protective effect normally associated with antibody, in these patients the antibody stopped the immune system killing the P. aeruginosa bacterium, worsening the patients' lung disease.
"Perhaps counter-intuitively, we decided to remove this antibody from the bloodstream and the outcomes were wholly positive," Professor Henderson said.
Dr Tony De Soyza, a senior lecturer at Newcastle University, said the researchers used a process known as plasmapheresis, which is not unlike kidney dialysis, to restore the ability of the patients' blood to kill their infecting pseudomonas.
Both patients reported a rapid improvement in health and wellbeing, greater independence and improved mobility compared to any point in the previous two years.
This is the first description of antibody-dependent enhancement of bacterial disease.
It may be widely applicable to other bacterial infections and offers hope for the treatment of some antibiotic resistant infections.
