Abstract
Nasopharyngeal colonization with nontypeable Haemophilus influenzae (NTHi) is a prerequisite for developing NTHi-associated infections, including otitis media. Therapies that block NTHi colonization may prevent disease development. We previously demonstrated that Haemophilus haemolyticus, a closely related human commensal, can inhibit NTHi colonization and infection of human respiratory epithelium in vitro We have now assessed whether Muribacter muris (a rodent commensal from the same family) can prevent NTHi colonization and disease in vivo using a murine NTHi otitis media model. Otitis media was modeled in BALB/c mice using coinfection with 1 × 104.5 PFU of influenza A virus MEM H3N2, followed by intranasal challenge with 5 × 107 CFU of NTHi R2866 Specr Mice were pretreated or not with an intranasal inoculation of 5 × 107 CFU M. muris 24 h before coinfection. NTHi and M. muris viable counts and inflammatory mediators (gamma interferon [IFN-γ], interleukin-1β [IL-1β], IL-6, keratinocyte chemoattractant [KC], and IL-10) were measured in nasal washes and middle ear tissue homogenate. M. muris pretreatment decreased the median colonization density of NTHi from 6 × 105 CFU/ml to 9 × 103 CFU/ml (P = 0.0004). Only 1/12 M. muris-pretreated mice developed otitis media on day 5 compared to 8/15 mice with no pretreatment (8% versus 53%, P = 0.0192). Inflammation, clinical score, and weight loss were also lower in M. muris-pretreated mice. We have demonstrated that a single dose of a closely related commensal can delay onset of NTHi otitis media in vivo Human challenge studies investigating prevention of NTHi colonization are warranted to reduce the global burden of otitis media and other NTHi diseases.
Highlights
Nontypeable Haemophilus influenzae (NTHi) is an opportunistic pathogen that colonizes the upper respiratory tract of humans
Intranasal administration of 5 ϫ 107 CFU of M. muris to mice prior to challenge with influenza A/Memphis/ 1/71 H3N2 virus (IAV) and NTHi (M. muris ϩ IAV ϩ NTHi group) reduced the NTHi density recovered from the nose of mice on day 5 from a median log 4.94 CFU/ml (95% confidence interval [CI] of median 4.36 to 5.50) to a median log 3.97 when compared with that of no pretreatment (IAV ϩ NTHi group; P Ͻ 0.001) (Fig. 1A)
The median density of NTHi in the middle ear on day 5 reduced from median log 2.96 to median log 1.92 (P ϭ 0.068)
Summary
Nontypeable Haemophilus influenzae (NTHi) is an opportunistic pathogen that colonizes the upper respiratory tract of humans. Microbial interference is currently being investigated to combat a range of bacterial infections, including pneumococcal otitis media in children using a nasal alpha-hemolytic streptococcal probiotic spray [18], experimental meningococcal meningitis in mice using intranasal delivery of the closely related commensal Neisseria lactamica [19], and pneumococcal pneumonia in mice using intranasal delivery of Streptococcus mitis [20] From these and other studies [21, 22], it appears that microbial interference requires the commensal and pathogenic species to belong to the same family of bacteria and be able to colonize the same niche
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