背景:自发性细菌性腹膜炎(SBP)是失代偿性肝硬化和腹水患者的严重且通常致命的感染。SBP的唯一治疗方法是抗生素治疗,但新出现的细菌耐药性问题需要新的治疗策略。人羊膜间充质基质细胞(hA-MSC)具有免疫调节和抗炎性质,其可以在这样的背景下用作疗法。
方法:肝硬化患者腹水(AF)中hA-MSCs的体外应用,随后感染了耐碳青霉烯类肠杆菌,已执行。我们评估了hA-MSCs对细菌负荷的影响,先天免疫因子,和巨噬细胞表型表达。
结果:将hA-MSCs添加到AF中,在24h时显著降低了两种细菌菌株的增殖,并对M1和M2极化产生不同的影响。C3a补体蛋白,和ficolin3在感染过程中的浓度,以细菌菌株依赖的方式。
结论:本研究显示了hA-MSC在治疗碳青霉烯类耐药菌感染的腹水中的潜在作用,为进一步研究hA-MSC在体内模型中的抗菌和抗炎作用奠定了基础。
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a severe and often fatal infection in patients with decompensated cirrhosis and ascites. The only cure for SBP is antibiotic therapy, but the emerging problem of bacterial resistance requires novel therapeutic strategies. Human amniotic mesenchymal stromal cells (hA-MSCs) possess immunomodulatory and anti-inflammatory properties that can be harnessed as a therapy in such a context.
METHODS: An in vitro applications of hA-MSCs in ascitic fluid (AF) of cirrhotic patients, subsequently infected with carbapenem-resistant Enterobacterales, was performed. We evaluated the effects of hA-MSCs on bacterial load, innate immunity factors, and macrophage phenotypic expression.
RESULTS: hA-MSCs added to AF significantly reduce the proliferation of both bacterial strains at 24 h and diversely affect M1 and M2 polarization, C3a complement protein, and ficolin 3 concentrations during the course of infection, in a bacterial strain-dependent fashion.
CONCLUSIONS: This study shows the potential usefulness of hA-MSC in treating ascites infected with carbapenem-resistant bacteria and lays the foundation to further investigate antibacterial and anti-inflammatory roles of hA-MSC in in vivo models.