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Bispecific antibody targets multiple Pseudomonas aeruginosa evasion mechanisms in the lung vasculature
Ajitha Thanabalasuriar, Bas G.J. Surewaard, Michelle E. Willson, Arpan S. Neupane, Charles K. Stover, Paul Warrener, George Wilson, Ashley E. Keller, Bret R. Sellman, Antonio DiGiandomenico, Paul Kubes
Ajitha Thanabalasuriar, Bas G.J. Surewaard, Michelle E. Willson, Arpan S. Neupane, Charles K. Stover, Paul Warrener, George Wilson, Ashley E. Keller, Bret R. Sellman, Antonio DiGiandomenico, Paul Kubes
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Research Article Immunology Infectious disease

Bispecific antibody targets multiple Pseudomonas aeruginosa evasion mechanisms in the lung vasculature

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Abstract

Pseudomonas aeruginosa is a major cause of severe infections that lead to bacteremia and high patient mortality. P. aeruginosa has evolved numerous evasion and subversion mechanisms that work in concert to overcome immune recognition and effector functions in hospitalized and immunosuppressed individuals. Here, we have used multilaser spinning-disk intravital microscopy to monitor the blood-borne stage in a murine bacteremic model of P. aeruginosa infection. P. aeruginosa adhered avidly to lung vasculature, where patrolling neutrophils and other immune cells were virtually blind to the pathogen’s presence. This cloaking phenomenon was attributed to expression of Psl exopolysaccharide. Although an anti-Psl mAb activated complement and enhanced neutrophil recognition of P. aeruginosa, neutrophil-mediated clearance of the pathogen was suboptimal owing to a second subversion mechanism, namely the type 3 secretion (T3S) injectisome. Indeed, T3S prevented phagosome acidification and resisted killing inside these compartments. Antibody-mediated inhibition of the T3S protein PcrV did not enhance bacterial phagocytosis but did enhance killing of the few bacteria ingested by neutrophils. A bispecific mAb targeting both Psl and PcrV enhanced neutrophil uptake of P. aeruginosa and also greatly increased inhibition of T3S function, allowing for phagosome acidification and bacterial killing. These data highlight the need to block multiple evasion and subversion mechanisms in tandem to kill P. aeruginosa.

Authors

Ajitha Thanabalasuriar, Bas G.J. Surewaard, Michelle E. Willson, Arpan S. Neupane, Charles K. Stover, Paul Warrener, George Wilson, Ashley E. Keller, Bret R. Sellman, Antonio DiGiandomenico, Paul Kubes

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Figure 6

MEDI3902 increases monocyte/eosinophil recognition of P. aeruginosa and decreases lung bacterial load and inflammation.

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MEDI3902 increases monocyte/eosinophil recognition of P. aeruginosa and ...
(A) Bacterial CFU were determined at 6 hours after i.v. infection with P. aeruginosa in lung after prophylactic antibody treatment. n = 6. Error bars represent SEM. One-way ANOVA statistical analysis was performed on data points; multiple comparisons were performed between indicated columns. *P = 0.0255, **P = 0.0109. (B) Mice were stained for CD45 (blue) for all hematopoietic cells and Ly6G (red) for neutrophils. The percentage of neutrophil-negative but CD45-positive cells containing P. aeruginosa–GFP was assessed at 1 hour after infection (number of FOV = 3, n = 3). Error bars represent SEM. (C) Flow cytometry was performed to identify Ly6G-negative cells that contained P. aeruginosa–GFP. Eosinophils are intermediate for Siglec-F and high for CD11b, while monocytes are Siglec-F negative and Cd11b high (n = 3, 3 FOV). Error bars represent SEM. One-way ANOVA statistical analysis was performed; P = 0.0667. (D) Whole lung homogenates were used to determine the cytokine/chemokine milieu 6 hours after infection with P. aeruginosa. One-way ANOVA analysis was performed on the indicated columns. P < 0.05 is significant. Error bars represent SEM. *P = 0.0373, **P = 0.0067, ***P = 0.0003. (E) Survival analysis of mice prophylactically treated with therapeutic antibodies and then subsequently infected i.v. with P. aeruginosa strain 6077. Mantel-Cox test was performed. There was a significant difference between MEDI3902-treated mice and IgG control mice (P < 0.0001). There was a significant difference between anti-PcrV–treated mice and IgG control mice (P < 0.0001). There was no significant difference between IgG control mice and anti-Psl–treated mice (P = 0.3722). Finally, there was a significant difference between mice treated with a mixture of the antibodies (anti-Psl + anti-PcrV) and MED3902-treated mice (P = 0.0491). Error bars represent SEM; n = 8 mice per group. All experiments were repeated 3 times unless otherwise indicated.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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