A novel anti-infective approach is being utilized to exploit stresses already imposed on invading organisms in vivo. Iron (Fe) metabolism is a key vulnerability of infecting bacteria because organisms require Fe for growth. Studies may indicate that possibly a """"""""Trojan horse"""""""" strategy that uses the metal gallium (Ga) to disrupt bacterial Fe metabolism holds promise as an antimicrobial approach. Due to its chemical similarity to Fe, Ga can substitute for Fe in many biologic systems and inhibit Fe-dependent processes. Data may show that Ga kills the opportunistic pathogen Pseudomonas aeruginosa (including antibiotic resistant strains), may be active against biofilms, and may treat three different model P. aeruginosa infections. Ga may be a promising new therapeutic for P. aeruginosa infections. A pharmacokinetic and safety study of intravenous (IV) Ga in subjects with cystic fibrosis (CF) is being proposed as chronic P. aeruginosa airway infections are the major cause of death in these patients and few treatments exist.

Public Health Relevance

Our data shows that gallium (Ga) kills the opportunistic pathogen Pseudomonas aeruginosa (including antibiotic resistant strains), is active against biofilms, and treats 3 different model P. aeruginosa infections. P. aeruginosa accounts for approximately 60% of the chronic lung infections in patients with cystic fibrosis (CF), an orphan disease, and ~ 90% of deaths are attributed to chronic airway damage caused by this organism. We propose to assess safety, tolerability and pharmacokinetics in this patient population. We will also evaluate preliminary clinical efficacy measures - lung function, sputum microbiology and respiratory symptoms. If this is successful, this approach could provide a novel agent to fight chronic infections with P. aeruginosa in other disease settings beyond CF.

Agency
National Institute of Health (NIH)
Institute
Food and Drug Administration (FDA)
Type
Research Project (R01)
Project #
5R01FD003704-02
Application #
7937704
Study Section
Special Emphasis Panel (ZFD1-OPD-N (01))
Project Start
2009-09-23
Project End
2013-09-22
Budget Start
2010-09-23
Budget End
2013-09-22
Support Year
2
Fiscal Year
2010
Total Cost
Indirect Cost
Name
University of Washington
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
West, Natalie E; Goss, Christopher H; Nichols, David P (2018) The Long and the Short of It in Cystic Fibrosis Clinical Research Outcomes. Ann Am Thorac Soc 15:430-431
Goss, Christopher H; Sykes, Jenna; Stanojevic, Sanja et al. (2018) Comparison of Nutrition and Lung Function Outcomes in Patients with Cystic Fibrosis Living in Canada and the United States. Am J Respir Crit Care Med 197:768-775
Ramos, Kathleen J; Somayaji, Ranjani; Nichols, David P et al. (2018) Comparative Effectiveness Research in Pediatric Respiratory Disease: Promise and Pitfalls. Paediatr Drugs 20:1-7
Ramos, Kathleen J; Sack, Coralynn S; Mitchell, Kristina H et al. (2017) Cystic Fibrosis is Associated with Adverse Neonatal Outcomes in Washington State, 1996-2013. J Pediatr 180:206-211.e1
Ramos, Kathleen J; Somayaji, Ranjani; Lease, Erika D et al. (2017) Cystic fibrosis physicians' perspectives on the timing of referral for lung transplant evaluation: a survey of physicians in the United States. BMC Pulm Med 17:21
Lechtzin, Noah; Mayer-Hamblett, Nicole; West, Natalie E et al. (2017) Home Monitoring of Patients with Cystic Fibrosis to Identify and Treat Acute Pulmonary Exacerbations. eICE Study Results. Am J Respir Crit Care Med 196:1144-1151
Sack, Cora S; Goss, Christopher H (2017) Yet Again, Air Pollution Impacts Lung Health. Ann Am Thorac Soc 14:1761-1762
Stephenson, Anne L; Sykes, Jenna; Stanojevic, Sanja et al. (2017) Survival Comparison of Patients With Cystic Fibrosis in Canada and the United States: A Population-Based Cohort Study. Ann Intern Med 166:537-546
Muhlebach, Marianne Sponer; Beckett, Valeria; Popowitch, Elena et al. (2017) Microbiological efficacy of early MRSA treatment in cystic fibrosis in a randomised controlled trial. Thorax 72:318-326
Heltshe, Sonya L; Cogen, Jonathan; Ramos, Kathleen J et al. (2017) Cystic Fibrosis: The Dawn of a New Therapeutic Era. Am J Respir Crit Care Med 195:979-984

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