[HTML][HTML] Evidence for bistable bacteria-neutrophil interaction and its clinical implications

R Malka, B Wolach, R Gavrieli… - The Journal of …, 2012 - Am Soc Clin Investig
R Malka, B Wolach, R Gavrieli, E Shochat, V Rom-Kedar
The Journal of clinical investigation, 2012Am Soc Clin Investig
Neutropenia, which may develop as a consequence of chemotherapy, increases the risk of
bacterial infection. Similarly, increased risk of bacterial infection appears in disorders of
phagocytic functions, such as the genetic disorder chronic granulomatous disease. To
elucidate the organizing principles behind these distinct immunodeficiency conditions, we
investigated the interaction between in vitro bacteria and human neutrophils by experiments
and mathematical modeling. The model and the experiments showed that the in vitro …
Neutropenia, which may develop as a consequence of chemotherapy, increases the risk of bacterial infection. Similarly, increased risk of bacterial infection appears in disorders of phagocytic functions, such as the genetic disorder chronic granulomatous disease. To elucidate the organizing principles behind these distinct immunodeficiency conditions, we investigated the interaction between in vitro bacteria and human neutrophils by experiments and mathematical modeling. The model and the experiments showed that the in vitro bacterial dynamics exhibit bistability for a certain range of neutrophil concentration and function. Thus, there is a critical bacterial concentration above which infection develops, and below which neutrophils defeat the bacteria. Whereas with normal neutrophil concentration and function, an infection may develop when the initial bacterial concentration is very high, under neutropenic conditions or when there is neutrophil dysfunction, the critical bacterial concentration can be lower, within the clinically relevant range. We conclude that critical bacterial concentration has clinically relevant implications. The individual maximum bearable bacterial concentration depended on neutrophil concentration, phagocytic activity, and patient barrier integrity; thus, the resulting maximal bearable bacterial concentration may vary by orders of magnitude between patients. Understanding the interplay between neutrophils and bacteria may enhance the development of new therapeutic approaches to bacterial infections.
The Journal of Clinical Investigation