Successful treatment of Pseudomonas aeruginosa respiratory tract infectionwith a sugar solution - a case report on a lectin based therapeutic principle

Background: Airway infections with Pseudomonas aeruginosa often represent a life-threatening event in immuno-compromised patients or patients with Cys tic Fibrosis. The adhesion of this bacterium to surfaces such as the airway epithelium is mediated by two lectins, sugar binding proteins. In addition to their adhesive properties, these lectins have been shown to stop human ciliary beating thus compromising the mucociliary clearance as an important non-specific defence mechanism of the airways. Inhibition of these lectins by their specific sugars galactose and fucose, respectively, could therefo re be of benefit in the elimination therapy of P. aeruginosa. Case report: An infant suffering from P. aeruginosa airway infection after chemotherapy for neuroblastoma, which could not successfully be treated by antibiotics, was subjected to a series of additional galactose/fucose inhalations, which eliminated the germ as evidenced by microbiological testing. This is the f irst report suggesting the effectiveness of a lectin-based therapeutic prin ciple in P. aeruginosa airway infection. Conclusion: The competitive inhibi tion of P. aeruginosa lectins by the lectin specific sugars galactose and f ucose may overcome particular mechanisms of bacterial resistance in patient s with P. aeruginosa airway infection. This underlying biochemical mechanis m and the outcome of our patient suggest a clinical benefit of this novel t herapeutic approach for immunocompromised patients or patients with cystic fibrosis suffering from infection with P. aeruginosa.