RT Journal Article T1 Cooperative action of SP-A and its trimeric recombinant fragment with polymyxins against Gram-negative respiratory bacteria A1 Coya, Juan Manuel A1 Fraile Ágreda, Víctor A1 Tapia, Lidia de A1 García-Fojeda García-Valdecasas, María Belén A1 Sáenz, Alejandra A1 Bengoechea, José A1 Kronqvist, Nina A1 Johansson, Jan A1 Casals Carro, María Cristina AB The exploration of therapies combining antimicrobial lung proteins and conventional antibiotics is important due to the growing problem of multidrug-resistant bacteria. The aim of this study was to investigate whether human SP-A and a recombinant trimeric fragment (rfhSP-A) have cooperative antimicrobial activity with antibiotics against pathogenic Gram-negative bacteria. We found that SP-A bound the cationic peptide polymyxin B (PMB) with an apparent dissociation constant (KD) of 0.32 ± 0.04 µM. SP-A showed synergistic microbicidal activity with polymyxin B and E, but not with other antibiotics, against three SP-A-resistant pathogenic bacteria:Klebsiella pneumoniae, non-typable Haemophilus influenzae (NTHi), and Pseudomonas aeruginosa. SP-A was not able to bind toK. pneumoniae, NTHi, or to mutant strains thereof expressing long-chain lipopolysaccharides (or lipooligosaccharides) and/or polysaccharide capsules. In the presence of PMB, SP-A induced the formation of SP-A/PMB aggregates that enhance PMB-induced bacterial membrane permeabilization. Furthermore, SP-A bound to a molecular derivative of PMB lacking the acyl chain (PMBN) with aKDof 0.26 ± 0.02 μM, forming SP-A/PMBN aggregates. PMBN has no bactericidal activity but can bind to the outer membrane of Gram-negative bacteria. Surprisingly, SP-A and PMBN showed synergistic bactericidal activity against Gram-negative bacteria. Unlike native supratrimeric SP-A, the trimeric rfhSP-A fragment had small but significant direct bactericidal activity against K. pneumoniae, NTHi, and P. aeruginosa. rfhSP-A did not bind to PMB under physiological conditions but acted additively with PMB and other antibiotics against these pathogenic bacteria. In summary, our results significantly improve our understanding of the antimicrobial actions of SP-A and its synergistic action with PMB. A peptide based on SP-A may aid the therapeutic use of PMB, a relatively cytotoxic antibiotic that is currently being reintroduced into clinics due to the global problem of antibiotic resistance. PB Frontiers SN 1664-3224 YR 2022 FD 2022 LK https://hdl.handle.net/20.500.14352/94515 UL https://hdl.handle.net/20.500.14352/94515 LA eng NO Coya JM, Fraile-Ágreda V, de Tapia L, García-Fojeda B, Sáenz A, Bengoechea JA, Kronqvist N, Johansson J and Casals C (2022) Cooperative action of SP-A and its trimeric recombinant fragment with polymyxins against Gram-negative respiratory bacteria. Front. Immunol. 13:927017. doi: 10.3389/fimmu.2022.927017 NO Ministerio de Ciencia, Innovación y Universidades (España) NO Swedish Research Council NO Universidad Complutense de Madrid NO Swedish Biotechnology and Biological Sciences Research Council NO Swedish Medical Research Council NO Comunidad de Madrid DS Docta Complutense RD 10 abr 2025