Antibacterial agents and innate immunity

Abstract

On their own, antibacterial agents cannot cure an infectious disease. They need help from the innate immune response followed by the adaptive immune response and inflammatory response. An overview of Toll-Like Receptors (TLR) as key players in the innate immune response is given followed by a review of published results obtained in the authors laboratory related to the effect of several antibacterial agents on the action of bacterial lipopolysaccharide (LPS), a ligand for TLR-4. The results indicated that the antibacterial agents tested were anti-inflammatory. Inflammation is a two edged sword; in moderation it is beneficial, but deleterious if in excess. It is suggested that infectious disease specialists monitor serum proinflammatory cytokine and/or nitric oxide levels of their patients on antibacterial therapy and when needed, treat with a cytokine, a TLR agonist or a TLR antagonist where indicated.Antibacterial agents on their own are not capable of eradicating infections efficiently. Help coming from the patient’s innate immune response followed by the adaptive immune response and inflammatory response is needed. This has been observed in patients with immunodeficiency diseases such as X-Linked Agammaglobulinemia, Chronic Granulomatous Disease and CD40 Ligand Deficiency (1). Treatment of these patients with antibacterial agents might temporarily control the infection. However, recurrences’ always occur.