Background: Retrocyclins are cyclic antimicrobial peptides that have been shown to be both broadly active and safe in animal models. RC-101, a synthetic retrocyclin, targets important human pathogens and is a candidate vaginal microbicide. Its activity against microbes associated with bacterial vaginosis is unknown.
Methods:We investigated the effect of RC-101 on toxin activity, bacterial growth and biofilm formation of Gardnerella vaginalis in vitro.Results: RC-101 potently inhibits the cytolytic activity of vaginolysin, the Gardnerella vaginalis toxin, on both erythrocytes and nucleated cells. RC-101 lacks inhibitory activity against planktonic G. vaginalis but markedly decreases biofilm formation.Conclusions: These dual properties, toxin inhibition and biofilm retardation, justify further exploration of RC-101 as a candidate agent for bacterial vaginosis prevention.Keywords: defensin, vaginolysin, bacterial vaginosis, biofilm
IntroductionBacterial vaginosis (BV) is a highly prevalent vaginal dysbiosis that has been linked to adverse pregnancy outcomes and enhanced transmission of sexually transmitted infections (STIs). The precise pathogenesis of BV remains unclear. However, loss of vaginal Lactobacillus and overgrowth of Gardnerella vaginalis are thought to be key elements of the disease process. G. vaginalis forms biofilms at the vaginal mucosal surface in vivo, and these appear to contribute to persistence and the frequent failure of antimicrobial therapy for BV.1,2 G. vaginalis biofilms may also be found in male partners of women with BV and may represent a transmissible state for this organism.3 In addition, G. vaginalis produces vaginolysin (VLY), a human-specific cholesterol-dependent cytolysin that lyses epithelial cells and erythrocytes and is thought to play an important role in BV pathogenesis. 4 VLY is inactive at normal vaginal pH (,4.5) but fully active at the higher pH levels noted in the BV milieu.
5Defensins are antimicrobial peptides that have important roles in immune defence and in shaping microbial ecology at mucosal surfaces.6 Q-Defensins, also known as retrocyclins, are 18-residue circular peptides related to the a-and b-defensins. Retrocyclins have broad antibacterial and antiviral activity, but the human retrocyclin gene does not produce a functional product owing to a premature stop codon.7 Based on several studies showing that retrocyclins prevent HIV and herpes simplex virus (HSV) infection, efforts are now under way to develop a topical intravaginal preparation of synthetic retrocyclin RC-101 for STI prophylaxis.8 RC-101 has been shown to lack significant effects on lactobacilli that normally colonize the vaginal tract and to be non-toxic to human cells. We hypothesized that RC-101 might have antibacterial and antitoxin effects against G. vaginalis and VLY that could make it useful for BV prophylaxis.
Materials and methods
Bacterial strains and growth conditionsGardnerella vaginalis strain 49145 was purchased from ATCC and was grown on solid human blood-bilayer Tween agar (BD Bios...