DESTOP · Destabilizing vascular colonization to stop meningitis

Before the antibiotic era chances of survival to bacterial meningitis were minimal. Nevertheless, nearly 100 years later, surprisingly little progress has been made and mortality rates currently remain unacceptably high (10-25%). Supported by clinical and experimental data, the central concept of the Destop project is that bacteria rapidly become insensitive to antibiotics during infection, which leads to treatment failure. We hypothesize that the emergence of such antibiotic insensitivity results from vascular colonization by Neisseria meningitidis i.e. when the bacteria adhere to the surface of the endothelium, proliferate and progressively occlude the vessel lumen. We propose to explore the mechanisms underlying four steps of vascular colonization that potentially alter bacterial sensitivity to antibiotics: (i) bacterial adhesion to the endothelium and auto-aggregation; (ii) colonization dependent changes in bacterial physiology, (iii) bacteria-induced plasma membrane deformation shielding adhering bacteria, and (iv) bacteria-triggered intravascular coagulation. For this, we will develop a multidisciplinary approach that involves: an in vivo humanized mouse model and innovative microfluidic devices - vessel-on-a-chip model and a bacterial confinement chamber. The Destop project will not only provide novel mechanistic insights in the meningitis pathogenesis process and allow to develop novel strategies to combat bacterial meningitis but also have broader impact by providing a better understanding of how tissues, as a context for infections, reduce the efficiency of treatment of numerous other bacterial pathogens.