A strategy for treating bacterial meningitis abandoned in the 1950s could be brought back into use to help overcome drug resistance, Swedish researchers have reported.
The discovery emerged from Swedish research into how the immune system reacts when it is overwhelmed by infection from meningitis bacteria.
This led them to explain how the 1950s treatment, developed in the USA, works.
At the time scientists noticed lumps in the cerebrospinal fluid and discovered they could be dissolved by using DNase drugs.
Combined with new antibiotics, this reduced mortality rates from 30% to 20% – but was ultimately abandoned because the DNase drugs in use at the time were extracted from animals and triggered serious allergic side-effects.
Researchers at Lund University have now discovered the lumps are caused by a "last-ditch" response by neutrophils, using a kind of netting to capture bacteria.
The cells create Neutrophil Extracellular Traps – NETs – with the aim of transporting bacteria to organs such as the spleen. In meningitis, they found, using rat models, the NETs get trapped in the cerebrospinal spaces – but can be broken up with the DNase enzyme.
Unlike in the 1950s, the researchers were able to use a DNase drug derived from humans.
The findings were reported in Nature Communications.
Researcher Adam Linder said: "At that time, everyone was so happy about the antibiotics, they reduced mortality for the infections and it was thought that we had won the war against bacteria. I believe we need to go back and take up a part of the research that took place around the time of the breakthrough for antibiotics.
"We can perhaps learn from some of the discoveries that were then flushed down the drain."
Nature Communications 10 April 2019
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