The innate immune protein calprotectin ablates the bactericidal activity of β-lactam antibiotics

β-lactam antibiotics are among the most widely used treatments for bacterial infections, yet therapeutic failure is common even when no genetic resistance is detected. Understanding how host factors influence antibiotic efficacy is critical for improving outcomes. Here, we identify a host-derived mechanism of antibiotic tolerance mediated by calprotectin (CP), a zinc-binding protein released in large quantities by neutrophils during infection. We show that CP induces tolerance to β-lactam antibiotics in <i>Staphylococcus aureus</i> by chelating zinc and inactivating autolysins, zinc-dependent enzymes required for cell wall degradation and bacterial lysis following β-lactam treatment. This protective effect was specific to β-lactam antibiotics at concentrations of CP showing minimal impact on bacterial growth or metabolic state. Mechanistic studies revealed that CP inhibits the autolytic activity of Atl, the major <i>S. aureus</i> autolysin, by depriving the enzyme of its zinc cofactor. In a murine infection model, the efficacy of oxacillin was significantly enhanced in CP-deficient mice, demonstrating that CP impairs β-lactam activity in vivo. These findings reveal a form of immune-mediated antibiotic tolerance driven by metal sequestration and suggest that zinc availability at infection sites plays a critical role in shaping treatment outcomes.

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Journal
Proceedings of the National Academy of Sciences
Published
2026-01-14
DOI
https://doi.org/10.1073/pnas.2513462123
Primary Topic
S100 Proteins and Annexins
Type
article
Field-Weighted Citation Impact
0.00

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article

The innate immune protein calprotectin ablates the bactericidal activity of β-lactam antibiotics

B. Conlon, Emily N. Kennedy, Joshua Parsons, Thomas E. Kehl‐Fie et al.
Proceedings of the National Academy of Sciences
S100 Proteins and Annexins
article

The innate immune protein calprotectin ablates the bactericidal activity of β-lactam antibiotics

B. Conlon, Emily N. Kennedy, Joshua Parsons, Thomas E. Kehl‐Fie, Jana N. Radin, Nikki Jane Wagner, Duyen T. Bui, Amanda Z. Velez, Heather M. Tong, Emily Alam, Emma Jung, Lauren C. Radlinski, Vance G. Fowler Jr.
article en

Abstract

β-lactam antibiotics are among the most widely used treatments for bacterial infections, yet therapeutic failure is common even when no genetic resistance is detected. Understanding how host factors influence antibiotic efficacy is critical for improving outcomes. Here, we identify a host-derived mechanism of antibiotic tolerance mediated by calprotectin (CP), a zinc-binding protein released in large quantities by neutrophils during infection. We show that CP induces tolerance to β-lactam antibiotics in <i>Staphylococcus aureus</i> by chelating zinc and inactivating autolysins, zinc-dependent enzymes required for cell wall degradation and bacterial lysis following β-lactam treatment. This protective effect was specific to β-lactam antibiotics at concentrations of CP showing minimal impact on bacterial growth or metabolic state. Mechanistic studies revealed that CP inhibits the autolytic activity of Atl, the major <i>S. aureus</i> autolysin, by depriving the enzyme of its zinc cofactor. In a murine infection model, the efficacy of oxacillin was significantly enhanced in CP-deficient mice, demonstrating that CP impairs β-lactam activity in vivo. These findings reveal a form of immune-mediated antibiotic tolerance driven by metal sequestration and suggest that zinc availability at infection sites plays a critical role in shaping treatment outcomes.

Proceedings of the National Academy of SciencesVol. 123(3)
University of North Carolina at Chapel Hill (US), University of Iowa (US), Duke University (US)
School of Medicine, Duke University, University of North Carolina at Chapel Hill
Good health and well-being
Openalex Percentile: Top 88%
S100 Proteins and Annexins
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