Phosphatidylinositol 5-Phosphate-Loaded Apoptotic Body-Like Liposomes for Mycobacterium abscessus Infection Management in Patients With Cystic Fibrosis

The study investigates therapeutic strategies for managing chronic Mycobacterium abscessus infections, particularly in people with cystic fibrosis (PWCF) who are ineligible for standard elexacaftor, tezacaftor, ivakaftor (ETI) treatments. Apoptotic body-like liposomes loaded with phosphatidylinositol 5-phosphate (ABL/PI5P) were tested in vitro in M. abscessus-infected macrophages from PWCF as potential treatment. ABL/PI5P reduced intracellular bacterial viability and showed enhanced effects on a M. abscessus clinical strain when combined with amikacin. Notably, ABL/PI5P was effective on macrophages from PWCF not receiving ETI therapy. The findings suggest ABL/PI5P liposomes as a promising alternative or adjunct therapy, especially for those who cannot access ETI treatment, warranting further clinical investigation.ABL/PI5P enhances anti-Mycobacterium abscessus response of macrophages from people with CF, receiving or not ETI therapy. Our results support the possible development of ABL/PI5P treatment as host-directed therapy against M. abscessus infection, especially in people with CF who cannot access ETI treatment.