Respiratory tract infections caused by multidrug-resistant (MDR) Gram-negative bacteria such as Pseudomonas aeruginosa are serious burdens to public health, especially in
cystic fibrosis patients. The combination of
colistin, a cationic
polypeptide antibiotic, and
ivacaftor, a
cystic fibrosis transmembrane regulator (
CFTR) protein modulator, displays a synergistic antibacterial effect against P. aeruginosa. The primary aim of the present study is to investigate the transport, accumulation and toxicity of a novel nanoparticle formulation containing
colistin and
ivacaftor in lung epithelial Calu-3 cells. The cell viability results demonstrated that
ivacaftor alone or in combination with
colistin in the physical mixture showed significant toxicity at an
ivacaftor concentration of 10 μg/mL or higher. However, the cellular toxicity was significantly reduced in the nanoparticle formulation.
Ivacaftor transport into the cells reached a plateau rapidly as compared to
colistin.
Colistin transport across the Calu-3 cell monolayer was less than
ivacaftor. A substantial amount (46-83%) of
ivacaftor, independent of dose, was accumulated in the cell monolayer following transport from the apical into the basal chamber, whereas the intracellular accumulation of
colistin was relatively low (2-15%). The nanoparticle formulation significantly reduced the toxicity of
colistin and
ivacaftor to Calu-3 cells by reducing the accumulation of both drugs in the cell and potential protective effects by
bovine serum albumin (BSA), which could be a promising safer option for the treatment of
respiratory infections caused by MDR P. aeruginosa.