Materials. Type I dextrin from corn (Mw = 7,500 g/mol), colistin sulfate, α-amylase from human saliva, N-hydroxysulfosuccinimide (sulfo-NHS), 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT), bicinchoninic acid (BCA) solution, dimethyl sulfoxide (DMSO), glucose and maltose oligomers (DP 2, 3, 6 and 7) were purchased from Sigma-Aldrich (Poole, UK). 1-Ethyl-3-(3-(dimethylamino)propyl carbodiimide hydrochloride) (EDC) was acquired from Pierce (Rockford, USA). Disodium hydrogen phosphate, potassium dihydrogen phosphate, potassium chloride, 4-dimethylaminopyridine (DMAP), and sodium chloride were from Fisher Scientific (Loughborough, UK). Unless otherwise stated, all chemicals were of analytical grade and used as received. All solvents were of general reagent grade (unless stated) and were from Fisher Scientific (Loughborough, UK). Colistimethate sodium (CMS, Colomycin®) was from Teva UK Limited (Eastbourne, UK).
Bacterial culture. The clinical isolates (V5 Escherichia coli AIM-1, V6 Klebsiella pneumoniae IR25 and V19 Acinetobacter baumannii 7789) and susceptibility testing method have been previously described by Khan et al.33 Bacterial colonies were grown on blood agar supplemented with 5% v/v defibrinated horse blood. Overnight cultures were prepared in tryptone soy broth (TSB) and Mueller-Hinton broth (MHB) was used for MIC determination (LabM; Bury, UK).
Synthesis of dextrin-colistin conjugates. Dextrin-colistin conjugates, having 1, 2.5 and 7.5 mol% succinoylation of dextrin (Mw = 7,500 g/mol; degree of polymerization (DP) = 50), were synthesized using EDC and sulfo-NHS, purified by fast protein liquid chromatography (FPLC) using a HiLoad 16/600 Superdex 75 column and characterized according to previously optimized methods11. Molecular weight was determined using a Viscotek TDA302 triple detector system, equipped with integrated refractive index (RI), viscometer and light scattering (LALS and RALS) detection and a Viscotek 2501 UV detector (210 nm). The column set consisted of an Ultrahydrogel guard column and two Ultrahydrogel 250 columns (7.8 mm X 300 mm) from Waters (Elstree, UK) in series, running at 30°C with PBS buffer eluent and a flow rate of 0.7 mL/min. Samples (300 µL) were injected into a 100 µL loop. A polyethylene oxide standard (Mw = 23,964, Mn = 23,502, IV = 0.404) from Malvern Panalytical (Malvern, UK) was employed for the calibration set up. The characteristics of dextrin-colistin conjugates used in these studies are summarized in Table S1.
Stability sample preparation.
Stability during storage. Three primary batches of colistin sulfate, CMS and dextrin-colistin conjugates were dissolved in PBS at 3 mg/mL and stored at -20, 4, 21 and 37°C for 0, 1, 3, 6, 9 and 12 months. In addition, to test the effect of repeated freeze-thaw on stability, a separate set of solutions were stored at -20°C and defrosted for 1 h at 20–22°C weekly for 5 cycles. Samples were analyzed using FPLC (free drug) and GPC (saccharide release) and antimicrobial activity, UV/vis absorbance and protein content (bicinchoninic acid (BCA) assay) of the samples stored for 12 months was assessed.
Fast Protein Liquid Chromatography. FPLC was performed using an ÄKTA Purifier from GE Healthcare (Amersham, UK) column with a UV detector and data analysis using Unicorn 5.31 software from GE Healthcare (Amersham, UK). Samples (200 µL) were injected into a 100 µL loop at 0.5 mL/min, connected to a prepacked Superdex 75 10/300 GL column with PBS buffer eluent. The proportion of free colistin was calculated by integrating the peaks corresponding to conjugate and free drug.
Gel Permeation Chromatography. GPC was performed using an Ultrahydrogel guard column and two Ultrahydrogel 120 columns (7.8 mm X 300 mm) from Waters (Elstree, UK) in series, connected to a Jasco PU-1580 HPLC pump with PBS buffer eluent and a flow rate of 1 mL/min. Samples (300 µL) were injected into a 100 µL loop and the eluate was monitored using a Jasco MD-2010 multi-wavelength UV detector (210 and 280 nm) and a Gilson 153 differential refractometer (Middleton, WI, USA) connected to a Polymer Laboratories PL DataStream (Church Stretton, UK). Dual detection enabled distinction of dextrin and saccharide components that are not bound to colistin. Cirrus GPC software (version 3.2, 2006) from Polymer Laboratories (Church Stretton, UK) was used for data analysis. Glucose and maltose oligomers (DP 2, 3, 6 and 7) were employed for calibration. Area under the curve of peaks corresponding to maltose, maltotriose and maltotetraose were used to calculate the proportion of free saccharides, compared to total AUC of all peaks > 300 g/mol.
Antimicrobial activity. The minimum inhibitory concentration (MIC) of colistin sulphate, CMS and dextrin-colistin conjugates was determined using the broth microdilution method in MH broth in accordance with standard guidelines34. Test organisms were suspended in MH broth (100 µL, 5 × 105 colony forming units (CFU)/mL) and incubated in 96-well microtitre plates in serial two-fold dilutions of the test compounds. The MIC was defined as the lowest concentration of test compound that produced no visible growth after 16–20 h. Results were expressed as mode (n = 3).
Degradation of dextrin-colistin conjugates by amylase. Dextrin-colistin conjugates were dissolved in PBS (3 mg/mL colistin base in PBS, pH 7.4) containing amylase (0, 20, 100 and 500 IU/L) and incubated at 37°C for 0, 2, 6, 12, 24, 48, 72, 168 h. Samples were analyzed using FPLC and GPC, as described previously.