%0 Journal Article %A Alexander G. Henderson %A Joy M. Davis %A Johnathan D. Keith %A Morgan E. Green %A Ashley M. Oden %A Steven M. Rowe %A Susan E Birket %T Static mucus impairs bacterial clearance and allows chronic infection with Pseudomonas aeruginosa in the cystic fibrosis rat %D 2022 %R 10.1183/13993003.01032-2021 %J European Respiratory Journal %P 2101032 %X Cystic fibrosis (CF) airway disease is characterised by chronic Pseudomonas aeruginosa infection. Successful eradication strategies have been hampered by a poor understanding of the mechanisms underlying conversion to chronicity. The CFTR-knockout (KO) rat harbors a progressive defect in mucociliary transport and viscosity. KO rats were infected before and after the appearance of the mucus defect, using a clinical, mucoid-isolate of P. aeruginosa embedded in agarose beads. Young KO rats that were exposed to bacteria before the development of mucociliary transport defects resolved the infection and subsequent tissue damage. However, older KO rats that were infected in the presence of hyperviscous and static mucus were unable to eradicate bacteria, but instead had bacterial persistence through 28 days post-infection that was accompanied by airway mucus occlusion and lingering inflammation. Normal rats responded to infection with increased mucociliary transport to supernormal rates, which reduced the severity of a second bacterial exposure. We therefore conclude that the aberrant mucus present in the CF airway permits persistence of P. aeruginosa in the lung.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Henderson has nothing to disclose.Conflict of interest: Dr. Davis has nothing to disclose.Conflict of interest: Dr. Keith has nothing to disclose.Conflict of interest: Dr. Green has nothing to disclose.Conflict of interest: Dr. Oden has nothing to disclose.Conflict of interest: Dr. Rowe reports In addition, Dr. Rowe has a patent Use of uOCT as a tool for diagnosis and drug discovery issued.Conflict of interest: Dr. Birket reports grants from NIH NHLBI, grants from Cystic Fibrosis Foundation, during the conduct of the study;. %U https://erj.ersjournals.com/content/erj/early/2022/01/20/13993003.01032-2021.full.pdf