Metabolites alleviate staphylococcal bloodstream infection in a NO-dependent manner via arginase inhibition

Staphylococcus aureus is a notorious bacterial pathogen that often causes soft tissue and bloodstream infections and invariably garners resistance mechanisms against new antibiotics. Host innate immunity modulated by metabolites has been proved as a powerful strategy against bacterial infections. However, few studies focus on the application of this strategy against S. aureus infection. Here, we identified four metabolite biomarkers, L-proline, L-isoleucine, L-leucine, and L-valine (PILV), by a metabolomics study. In animal models of S. aureus bloodstream infection, exogenous administration of each metabolite or PILV shows an anti-infective effect, while PILV treatment has higher protection than individual metabolite treatment. Each metabolite targets nitric oxide (NO) to kill S. aureus via arginase inhibition, and PILV exhibits additive inhibition of arginase activity that causes further killing. This suppression also contributes to the metabolite-mediated phagocytic killing of S. aureus in human blood. Our finding demonstrates the metabolite-mediated innate immunity as a therapeutic intervention for S. aureus infection.