rCST9/rCSTC treatment modulated inflammatory responses and preserved lung integrity in a mouse model of pneumonia. BALB/c mice (n = 6 mice/group) were infected i.n. with NDM-1 K. pneumoniae (1.82 × 108 CFU/mouse) and then treated with an i.n. dose of rCST9/rCSTC (50 pg of each/mouse) at 1 h p.i. followed by 500 pg (each) of rCST9/rCSTC per mouse at 3 days p.i. or administered a single i.p. dose of rCST9/rCSTC (500 pg of each/mouse). Sera were collected and lungs, livers, and spleens harvested at 5 days p.i. Fold changes in the overall cytokine levels in the serum (A) and lungs (B) for rCST-treated mice were decreased compared to those for untreated NDM-1 K. pneumoniae-infected mice. Both rCST9/rCSTC treatments modulated cytokine secretion in the serum (C) as well as in all tested organs (D) and significantly reduced the bacterial burden in the lungs (E). (F) Lung histology (H&E staining; magnification, ×40) for the same treated and/or infected mice showed that both rCST treatment regimens minimized lung pathology caused by NDM-1 K. pneumoniae. (G) Further, rCST treatment reduced the number of apoptotic cells compared to that for untreated infected mice. (H) Likewise, MDA detection in the lungs was significantly decreased in rCST-treated infected mice. Graphical data are presented as means and SEM, and asterisks signify significant differences (P < 0.05).