Keren Iris, Mulcahy Lawrence R, Lewis Kim
Antimicrobial Discovery Center and Department of Biology, Northeastern University, Boston, Massachusetts, USA.
Methods Enzymol. 2012;517:387-406. doi: 10.1016/B978-0-12-404634-4.00019-X.
Persisters are specialized survivor cells that protect bacterial populations from killing by antibiotics. Persisters are dormant phenotypic variants of regular cells rather than mutants. Bactericidal antibiotics kill by corrupting their targets into producing toxic products; tolerance to antibiotics follows when targets are inactive. Transcriptome analysis of isolated persisters points to toxin/antitoxin modules as a principle component of persister formation. Mechanisms of persister formation are redundant, making it difficult to eradicate these cells. In Escherichia coli, toxins RelE and MazF cause dormancy by degrading mRNA; HipA inhibits translation by phosphorylating Ef-Tu; and TisB forms an anion channel in the membrane, leading to a decrease in pmf and ATP levels. Prolonged treatment of chronic infections with antibiotics selects for hip mutants that produce more persister cells. Eradication of tolerant persisters is a serious challenge. Some of the existing antibiotics are capable of killing persisters, pointing to ways of developing therapeutics to treat chronic infections. Mitomycin is a prodrug which is converted into a reactive compound forming adducts with DNA upon entering the cell. Prolonged treatment with aminoglycosides that cause mistranslation leading to misfolded peptides can sterilize a stationary culture of Pseudomonas aeruginosa, a pathogen responsible for chronic, highly tolerant infections of cystic fibrosis patients. Finally, one of the best bactericidal agents is rifampin, an inhibitor of RNA polymerase, and we suggest that it "kills" by preventing persister resuscitation.
持留菌是一类特殊的存活细胞,可保护细菌群体免受抗生素的杀灭。持留菌是正常细胞的休眠表型变体,而非突变体。杀菌性抗生素通过破坏其靶点以产生有毒产物来发挥杀菌作用;当靶点不活跃时,细菌就会产生抗生素耐受性。对分离出的持留菌进行转录组分析表明,毒素/抗毒素模块是持留菌形成的主要成分。持留菌形成的机制是冗余的,这使得根除这些细胞变得困难。在大肠杆菌中,毒素RelE和MazF通过降解mRNA导致休眠;HipA通过磷酸化Ef-Tu抑制翻译;TisB在膜上形成阴离子通道,导致质子动力势和ATP水平降低。用抗生素长期治疗慢性感染会选择产生更多持留菌细胞的hip突变体。根除耐受性持留菌是一项严峻的挑战。一些现有的抗生素能够杀死持留菌,这为开发治疗慢性感染的疗法指明了方向。丝裂霉素是一种前体药物,进入细胞后会转化为一种与DNA形成加合物的活性化合物。用导致错义翻译从而产生错误折叠肽的氨基糖苷类药物进行长期治疗,可以使铜绿假单胞菌的静止培养物灭菌,铜绿假单胞菌是导致囊性纤维化患者慢性、高度耐受性感染的病原体。最后,最好的杀菌药物之一是利福平,它是RNA聚合酶的抑制剂,我们认为它通过阻止持留菌复苏来“杀死”它们。