重新利用非抗菌药物和临床分子来治疗细菌感染。
Repurposing Non-Antimicrobial Drugs and Clinical Molecules to Treat Bacterial Infections.
作者信息
Younis Waleed, Thangamani Shankar, Seleem Mohamed N
机构信息
Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, West Lafayette, IN 47906, USA.
出版信息
Curr Pharm Des. 2015;21(28):4106-11. doi: 10.2174/1381612821666150506154434.
There is a pressing need to develop novel antimicrobials to circumvent the scourge of antimicrobial resistance. The objective of this study is to identify non-antibiotic drugs with potent antimicrobial activity, within an applicable clinical range. A library, containing 727 FDA approved drugs and small molecules, was screened against ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter cloacae). Drugs that showed antimicrobial activity in an applicable clinical range were further tested in vitro and in vivo in an infected mouse model. The initial screening identified 24 non-antibiotic drugs and clinical molecules active against Gram-positive pathogens including methicillin- resistant S. aureus (MRSA) and vancomycin-resistant enterococcus (VRE) isolates. Two non-antibiotic drugs showed activity against Gram-negative pathogens. Among the active non-antibiotic drugs, only ebselen (EB) and 5-fluoro-2'-deoxyuridine (FdUrd), showed bactericidal activity, in an applicable clinical range, against multi-drug-resistant Staphylococcus isolates including MRSA, vancomycin-resistant S. aureus (VRSA), and vancomycin-intermediate S. aureus (VISA). The minimum inhibitory concentration at which 90% of clinical isolates of S. aureus were inhibited (MIC90) was found to be 0.25 and 0.0039mg/L for EB and FdUrd, respectively. Treatment with EB orally significantly increased mice survival in a lethal model of septicemic MRSA infection by (60%) compared to that of control. FdUrd oral and intraperitoneal treatment significantly enhanced mouse survival by 60% and 100%, respectively. These data encourage screening and repurposing of non-antibiotic drugs and clinical molecules to treat multidrug-resistant bacterial infections.
迫切需要开发新型抗菌药物以应对抗菌药物耐药性的威胁。本研究的目的是在适用的临床范围内鉴定具有强效抗菌活性的非抗生素药物。针对ESKAPE病原体(粪肠球菌、金黄色葡萄球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和阴沟肠杆菌)对一个包含727种FDA批准药物和小分子的文库进行了筛选。在适用临床范围内显示出抗菌活性的药物在感染小鼠模型中进行了体外和体内进一步测试。初步筛选鉴定出24种对革兰氏阳性病原体有活性的非抗生素药物和临床分子,包括耐甲氧西林金黄色葡萄球菌(MRSA)和耐万古霉素肠球菌(VRE)分离株。两种非抗生素药物对革兰氏阴性病原体有活性。在有活性的非抗生素药物中,只有依布硒啉(EB)和5-氟-2'-脱氧尿苷(FdUrd)在适用临床范围内对包括MRSA、耐万古霉素金黄色葡萄球菌(VRSA)和万古霉素中介金黄色葡萄球菌(VISA)在内的多重耐药金黄色葡萄球菌分离株显示出杀菌活性。发现EB和FdUrd对90%的金黄色葡萄球菌临床分离株产生抑制作用的最低抑菌浓度(MIC90)分别为0.25和0.0039mg/L。与对照组相比,口服EB治疗在败血症性MRSA感染致死模型中显著提高了小鼠存活率(60%)。FdUrd口服和腹腔内治疗分别显著提高了小鼠存活率60%和100%。这些数据鼓励对非抗生素药物和临床分子进行筛选和重新利用以治疗多重耐药细菌感染。