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一种通透性增强药物与细菌外排泵抑制剂协同作用,恢复了多重耐药铜绿假单胞菌菌株对抗生素的敏感性。

A permeability-increasing drug synergizes with bacterial efflux pump inhibitors and restores susceptibility to antibiotics in multi-drug resistant Pseudomonas aeruginosa strains.

机构信息

University of Navarra, Department of Microbiology and Parasitology, Irunlarrea 1, 31008, Pamplona, Spain.

Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.

出版信息

Sci Rep. 2019 Mar 5;9(1):3452. doi: 10.1038/s41598-019-39659-4.

Abstract

Resistance to antibiotics poses a major global threat according to the World Health Organization. Restoring the activity of existing drugs is an attractive alternative to address this challenge. One of the most efficient mechanisms of bacterial resistance involves the expression of efflux pump systems capable of expelling antibiotics from the cell. Although there are efflux pump inhibitors (EPIs) available, these molecules are toxic for humans. We hypothesized that permeability-increasing antimicrobial peptides (AMPs) could lower the amount of EPI necessary to sensitize bacteria to antibiotics that are efflux substrates. To test this hypothesis, we measured the ability of polymyxin B nonapeptide (PMBN), to synergize with antibiotics in the presence of EPIs. Assays were performed using planktonic and biofilm-forming cells of Pseudomonas aeruginosa strains overexpressing the MexAB-OprM efflux system. Synergy between PMBN and EPIs boosted azithromycin activity by a factor of 2,133 and sensitized P. aeruginosa to all tested antibiotics. This reduced several orders of magnitude the amount of inhibitor needed for antibiotic sensitization. The selected antibiotic-EPI-PMBN combination caused a 10 million-fold reduction in the viability of biofilm forming cells. We proved that AMPs can synergize with EPIs and that this phenomenon can be exploited to sensitize bacteria to antibiotics.

摘要

根据世界卫生组织的说法,抗生素耐药性是一个主要的全球威胁。恢复现有药物的活性是应对这一挑战的一种有吸引力的替代方法。细菌耐药性的最有效机制之一涉及表达能够将抗生素从细胞中排出的外排泵系统。尽管有外排泵抑制剂 (EPI) 可用,但这些分子对人类有毒。我们假设通透性增加的抗菌肽 (AMP) 可以降低使细菌对抗生素敏感所需的 EPI 量,这些抗生素是外排底物。为了验证这一假设,我们测量了多粘菌素 B 九肽 (PMBN) 在存在 EPI 的情况下与抗生素协同作用的能力。使用过度表达 MexAB-OprM 外排系统的铜绿假单胞菌菌株的浮游细胞和生物膜形成细胞进行了测定。PMBN 和 EPI 之间的协同作用使阿奇霉素的活性提高了 2,133 倍,并使铜绿假单胞菌对所有测试的抗生素敏感。这将抗生素敏感化所需的抑制剂量减少了几个数量级。所选的抗生素-EPI-PMBN 组合使生物膜形成细胞的活力降低了 1000 万倍。我们证明 AMP 可以与 EPI 协同作用,并且可以利用这种现象使细菌对抗生素敏感。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0553/6401119/c12dc61557e9/41598_2019_39659_Fig1_HTML.jpg

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