Roche Pharma Research and Early Development, Immunology, Infectious Disease and Ophthalmology, Roche Innovation Center Basel, F. Hoffmann-La Roche, Basel, Switzerland.
Roche Pharma Research and Early Development, Therapeutic Modalities, Roche Innovation Center Basel, F. Hoffmann-La Roche, Basel, Switzerland.
Nature. 2024 Jan;625(7995):566-571. doi: 10.1038/s41586-023-06873-0. Epub 2024 Jan 3.
Carbapenem-resistant Acinetobacter baumannii (CRAB) has emerged as a major global pathogen with limited treatment options. No new antibiotic chemical class with activity against A. baumannii has reached patients in over 50 years. Here we report the identification and optimization of tethered macrocyclic peptide (MCP) antibiotics with potent antibacterial activity against CRAB. The mechanism of action of this molecule class involves blocking the transport of bacterial lipopolysaccharide from the inner membrane to its destination on the outer membrane, through inhibition of the LptBFGC complex. A clinical candidate derived from the MCP class, zosurabalpin (RG6006), effectively treats highly drug-resistant contemporary isolates of CRAB both in vitro and in mouse models of infection, overcoming existing antibiotic resistance mechanisms. This chemical class represents a promising treatment paradigm for patients with invasive infections due to CRAB, for whom current treatment options are inadequate, and additionally identifies LptBFGC as a tractable target for antimicrobial drug development.
碳青霉烯类耐药鲍曼不动杆菌(CRAB)已成为一种主要的全球性病原体,其治疗选择有限。50 多年来,尚无新的抗生素化学类别对鲍曼不动杆菌具有活性。在这里,我们报告了与具有抗 CRAB 活性的强抗菌活性的连接大环肽(MCP)抗生素的鉴定和优化。该分子类别的作用机制涉及通过抑制 LptBFGC 复合物,阻止细菌脂多糖从内膜向其在外膜上的目的地转运。源自 MCP 类的临床候选药物zosurabalpin(RG6006),在体外和感染的小鼠模型中,可有效治疗高度耐药的当代 CRAB 分离株,克服了现有的抗生素耐药机制。对于因 CRAB 而患有侵袭性感染的患者,该化学类别代表了一种有前途的治疗方案,因为目前的治疗选择不足,此外还确定 LptBFGC 是一种可用于抗菌药物开发的可行靶标。
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