吡啶哌嗪外排泵抑制剂提高了针对肺炎克雷伯菌的体内抗生素疗效。
Pyridylpiperazine efflux pump inhibitor boosts in vivo antibiotic efficacy against K. pneumoniae.
机构信息
Univ. Lille, Inserm, Institut Pasteur de Lille, U1177 - Drugs and Molecules for Living Systems, F-59000, Lille, France.
Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019 - UMR 9017 - CIIL - Center for Infection and Immunity of Lille, F-59000, Lille, France.
出版信息
EMBO Mol Med. 2024 Jan;16(1):93-111. doi: 10.1038/s44321-023-00007-9. Epub 2023 Dec 20.
Antimicrobial resistance is a global problem, rendering conventional treatments less effective and requiring innovative strategies to combat this growing threat. The tripartite AcrAB-TolC efflux pump is the dominant constitutive system by which Enterobacterales like Escherichia coli and Klebsiella pneumoniae extrude antibiotics. Here, we describe the medicinal chemistry development and drug-like properties of BDM91288, a pyridylpiperazine-based AcrB efflux pump inhibitor. In vitro evaluation of BDM91288 confirmed it to potentiate the activity of a panel of antibiotics against K. pneumoniae as well as revert clinically relevant antibiotic resistance mediated by acrAB-tolC overexpression. Using cryo-EM, BDM91288 binding to the transmembrane region of K. pneumoniae AcrB was confirmed, further validating the mechanism of action of this inhibitor. Finally, proof of concept studies demonstrated that oral administration of BDM91288 significantly potentiated the in vivo efficacy of levofloxacin treatment in a murine model of K. pneumoniae lung infection.
抗微生物药物耐药性是一个全球性问题,使传统疗法的效果降低,需要采取创新策略来应对这一日益严重的威胁。肠杆菌科细菌(如大肠杆菌和肺炎克雷伯菌)的三组分AcrAB-TolC 外排泵是主要的组成型系统,通过该系统将抗生素排出细胞外。在这里,我们描述了基于吡啶哌嗪的 AcrB 外排泵抑制剂 BDM91288 的药物化学开发和类药性。BDM91288 的体外评估证实,它可以增强一组抗生素对肺炎克雷伯菌的活性,并逆转由 acrAB-tolC 过表达介导的临床相关抗生素耐药性。通过冷冻电镜,证实了 BDM91288 与肺炎克雷伯菌 AcrB 的跨膜区域结合,进一步验证了该抑制剂的作用机制。最后,概念验证研究表明,BDM91288 的口服给药可显著增强左氧氟沙星在肺炎克雷伯菌肺部感染小鼠模型中的体内疗效。