Salama Ehab A, Elgammal Yehia, Wijeratne Aruna, Lanman Nadia A, Utturkar Sagar M, Farhangian Atena, Li Jianing, Meunier Brigitte, Hazbun Tony R, Seleem Mohamed N
Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA.
Center for One Health Research, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA.
Emerg Microbes Infect. 2024 Dec;13(1):2322649. doi: 10.1080/22221751.2024.2322649. Epub 2024 Mar 3.
has emerged as a problematic fungal pathogen associated with high morbidity and mortality. Amphotericin B (AmB) is the most effective antifungal used to treat invasive fungal candidiasis, with resistance rarely observed among clinical isolates. However, possesses extraordinary resistant profiles against all available antifungal drugs, including AmB. In our pursuit of potential solutions, we screened a panel of 727 FDA-approved drugs. We identified the proton pump inhibitor lansoprazole (LNP) as a potent enhancer of AmB's activity against LNP also potentiates the antifungal activity of AmB against other medically important species of and Our investigations into the mechanism of action unveiled that LNP metabolite(s) interact with a crucial target in the mitochondrial respiratory chain (complex III, known as cytochrome ). This interaction increases oxidative stress within fungal cells. Our results demonstrated the critical role of an active respiratory function in the antifungal activity of LNP. Most importantly, LNP restored the efficacy of AmB in an immunocompromised mouse model, resulting in a 1.7-log (∼98%) CFU reduction in the burden of in the kidneys. Our findings strongly advocate for a comprehensive evaluation of LNP as a cytochrome inhibitor for combating drug-resistant infections.
已成为一种与高发病率和死亡率相关的有问题的真菌病原体。两性霉素B(AmB)是用于治疗侵袭性真菌念珠菌病最有效的抗真菌药物,临床分离株中很少观察到耐药性。然而,对所有可用的抗真菌药物,包括AmB,都具有非凡的耐药性。在我们寻求潜在解决方案的过程中,我们筛选了一组727种FDA批准的药物。我们确定质子泵抑制剂兰索拉唑(LNP)是AmB对其活性的有效增强剂,LNP还增强了AmB对其他医学上重要的念珠菌属和曲霉菌属物种的抗真菌活性。我们对作用机制的研究揭示,LNP代谢物与线粒体呼吸链中的一个关键靶点(复合体III,即细胞色素)相互作用。这种相互作用增加了真菌细胞内的氧化应激。我们的结果证明了活跃的呼吸功能在LNP抗真菌活性中的关键作用。最重要的是,LNP在免疫受损小鼠模型中恢复了AmB的疗效,导致肾脏中念珠菌负担减少了1.7个对数(约98%)CFU。我们的发现强烈主张对LNP作为一种细胞色素抑制剂用于对抗耐药念珠菌感染进行全面评估。