Voskuil Martin I, Covey Christopher R, Reichlen Matthew J, Chatterjee Anushila, Duerkop Breck A, Dawadi Surendra, Aldrich Courtney C, Aaring Alexander
Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, CO, United States.
Department of Medicinal Chemistry, University of Minnesota, Minneapolis, MN, United States.
Front Microbiol. 2025 Apr 3;16:1539139. doi: 10.3389/fmicb.2025.1539139. eCollection 2025.
Clofazimine (CFZ) is an anti-leprosy drug shown to improve outcomes in treatment of multidrug-resistant tuberculosis (TB) and nontuberculous mycobacterial infections. Studies in and identified CFZ resistance mutations in the gene that encodes the MmpR5/MmpT5 regulator, which increase expression of the mycobactin (MBT) transporter, MmpS5/L5. We found exposure of to CFZ induced a pattern of gene expression that mirrored low iron conditions, including strong induction of genes that encode MBT synthesis and transport. We identified a corresponding increase in MBT levels indicating a role in iron homeostasis in CFZ activity. CFZ bactericidal activity against both and was increased in high iron conditions in which MTB synthesis and transport was limited. We show the presence of MBT correlated with decreased CFZ killing activity while inhibition of MBT synthesis increased killing. Considerable iron efflux was observed during CFZ treatment indicating iron loss may be a feature of CFZ anti-mycobacterial activity. CFZ solubility studies and CFZ-mediated reduction of free iron indicate a potential redox interaction between CFZ and iron. MBT or MBT flux across the cell envelope appears to block CFZ killing in and potentially . The specific mechanism by which MBT inhibits CFZ lethality remains unclear but may involve, increased iron acquisition, the MmpS5/L5 MBT efflux pump, or the CFZ subcellular localization altered by the redox state and solubility of CFZ. CFZ has thus far been proven most effective against , which lacks MBT, indicating an understanding of the complex interaction of CFZ with iron acquisition systems may suggest more effective therapeutic applications.
氯法齐明(CFZ)是一种抗麻风病药物,已被证明可改善耐多药结核病(TB)和非结核分枝杆菌感染的治疗效果。在[相关研究]中鉴定出在编码MmpR5/MmpT5调节因子的基因中存在CFZ抗性突变,该突变会增加分枝杆菌素(MBT)转运蛋白MmpS5/L5的表达。我们发现[结核分枝杆菌(MTB)]暴露于CFZ会诱导一种基因表达模式,这种模式与低铁条件下的模式相似,包括强烈诱导编码MBT合成和转运的基因。我们发现MBT水平相应增加,表明其在CFZ活性的铁稳态中发挥作用。在高铁条件下,MTB合成和转运受到限制,CFZ对[MTB]和[其他非结核分枝杆菌]的杀菌活性增强。我们发现MBT的存在与CFZ杀伤活性降低相关,而抑制MBT合成则会增加杀伤作用。在CFZ治疗期间观察到大量铁外流,表明铁流失可能是CFZ抗分枝杆菌活性的一个特征。CFZ溶解度研究以及CFZ介导的游离铁还原表明CFZ与铁之间可能存在氧化还原相互作用。MBT或MBT穿过细胞膜的通量似乎会阻止CFZ对[MTB]以及可能对[其他非结核分枝杆菌]的杀伤。MBT抑制CFZ致死性的具体机制尚不清楚,但可能涉及铁摄取增加、MmpS5/L5 MBT外排泵,或CFZ的亚细胞定位因CFZ的氧化还原状态和溶解度而改变。迄今为止,CFZ已被证明对缺乏MBT的[MTB]最有效,这表明了解CFZ与铁摄取系统的复杂相互作用可能会提示更有效的治疗应用。