OBJECTIVES:Metallo-β-lactamases (MBLs) are an emerging class of antimicrobial resistance enzymes that degrade β-lactam antibiotics, including last-resort carbapenems. Infections caused by carbapenemase-producing Enterobacteriaceae (CPE) are increasingly prevalent, but treatment options are limited. While several serine-dependent β-lactamase inhibitors are formulated with commonly prescribed β-lactams, no MBL inhibitors are currently approved for combinatorial therapies. New compounds that target MBLs to restore carbapenem activity against CPE are therefore urgently needed. Herein we identified and characterized novel synthetic peptide inhibitors that bound to and inhibited NDM-1, which is an emerging β-lactam resistance mechanism in CPE. METHODS:We leveraged Surface Localized Antimicrobial displaY (SLAY) to identify and characterize peptides that inhibit NDM-1, which is a primary carbapenem resistance mechanism in CPE. Lead inhibitor sequences were chemically synthesized and MBCs and MICs were calculated in the presence/absence of carbapenems. Kinetic analysis with recombinant NDM-1 and select peptides tested direct binding and supported NDM-1 inhibitor mechanisms of action. Inhibitors were also tested for cytotoxicity. RESULTS:We identified approximately 1700 sequences that potentiated carbapenem-dependent killing against NDM-1 Escherichia coli. Several also enhanced meropenem-dependent killing of other CPE. Biochemical characterization of a subset indicated the peptides penetrated the bacterial periplasm and directly bound NDM-1 to inhibit enzymatic activity. Additionally, each demonstrated minimal haemolysis and cytotoxicity against mammalian cell lines. CONCLUSIONS:Our approach advances a molecular platform for antimicrobial discovery, which complements the growing need for alternative antimicrobials. We also discovered lead NDM-1 inhibitors, which serve as a starting point for further chemical optimization.

译文

目的:金属-β-内酰胺酶(MBLs)是一类新兴的抗微生物耐药性酶,可降解β-内酰胺类抗生素,包括最后一种碳青霉烯。由产生碳青霉烯酶的肠杆菌科(CPE)引起的感染越来越普遍,但治疗选择有限。尽管几种丝氨酸依赖性β-内酰胺酶抑制剂与通常处方的β-内酰胺一起配制,但目前尚无MBL抑制剂被批准用于组合疗​​法。因此,迫切需要靶向MBL的新化合物,以恢复针对CPE的碳青霉烯活性。本文中,我们鉴定并表征了与NDM-1结合并抑制NDM-1的新型合成肽抑制剂,NDM-1是CPE中新兴的β-内酰胺抗性机制。
方法:我们利用表面局部抗菌素置换(SLAY)来鉴定和表征抑制NDM-1的肽,这是CPE中主要的碳青霉烯耐药机制。化学合成先导抑制剂序列,并在碳青霉烯存在/不存在下计算MBC和MIC。用重组NDM-1和选择的肽进行的动力学分析测试了直接结合和支持的NDM-1抑制剂的作用机理。还测试了抑制剂的细胞毒性。
结果:我们鉴定了大约1700个序列,可增强碳青霉烯类药物对NDM-1大肠杆菌的杀伤作用。一些还增强了对其他CPE的美洛培南依赖性杀伤。子集的生化特征表明,肽穿透细菌周质并直接结合NDM-1以抑制酶活性。另外,每个都表现出最小的针对哺乳动物细胞系的溶血作用和细胞毒性。
结论:我们的方法为抗菌药物发现提供了分子平台,从而补充了对替代抗菌药物日益增长的需求。我们还发现了NDM-1铅抑制剂,可作为进一步化学优化的起点。

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