1
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Stoorza AM, Duerfeldt AS. Guiding the Way: Traditional Medicinal Chemistry Inspiration for Rational Gram-Negative Drug Design. J Med Chem 2024; 67:65-80. [PMID: 38134355 DOI: 10.1021/acs.jmedchem.3c01831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
The discovery and development of small-molecule therapeutics effective against Gram-negative pathogens are highly challenging tasks. Most compounds that are active in biochemical settings fail to exhibit whole-cell activity. The major reason for this lack of activity is the effectiveness of bacterial cell envelopes as permeability barriers. These barriers originate from the nutrient-selective outer membranes, which act synergistically with polyspecific efflux pumps. Guiding principles to enable rational optimization of small molecules for efficient penetration and intracellular accumulation in Gram-negative bacteria would have a transformative impact on the discovery and design of chemical probes and therapeutics. In this Perspective, we draw on inspiration from traditional medicinal chemistry approaches for eukaryotic drug design to present a broader call for action in developing comparable approaches for Gram-negative bacteria.
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Affiliation(s)
- Alexis M Stoorza
- Department of Medicinal Chemistry, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55414, United States
| | - Adam S Duerfeldt
- Department of Medicinal Chemistry, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55414, United States
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2
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Ganesh BH, Raj AG, Aruchamy B, Nanjan P, Drago C, Ramani P. Pyrrole: A Decisive Scaffold for the Development of Therapeutic Agents and Structure-Activity Relationship. ChemMedChem 2024; 19:e202300447. [PMID: 37926686 DOI: 10.1002/cmdc.202300447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/25/2023] [Accepted: 11/01/2023] [Indexed: 11/07/2023]
Abstract
An overview of pyrroles as distinct scaffolds with therapeutic potential and the significance of pyrrole derivatives for drug development are provided in this article. It lists instances of naturally occurring pyrrole-containing compounds and describes the sources of pyrroles in nature, including plants and microbes. It also explains the many conventional and modern synthetic methods used to produce pyrroles. The key topics are the biological characteristics, pharmacological behavior, and functional alterations displayed by pyrrole derivatives. It also details how pyrroles are used to treat infectious diseases. It describes infectious disorders resistant to standard treatments and discusses the function of compounds containing pyrroles in combating infectious diseases. Furthermore, the review covers the uses of pyrrole derivatives in treating non-infectious diseases and resistance mechanisms in non-infectious illnesses like cancer, diabetes, and Alzheimer's and Parkinson's diseases. The important discoveries and probable avenues for pyrrole research are finally summarized, along with their significance for medicinal chemists and drug development. A reference from the last two decades is included in this review.
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Affiliation(s)
- Bharathi Hassan Ganesh
- Dhanvanthri Laboratory, Department of Sciences, Amrita School of Physical Sciences, Coimbatore, 641112, Amrita Vishwa Vidyapeetham, India
- Center of Excellence in Advanced Materials & Green Technologies (CoE-AMGT), Amrita School of Engineering, Coimbatore, 641112, Amrita Vishwa Vidyapeetham, India
| | - Anirudh G Raj
- Dhanvanthri Laboratory, Department of Sciences, Amrita School of Physical Sciences, Coimbatore, 641112, Amrita Vishwa Vidyapeetham, India
| | - Baladhandapani Aruchamy
- Dhanvanthri Laboratory, Department of Sciences, Amrita School of Physical Sciences, Coimbatore, 641112, Amrita Vishwa Vidyapeetham, India
- Center of Excellence in Advanced Materials & Green Technologies (CoE-AMGT), Amrita School of Engineering, Coimbatore, 641112, Amrita Vishwa Vidyapeetham, India
| | - Pandurangan Nanjan
- Dhanvanthri Laboratory, Department of Sciences, Amrita School of Physical Sciences, Coimbatore, 641112, Amrita Vishwa Vidyapeetham, India
- Amrita School of Engineering, Coimbatore, 641112, Amrita Vishwa Vidyapeetham, India
| | - Carmelo Drago
- Institute of Biomolecular Chemistry CNR, via Paolo Gaifami 18, 95126, Catania, Italy
| | - Prasanna Ramani
- Dhanvanthri Laboratory, Department of Sciences, Amrita School of Physical Sciences, Coimbatore, 641112, Amrita Vishwa Vidyapeetham, India
- Center of Excellence in Advanced Materials & Green Technologies (CoE-AMGT), Amrita School of Engineering, Coimbatore, 641112, Amrita Vishwa Vidyapeetham, India
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3
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Ahmed S, Mital A, Akhir A, Saxena D, Ahmad MN, Dasgupta A, Chopra S, Jain R. Pyrrole-thiazolidinone hybrids as a new structural class of broad-spectrum anti-infectives. Eur J Med Chem 2023; 260:115757. [PMID: 37659197 DOI: 10.1016/j.ejmech.2023.115757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/16/2023] [Accepted: 08/23/2023] [Indexed: 09/04/2023]
Abstract
A series of pyrrole-thiazolidinone hybrids was designed, synthesized and evaluated for activities against ESKAP bacteria panel and mycobacterial pathogens. From the series, compound 9d showed prominent activity against S. aureus (MIC = 0.5 μg/mL) and compound 9k showed the most promising activity against M. tuberculosis H37Rv (MIC = 0.5 μg/mL). Potent derivatives were found to be non-toxic when tested against Vero cells. Compound 9d upon evaluation in vitro against several MRSA and VRSA strains produced activity comparable or better than standard drugs. In the anti-biofilm assay, 9d reduced S. aureus biofilm by >11% at 10x MIC. The dual inhibitory effect exhibited by pyrrole-thiazolidinone hybrids confirms their potential as new class of promising anti-infective agents.
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Affiliation(s)
- Shujauddin Ahmed
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research, Sector 67, S.A.S. Nagar, Punjab, 160 062, India
| | - Alka Mital
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research, Sector 67, S.A.S. Nagar, Punjab, 160 062, India
| | - Abdul Akhir
- Division of Molecular Microbiology and Immunology, Central Drug Research Institute (CSIR-CDRI), Sector 10, Jankipuram Extension, Sitapur Road, Lucknow, Uttar Pradesh, 226 031, India
| | - Deepanshi Saxena
- Division of Molecular Microbiology and Immunology, Central Drug Research Institute (CSIR-CDRI), Sector 10, Jankipuram Extension, Sitapur Road, Lucknow, Uttar Pradesh, 226 031, India
| | - Mohammad Naiyaz Ahmad
- Division of Molecular Microbiology and Immunology, Central Drug Research Institute (CSIR-CDRI), Sector 10, Jankipuram Extension, Sitapur Road, Lucknow, Uttar Pradesh, 226 031, India
| | - Arunava Dasgupta
- Division of Molecular Microbiology and Immunology, Central Drug Research Institute (CSIR-CDRI), Sector 10, Jankipuram Extension, Sitapur Road, Lucknow, Uttar Pradesh, 226 031, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India
| | - Sidharth Chopra
- Division of Molecular Microbiology and Immunology, Central Drug Research Institute (CSIR-CDRI), Sector 10, Jankipuram Extension, Sitapur Road, Lucknow, Uttar Pradesh, 226 031, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201 002, India.
| | - Rahul Jain
- Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research, Sector 67, S.A.S. Nagar, Punjab, 160 062, India.
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4
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Hu Z, Leus IV, Chandar B, Sherborne BS, Avila QP, Rybenkov VV, Zgurskaya HI, Duerfeldt AS. Structure-Uptake Relationship Studies of Oxazolidinones in Gram-Negative ESKAPE Pathogens. J Med Chem 2022; 65:14144-14179. [PMID: 36257060 PMCID: PMC9942527 DOI: 10.1021/acs.jmedchem.2c01349] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The clinical success of linezolid for treating Gram-positive infections paired with the high conservation of bacterial ribosomes predicts that if oxazolidinones were engineered to accumulate in Gram-negative bacteria, then this pharmacological class would find broad utility in eradicating infections. Here, we report an investigative study of a strategically designed library of oxazolidinones to determine the effects of molecular structure on accumulation and biological activity. Escherichia coli, Acinetobacter baumannii, and Pseudomonas aeruginosa strains with varying degrees of compromise (in efflux and outer membrane) were used to identify motifs that hinder permeation across the outer membrane and/or enhance efflux susceptibility broadly and specifically between species. The results illustrate that small changes in molecular structure are enough to overcome the efflux and/or permeation issues of this scaffold. Three oxazolidinone analogues (3e, 8d, and 8o) were identified that exhibit activity against all three pathogens assessed, a biological profile not observed for linezolid.
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Affiliation(s)
- Ziwei Hu
- Department of Medicinal Chemistry, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55414, United States
| | - Inga V Leus
- Department of Chemistry & Biochemistry, University of Oklahoma, Stephenson Life Sciences Research Center, Norman, Oklahoma 73019, United States
| | - Brinda Chandar
- Department of Chemistry & Biochemistry, University of Oklahoma, Stephenson Life Sciences Research Center, Norman, Oklahoma 73019, United States
| | | | - Quentin P Avila
- Department of Chemistry & Biochemistry, University of Oklahoma, Stephenson Life Sciences Research Center, Norman, Oklahoma 73019, United States
| | - Valentin V Rybenkov
- Department of Chemistry & Biochemistry, University of Oklahoma, Stephenson Life Sciences Research Center, Norman, Oklahoma 73019, United States
| | - Helen I Zgurskaya
- Department of Chemistry & Biochemistry, University of Oklahoma, Stephenson Life Sciences Research Center, Norman, Oklahoma 73019, United States
| | - Adam S Duerfeldt
- Department of Medicinal Chemistry, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota 55414, United States
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5
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Bourgard C, Rodríguez-Hernández D, Rudenko A, Rutgersson C, Palm M, Larsson DGJ, Farewell A, Grøtli M, Sunnerhagen P. Development of Dicationic Bisguanidine-Arylfuran Derivatives as Potent Agents against Gram-Negative Bacteria. Antibiotics (Basel) 2022; 11:antibiotics11081115. [PMID: 36009984 PMCID: PMC9404985 DOI: 10.3390/antibiotics11081115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 11/29/2022] Open
Abstract
Antibiotic resistance among bacteria is a growing global challenge. A major reason for this is the limited progress in developing new classes of antibiotics active against Gram-negative bacteria. Here, we investigate the antibacterial activity of a dicationic bisguanidine-arylfuran, originally developed as an antitrypanosomal agent, and new derivatives thereof. The compounds showed good activity (EC50 2–20 µM) against antibiotic-resistant isolates of the Gram-negative members of the ESKAPE group (Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.) and Escherichia coli with different antibiotic susceptibility patterns, including ESBL isolates. Cytotoxicity was moderate, and several of the new derivatives were less cytotoxic than the lead molecule, offering better selectivity indices (40–80 for several ESKAPE isolates). The molecular mechanism for the antibacterial activity of these molecules is unknown, but sensitivity profiling against human ESKAPE isolates and E. coli collections with known susceptibility patterns against established antibiotics indicates that it is distinct from lactam and quinolone antibiotics.
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Affiliation(s)
- Catarina Bourgard
- Department of Chemistry and Molecular Biology, University of Gothenburg, S-405 30 Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, S-405 30 Gothenburg, Sweden
| | - Diego Rodríguez-Hernández
- Department of Chemistry and Molecular Biology, University of Gothenburg, S-405 30 Gothenburg, Sweden
| | - Anastasia Rudenko
- Department of Chemistry and Molecular Biology, University of Gothenburg, S-405 30 Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, S-405 30 Gothenburg, Sweden
| | - Carolin Rutgersson
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, S-405 30 Gothenburg, Sweden
- Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, S-413 46 Gothenburg, Sweden
| | - Martin Palm
- Department of Chemistry and Molecular Biology, University of Gothenburg, S-405 30 Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, S-405 30 Gothenburg, Sweden
| | - D. G. Joakim Larsson
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, S-405 30 Gothenburg, Sweden
- Institute of Biomedicine, Department of Infectious Diseases, University of Gothenburg, S-413 46 Gothenburg, Sweden
| | - Anne Farewell
- Department of Chemistry and Molecular Biology, University of Gothenburg, S-405 30 Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, S-405 30 Gothenburg, Sweden
| | - Morten Grøtli
- Department of Chemistry and Molecular Biology, University of Gothenburg, S-405 30 Gothenburg, Sweden
- Correspondence: (M.G.); (P.S.)
| | - Per Sunnerhagen
- Department of Chemistry and Molecular Biology, University of Gothenburg, S-405 30 Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, S-405 30 Gothenburg, Sweden
- Correspondence: (M.G.); (P.S.)
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6
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Semenya D, Touitou M, Masci D, Ribeiro CM, Pavan FR, Dos Santos Fernandes GF, Gianibbi B, Manetti F, Castagnolo D. Tapping into the antitubercular potential of 2,5-dimethylpyrroles: A structure-activity relationship interrogation. Eur J Med Chem 2022; 237:114404. [PMID: 35486992 DOI: 10.1016/j.ejmech.2022.114404] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/16/2022] [Accepted: 04/18/2022] [Indexed: 01/29/2023]
Abstract
An exploration of the chemical space around a 2,5-dimethylpyrrole scaffold of antitubercular hit compound 1 has led to the identification of new derivatives active against Mycobacterium tuberculosis and multidrug-resistant clinical isolates. Analogues incorporating a cyclohexanemethyl group on the methyleneamine side chain at C3 of the pyrrole core, including 5n and 5q, exhibited potent inhibitory effects against the M. tuberculosis strains, substantiating the essentiality of the moiety to their antimycobacterial activity. In addition, selected derivatives showed promising cytotoxicity profiles against human pulmonary fibroblasts and/or murine macrophages, proved to be effective in inhibiting the growth of intracellular mycobacteria, and elicited either bactericidal effects, or bacteriostatic activity comparable to 1. Computational studies revealed that the new compounds bind to the putative target, MmpL3, in a manner similar to that of known inhibitors BM212 and SQ109.
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Affiliation(s)
- Dorothy Semenya
- School of Cancer and Pharmaceutical Sciences, King's College London, 150 Stamford Street, SE1 9NH, London, United Kingdom
| | - Meir Touitou
- School of Cancer and Pharmaceutical Sciences, King's College London, 150 Stamford Street, SE1 9NH, London, United Kingdom
| | - Domiziana Masci
- School of Cancer and Pharmaceutical Sciences, King's College London, 150 Stamford Street, SE1 9NH, London, United Kingdom
| | - Camila Maringolo Ribeiro
- Tuberculosis Research Laboratory, School of Pharmaceutical Sciences, Sao Paulo State University (UNESP), Rod. Araraquara-Jau, km1, 14800-903, Araraquara, Brazil
| | - Fernando Rogerio Pavan
- Tuberculosis Research Laboratory, School of Pharmaceutical Sciences, Sao Paulo State University (UNESP), Rod. Araraquara-Jau, km1, 14800-903, Araraquara, Brazil
| | | | - Beatrice Gianibbi
- Dipartimento di Biotecnologie, Chimica e Farmacia, Dipartimento di Eccellenza 2018-2022, University of Siena, via A. Moro 2, I-53100, Siena, Italy
| | - Fabrizio Manetti
- Dipartimento di Biotecnologie, Chimica e Farmacia, Dipartimento di Eccellenza 2018-2022, University of Siena, via A. Moro 2, I-53100, Siena, Italy
| | - Daniele Castagnolo
- School of Cancer and Pharmaceutical Sciences, King's College London, 150 Stamford Street, SE1 9NH, London, United Kingdom.
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7
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Moghadam ES, Mireskandari K, Abdel-Jalil R, Amini M. An approach to pharmacological targets of pyrrole family from a medicinal chemistry viewpoint. Mini Rev Med Chem 2022; 22:2486-2561. [PMID: 35339175 DOI: 10.2174/1389557522666220325150531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/12/2022] [Accepted: 01/30/2022] [Indexed: 11/22/2022]
Abstract
Pyrrole is one of the most widely used heterocycles in the pharmaceutical industry. Due to the importance of pyrrole structure in drug design and development, herein, we tried to conduct an extensive review of the bioactive pyrrole based compounds reported recently. The bioactivity of pyrrole derivatives varies, so in the review, we categorized them based on their direct pharmacologic targets. Therefore, readers are able to find the variety of biologic targets for pyrrole containing compounds easily. This review explains around seventy different biologic targets for pyrrole based derivatives, so, it is helpful for medicinal chemists in design and development novel bioactive compounds for different diseases. This review presents an extensive meaningful structure activity relationship for each reported structure as much as possible. The review focuses on papers published between 2018 and 2020.
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Affiliation(s)
- Ebrahim Saeedian Moghadam
- Department of Medicinal Chemistry, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran14176, Iran.
- The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran.
- Department of Chemistry, College of Science, Sultan Qaboos University, Muscat, P.O. Box 36, P.C. 123, Sultanate of Oman
| | - Katayoon Mireskandari
- Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Raid Abdel-Jalil
- Department of Chemistry, College of Science, Sultan Qaboos University, Muscat, P.O. Box 36, P.C. 123, Sultanate of Oman
| | - Mohsen Amini
- Department of Medicinal Chemistry, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran14176, Iran.
- The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
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8
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Semenya D, Touitou M, Ribeiro CM, Pavan FR, Pisano L, Singh V, Chibale K, Bano G, Toscani A, Manetti F, Gianibbi B, Castagnolo D. Structural Rigidification of N-Aryl-pyrroles into Indoles Active against Intracellular and Drug-Resistant Mycobacteria. ACS Med Chem Lett 2021; 13:63-69. [PMID: 35059125 PMCID: PMC8762742 DOI: 10.1021/acsmedchemlett.1c00431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 12/01/2021] [Indexed: 01/16/2023] Open
Abstract
A series of indolyl-3-methyleneamines incorporating lipophilic side chains were designed through a structural rigidification approach and synthesized for investigation as new chemical entities against Mycobacterium tuberculosis (Mtb). The screening led to the identification of a 6-chloroindole analogue 7j bearing an N-octyl chain and a cycloheptyl moiety, which displayed potent in vitro activity against laboratory and clinical Mtb strains, including a pre-extensively drug-resistant (pre-XDR) isolate. 7j also demonstrated a marked ability to restrict the intracellular growth of Mtb in murine macrophages. Further assays geared toward mechanism of action elucidation have thus far ruled out the involvement of various known promiscuous targets, thereby suggesting that the new indole 7j may inhibit Mtb via a unique mechanism.
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Affiliation(s)
- Dorothy Semenya
- School
of Cancer and Pharmaceutical Sciences, King’s
College London, 150 Stamford Street, London SE1 9NH, United Kingdom
| | - Meir Touitou
- School
of Cancer and Pharmaceutical Sciences, King’s
College London, 150 Stamford Street, London SE1 9NH, United Kingdom
| | - Camila Maringolo Ribeiro
- Tuberculosis
Research Laboratory, School of Pharmaceutical Sciences, Sao Paulo State University (UNESP), Rodovia Araraquara-Jau, km1, 14800-903 Araraquara, Brazil
| | - Fernando Rogerio Pavan
- Tuberculosis
Research Laboratory, School of Pharmaceutical Sciences, Sao Paulo State University (UNESP), Rodovia Araraquara-Jau, km1, 14800-903 Araraquara, Brazil
| | - Luca Pisano
- School
of Cancer and Pharmaceutical Sciences, King’s
College London, 150 Stamford Street, London SE1 9NH, United Kingdom
| | - Vinayak Singh
- Drug
Discovery and Development Centre (H3D), University of Cape Town, Rondebosch 7701, South Africa,South
African Medical Research Council Drug Discovery and Development Research
Unit, Department of Chemistry and Institute of Infectious Disease
and Molecular Medicine, University of Cape
Town, Rondebosch 7701, South Africa
| | - Kelly Chibale
- Drug
Discovery and Development Centre (H3D), University of Cape Town, Rondebosch 7701, South Africa,South
African Medical Research Council Drug Discovery and Development Research
Unit, Department of Chemistry and Institute of Infectious Disease
and Molecular Medicine, University of Cape
Town, Rondebosch 7701, South Africa
| | - Georg Bano
- School
of Cancer and Pharmaceutical Sciences, King’s
College London, 150 Stamford Street, London SE1 9NH, United Kingdom
| | - Anita Toscani
- School
of Cancer and Pharmaceutical Sciences, King’s
College London, 150 Stamford Street, London SE1 9NH, United Kingdom
| | - Fabrizio Manetti
- Dipartimento
di Biotecnologie, Chimica e Farmacia, Università
di Siena, via Aldo Moro
2, I-53100 Siena, Italy
| | - Beatrice Gianibbi
- Dipartimento
di Biotecnologie, Chimica e Farmacia, Università
di Siena, via Aldo Moro
2, I-53100 Siena, Italy
| | - Daniele Castagnolo
- School
of Cancer and Pharmaceutical Sciences, King’s
College London, 150 Stamford Street, London SE1 9NH, United Kingdom,
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9
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Haloi N, Vasan AK, Geddes EJ, Prasanna A, Wen PC, Metcalf WW, Hergenrother PJ, Tajkhorshid E. Rationalizing the generation of broad spectrum antibiotics with the addition of a positive charge. Chem Sci 2021; 12:15028-15044. [PMID: 34909143 PMCID: PMC8612397 DOI: 10.1039/d1sc04445a] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/13/2021] [Indexed: 11/28/2022] Open
Abstract
Antibiotic resistance of Gram-negative bacteria is largely attributed to the low permeability of their outer membrane (OM). Recently, we disclosed the eNTRy rules, a key lesson of which is that the introduction of a primary amine enhances OM permeation in certain contexts. To understand the molecular basis for this finding, we perform an extensive set of molecular dynamics (MD) simulations and free energy calculations comparing the permeation of aminated and amine-free antibiotic derivatives through the most abundant OM porin of E. coli, OmpF. To improve sampling of conformationally flexible drugs in MD simulations, we developed a novel, Monte Carlo and graph theory based algorithm to probe more efficiently the rotational and translational degrees of freedom visited during the permeation of the antibiotic molecule through OmpF. The resulting pathways were then used for free-energy calculations, revealing a lower barrier against the permeation of the aminated compound, substantiating its greater OM permeability. Further analysis revealed that the amine facilitates permeation by enabling the antibiotic to align its dipole to the luminal electric field of the porin and form favorable electrostatic interactions with specific, highly-conserved charged residues. The importance of these interactions in permeation was further validated with experimental mutagenesis and whole cell accumulation assays. Overall, this study provides insights on the importance of the primary amine for antibiotic permeation into Gram-negative pathogens that could help the design of future antibiotics. We also offer a new computational approach for calculating free-energy of processes where relevant molecular conformations cannot be efficiently captured.
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Affiliation(s)
- Nandan Haloi
- Theoretical and Computational Biophysics Group, NIH Center for Macromolecular Modeling and Bioinformatics, Beckman Institute for Advanced Science and Technology, Department of Biochemistry, Center for Biophysics and Quantitative Biology, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
| | - Archit Kumar Vasan
- Theoretical and Computational Biophysics Group, NIH Center for Macromolecular Modeling and Bioinformatics, Beckman Institute for Advanced Science and Technology, Department of Biochemistry, Center for Biophysics and Quantitative Biology, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
| | - Emily J Geddes
- Department of Chemistry, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
| | - Arjun Prasanna
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
- Department of Microbiology, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
| | - Po-Chao Wen
- Theoretical and Computational Biophysics Group, NIH Center for Macromolecular Modeling and Bioinformatics, Beckman Institute for Advanced Science and Technology, Department of Biochemistry, Center for Biophysics and Quantitative Biology, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
| | - William W Metcalf
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
- Department of Microbiology, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
| | - Paul J Hergenrother
- Department of Chemistry, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
| | - Emad Tajkhorshid
- Theoretical and Computational Biophysics Group, NIH Center for Macromolecular Modeling and Bioinformatics, Beckman Institute for Advanced Science and Technology, Department of Biochemistry, Center for Biophysics and Quantitative Biology, University of Illinois at Urbana-Champaign Urbana IL 61801 USA
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10
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An LC-MS/MS assay and complementary web-based tool to quantify and predict compound accumulation in E. coli. Nat Protoc 2021; 16:4833-4854. [PMID: 34480129 PMCID: PMC8715754 DOI: 10.1038/s41596-021-00598-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/25/2021] [Indexed: 02/08/2023]
Abstract
Novel classes of broad-spectrum antibiotics have been extremely difficult to discover, largely due to the impermeability of the Gram-negative membranes coupled with a poor understanding of the physicochemical properties a compound should possess to promote its accumulation inside the cell. To address this challenge, numerous methodologies for assessing intracellular compound accumulation in Gram-negative bacteria have been established, including classic radiometric and fluorescence-based methods. The recent development of accumulation assays that utilize liquid chromatography-tandem mass spectrometry (LC-MS/MS) have circumvented the requirement for labeled compounds, enabling assessment of a substantially broader range of small molecules. Our unbiased study of accumulation trends in Escherichia coli using an LC-MS/MS-based assay led to the development of the eNTRy rules, which stipulate that a compound is most likely to accumulate in E. coli if it has an ionizable Nitrogen, has low Three-dimensionality and is relatively Rigid. To aid in the implementation of the eNTRy rules, we developed a complementary web tool, eNTRyway, which calculates relevant properties and predicts compound accumulation. Here we provide a comprehensive protocol for analysis and prediction of intracellular accumulation of small molecules in E. coli using an LC-MS/MS-based assay (which takes ~2 d) and eNTRyway, a workflow that is readily adoptable by any microbiology, biochemistry or chemical biology laboratory.
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11
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Muñoz KA, Hergenrother PJ. Facilitating Compound Entry as a Means to Discover Antibiotics for Gram-Negative Bacteria. Acc Chem Res 2021; 54:1322-1333. [PMID: 33635073 DOI: 10.1021/acs.accounts.0c00895] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
It has been over half a century since the last class of antibiotics active against the most problematic Gram-negative bacteria was approved by the Food and Drug Administration (FDA). The major challenge with developing antibiotics to treat these infections is not drug-target engagement but rather the inability of most small molecules to traverse the Gram-negative membranes, be retained, and accumulate within the cell. Despite an abundance of lead compounds, limited understanding of the physicochemical properties needed for compound accumulation (or avoidance of efflux) in Gram-negative bacteria has precluded a generalizable approach for developing Gram-negative antibiotics. Indeed, in many instances, despite years of intensive derivatization efforts and the synthesis of hundreds of compounds aimed at building in Gram-negative activity, little or no progress has been made in expanding the spectrum of activity for many Gram-positive-only antibiotics. In this Account, we describe the discovery and successful applications of a promising strategy for enhancing the accumulation of Gram-positive-only antibiotics as a means of imbuing compounds with broad-spectrum activity.Utilizing a prospective approach examining the accumulation in Escherichia coli for more than 180 diverse compounds, we found that small molecules have an increased likelihood to accumulate in E. coli when they contain an ionizable Nitrogen, have low Three-dimensionality, and are Rigid. Implementing these guidelines, codified as the "eNTRy rules" and assisted by web application www.entry-way.org, we have facilitated compound entry and systematically built Gram-negative activity into Gram-positive-only antibiotics. Though each antibiotic will have case-specific considerations, we describe a set of important criteria to consider when selecting candidate Gram-positive-only antibiotics for conversion to Gram-negative-active versions via the eNTRy rules. As detailed herein, using this blueprint the spectrum of activity was expanded for three antibiotic classes that engage three different biological targets: DNA gyrase inhibitor 6DNM, FabI inhibitor Debio-1452, and FMN riboswitch inhibitor Ribocil C. In each scenario, the eNTRy rules guided the synthesis of key analogues predisposed to accumulate in Gram-negative bacteria leading to compounds that display antibiotic activity (minimum inhibitory concentrations (MIC) ≤8 μg mL-1) against E. coli and other Gram-negative ESKAPE pathogens. While the eNTRy rules will continue to be refined and enhanced as more accumulation data is gathered, on the basis of these collective results and on other examples not covered herein it is clear that the eNTRy rules are actionable for the development of novel broad-spectrum antibiotics from Gram-positive-only compounds. By enabling the prediction of compound accumulation, the eNTRy rules should facilitate the process of discovering and developing novel antibiotics active against Gram-negative bacteria.
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Affiliation(s)
- Kristen A. Muñoz
- Department of Chemistry Institute for Genomic Biology, University of Illinois, Urbana−Champaign, Urbana, Illinois 61801, United States
| | - Paul J. Hergenrother
- Department of Chemistry Institute for Genomic Biology, University of Illinois, Urbana−Champaign, Urbana, Illinois 61801, United States
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Kim SH, Semenya D, Castagnolo D. Antimicrobial drugs bearing guanidine moieties: A review. Eur J Med Chem 2021; 216:113293. [PMID: 33640673 DOI: 10.1016/j.ejmech.2021.113293] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/31/2022]
Abstract
Compounds incorporating guanidine moieties constitute a versatile class of biologically interesting molecules with a wide array of applications. As such, guanidines have been exploited as privileged structural motifs in designing novel drugs for the treatment of various infectious and non-infectious diseases. In designing anti-infective agents, this moiety carries great appeal by virtue of attributes such as hydrogen-bonding capability and protonatability at physiological pH in the context of interaction with biological targets. This review provides an overview of recent advances in hit-to-lead development studies of antimicrobial guanidine-containing compounds with the aim to highlight their structural diversity and the pharmacological relevance of the moiety to drug activity, insofar as possible. In so doing, emphasis is put on chemical and microbiological properties of such compounds in relation to antibacterial, antifungal and antimalarial activities.
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Affiliation(s)
- Seong-Heun Kim
- School of Cancer and Pharmaceutical Sciences, King's College London, 150 Stamford Street, SE1 9NH, London, United Kingdom
| | - Dorothy Semenya
- School of Cancer and Pharmaceutical Sciences, King's College London, 150 Stamford Street, SE1 9NH, London, United Kingdom
| | - Daniele Castagnolo
- School of Cancer and Pharmaceutical Sciences, King's College London, 150 Stamford Street, SE1 9NH, London, United Kingdom.
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Perlmutter SJ, Geddes EJ, Drown BS, Motika SE, Lee MR, Hergenrother PJ. Compound Uptake into E. coli Can Be Facilitated by N-Alkyl Guanidiniums and Pyridiniums. ACS Infect Dis 2021; 7:162-173. [PMID: 33228356 PMCID: PMC7796962 DOI: 10.1021/acsinfecdis.0c00715] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Multidrug-resistant Gram-negative bacterial infections are on the rise, and with no FDA approvals for new classes of broad-spectrum antibiotics in over 50 years, these infections constitute a major threat to human health. A significant challenge is the inability of most compounds to accumulate in Gram-negative bacteria. Recently developed predictive guidelines show that appending a primary amine to an appropriately shaped compound can enhance Gram-negative accumulation. Here, we report that other positively charged nitrogen functional groups, namely, N-alkyl guanidiniums and pyridiniums, can also facilitate compound uptake into Gram-negative bacteria. The accumulation of a set of 60 nonantibiotic compounds, consisting of 20 primary amines and their corresponding guanidiniums and pyridiniums, was assessed in Escherichia coli. We also installed these alternate functional groups onto antibiotic scaffolds and assessed their accumulation and antibacterial activity in Gram-negative bacteria. The results suggest that other positively-charged, nitrogen-containing functional groups should be considered when designing antibiotics with Gram-negative activity.
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Affiliation(s)
- Sarah J Perlmutter
- Roger Adams Laboratory, Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States
- Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana, Illinois 61801, United States
| | - Emily J Geddes
- Roger Adams Laboratory, Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States
- Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana, Illinois 61801, United States
| | - Bryon S Drown
- Roger Adams Laboratory, Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States
- Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana, Illinois 61801, United States
| | - Stephen E Motika
- Roger Adams Laboratory, Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States
- Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana, Illinois 61801, United States
| | - Myung Ryul Lee
- Roger Adams Laboratory, Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States
- Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana, Illinois 61801, United States
| | - Paul J Hergenrother
- Roger Adams Laboratory, Department of Chemistry, University of Illinois, Urbana, Illinois 61801, United States
- Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana, Illinois 61801, United States
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14
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Quiroga D, Becerra LD, Coy-Barrera E. Solvent Free Three-Component Synthesis of 2,4,5-trisubstituted-1 H-pyrrol-3-ol-type Compounds from L-tryptophan: DFT-B3LYP Calculations for the Reaction Mechanism and 3 H-pyrrol-3-one↔1 H-pyrrol-3-ol Tautomeric Equilibrium. Molecules 2020; 25:molecules25194402. [PMID: 32992704 PMCID: PMC7582317 DOI: 10.3390/molecules25194402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/19/2020] [Accepted: 09/24/2020] [Indexed: 11/16/2022] Open
Abstract
In this paper, we describe the solvent-free three-component synthesis of 2,4,5-trisubstituted-1H-pyrrol-3-ol-type compounds from L-tryptophan. The first step of the synthetic methodology involved the esterification of L-tryptophan in excellent yields (93-98%). Equimolar mixtures of alkyl 2-aminoesters, 1,3-dicarbonyl compounds, and potassium hydroxide (0.1 eq.) were heated under solvent-free conditions. The title compounds were obtained in moderate to good yields (45%-81%). Density functional theory using "Becke, 3-parameter, Lee-Yang-Parr" correlational functional (DFT-B3LYP) calculations were performed to understand the molecular stability of the synthesized compounds and the tautomeric equilibrium from 3H-pyrrol-3-one type intermediates to 1H-pyrrol-3-ol type aromatized rings.
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Motika SE, Ulrich RJ, Geddes EJ, Lee HY, Lau GW, Hergenrother PJ. Gram-Negative Antibiotic Active Through Inhibition of an Essential Riboswitch. J Am Chem Soc 2020; 142:10856-10862. [PMID: 32432858 DOI: 10.1021/jacs.0c04427] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Multidrug-resistant Gram-negative (GN) infections for which there are few available treatment options are increasingly common. The development of new antibiotics for these pathogens is challenging because of the inability of most small molecules to accumulate inside GN bacteria. Using recently developed predictive guidelines for compound accumulation in Escherichia coli, we have converted the antibiotic Ribocil C, which targets the flavin mononucleotide (FMN) riboswitch, from a compound lacking whole-cell activity against wild-type GN pathogens into a compound that accumulates to a high level in E. coli, is effective against Gram-negative clinical isolates, and has efficacy in mouse models of GN infections. This compound allows for the first assessment of the translational potential of FMN riboswitch binders against wild-type Gram-negative bacteria.
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Affiliation(s)
| | | | | | | | - Gee W Lau
- Department of Pathobiology, University of Illinois, Urbana, Illinois 61802, United States
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Laws M, Hind C, Favaron A, Jamshidi S, Evans B, Clifford M, Sutton JM, Rahman KM. N1-Benzofused Modification of Fluoroquinolones Reduces Activity Against Gram-Negative Bacteria. ACS OMEGA 2020; 5:11923-11934. [PMID: 32548371 PMCID: PMC7271024 DOI: 10.1021/acsomega.9b03910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/10/2020] [Indexed: 06/11/2023]
Abstract
The fluoroquinolone class of antibiotics has a well-established structure-activity relationship (SAR) and a long history in the clinic, but the effect of electron-rich benzofused substituents at the N1 position remains poorly explored. Because groups at this position are part of the topoisomerase-DNA binding complex and form a hydrophobic interaction with the major groove of DNA, it was hypothesized that an electron-rich benzofused N1 substituent could enhance this interaction. Molecular modeling techniques were employed to evaluate the binding of certain N1-modified fluoroquinolones to DNA gyrase targets from both Staphylococcus aureus and Klebsiella pneumoniae species compared with ciprofloxacin and norfloxacin. Seven N1-modified fluoroquinolones were subsequently synthesized and tested against a panel of Gram-negative pathogens to determine minimum inhibitory concentration (MIC) values. Gram-negative outer membrane penetration was investigated using the membrane permeabilizer polymyxin B nonapeptide and compound efflux via resistance-nodulation-division-family efflux transporters was evaluated using the known efflux pump inhibitor phenylalanine-arginine β-naphthylamide. Additionally, the target inhibitory activity of representative compound 6e was determined in a cell-free environment. A correlation between N1 substituent hydrophobicity and activity was observed across the MIC panel, with compound activity decreasing with increased hydrophobicity. Those compounds with highest hydrophobicity were inactive because of poor solubility profiles whereas compounds with intermediate hydrophobicity were inactive because of impaired outer membrane penetration, and reduced inhibition of topoisomerase targets, the latter in contrast to modeling predictions. This study adds new information to the fluoroquinolone SAR and suggests limited utility of large hydrophobic substituents at the N1 position of fluoroquinolones.
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Affiliation(s)
- Mark Laws
- Institute
of Pharmaceutical Sciences, School of Cancer and Pharmaceutical Sciences, King’s College London, Franklin-Wilkins Building, 150 Stamford
Street, London SE1 9NH, U.K.
| | - Charlotte Hind
- Public
Health England, National Infection Service, Research and Development
Institute, Porton Down, Salisbury, Wiltshire SP4 0JG, U.K.
| | - Andrea Favaron
- Institute
of Pharmaceutical Sciences, School of Cancer and Pharmaceutical Sciences, King’s College London, Franklin-Wilkins Building, 150 Stamford
Street, London SE1 9NH, U.K.
| | - Shirin Jamshidi
- Institute
of Pharmaceutical Sciences, School of Cancer and Pharmaceutical Sciences, King’s College London, Franklin-Wilkins Building, 150 Stamford
Street, London SE1 9NH, U.K.
| | - Bonnie Evans
- Public
Health England, National Infection Service, Research and Development
Institute, Porton Down, Salisbury, Wiltshire SP4 0JG, U.K.
| | - Melanie Clifford
- Public
Health England, National Infection Service, Research and Development
Institute, Porton Down, Salisbury, Wiltshire SP4 0JG, U.K.
| | - J. Mark Sutton
- Public
Health England, National Infection Service, Research and Development
Institute, Porton Down, Salisbury, Wiltshire SP4 0JG, U.K.
| | - Khondaker Miraz Rahman
- Institute
of Pharmaceutical Sciences, School of Cancer and Pharmaceutical Sciences, King’s College London, Franklin-Wilkins Building, 150 Stamford
Street, London SE1 9NH, U.K.
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17
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Touitou M, Manetti F, Ribeiro CM, Pavan FR, Scalacci N, Zrebna K, Begum N, Semenya D, Gupta A, Bhakta S, McHugh TD, Senderowitz H, Kyriazi M, Castagnolo D. Improving the Potency of N-Aryl-2,5-dimethylpyrroles against Multidrug-Resistant and Intracellular Mycobacteria. ACS Med Chem Lett 2020; 11:638-644. [PMID: 32435364 DOI: 10.1021/acsmedchemlett.9b00515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 12/10/2019] [Indexed: 11/28/2022] Open
Abstract
A series of N-phenyl-2,5-dimethylpyrrole derivatives, designed as hybrids of the antitubercular agents BM212 and SQ109, have been synthesized and evaluated against susceptible and drug-resistant mycobacteria strains. Compound 5d, bearing a cyclohexylmethylene side chain, showed high potency against M. tuberculosis including MDR-TB strains at submicromolar concentrations. The new compound shows bacteriostatic activity and low toxicity and proved to be effective against intracellular mycobacteria too, showing an activity profile similar to isoniazid.
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Affiliation(s)
- Meir Touitou
- School of Cancer and Pharmaceutical Sciences, King’s College London, 150 Stamford Street, London SE1 9NH, U.K
- Department of Chemistry, Faculty of Exact Sciences, Bar-Ilan University Ramat-Gan 5290002, Israel
| | - Fabrizio Manetti
- Dipartimento di Biotecnologie, Chimica e Farmacia, via A. Moro 2, I-53100 Siena, Italy
| | - Camila Maringolo Ribeiro
- Tuberculosis Research Laboratory, School of Pharmaceutical Sciences, Sao Paulo State University (UNESP), Rod. Araraquara-Jau, km1, 14800-903 Araraquara, Brazil
| | - Fernando Rogerio Pavan
- Tuberculosis Research Laboratory, School of Pharmaceutical Sciences, Sao Paulo State University (UNESP), Rod. Araraquara-Jau, km1, 14800-903 Araraquara, Brazil
| | - Nicolò Scalacci
- School of Cancer and Pharmaceutical Sciences, King’s College London, 150 Stamford Street, London SE1 9NH, U.K
| | - Katarina Zrebna
- School of Cancer and Pharmaceutical Sciences, King’s College London, 150 Stamford Street, London SE1 9NH, U.K
| | - Neelu Begum
- Centre for Clinical Microbiology, University College London, London NW3 2PF, U.K
| | - Dorothy Semenya
- School of Cancer and Pharmaceutical Sciences, King’s College London, 150 Stamford Street, London SE1 9NH, U.K
| | - Antima Gupta
- Mycobacteria Research Laboratory, Department of Biological Sciences, Institute of Structural and Molecular Biology, Birkbeck, University of London, Malet Street, London WC1E 7HX, U.K
| | - Sanjib Bhakta
- Mycobacteria Research Laboratory, Department of Biological Sciences, Institute of Structural and Molecular Biology, Birkbeck, University of London, Malet Street, London WC1E 7HX, U.K
| | - Timothy D. McHugh
- Centre for Clinical Microbiology, University College London, London NW3 2PF, U.K
| | - Hanoch Senderowitz
- Department of Chemistry, Faculty of Exact Sciences, Bar-Ilan University Ramat-Gan 5290002, Israel
| | - Melina Kyriazi
- School of Cancer and Pharmaceutical Sciences, King’s College London, 150 Stamford Street, London SE1 9NH, U.K
| | - Daniele Castagnolo
- School of Cancer and Pharmaceutical Sciences, King’s College London, 150 Stamford Street, London SE1 9NH, U.K
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