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Ayasse N, Berg P, Svendsen SL, Rousing AQ, Sørensen MV, Fedosova NU, Leipziger J. Trimethoprim inhibits renal H +-K +-ATPase in states of K + depletion. Am J Physiol Renal Physiol 2024; 326:F143-F151. [PMID: 37942538 DOI: 10.1152/ajprenal.00273.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/23/2023] [Accepted: 11/06/2023] [Indexed: 11/10/2023] Open
Abstract
There is growing consensus that under physiological conditions, collecting duct H+ secretion is independent of epithelial Na+ channel (ENaC) activity. We have recently shown that the direct ENaC inhibitor benzamil acutely impairs H+ excretion by blocking renal H+-K+-ATPase. However, the question remains whether inhibition of ENaC per se causes alterations in renal H+ excretion. To revisit this question, we studied the effect of the antibiotic trimethoprim (TMP), which is well known to cause K+ retention by direct ENaC inhibition. The acute effect of TMP (5 µg/g body wt) was assessed in bladder-catheterized mice, allowing real-time measurement of urinary pH, electrolyte, and acid excretion. Dietary K+ depletion was used to increase renal H+-K+-ATPase activity. In addition, the effect of TMP was investigated in vitro using pig gastric H+-K+-ATPase-enriched membrane vesicles. TMP acutely increased natriuresis and decreased kaliuresis, confirming its ENaC-inhibiting property. Under control diet conditions, TMP had no effect on urinary pH or acid excretion. Interestingly, K+ depletion unmasked an acute urine alkalizing effect of TMP. This finding was corroborated by in vitro experiments showing that TMP inhibits H+-K+-ATPase activity, albeit at much higher concentrations than benzamil. In conclusion, under control diet conditions, TMP inhibited ENaC function without changing urinary H+ excretion. This finding further supports the hypothesis that the inhibition of ENaC per se does not impair H+ excretion in the collecting duct. Moreover, TMP-induced urinary alkalization in animals fed a low-K+ diet highlights the importance of renal H+-K+-ATPase-mediated H+ secretion in states of K+ depletion.NEW & NOTEWORTHY The antibiotic trimethoprim (TMP) often mediates K+ retention and metabolic acidosis. We suggest a revision of the underlying mechanism that causes metabolic acidosis. Our results indicate that TMP-induced metabolic acidosis is secondary to epithelial Na+ channel-dependent K+ retention. Under control dietary conditions, TMP does not per se inhibit collecting duct H+ secretion. These findings add further argument against a physiologically relevant voltage-dependent mechanism of collecting duct H+ excretion.
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Affiliation(s)
- Niklas Ayasse
- Department of Biomedicine, Physiology, Aarhus University, Aarhus, Denmark
- Vth Department of Medicine, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Peder Berg
- Department of Biomedicine, Physiology, Aarhus University, Aarhus, Denmark
| | - Samuel L Svendsen
- Department of Biomedicine, Physiology, Aarhus University, Aarhus, Denmark
| | | | | | - Natalya U Fedosova
- Department of Biomedicine, Physiology, Aarhus University, Aarhus, Denmark
| | - Jens Leipziger
- Department of Biomedicine, Physiology, Aarhus University, Aarhus, Denmark
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Manna MS, Tamer YT, Gaszek I, Poulides N, Ahmed A, Wang X, Toprak FCR, Woodard DR, Koh AY, Williams NS, Borek D, Atilgan AR, Hulleman JD, Atilgan C, Tambar U, Toprak E. A trimethoprim derivative impedes antibiotic resistance evolution. Nat Commun 2021; 12:2949. [PMID: 34011959 PMCID: PMC8134463 DOI: 10.1038/s41467-021-23191-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 04/06/2021] [Indexed: 01/07/2023] Open
Abstract
The antibiotic trimethoprim (TMP) is used to treat a variety of Escherichia coli infections, but its efficacy is limited by the rapid emergence of TMP-resistant bacteria. Previous laboratory evolution experiments have identified resistance-conferring mutations in the gene encoding the TMP target, bacterial dihydrofolate reductase (DHFR), in particular mutation L28R. Here, we show that 4'-desmethyltrimethoprim (4'-DTMP) inhibits both DHFR and its L28R variant, and selects against the emergence of TMP-resistant bacteria that carry the L28R mutation in laboratory experiments. Furthermore, antibiotic-sensitive E. coli populations acquire antibiotic resistance at a substantially slower rate when grown in the presence of 4'-DTMP than in the presence of TMP. We find that 4'-DTMP impedes evolution of resistance by selecting against resistant genotypes with the L28R mutation and diverting genetic trajectories to other resistance-conferring DHFR mutations with catalytic deficiencies. Our results demonstrate how a detailed characterization of resistance-conferring mutations in a target enzyme can help identify potential drugs against antibiotic-resistant bacteria, which may ultimately increase long-term efficacy of antimicrobial therapies by modulating evolutionary trajectories that lead to resistance.
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Affiliation(s)
- Madhu Sudan Manna
- grid.267313.20000 0000 9482 7121Green Center for Systems Biology, University of Texas Southwestern Medical Center, Dallas, TX USA ,grid.267313.20000 0000 9482 7121Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Yusuf Talha Tamer
- grid.267313.20000 0000 9482 7121Green Center for Systems Biology, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Ilona Gaszek
- grid.267313.20000 0000 9482 7121Green Center for Systems Biology, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Nicole Poulides
- grid.267313.20000 0000 9482 7121Green Center for Systems Biology, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Ayesha Ahmed
- grid.267313.20000 0000 9482 7121Green Center for Systems Biology, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Xiaoyu Wang
- grid.267313.20000 0000 9482 7121Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Furkan C. R. Toprak
- grid.264756.40000 0004 4687 2082Texas A&M University, College Station, TX USA
| | - DaNae R. Woodard
- grid.267313.20000 0000 9482 7121Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Andrew Y. Koh
- grid.267313.20000 0000 9482 7121Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX USA ,grid.267313.20000 0000 9482 7121Department of Microbiology, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Noelle S. Williams
- grid.267313.20000 0000 9482 7121Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Dominika Borek
- grid.267313.20000 0000 9482 7121Department of Molecular Biophysics, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Ali Rana Atilgan
- grid.5334.10000 0004 0637 1566Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - John D. Hulleman
- grid.267313.20000 0000 9482 7121Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX USA ,grid.267313.20000 0000 9482 7121Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Canan Atilgan
- grid.5334.10000 0004 0637 1566Faculty of Engineering and Natural Sciences, Sabanci University, Istanbul, Turkey
| | - Uttam Tambar
- grid.267313.20000 0000 9482 7121Department of Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX USA
| | - Erdal Toprak
- grid.267313.20000 0000 9482 7121Green Center for Systems Biology, University of Texas Southwestern Medical Center, Dallas, TX USA ,grid.267313.20000 0000 9482 7121Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, TX USA
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Yiee JH, Baskin LS, Patel N, Yang J, Disandro M. Prospective Blinded Laboratory Assessment of Prophylactic Antibiotic Compliance in a Pediatric Outpatient Setting. J Urol 2012; 187:2176-81. [DOI: 10.1016/j.juro.2012.01.130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Indexed: 01/16/2023]
Affiliation(s)
- Jenny H. Yiee
- Department of Urology, University of California, Los Angeles, California
- Department of Urology, University of California, San Francisco, California
| | - Laurence S. Baskin
- Department of Urology, University of California, San Francisco, California
| | - Neal Patel
- Department of Urology, University of California, San Francisco, California
| | - Jennifer Yang
- Department of Urology, University of California, San Francisco, California
- Department of Urology, University of California, Davis, California
| | - Michael Disandro
- Department of Urology, University of California, San Francisco, California
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Abstract
Aerococcus urinae has been described as resistant to trimethoprim-sulfamethoxazole (SXT), but the test medium may affect this observation. Twenty-seven clinical isolates of A. urinae tested susceptible to SXT in cation-adjusted Mueller-Hinton broth (CAMHB) plus lysed horse blood and resistant in CAMHB plus lysed sheep blood.
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Kamel AH, Almeida SAA, Sales MGF, Moreira FTC. Sulfadiazine-potentiometric sensors for flow and batch determinations of sulfadiazine in drugs and biological fluids. ANAL SCI 2009; 25:365-71. [PMID: 19276592 DOI: 10.2116/analsci.25.365] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
New PVC membrane electrodes for the determination of sulfadiazine (SDZ) are presented. The electrodes are fabricated with conventional and tubular configurations with a graphite-based electrical contact, and no internal reference solution. The selective membranes consist of bis(triphenylphosphoranilidene)ammonium.SDZ (electrode A), tetraoctylammonium bromide (electrode B), or iron(II)-phthalocyanine (FePC) (electrode C) electroactive materials dispersed in a PVC matrix of o-nitrophenyl octyl ether (o-NPOE) plasticizer. The sensors A, B, and C displayed linear responses over the concentration ranges 1.0 x 10(-2) - 1.0 x 10(-5), 1.0 x 10(-2) - 7.5 x 10(-6), and 3.2 x 10(-2) - 7.0 x 10(-6) mol l(-1) (detection limits of 1.09, 2.04 and 0.87 microg ml(-1)) with anionic slopes of -57.3 +/- 0.1, -46.7 +/- 0.5, and -65.1 +/- 0.2 mV decade(-1), respectively. No effect from pH was observed within 4.0 - 5.5, 4.8 - 10, and 4.5 - 8, respectively, and good selectivity was found. The sensors were applied to the analysis of pharmaceuticals and biological fluids in steady state and in flow conditions.
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Affiliation(s)
- Ayman H Kamel
- REQUIMTE, Instituto Superior de Engenharia do Porto, R. Dr. António Bernardino de Almeida 431,4200-072 Porto, Portugal
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Hanson E, Hansson S, Jodal U. Trimethoprim-sulphadiazine prophylaxis in children with vesico-ureteric reflux. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1989; 21:201-4. [PMID: 2727636 DOI: 10.3109/00365548909039969] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The efficacy of long-term low-dose prophylaxis with co-trimazine (1-2 mg trimethoprim and 4.5-9 mg sulphadiazine per kg body weight) was studied in 55 children with dilated vesico-ureteric reflux. Of 44 girls, there were 13 with break-through urinary tract infection, all caused by resistant bacteria and in all but one case of pyelonephritic type. The recurrence rate was 1.5/100 treatment months. In 11 boys, there were no break-through infections in 311 treatment months. Co-trimazine was thus an effective drug for prevention of urinary tract infection in this high-risk population.
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Affiliation(s)
- E Hanson
- Department of Paediatric Surgery, University of Göteborg, Sweden
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