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Chee Wezen X, Chandran A, Eapen RS, Waters E, Bricio-Moreno L, Tosi T, Dolan S, Millership C, Kadioglu A, Gründling A, Itzhaki LS, Welch M, Rahman T. Structure-Based Discovery of Lipoteichoic Acid Synthase Inhibitors. J Chem Inf Model 2022; 62:2586-2599. [PMID: 35533315 PMCID: PMC9131456 DOI: 10.1021/acs.jcim.2c00300] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Indexed: 01/20/2023]
Abstract
Lipoteichoic acid synthase (LtaS) is a key enzyme for the cell wall biosynthesis of Gram-positive bacteria. Gram-positive bacteria that lack lipoteichoic acid (LTA) exhibit impaired cell division and growth defects. Thus, LtaS appears to be an attractive antimicrobial target. The pharmacology around LtaS remains largely unexplored with only two small-molecule LtaS inhibitors reported, namely "compound 1771" and the Congo red dye. Structure-based drug discovery efforts against LtaS remain unattempted due to the lack of an inhibitor-bound structure of LtaS. To address this, we combined the use of a molecular docking technique with molecular dynamics (MD) simulations to model a plausible binding mode of compound 1771 to the extracellular catalytic domain of LtaS (eLtaS). The model was validated using alanine mutagenesis studies combined with isothermal titration calorimetry. Additionally, lead optimization driven by our computational model resulted in an improved version of compound 1771, namely, compound 4 which showed greater affinity for binding to eLtaS than compound 1771 in biophysical assays. Compound 4 reduced LTA production in S. aureus dose-dependently, induced aberrant morphology as seen for LTA-deficient bacteria, and significantly reduced bacteria titers in the lung of mice infected with S. aureus. Analysis of our MD simulation trajectories revealed the possible formation of a transient cryptic pocket in eLtaS. Virtual screening (VS) against the cryptic pocket led to the identification of a new class of inhibitors that could potentiate β-lactams against methicillin-resistant S. aureus. Our overall workflow and data should encourage further drug design campaign against LtaS. Finally, our work reinforces the importance of considering protein conformational flexibility to a successful VS endeavor.
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Affiliation(s)
- Xavier Chee Wezen
- Science
Program, School of Chemical Engineering and Science, Faculty of Engineering,
Computing and Science, Swinburne University
of Technology Sarawak, Kuching 93350, Malaysia
| | - Aneesh Chandran
- Department
of Biotechnology & Microbiology, Kannur
University, Kannur 670 661, Kerala, India
| | | | - Elaine Waters
- Department
of Clinical Infection Microbiology and Immunology, Institute of Infection
and Global Health, University of Liverpool, Liverpool L69 7BE, U.K.
| | - Laura Bricio-Moreno
- Department
of Clinical Infection Microbiology and Immunology, Institute of Infection
and Global Health, University of Liverpool, Liverpool L69 7BE, U.K.
| | - Tommaso Tosi
- Section
of Molecular Microbiology and MRC Centre for Molecular Bacteriology
and Infection, Imperial College London, London SW7 2AZ, U.K.
| | - Stephen Dolan
- Department
of Biochemistry, University of Cambridge, Cambridge CB2 1QW, U.K.
| | - Charlotte Millership
- Section
of Molecular Microbiology and MRC Centre for Molecular Bacteriology
and Infection, Imperial College London, London SW7 2AZ, U.K.
| | - Aras Kadioglu
- Department
of Clinical Infection Microbiology and Immunology, Institute of Infection
and Global Health, University of Liverpool, Liverpool L69 7BE, U.K.
| | - Angelika Gründling
- Section
of Molecular Microbiology and MRC Centre for Molecular Bacteriology
and Infection, Imperial College London, London SW7 2AZ, U.K.
| | - Laura S. Itzhaki
- Department
of PharmacologyUniversity of CambridgeCambridgeCB2 1PDU.K.
| | - Martin Welch
- Department
of Biochemistry, University of Cambridge, Cambridge CB2 1QW, U.K.
| | - Taufiq Rahman
- Department
of PharmacologyUniversity of CambridgeCambridgeCB2 1PDU.K.
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Holmes A, Kelly BD, Perera M, Eapen RS, Bolton DM, Lawrentschuk N. A systematic scoping review of multidisciplinary cancer team and decision-making in the management of men with advanced prostate cancer. World J Urol 2020; 39:297-306. [PMID: 32500304 DOI: 10.1007/s00345-020-03265-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/16/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The early diagnosis of prostate cancer and subsequent access to the treatment options helps to achieve optimal cancer outcomes. As the treatment options for patients with advanced prostate cancer continues to evolve, patients need to access a multidisciplinary team (MDT) meeting to receive best-practice care. METHODS In this paper a MEDLINE review was performed to assess clinical decision making in the context of MDT discussions for patients with advanced prostate cancer. RESULTS From 441 returned articles and abstracts, 50 articles were assessed for eligibility and 16 articles included for analysis. Sixteen articles were identified, 9 of the 16 articles used quantitative methodology including three retrospective analysis of clinical registry data, patient medical records and/or MDT meeting notes and three cross-sectional surveys. Other study designs included one observation study and one study using a combination of qualitative and quantitative methodologies and one mini-review. There were also four editorials included in the review and two consensus statements. CONCLUSION This paper highlights the important role the inter-disciplinary MDT has on shared decision making for men with advanced prostate cancer. The application of MDT care is a rapidly growing trend in uro-oncology and an efficient MDT service requires further research to assess its efficiency so that it may expand through all aspect of uro-oncology.
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Affiliation(s)
- A Holmes
- Department of Surgery, Austin Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - B D Kelly
- Department of Surgery, Austin Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - M Perera
- Department of Surgery, Austin Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - R S Eapen
- Department of Surgery, Austin Hospital, University of Melbourne, Melbourne, VIC, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - D M Bolton
- Department of Surgery, Austin Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - N Lawrentschuk
- Department of Surgery, Austin Hospital, University of Melbourne, Melbourne, VIC, Australia. .,Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia. .,EJ Whitten Prostate Cancer Research Centre at Epworth Healthcare, Melbourne, Australia. .,Department of Urology, Royal Melbourne Hospital, Melbourne, Australia.
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Eapen RS, Nzenza TC, Murphy DG, Hofman MS, Cooperberg M, Lawrentschuk N. PSMA PET applications in the prostate cancer journey: from diagnosis to theranostics. World J Urol 2018; 37:1255-1261. [PMID: 30374609 DOI: 10.1007/s00345-018-2524-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 10/08/2018] [Indexed: 12/18/2022] Open
Abstract
The heterogeneity of prostate cancer has made imaging modalities of crucial importance in this disease. Accurate diagnosis and staging of the volume and extent of disease, especially in advanced and metastatic prostate cancer, can help to tailor the timing and modalities of treatment. While MRI has been effective in the detection of significant prostate cancer, its use in the identification and quantification of extraprostatic disease is limited. This gap is now being filled by PSMA PET. PSMA PET scans have now been shown to have a role in all stages in the prostate cancer journey. Emerging evidence has shown its promise in primary staging, restaging and theranostics. In this paper, we review the evidence for the use of PSMA PET in the various stages of prostate cancer, from initial diagnosis to advanced metastatic disease where other systemic treatments have failed.
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Affiliation(s)
- R S Eapen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia. .,Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia. .,Olivia Newton-John Cancer Research Institute, Austin Hospital, Melbourne, Australia. .,Department of Urology, Austin Hospital, Melbourne, Australia.
| | - T C Nzenza
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.,Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, Austin Hospital, Melbourne, Australia.,Young Urology Researchers Organisation (YURO), Melbourne, Australia
| | - D G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - M S Hofman
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.,Department of Molecular Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - M Cooperberg
- Department of Urology, Helen Diller Comprehensive Cancer Centre, University of California, San Francisco, USA
| | - N Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia.,Department of Surgery, University of Melbourne, Austin Hospital, Melbourne, Australia.,Olivia Newton-John Cancer Research Institute, Austin Hospital, Melbourne, Australia
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McMahon CJ, Nagueh SF, Eapen RS, Dreyer WJ, Finkelshtyn I, Cao X, Eidem BW, Bezold LI, Denfield SW, Towbin JA, Pignatelli RH. Echocardiographic predictors of adverse clinical events in children with dilated cardiomyopathy: a prospective clinical study. Heart 2004; 90:908-15. [PMID: 15253966 PMCID: PMC1768368 DOI: 10.1136/hrt.2003.020966] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To compare tissue Doppler (TD) velocities between patients with dilated cardiomyopathy (DCM) and normal controls and to determine whether TD velocities, Tei index, right ventricular fractional area change, and left ventricular ejection fraction (LVEF) predict adverse clinical outcomes in children with DCM. METHODS Prospective evaluation of children with DCM. RESULTS 54 children with DCM and 54 age and sex matched control group participants were studied. Mitral inflow velocities were similar for both groups except for decreased mitral deceleration time in patients with DCM. Systolic and diastolic TD velocities at the mitral annulus (septal and lateral sides) and tricuspid annulus were significantly reduced in children with DCM compared with controls (p < 0.001 for each). By multivariate analysis, after adjustment for Tei index and right ventricular fractional area change, decreased LVEF and tricuspid velocity during early diastole (Ea) were predictors of the primary end point (PEP), a composite end point consisting of need for hospitalisation or the outcome transplantation or death. Tricuspid Ea velocity < 8.5 cm/s had 87% specificity and 60% sensitivity for reaching the PEP. LVEF < 30% had 68% specificity and 74% sensitivity for the PEP. Combined LVEF < 30% and tricuspid Ea < 11.5 cm/s had 100% specificity and 44% sensitivity for the PEP. CONCLUSIONS Children with DCM have significantly lower TD velocities than normal controls. In such cases, lower LVEF (< 30%) is more sensitive but less specific than lower tricuspid Ea velocities (< 8.5 cm/s) in predicting which patients are at risk of hospitalisation, transplantation, or death.
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Affiliation(s)
- C J McMahon
- Lillie Frank Abercrombie Division of Pediatric Cardiology, Texas Children's Hospital, 6621 Fannin, Houston, Texas 77030, USA.
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Affiliation(s)
- R S Eapen
- University of Texas, Southwestern Medical, Dallas, TX 75235, USA
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Abstract
We sought to determine the effect of prenatal diagnosis of congenital heart disease, specifically critical left heart obstructive (LHO) lesions, on postnatal morbidity and mortality. Several studies have found no significant improvement in mortality in infants with prenatally detected heart disease compared to infants diagnosed postnatally. Few reports have focused on the specific effects of prenatal diagnosis on the perinatal course. All newborns with LHO seen between July 1993 and July 1996 were identified and divided into two groups based on prenatal vs. postnatal diagnosis. Hospital records were reviewed for demographic and outcome variables. The outcome variables included degree of metabolic acidosis, hemodynamic instability, noncardiac organ dysfunction, delayed surgical intervention, and surgical mortality. Twenty-three fetuses were diagnosed with LHO lesions. Postnatally, 45 newborns presented with LHO anomalies. Prenatal diagnosis resulted in avoidance of hemodynamic compromise, reduced organ dysfunction, and reduced surgical delays. There was no significant difference in surgical mortality. Prenatal diagnosis significantly decreases postnatal morbidity in infants with LHO lesions. Although surgical results are similar, the reduced morbidity decreases surgical delays and potentially may impact on neurodevelopmental outcomes.
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Affiliation(s)
- R S Eapen
- Department of Pediatrics, The Ohio State University, Children's Hospital, Columbus 43205, USA
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