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Fraile García L, Aramburu Arnuelos J, López González E, Bellés-Bellés A, Muñoz Santa A, Sánchez Báscones E, Mormeneo Bayo S, Bernet Sánchez A, Prats Sánchez I, Cumplido Portillo A, García González M. Azithromycin and moxifloxacin resistance determinants in Mycoplasma genitalium in Lleida, Spain. Rev Esp Quimioter 2024; 37:270-273. [PMID: 38591493 PMCID: PMC11094637 DOI: 10.37201/req/015.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/12/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVE Mycoplasma genitalium (MG) is a microorganism related to sexually transmitted infections. Antibiotic resistance of MG leads to an increase in treatment failure rates and the persistence of the infection. The aim of this study was to describe the most frequent mutations associated with azithromycin and moxifloxacin resistance in our geographical area. METHODS A prospective study from May 2019 to May 2023 was performed. MG-positive samples were collected. Real-time PCRs (AllplexTM MG-AziR Assay and AllplexTM MG-MoxiR Assay, Seegene) were performed in MG positive samples to detect mutations in 23S rRNA V domain and parC gene. RESULTS A 37.1% of samples presented resistance determinants to azithromycin and the most common mutation detected was A2059G (57.9%). Resistance to moxifloxacin was studied in 72 azithromycin-resistant samples and 36.1% showed mutations, being G248T the most prevalent (73.1%). CONCLUSIONS The resistance to different lines of treat ment suggests the need for a targeted therapy and the performing of a test of cure afterwards.
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Affiliation(s)
| | | | | | - A Bellés-Bellés
- Alba Bellés Bellés. Sección de Microbiología y Parasitología, Hospital Universitari Arnau de Vilanova. Avenida Rovira Roure 80, 25198. Lleida, Spain.
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Wang M, Wu H, Jiang W, Ren Y, Yuan X, Wang Y, Zhou J, Feng W, Wang Y, Xu T, Zhang D, Fang Y, He C, Li W. Differences in nature killer cell response and interference with mitochondrial DNA induced apoptosis in moxifloxacin environment. Int Immunopharmacol 2024; 132:111970. [PMID: 38608472 DOI: 10.1016/j.intimp.2024.111970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVES As antibiotics become more prevalent, accuracy and safety are critical. Moxifloxacin (MXF) have been reported to have immunomodulatory effects on a variety of immune cells and even anti-proliferative and pro-apoptotic effects, but the mechanism of action is not fully clear. METHODS Peripheral blood mononuclear cells (PBMC) from experimental groups of healthy adults (n = 3) were treated with MXF (10ug/ml) in vitro for 24 h. Single-cell sequencing was performed to investigate differences in the response of each immune cell to MXF. Flow cytometry determined differential gene expression in subsets of most damaged NK cells. Pseudo-time analysis identified drivers that influence MXF-stimulated cell differentiation. Detection of mitochondrial DNA and its involvement in the mitochondrial respiratory chain pathway clarifies the origin of MXF-induced stress injury. RESULTS Moxifloxacin-environmental NK cells are markedly reduced: a new subset of NK cells emerges, and immediate-early-response genes in this subset indicate the presence of an early activation response. The inhibitory receptor-dominant subset shows enhanced activation, leading to increased expression of cytokines and chemokines. The near-mature subset showed greater cytotoxicity and the most pronounced cellular damage. CD56bright cells responded by antagonizing the regulation of activation and inhibitory signals, demonstrating a strong cleavage capacity. The severe depletion of mitochondrial genes was focused on apoptosis induced by the mitochondrial respiratory chain complex. CONCLUSION NK cells exhibit heightened sensitivity to the MXF environment. Different NK subsets upregulate the expression of cytokines and chemokines through different activation pathways. Concurrently, MXF induces impairment of the mitochondrial oxidative phosphorylation system, culminating in apoptosis.
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Affiliation(s)
- Mengqing Wang
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Hao Wu
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Weiwei Jiang
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Yunfei Ren
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Xiaowei Yuan
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Yanan Wang
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Jian Zhou
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Wei Feng
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Yusen Wang
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Tianpeng Xu
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Danying Zhang
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Yunhao Fang
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Chao He
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China
| | - Wenfang Li
- Department of Emergency and Critical Care, Second Affiliated Hospital of Naval Medical University, Shanghai 200003, China.
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Tessier E, Ruffier d'Epenoux L, Lartigue MF, Chaufour L, Plouzeau-Jayle C, Chenouard R, Guérin F, Tandé D, Lamoureux C, Bémer P, Corvec S. Comparison of the in vitro activities of delafloxacin and comparators against Staphylococcus epidermidis clinical strains involved in osteoarticular infections: a CRIOGO multicentre retrospective study. J Antimicrob Chemother 2024; 79:1045-1050. [PMID: 38507272 DOI: 10.1093/jac/dkae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/29/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVES Staphylococcus epidermidis bone and joint infections (BJIs) on material are often difficult to treat. The activity of delafloxacin has not yet been studied on S. epidermidis in this context. The aim of this study was to assess its in vitro activity compared with other fluoroquinolones, against a large collection of S. epidermidis clinical strains. METHODS We selected 538 S. epidermidis strains isolated between January 2015 and February 2023 from six French teaching hospitals. One hundred and fifty-two strains were ofloxacin susceptible and 386 were ofloxacin resistant. Identifications were performed by MS and MICs were determined using gradient concentration strips for ofloxacin, levofloxacin, moxifloxacin and delafloxacin. RESULTS Ofloxacin-susceptible strains were susceptible to all fluoroquinolones. Resistant strains had higher MICs of all fluoroquinolones. Strains resistant to ofloxacin (89.1%) still showed susceptibility to delafloxacin when using the Staphylococcus aureus 2021 CA-SFM/EUCAST threshold of 0.25 mg/L. In contrast, only 3.9% of the ofloxacin-resistant strains remained susceptible to delafloxacin with the 0.016 mg/L S. aureus breakpoint according to CA-SFM/EUCAST guidelines in 2022. The MIC50 was 0.094 mg/L and the MIC90 was 0.38 mg/L. CONCLUSIONS We showed low delafloxacin MICs for ofloxacin-susceptible S. epidermidis strains and a double population for ofloxacin-resistant strains. Despite the absence of breakpoints for S. epidermidis, delafloxacin may be an option for the treatment of complex BJI, including strains with MICs of ≤0.094 mg/L, leading to 64% susceptibility. This study underlines the importance for determining specific S. epidermidis delafloxacin breakpoints for the management of BJI on material.
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Affiliation(s)
- E Tessier
- Service de Bactériologie et des Contrôles Microbiologiques, CHU Nantes, Nantes, France
| | - L Ruffier d'Epenoux
- Service de Bactériologie et des Contrôles Microbiologiques, CHU Nantes, Nantes, France
- INSERM, INCIT U1302, CHU Nantes, Université de Nantes, Nantes F-44000, France
| | - M F Lartigue
- Service de Bactériologie-Virologie-Hygiène, CHU Tours, Tours, France
- ISP, UMR1282, Université de Tours, INRAe, Tours, France
| | - L Chaufour
- Service de Bactériologie-Virologie-Hygiène, CHU Tours, Tours, France
| | - C Plouzeau-Jayle
- Service de Bactériologie et d'Hygiène hospitalière, CHU Poitiers, Poitiers, France
| | - R Chenouard
- Service de Bactériologie, CHU Angers, Angers, France
| | - F Guérin
- Service de Bactériologie-Hygiène hospitalière & CNR de la résistance aux Antibiotiques (laboratoire associé 'Entérocoques'), CHU Rennes, Rennes, France
| | - D Tandé
- Unité de Bactériologie, Pôle de Biologie-Pathologie CHU Brest, Brest, France
| | - C Lamoureux
- Unité de Bactériologie, Pôle de Biologie-Pathologie CHU Brest, Brest, France
| | - P Bémer
- Service de Bactériologie et des Contrôles Microbiologiques, CHU Nantes, Nantes, France
| | - S Corvec
- Service de Bactériologie et des Contrôles Microbiologiques, CHU Nantes, Nantes, France
- INSERM, INCIT U1302, CHU Nantes, Université de Nantes, Nantes F-44000, France
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Imperiale BR, Mancino MB, Moyano RD, de la Barrera S, Morcillo NS. In vitro and ex vivo activity of the fluoroquinolone DC-159a against mycobacteria. J Antibiot (Tokyo) 2024; 77:306-314. [PMID: 38438500 DOI: 10.1038/s41429-024-00709-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 03/06/2024]
Abstract
Antimicrobial resistance is a global health problem. In 2021, it was estimated almost half a million of multidrug-resistant tuberculosis (MDR-TB) cases. Besides, non-tuberculous mycobacteria (NTM) are highly resistant to several drugs and the emergence of fluoroquinolone (FQ) resistant M. tuberculosis (Mtb) is also a global concern making treatments difficult and with variable outcome. The aim of this study was to evaluate the activity of the FQ, DC-159a, against Mtb and NTM and to explore the cross-resistance with the currently used FQs.A total of 12 pre-extensively drug-resistant (XDR) Mtb, 2 XDR, 36 fully drug susceptible strains and 41 NTM isolates were included to estimate the in vitro activity of DC-159a, moxifloxacin (MOX) and levofloxacin (LX), using minimal inhibitory and bactericidal concentration (MIC and MBC). The activity inside the human macrophages and pulmonary epithelial cells were also determined.DC-159a was active in vitro and ex vivo against mycobacteria. Besides, it was more active than MOX/LX. Moreover, no cross-resistance was evidenced between DC-159a and LX/MOX as DC-159a could inhibit Mtb and MAC strains that were already resistant to LX/MOX.DC-159a could be a possible candidate in new therapeutic regimens for MDR/ XDR-TB and mycobacterioses cases.
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Affiliation(s)
- Belén R Imperiale
- Institute of Experimental Medicine (IMEX)-CONICET, National Academy of Medicine, Buenos Aires City, Argentina.
| | - María B Mancino
- Dr. Cetrángolo Hospital, Florida, Buenos Aires Province, Argentina
| | - Roberto D Moyano
- IABIMO-CONICET, INTA CiCVyA, Hurlingham, Buenos Aires Province, Argentina
| | - Silvia de la Barrera
- Institute of Experimental Medicine (IMEX)-CONICET, National Academy of Medicine, Buenos Aires City, Argentina
| | - Nora S Morcillo
- Dr. Cetrángolo Hospital, Florida, Buenos Aires Province, Argentina
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Fan C, Eedara BB, Sinha S, Uddin MKM, Doyle C, Banu S, Das SC. Triple combination dry powder formulation of pretomanid, moxifloxacin, and pyrazinamide for treatment of multidrug-resistant tuberculosis. Int J Pharm 2024; 654:123984. [PMID: 38461874 DOI: 10.1016/j.ijpharm.2024.123984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/12/2024]
Abstract
Both latent and multidrug-resistant tuberculosis (TB) have been causing significant concern worldwide. A novel drug, pretomanid (PA-824), has shown a potent bactericidal effect against both active and latent forms of Mycobacterium tuberculosis (MTb) and a synergistic effect when combined with pyrazinamide and moxifloxacin. This study aimed to develop triple combination spray dried inhalable formulations composed of antitubercular drugs, pretomanid, moxifloxacin, and pyrazinamide (1:2:8 w/w/w), alone (PaMP) and in combination with an aerosolization enhancer, L-leucine (20 % w/w, PaMPL). The formulation PaMPL consisted of hollow, spherical, dimpled particles (<5 μm) and showed good aerosolization behaviour with a fine particle fraction of 70 %. Solid-state characterization of formulations with and without L-leucine confirmed the amorphous nature of moxifloxacin and pretomanid and the crystalline nature of pyrazinamide with polymorphic transformation after the spray drying process. Further, the X-ray photoelectron spectroscopic analysis revealed the predominant surface composition of L-leucine on PaMPL dry powder particles. The dose-response cytotoxicity results showed pyrazinamide and moxifloxacin were non-toxic in both A549 and Calu-3 cell lines up to 150 µg/mL. However, the cell viability gradually decreased to 50 % when the pretomanid concentration increased to 150 µg/mL. The in vitro efficacy studies demonstrated that the triple combination formulation had more prominent antibacterial activity with a minimum inhibitory concentration (MIC) of 1 µg/mL against the MTb H37Rv strain as compared to individual drugs. In conclusion, the triple combination of pretomanid, moxifloxacin, and pyrazinamide as an inhalable dry powder formulation will potentially improve treatment efficacy with fewer systemic side effects in patients suffering from latent and multidrug-resistant TB.
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Affiliation(s)
- Claire Fan
- School of Pharmacy, University of Otago, 18 Frederick St, Dunedin 9054, New Zealand
| | - Basanth Babu Eedara
- School of Pharmacy, University of Otago, 18 Frederick St, Dunedin 9054, New Zealand; Transpire Bio Inc., 2945 W Corporate Lakes Blvd Suite A, Weston, FL 33331, USA
| | - Shubhra Sinha
- School of Pharmacy, University of Otago, 18 Frederick St, Dunedin 9054, New Zealand
| | - Mohammad Khaja Mafij Uddin
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Colin Doyle
- The University of Auckland, 20 Symonds Street, Auckland, New Zealand
| | - Sayera Banu
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Shyamal C Das
- School of Pharmacy, University of Otago, 18 Frederick St, Dunedin 9054, New Zealand.
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Ch S, Paul M, Padaga SG, Ghosh B, Biswas S. Cationized gelatin-sodium alginate polyelectrolyte nanoparticles encapsulating moxifloxacin as an eye drop to treat bacterial keratitis. Int J Biol Macromol 2024; 264:130457. [PMID: 38432265 DOI: 10.1016/j.ijbiomac.2024.130457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 02/16/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
A mucoadhesive polyelectrolyte complex (PEC) nanoparticles were developed for ocular moxifloxacin (Mox) delivery in Bacterial Keratitis (BK). Moxifloxacin-loaded G/CG-Alg NPs were prepared by an amalgamation of cationic polymers (gelatin (G)/cationized gelatin (CG)), and anionic polymer (sodium alginate (Alg)) along with Mox respectively. Mox@CG-Alg NPs were characterized for physicochemical parameters such as particle size (DLS technique), morphology (SEM analysis), DSC, XRD, encapsulation efficiency, drug loading, mucoadhesive study (by texture analyzer), mucin turbidity, and viscosity assessment. The NPs uptake and toxicity of the formulation were analyzed in the Human Corneal Epithelial (HCE) cell line and an ocular irritation study was performed on the HET-CAM. The results indicated that the CG-Alg NPs, with optimal size (217.2 ± 4 nm) and polydispersity (0.22 ± 0.05), have shown high cellular uptake in monolayer and spheroids of HCE. The drug-loaded formulation displayed mucoadhesiveness, trans-corneal permeation, and sustained the release of the Mox. The anti-bacterial efficacy studied on planktonic bacteria/biofilms of P. aeruginosa and S. aureus (in vitro) indicated that the Mox@CG-Alg NPs displayed low MIC, higher zone of bacterial growth inhibition, and cell death compared to free Mox. A significant reduction of bacterial load was observed in the BK-induced mouse model.
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Affiliation(s)
- Sanjay Ch
- Nanomedicine Research Laboratory, Department of Pharmacy, Birla Institute of Technology & Science-Pilani, Hyderabad Campus, Medchal, Hyderabad 500078, Telangana, India
| | - Milan Paul
- Nanomedicine Research Laboratory, Department of Pharmacy, Birla Institute of Technology & Science-Pilani, Hyderabad Campus, Medchal, Hyderabad 500078, Telangana, India
| | - Sri Ganga Padaga
- Nanomedicine Research Laboratory, Department of Pharmacy, Birla Institute of Technology & Science-Pilani, Hyderabad Campus, Medchal, Hyderabad 500078, Telangana, India
| | - Balaram Ghosh
- Nanomedicine Research Laboratory, Department of Pharmacy, Birla Institute of Technology & Science-Pilani, Hyderabad Campus, Medchal, Hyderabad 500078, Telangana, India
| | - Swati Biswas
- Nanomedicine Research Laboratory, Department of Pharmacy, Birla Institute of Technology & Science-Pilani, Hyderabad Campus, Medchal, Hyderabad 500078, Telangana, India.
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Brase C, Kanefendt F, Loewen S, Himmel H, Schmitz S. No Influence of Asundexian on Cardiac Repolarization. Clin Pharmacol Drug Dev 2024; 13:265-280. [PMID: 38224232 DOI: 10.1002/cpdd.1366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/28/2023] [Indexed: 01/16/2024]
Abstract
Inhibition of activated factor XI reduces thrombogenesis while maintaining physiological hemostasis, with the expectation of reduced bleeding risk compared with standard of care in the clinical setting. Asundexian (BAY 2433334), an activated factor XI inhibitor, is in clinical development for the prevention of thromboembolic events. The effect of asundexian and its plasma metabolite M10 on cardiac repolarization and potential interactions with the hNav1.5 sodium, hCav1.2 calcium, and human ether-à-go-go-related gene (hERG) potassium channels was investigated in vitro. Additionally, asundexian effects on cardiac parameters and electrocardiogram were examined in telemetered beagle dogs. A randomized, placebo-controlled, 4-way crossover, thorough QT study in healthy adults evaluated the influence of 50 and 150 mg of asundexian on the corrected QT interval, including 400 mg of moxifloxacin as positive control. Across all studies, asundexian and M10 were not associated with any effects on cardiac repolarization. The largest in vitro effects of asundexian (approximately 20% inhibition) were seen for hCav1.2 and hERG. Throughout the thorough QT study, the upper limits of the one-sided 95% confidence interval of placebo-corrected mean changes from baseline in Fridericia corrected QT for 50 and 150 mg of asundexian were below Δ = 10 milliseconds. Asundexian demonstrated favorable safety and tolerability profiles.
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Affiliation(s)
| | | | | | - Herbert Himmel
- Research & Development, Pharmaceuticals Safety Pharmacology, Bayer AG, Wuppertal, Germany
| | - Sebastian Schmitz
- Research and Early Development, Statistics, Bayer AG, Wuppertal, Germany
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Sreedhar SS, Rajalakshmi AR, Nagarajan S, Easow JM, Rajendran P. Comparison of preoperative prophylaxis with povidone-iodine (5%) and moxifloxacin (0.5%) versus povidone-iodine (5%) alone: a prospective study from India. Int Ophthalmol 2024; 44:48. [PMID: 38337066 DOI: 10.1007/s10792-024-03025-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/11/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To compare the effect of povidone-iodine (PI) 5% and moxifloxacin 0.5% solutions versus PI 5% solution alone on the conjunctival bacterial flora. METHODOLOGY This is a comparative study in which the study population comprised adult patients scheduled for elective small incision cataract surgery. The eye to be operated (control eye) received topical moxifloxacin 0.5% drops 4 times, 1 day before surgery and 2 applications on the day of surgery. As placebo, the contralateral eye (study eye) received saline 0.90% drops as per the same schedule. Before surgery, on table, PI 5% was instilled in the conjunctival sac in both eyes. Conjunctival swabs were taken before initiation of therapy and 3 min after instillation of PI. RESULTS Of the 96 pairs of eyes included in the study, conjunctival cultures before prophylaxis were similar between the two groups (p = 0.31), with 54 samples (56%) of the study group and 49 (51%) of the control group showing growth. With positive cultures reducing to 7 (14%) in the study group and 8 (16%) in the control group, both the prophylaxis methods appeared equally efficacious (p = 0.79). Both the groups showed a significant reduction in positive cultures following prophylaxis (p < 0.0001). CONCLUSIONS PI 5% alone as preoperative prophylaxis was as effective as its combination therapy with moxifloxacin 0.5% in the reduction in conjunctival bacterial colonization.
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Affiliation(s)
- Sanjana S Sreedhar
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India.
| | - Swathi Nagarajan
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - Joshy M Easow
- Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
| | - Prabha Rajendran
- Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
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Malani M, Thodikayil AT, Saha S, Nirmal J. Carboxylated nanofibrillated cellulose empowers moxifloxacin to overcome Staphylococcus aureus biofilm in bacterial keratitis. Carbohydr Polym 2024; 324:121558. [PMID: 37985120 DOI: 10.1016/j.carbpol.2023.121558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/21/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
Bacterial keratitis is one of the vision-threatening ocular diseases that is increasing at an alarming rate due to antimicrobial resistance. One of the primary causes of antimicrobial resistance could be biofilm formation, which alters the mechanism and physiology of the microorganisms. Even a potent drug fails to inhibit biofilm due to the extracellular polysaccharide matrix surrounding the bacteria, inhibiting the permeation of drugs. Therefore, we aimed to develop carboxylated nanocellulose fibers loaded with moxifloxacin (Mox-cNFC) as a novel drug delivery system to treat bacterial corneal infection. Nanocellulose fibers were fabricated using a two-step method involving citric acid hydrolysis followed by TEMPO oxidation to introduce carboxylated groups (1.12 mmol/g). The Mox-cNFC particles showed controlled drug release till 40 h through diffusion. In vitro biofilm inhibition studies showed the particle's ability to disrupt the biofilm matrix and enhance the drug penetration to achieve optimal concentrations that inhibit the persister cells (without increasing minimum inhibitory concentration), thereby reducing the bacterial drug-resistant property. In vivo studies revealed the therapeutic potential of Mox-cNFC to treat Staphylococcus aureus-induced bacterial keratitis with once-a-day treatment, unlike neat moxifloxacin. Mox-cNFC could improve patient compliance by reducing the frequency of instillation and a controlled drug release to prevent toxicity.
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Affiliation(s)
- Manisha Malani
- Translational Pharmaceutics Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science-Pilani, Hyderabad Campus, Hyderabad 500078, Telangana, India
| | | | - Sampa Saha
- Department of Materials Science and Engineering, Indian Institute of Technology Delhi, New Delhi 110016, India.
| | - Jayabalan Nirmal
- Translational Pharmaceutics Research Laboratory, Department of Pharmacy, Birla Institute of Technology and Science-Pilani, Hyderabad Campus, Hyderabad 500078, Telangana, India.
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10
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Mahmoud R, Kotb NM, GadelHak Y, El-Ela FIA, Shehata AZ, Othman SI, Allam AA, Rudayni HA, Zaher A. Investigation of ternary Zn-Co-Fe layered double hydroxide as a multifunctional 2D layered adsorbent for moxifloxacin and antifungal disinfection. Sci Rep 2024; 14:806. [PMID: 38191628 PMCID: PMC10774404 DOI: 10.1038/s41598-023-48382-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/26/2023] [Indexed: 01/10/2024] Open
Abstract
Layered double hydroxides have recently gained wide interest as promising multifunctional nanomaterials. In this work, a multifunctional ternary Zn-Co-Fe LDH was prepared and characterized using XRD, FTIR, BET, TEM, SEM, and EDX. This LDH showed a typical XRD pattern with a crystallite size of 3.52 nm and a BET surface area of 155.9 m2/g. This LDH was investigated, for the first time, as an adsorbent for moxifloxacin, a common fluoroquinolones antibiotic, showing a maximum removal efficiency and equilibrium time of 217.81 mg/g and 60 min, respectively. Its antifungal activity, for the first time, was investigated against Penicillium notatum, Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger, and Mucor fungi at various concentrations (1000-1.95 µg/mL). This LDH was found to be effective against a variety of fungal strains, particularly Penicillium and Mucor species and showed zones of inhibition of 19.3 and 21.6 mm for Penicillium and Mucor, respectively, with an inhibition of 85% for Penicillium species and 68.3% for Mucormycosis. The highest antifungal efficacy results were obtained at very low MIC concentrations (33.3 and 62 µg/ml) against Penicillium and Mucor, respectively. The results of this study suggest a promising multifunctional potential of this LDH for water and wastewater treatment and disinfection applications.
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Affiliation(s)
- Rehab Mahmoud
- Chemistry Department, Faculty of Science, Beni-Suef University, Beni-Suef, 62511, Egypt.
| | - Nada M Kotb
- Hydrogeology and Environment Department, Faculty of Earth Sciences, Beni-Suef University, Beni-Suef, Egypt
| | - Yasser GadelHak
- Department of Materials Science and Nanotechnology, Faculty of Postgraduate Studies for Advanced Sciences, Beni-Suef University, Beni-Suef, 62511, Egypt
| | - Fatma I Abo El-Ela
- Department of Pharmacology, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, 62511, Egypt
| | - Ayman Z Shehata
- Department of Food Safety and Technology, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Sarah I Othman
- Department of Biology, College of Science, Princess Nourah Bint Abdulrahman University, P.O. BOX 84428, 11671, Riyadh, Saudi Arabia
| | - Ahmed A Allam
- Department of Biology, College of Science, Imam Muhammad Ibn Saud Islamic University, 11623, Riyadh, Saudi Arabia
- Department of Zoology, Faculty of Science, Beni-Suef University, Beni-Suef, 62511, Egypt
| | - Hassan Ahmed Rudayni
- Department of Biology, College of Science, Imam Muhammad Ibn Saud Islamic University, 11623, Riyadh, Saudi Arabia
| | - Amal Zaher
- Environmental Science and Industrial Development Department, Faculty of Postgraduate Studies for Advanced Sciences, Beni-Suef University, Beni-Suef, Egypt
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Green E, Dum R, Shook J, Krawiec C. A multicenter retrospective electronic health record database evaluation of subjects with Mycoplasma genitalium. J Am Pharm Assoc (2003) 2024; 64:295-300.e3. [PMID: 37839697 PMCID: PMC10872633 DOI: 10.1016/j.japh.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/30/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Mycoplasma genitalium is a sexually transmitted infection (STI) increasing in prevalence. The recent availability of nucleic acid amplification tests (NAATs) has led to updated diagnostic and treatment guidelines. As medication therapy experts, pharmacists can facilitate appropriate antimicrobial selection and stewardship and optimize best patient-care practices in the setting of M. genitalium infection. OBJECTIVE This study aimed to evaluate patient demographics, therapeutic approaches, and complications of patients with laboratory evidence of M. genitalium hypothesizing that younger adolescent females are affected by this organism, receive suboptimal treatment, and have more complications than adults. METHODS This was a retrospective cohort study using TriNetX multicenter electronic health record data of subjects aged 12 years and older with evidence of M. genitalium DNA detected via NAATs. The cohort was divided into 2 age groups: adolescents (12-21 years) and adults (older than 21 years). We evaluated age, sex, race, ethnicity, diagnostic codes, and medication codes. RESULTS Our study included 1126 subjects (192 adolescents [17.1%] and 934 adults [82.9%]) who tested positive for M. genitalium. Subjects in the adolescent group had higher odds of being women (2.52 [1.80, 3.54], P < 0.001), having inflammatory diseases of female pelvic organs diagnostic codes (1.51 [1.06, 2.16], P = 0.025), increased odds of azithromycin prescription (1.70 [1.17, 2.48], P = 0.005), and decreased odds of moxifloxacin prescription (0.41 [0.26, 0.64], P < 0.001). CONCLUSIONS Our study revealed a higher prevalence of M. genitalium infection in adults and adolescents with increased odds of receiving azithromycin and decreased odds of receiving moxifloxacin. Both age groups had decreased odds of receiving doxycycline compared with azithromycin despite guidelines recommending initial empirical antibiotic treatment with doxycycline and growing macrolide resistance. Suboptimal treatment of this infection may lead to lifelong complications. Pharmacists may provide crucial guidance and education to both patients and health care providers regarding appropriate treatment for M. genitalium.
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Perez-Alba E, Flores-Treviño S, Villarreal-Salazar V, Bocanegra-Ibarias P, Vilchez-Cavazos F, Camacho-Ortiz A. Planktonic and biofilm states of Staphylococcus aureus isolated from bone and joint infections and the in vitro effect of orally available antibiotics. J Appl Microbiol 2023; 134:lxad258. [PMID: 37977856 DOI: 10.1093/jambio/lxad258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 10/02/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023]
Abstract
AIMS To demonstrate the in vitro activity of orally available antibiotics against Staphylococcus aureus isolated from bone or orthopedic implant materials. The biofilm eradication of the combination of three antibiotics was also assessed. METHODS AND RESULTS Clinical isolates from orthopedic infection samples were collected, and S. aureus isolates were classified according to their biofilm production and composition. Almost all S. aureus isolates (n = 36, 97.3%) produced biofilm and the major biofilm components were polysaccharides. Antimicrobial susceptibility was determined in planktonic (minimal inhibitory concentration; MIC) and biofilm cells (minimal biofilm eradication concentration; MBEC) using the MBEC Calgary Device. Overall, the MBEC ranged higher than the MIC. When combined at borderline-susceptible concentrations, moxifloxacin-rifampin and doxycycline-rifampin were both able to eradicate biofilms in a third of the strains whereas the doxycycline-moxifloxacin combination proved ineffective at eradicating biofilm, inhibiting it only in three strains. CONCLUSIONS We propose rifampin in combination with moxifloxacin or doxycycline for the design of clinical trials of bone and/or orthopedic device infection without proper debridement or material retention.
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Affiliation(s)
- Eduardo Perez-Alba
- Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León., Av. Dr. José Eleuterio González S/N, Mitras Centro, 64460 Monterrey, N.L., Mexico
| | - Samantha Flores-Treviño
- Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León., Av. Dr. José Eleuterio González S/N, Mitras Centro, 64460 Monterrey, N.L., Mexico
| | - Verónica Villarreal-Salazar
- Departamento de Microbiología e Inmunología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León., Pedro de Alba, Niños Héroes, Ciudad Universitaria, 66455 San Nicolás de los Garza, N.L., Mexico
| | - Paola Bocanegra-Ibarias
- Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León., Av. Dr. José Eleuterio González S/N, Mitras Centro, 64460 Monterrey, N.L., Mexico
| | - Félix Vilchez-Cavazos
- Servicio de Ortopedia y Traumatología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León., Av. Dr. José Eleuterio González S/N, Mitras Centro, 64460 Monterrey, N.L., Mexico
| | - Adrián Camacho-Ortiz
- Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León., Av. Dr. José Eleuterio González S/N, Mitras Centro, 64460 Monterrey, N.L., Mexico
- Departamento de Epidemiología Hospitalaria y Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León., Av. Dr. José Eleuterio González S/N, Mitras Centro, 64460 Monterrey, N.L., Mexico
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13
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Huang HT, Lin WH, Chan TH, Jou R. Genetic surveillance and outcomes of pyrazinamide and fluoroquinolones-resistant tuberculosis in Taiwan. J Microbiol Immunol Infect 2023; 56:1236-1244. [PMID: 37690869 DOI: 10.1016/j.jmii.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Pyrazinamide (PZA) and fluoroquinolone (FQ), particularly moxifloxacin (MXF), are essential drugs in the World Health Organization (WHO) recommended short-course regimen to treat drug-susceptible tuberculosis (TB). METHODS To understand the extent of PZA and MXF susceptibility in general TB cases in Taiwan, we conducted retrospective analyses of 385 conservative Mycobacterium tuberculosis complex (MTBC) isolates identified from 4 TB laboratories in different regions of Taiwan. The case information was obtained from the TB registry. Genotypic drug susceptibility testing (DST) was performed by sequencing drug-resistance associated genes, PZA (pncA) and FQ (gyrA, and gyrB). Phenotypic DST was determined using the Bactec MGIT 960 system or the agar proportion method. Genotyping was carried out using spacer oligonucleotide typing. RESULTS In this study, 4.7% (18/385) cases' isolates harbored pncA mutations and 7.0% (27/385) cases' isolates harbored gyrA or gyrB mutation. Notably, pncA mutation was associated with Beijing family genotypes (P = 0.028), East African-Indian (EAI) genotypes (P = 0.047) and MDR-TB (P < 0.001). Whereas, gyrA or gyrB mutation was associated with EAI genotypes (P = 0.020) and MDR-TB (P = 0.006). In addition, a statistically significant difference was found between the favorable outcomes using active and inactive PZA (P = 0.009) in 38 case isolates with any pncA, gyrA, or gyrB mutation. CONCLUSION We concluded that routine PZA and FQ susceptibility tests are recommended for guiding the treatment of TB.
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Affiliation(s)
- Hsin-Ting Huang
- Tuberculosis Research Center, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan; Reference Laboratory of Mycobacteriology, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan
| | - Wan-Hsuan Lin
- Tuberculosis Research Center, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan; Reference Laboratory of Mycobacteriology, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan
| | - Tai-Hua Chan
- Tuberculosis Research Center, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan; Reference Laboratory of Mycobacteriology, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan
| | - Ruwen Jou
- Tuberculosis Research Center, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan; Reference Laboratory of Mycobacteriology, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan.
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Singh S, Gumbo T, Alffenaar JW, Boorgula GD, Shankar P, Thomas TA, Dheda K, Malinga L, Raj P, Aryal S, Srivastava S. Meropenem-vaborbactam restoration of first-line drug efficacy and comparison of meropenem-vaborbactam-moxifloxacin versus BPaL MDR-TB regimen. Int J Antimicrob Agents 2023; 62:106968. [PMID: 37726063 PMCID: PMC10850916 DOI: 10.1016/j.ijantimicag.2023.106968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/31/2023] [Accepted: 09/09/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Meropenem in combination with β-lactamase inhibitors (BLIs) and other drugs was tested to identify alternative treatment regimens for multidrug-resistant tuberculosis (MDR-TB). METHODS The following were performed: (1) MIC experiments; (2) static time-kill studies (STKs) with different BLIs; and (3) a hollow fibre model system of TB (HFS-TB) studies with meropenem-vaborbactam combined with human equivalent daily doses of 20 mg/kg or 35 mg/kg rifampin, or moxifloxacin 400 mg, or linezolid 600 mg vs. bedaquiline-pretonamid-linezolid (BPaL) for MDR-TB. The studies were performed using Mycobacterium tuberculosis (M. tuberculosis) H37Rv and an MDR-TB clinical strain (named M. tuberculosis 16D) that underwent whole genome sequencing. Exponential decline models were used to calculate the kill rate constant (K) of different HFS-TB regimens. RESULTS Whole genome sequencing revealed mutations associated with resistance to rifampin, isoniazid, and cephalosporins. The meropenem-vaborbactam MIC of M. tuberculosis was H37Rv 2 mg/L and > 128 mg/L for M. tuberculosis 16D. Relebactam and vaborbactam improved both the potency and efficacy of meropenem in STKs. Meropenem-vaborbactam alone failed to kill M. tuberculosis 16D but killed below day 0 burden when combined with isoniazid and rifampin, with the moxifloxacin combination being the most effective and outranking bedaquiline and pretomanid. In the HFS-TB, meropenem-vaborbactam-moxifloxacin and BPaL had the highest K (log10 cfu/mL/day) of 0.31 (95% CI 0.17-0.58) and 0.34 (95% CI 0.21-0.56), while meropenem-vaborbactam-rifampin (35 mg/kg) had a K of 0.18 (95% CI 0.12-0.25). The K for meropenem-vaborbactam-moxifloxacin-linezolid demonstrated antagonism. CONCLUSION Adding meropenem-vaborbactam could potentially restore the efficacy of isoniazid and rifampin against MDR-TB. The meropenem-vaborbactam-moxifloxacin backbone regimen has implications for creating a new effective MDR-TB regimen.
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Affiliation(s)
- Sanjay Singh
- Department of Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX, USA
| | - Tawanda Gumbo
- Quantitative Preclinical & Clinical Sciences Department, Praedicare Inc., Dallas, TX, USA; Hollow Fiber System & Experimental Therapeutics Laboratories, Praedicare Inc, Dallas, TX, USA
| | - Jan-Willem Alffenaar
- Sydney Institute for Infectious Diseases, The University of Sydney, Sydney, New South Wales, Australia; School of Pharmacy, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia; Westmead Hospital, Sydney, New South Wales, Australia
| | - Gunavanthi D Boorgula
- Department of Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX, USA
| | - Prem Shankar
- Department of Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX, USA
| | - Tania A Thomas
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
| | - Keertan Dheda
- The Center for Lung Infection and Immunity Unit, Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Lesibana Malinga
- Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa
| | - Prithvi Raj
- Department of Immunology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Santosh Aryal
- Department of Pharmaceutical Sciences and Health Outcomes, The Ben and Maytee Fisch College of Pharmacy, University of Texas at Tyler, Tyler, TX, USA
| | - Shashikant Srivastava
- Department of Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX, USA; Department of Cellular and Molecular Biology, UT Health Science Centre at Tyler, Tyler, TX, US.
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Sirichoat A, Kaewprasert O, Hinwan Y, Faksri K. Phenotypic drug-susceptibility profiles and genetic analysis based on whole-genome sequencing of Mycobacterium avium complex isolates in Thailand. PLoS One 2023; 18:e0294677. [PMID: 37992075 PMCID: PMC10664917 DOI: 10.1371/journal.pone.0294677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/31/2023] [Indexed: 11/24/2023] Open
Abstract
Mycobacterium avium complex (MAC) infections are a significant clinical challenge. Determining drug-susceptibility profiles and the genetic basis of drug resistance is crucial for guiding effective treatment strategies. This study aimed to determine the drug-susceptibility profiles of MAC clinical isolates and to investigate the genetic basis conferring drug resistance using whole-genome sequencing (WGS) analysis. Drug-susceptibility profiles based on minimum inhibitory concentration (MIC) assays were determined for 38 MAC clinical isolates (12 Mycobacterium avium and 26 Mycobacterium intracellulare). Mutations associated with drug resistance were identified through genome analysis of these isolates, and their phylogenetic relationships were also examined. Drug resistance, based on MIC values, was most commonly observed for moxifloxacin (81.6%), followed by linezolid (78.9%), clarithromycin (44.7%) and amikacin (36.8%). We identified specific mutations associated with resistance to amikacin. These include the rrs mutation at C464T in amikacin intermediate-resistance M. avium, and two mutations at T250A and G1453T in amikacin non-susceptible M. intracellulare. Mutations in rrl at A2058G, A2059C and A2059G were potentially linked to clarithromycin resistance. MAC clinical isolates not susceptible to linezolid exhibited mutations in rplC at G237C and C459T, as well as two rplD mutations at G443A and A489G. GyrB substitution Thr521Ala (T521A) was identified in moxifloxacin non-susceptible isolates, which may contribute to this resistance. A phylogeny of our MAC isolates revealed high levels of genetic diversity. Our findings suggest that the standard treatment regimen for MAC infections using moxifloxacin, linezolid, clarithromycin and amikacin may be driving development of resistance, potentially due to specific mutations. The combination of phenotypic and genotypic susceptibility testing can be valuable in guiding the clinical use of drugs for the treatment of MAC infections.
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Affiliation(s)
- Auttawit Sirichoat
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, Thailand
| | - Orawee Kaewprasert
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, Thailand
| | - Yothin Hinwan
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, Thailand
| | - Kiatichai Faksri
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Research and Diagnostic Center for Emerging Infectious Diseases (RCEID), Khon Kaen University, Khon Kaen, Thailand
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16
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Musisi E, Wyness A, Eldirdiri S, Dombay E, Mtafya B, Ntinginya NE, Heinrich N, Kibiki GS, Hoelscher M, Boeree M, Aarnoutse R, Gillespie SH, Sabiiti W. Effect of seven anti-tuberculosis treatment regimens on sputum microbiome: a retrospective analysis of the HIGHRIF study 2 and PanACEA MAMS-TB clinical trials. Lancet Microbe 2023; 4:e913-e922. [PMID: 37832571 DOI: 10.1016/s2666-5247(23)00191-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 05/18/2023] [Accepted: 06/14/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Respiratory tract microbiota has been described as the gatekeeper for respiratory health. We aimed to assess the impact of standard-of-care and experimental anti-tuberculosis treatment regimens on the respiratory microbiome and implications for treatment outcomes. METHODS In this retrospective study, we analysed the sputum microbiome of participants with tuberculosis treated with six experimental regimens versus standard-of-care who were part of the HIGHRIF study 2 (NCT00760149) and PanACEA MAMS-TB (NCT01785186) clinical trials across a 3-month treatment follow-up period. Samples were from participants in Mbeya, Kilimanjaro, Bagamoyo, and Dar es Salaam, Tanzania. Experimental regimens were composed of different combinations of rifampicin (R), isoniazid (H), pyrazinamide (Z), ethambutol (E), moxifloxacin (M), and a new drug, SQ109 (Q). Reverse transcription was used to create complementary DNA for each participant's total sputum RNA and the V3-V4 region of the 16S rRNA gene was sequenced using the Illumina metagenomic technique. Qiime was used to analyse the amplicon sequence variants and estimate alpha diversity. Descriptive statistics were applied to assess differences in alpha diversity pre-treatment and post-treatment initiation and the effect of each treatment regimen. FINDINGS Sequence data were obtained from 397 pre-treatment and post-treatment samples taken between Sept 26, 2008, and June 30, 2015, across seven treatment regimens. Pre-treatment microbiome (206 genera) was dominated by Firmicutes (2860 [44%] of 6500 amplicon sequence variants [ASVs]) at the phylum level and Streptococcus (2340 [36%] ASVs) at the genus level. Two regimens had a significant depressing effect on the microbiome after 2 weeks of treatment, HR20mg/kgZM (Shannon diversity index p=0·0041) and HR35mg/kgZE (p=0·027). Gram-negative bacteria were the most sensitive to bactericidal activity of treatment with the highest number of species suppressed being under the moxifloxacin regimen. By week 12 after treatment initiation, microbiomes had recovered to pre-treatment level except for the HR35mg/kgZE regimen and for genus Mycobacterium, which did not show recovery across all regimens. Tuberculosis culture conversion to negative by week 8 of treatment was associated with clearance of genus Neisseria, with a 98% reduction of the pre-treatment level. INTERPRETATION HR20mg/kgZM was effective against tuberculosis without limiting microbiome recovery, which implies a shorter efficacious anti-tuberculosis regimen with improved treatment outcomes might be achieved without harming the commensal microbiota. FUNDING European and Developing Countries Clinical Trials Partnership and German Ministry of Education and Research.
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Affiliation(s)
- Emmanuel Musisi
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, UK
| | - Adam Wyness
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, UK; Scottish Association of Marine Science, Oban, UK
| | - Sahar Eldirdiri
- Department of Microbiology, Kettering General Hospital, Kettering, UK
| | - Evelin Dombay
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, UK
| | - Bariki Mtafya
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, UK; National Institute for Medical Research, Mbeya Medical Research Centre, Mbeya, Tanzania
| | - Nyanda E Ntinginya
- National Institute for Medical Research, Mbeya Medical Research Centre, Mbeya, Tanzania
| | - Norbert Heinrich
- Division of Infectious Diseases and Tropical Medicine, University Hospital, University of Munich (LMU), Munich, Germany
| | - Gibson S Kibiki
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania; Africa Research Excellence Fund (AREF), London, UK
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, University Hospital, University of Munich (LMU), Munich, Germany; Fraunhofer ITMP, Immunology, Infection and Pandemic Research, Munich, Germany
| | - Martin Boeree
- Department of Lung Diseases, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Rob Aarnoutse
- Department of Pharmacy, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Stephen H Gillespie
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, UK
| | - Wilber Sabiiti
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, UK.
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17
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Mostafa RE, Shaffie NM, Allam RM. Protective effects of royal jelly and Echinacea against moxifloxacin-induced renal and hepatic injury in rats. Drug Chem Toxicol 2023; 46:1193-1202. [PMID: 36322409 DOI: 10.1080/01480545.2022.2141773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 06/16/2023]
Abstract
Antibiotic use, especially fluoroquinolones, has been linked to extensive renal and hepatic injury thus inflicts a considerable health problem. Fifty rats were allocated into five groups (n = 10). Group 1 represented the normal-control group. Group 2 received moxifloxacin only (MOX; 8 mg/kg/day, i.p.) for seven days and represented the MOX-control group. Groups 3, 4, and 5 received MOX for seven days accompanied by royal jelly (RJ; 100 mg/kg/day, p.o.), Echinacea (ECH; 40 mg/kg/day, p.o.), and a combination of both at the aforementioned doses respectively for 30 days. All groups were investigated for renal and hepatic function tests. Renal tissue content of kidney injury molecule-1 (KIM-1) along with renal and hepatic tissue contents of reduced glutathione (GSH) and malondialdehyde (MDA) were assessed for all groups. Histopathological examination was performed followed by immunohistochemical staining for caspase-3 in renal and hepatic tissues. MOX administration resulted in significant renal and hepatic damage. RJ and ECH significantly improved the serum parameters of renal and hepatic functions along with increasing GSH and decreasing MDA in renal and hepatic tissues. Renal contents of KIM-1 were also reduced. Moreover, RJ, ECH, and their combination amended MOX-induced histopathological changes and significantly reduced caspase-3 immunohistochemical staining in both renal and hepatic tissues. The current study is the first to elucidate the effect of RJ, ECH, and their combination against MOX-induced renal and hepatic injury in rats. The study suggests that these protective effects are mainly via the reduction of oxidative stress induced by MOX administration.
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Affiliation(s)
- Rasha E Mostafa
- Department of Pharmacology, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), Cairo, Egypt
| | - Nermeen M Shaffie
- Department of Pathology, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), Cairo, Egypt
| | - Rasha M Allam
- Department of Pharmacology, Medical Research and Clinical Studies Institute, National Research Centre (ID: 60014618), Cairo, Egypt
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Wang DM, Liu H, Zheng YL, Xu YH, Liao Y. Epidemiology of Nontuberculous Mycobacteria in Tuberculosis suspects, Southwest of China, 2017-2022. Front Cell Infect Microbiol 2023; 13:1282902. [PMID: 38029240 PMCID: PMC10644767 DOI: 10.3389/fcimb.2023.1282902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives This study summarizes the epidemiological characteristics, species distribution, and drug sensitivity of clinical nontuberculous mycobacteria (NTM) isolates at the Public Health Clinical Center of Chengdu, China, from January 2017 to December 2022. Methods We retrospectively analyzed data from patients with clinically isolated NTM strains. Chi-square analysis assessed the rate of Mycobacterium strain isolation over 6 years. Results The number of samples tested for Mycobacterium tuberculosis (MTB) and/or NTM increased each year, while MTB detection decreased and NTM detection rose significantly each year (P=0.03). The average age of NTM patients was 51 ± 17.53 years, with a 14.1% HIV infection rate. The predominant isolates were Mycobacterium avium-intracellulare (MAC) and M. chelonae/M. abscessus, with 96.4% of cases being of Han ethnicity. Amikacin, moxifloxacin, and clarithromycin were effective against M. avium and M. intracellulare; linezolid, amikacin, and cefoxitin were effective against M. chelonae/M. abscessus. Over 90% of NTM cases originated from the respiratory tract. Conclusion The NTM isolation rate in Southwest China has risen in recent years, primarily among elderly patients with a high HIV co-infection rate. The main NTM isolates were MAC and M. chelonae/M. abscessus. Amikacin, moxifloxacin, clarithromycin, and linezolid exhibited strong antibacterial activity against SGM, while amikacin and linezolid displayed relatively better antibacterial activity against RGM. The prevalence of NTM infection may be positively associated with regional economic development and health conditions.
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Affiliation(s)
- Dong-Mei Wang
- Department of Science and Education Division, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Hong Liu
- Department of Science and Education Division, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Yong-Li Zheng
- Department of Science and Education Division, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Yuan-Hong Xu
- Department of Science and Education Division, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China
| | - Yi Liao
- Department of Clinical Laboratory Medicine, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Mushtaq F, Raza SM, Ahmad A, Aslam H, Adeel A, Saleem S, Ahmad I. Antimicrobial drug resistant features of Mycobacterium tuberculosis associated with treatment failure. PLoS One 2023; 18:e0293194. [PMID: 37883448 PMCID: PMC10602240 DOI: 10.1371/journal.pone.0293194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/08/2023] [Indexed: 10/28/2023] Open
Abstract
Tuberculosis stands as a prominent cause of mortality in developing countries. The treatment of tuberculosis involves a complex procedure requiring the administration of a panel of at least four antimicrobial drugs for the duration of six months. The occurrence of treatment failure after the completion of a standard treatment course presents a serious medical problem. The purpose of this study was to evaluate antimicrobial drug resistant features of Mycobacterium tuberculosis associated with treatment failure. Additionally, it aimed to evaluate the effectiveness of second line drugs such as amikacin, linezolid, moxifloxacin, and the efflux pump inhibitor verapamil against M. tuberculosis isolates associated with treatment failure. We monitored 1200 tuberculosis patients who visited TB centres in Lahore and found that 64 of them were not cured after six months of treatment. Among the M. tuberculosis isolates recovered from the sputum of these 64 patients, 46 (71.9%) isolates were simultaneously resistant to rifampicin and isoniazid (MDR), and 30 (46.9%) isolates were resistant to pyrazinamide, Resistance to amikacin was detected in 17 (26,5%) isolates whereas resistance to moxifloxacin and linezolid was detected in 1 (1.5%) and 2 (3.1%) isolates respectively. Among MDR isolates, the additional resistance to pyrazinamide, amikacin, and linezolid was detected in 15(23.4%), 4(2.6%) and 1(1.56%) isolates respectively. One isolate simultaneously resistant to rifampicin, isoniazid, amikacin, pyrazinamide, and linezolid was also identified. In our investigations, the most frequently mutated amino acid in the treatment failure group was Serine 315 in katG. Three novel mutations were detected at codons 99, 149 and 154 in pncA which were associated with pyrazinamide resistance. The effect of verapamil on the minimum inhibitory concentration of isoniazid and rifampicin was observed in drug susceptible isolates but not in drug resistant isolates. Rifampicin and isoniazid enhanced the transcription of the efflux pump gene rv1258 in drug susceptible isolates collected from the treatment failure patients. Our findings emphasize a high prevalence of MDR isolates linked primarily to drug exposure. Moreover, the use of amikacin as a second line drug may not be the most suitable choice in such cases.
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Affiliation(s)
- Fizza Mushtaq
- Institute of Biomedical and Allied Health Sciences, University of Health Sciences, Lahore, Pakistan
- Department of Molecular Biology and Umeå Centre for Microbial Research (UCMR), Umeå University, Umeå, Sweden
| | - Syed Mohsin Raza
- Institute of Biomedical and Allied Health Sciences, University of Health Sciences, Lahore, Pakistan
| | - Adeel Ahmad
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan
| | - Hina Aslam
- Institute of Biomedical and Allied Health Sciences, University of Health Sciences, Lahore, Pakistan
| | - Atiqa Adeel
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan
| | - Sidrah Saleem
- Department of Microbiology, University of Health Sciences, Lahore, Pakistan
| | - Irfan Ahmad
- Institute of Biomedical and Allied Health Sciences, University of Health Sciences, Lahore, Pakistan
- Department of Molecular Biology and Umeå Centre for Microbial Research (UCMR), Umeå University, Umeå, Sweden
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20
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Cheng Y, Gaudy A, Liu L, Ye Y, Thomas M, Xue Y, Zhou S, Li Y. Exposure-Response Analysis to Assess the Concentration-QTc Relationship of Iberdomide. Clin Pharmacol Drug Dev 2023; 12:819-825. [PMID: 37079714 DOI: 10.1002/cpdd.1254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/26/2023] [Indexed: 04/22/2023]
Abstract
Iberdomide is an orally available cereblon-modulating agent being developed for the treatment of hematologic malignancies and autoimmune-mediated diseases. To assess the potential concentration-QTc relationship in humans and to ascertain or exclude a potential QT effect by iberdomide, a plasma concentration and ΔQTcF (change from baseline of corrected QT interval using the Fridericia formula) model of iberdomide was developed. Iberdomide concentration and paired high-quality, intensive electrocardiogram signal from a single-ascending-dose study in healthy subjects (N = 56) were included in the analysis. The primary analysis was based on a linear mixed-effect model with ΔQTcF as the dependent variable; iberdomide plasma concentration and baseline QTcF as continuous covariates; treatment (active or placebo) and time as a categorical factor; and a random intercept per subject. The predicted change from baseline and placebo corrected (ΔΔQTcF) at the observed geometric mean maximum plasma concentration and 2-sided 90% confidence intervals at different dose levels were calculated. The upper bound of the 90% confidence interval of the model-predicted ΔΔQTcF effect at maximum concentration from the supratherapeutic dose of 6 mg (2.54 milliseconds) is <10-millisecond threshold, suggesting that iberdomide does not have a clinically relevant QT prolongation liability.
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Affiliation(s)
- Yiming Cheng
- Clinical Pharmacology & Pharmacometrics, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Allison Gaudy
- Clinical Pharmacology & Pharmacometrics, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Liangang Liu
- Global Biometrics and Data Sciences, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Ying Ye
- Clinical Pharmacology & Pharmacometrics, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Michael Thomas
- Clinical Pharmacology & Pharmacometrics, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Yongjun Xue
- Nonclinical Research & Development, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Simon Zhou
- Clinical Pharmacology & Pharmacometrics, Bristol Myers Squibb, Princeton, New Jersey, USA
| | - Yan Li
- Clinical Pharmacology & Pharmacometrics, Bristol Myers Squibb, Princeton, New Jersey, USA
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Murray GL, Plummer EL, Bodiyabadu K, Vodstrcil LA, Huaman JL, Danielewski JA, Chua TP, Machalek DA, Garland S, Doyle M, Sweeney EL, Whiley DM, Bradshaw CS. gyrA Mutations in Mycoplasma genitalium and Their Contribution to Moxifloxacin Failure: Time for the Next Generation of Resistance-Guided Therapy. Clin Infect Dis 2023; 76:2187-2195. [PMID: 36722416 PMCID: PMC10273371 DOI: 10.1093/cid/ciad057] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/22/2023] [Accepted: 01/27/2023] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Although single nucleotide polymorphisms (SNPs) in Mycoplasma genitalium parC contribute to fluoroquinolone treatment failure, data are limited for the homologous gene, gyrA. This study investigated the prevalence of gyrA SNPs and their contribution to fluoroquinolone failure. METHODS Samples from 411 patients (male and female) undergoing treatment for M. genitalium infection (Melbourne Sexual Health Centre, March 2019-February 2020) were analyzed by Sanger sequencing (gyrA and parC). For patients treated with moxifloxacin (n = 194), the association between SNPs and microbiologic treatment outcome was analyzed. RESULTS The most common parC SNP was G248T/S83I (21.1% of samples), followed by D87N (2.3%). The most common gyrA SNP was G285A/M95I (7.1%). Dual parC/gyrA SNPs were found in 8.6% of cases. One third of infections harboring parC G248T/S83I SNP had a concurrent SNP in gyrA conferring M95I. SNPs in gyrA cooccurred with parC S83I variations. Treatment failure was higher in patients with parC S83I/gyrA dual SNPs when compared with infections with single S83I SNP alone from analysis of (1) 194 cases in this study (81.2% vs 45.8%, P = .047), and (2) pooled analysis of a larger population of 535 cases (80.6% vs 43.2%; P = .0027), indicating a strong additive effect. CONCLUSIONS Compared with parC S83I SNP alone, M. genitalium infections with dual mutations affecting parC/gyrA had twice the likelihood of failing moxifloxacin. Although antimicrobial resistance varies by region globally, these data indicate that gyrA should be considered as a target for future resistance assays in Australasia. We propose a strategy for the next generation of resistance-guided therapy incorporating parC and gyrA testing.
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Affiliation(s)
- Gerald L Murray
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Erica L Plummer
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Kaveesha Bodiyabadu
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Lenka A Vodstrcil
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jose L Huaman
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Jennifer A Danielewski
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Teck Phui Chua
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Dorothy A Machalek
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Suzanne Garland
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Victoria, Australia
- Women's Centre for Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Michelle Doyle
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Emma L Sweeney
- The University of Queensland Centre for Clinical Research (UQ-CCR), Queensland, Australia
- SpeeDx Pty Ltd, Sydney, New South Wales, Australia
| | - David M Whiley
- The University of Queensland Centre for Clinical Research (UQ-CCR), Queensland, Australia
- Pathology Queensland Central Laboratory, Queensland, Australia
| | - Catriona S Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Sandri A, Carelli M, Visentin A, Savoldi A, De Grandi G, Mirandola M, Lleo MM, Signoretto C, Cordioli M. Mycoplasma genitalium antibiotic resistance-associated mutations in genital and extragenital samples from men-who-have-sex-with-men attending a STI clinic in Verona, Italy. Front Cell Infect Microbiol 2023; 13:1155451. [PMID: 37065200 PMCID: PMC10102577 DOI: 10.3389/fcimb.2023.1155451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundMycoplasma genitalium (MG) is one of the most warning emerging sexually transmitted pathogens also due to its ability in developing resistance to antibiotics. MG causes different conditions ranging from asymptomatic infections to acute mucous inflammation. Resistance-guided therapy has demonstrated the best cure rates and macrolide resistance testing is recommended in many international guidelines. However, diagnostic and resistance testing can only be based on molecular methods, and the gap between genotypic resistance and microbiological clearance has not been fully evaluated yet. This study aims at finding mutations associated with MG antibiotic resistance and investigating the relationship with microbiological clearance amongst MSM.MethodsFrom 2017 to 2021, genital (urine) and extragenital (pharyngeal and anorectal swabs) biological specimens were provided by men-who-have-sex-with-men (MSM) attending the STI clinic of the Infectious Disease Unit at the Verona University Hospital, Verona, Italy. A total of 1040 MSM were evaluated and 107 samples from 96 subjects resulted positive for MG. Among the MG-positive samples, all those available for further analysis (n=47) were considered for detection of mutations known to be associated with macrolide and quinolone resistance. 23S rRNA, gyrA and parC genes were analyzed by Sanger sequencing and Allplex™ MG and AziR Assay (Seegene).ResultsA total of 96/1040 (9.2%) subjects tested positive for MG in at least one anatomical site. MG was detected in 107 specimens: 33 urine samples, 72 rectal swabs and 2 pharyngeal swabs. Among them, 47 samples from 42 MSM were available for investigating the presence of mutations associated with macrolide and quinolone resistance: 30/47 (63.8%) showed mutations in 23S rRNA while 10/47 (21.3%) in parC or gyrA genes. All patients with positive Test of Cure (ToC) after first-line treatment with azithromycin (n=15) were infected with 23S rRNA-mutated MG strains. All patients undergoing second-line moxifloxacin treatment (n=13) resulted negative at ToC, even those carrying MG strains with mutations in parC gene (n=6).ConclusionOur observations confirm that mutations in 23S rRNA gene are associated with azithromycin treatment failure and that mutations in parC gene alone are not always associated with phenotypic resistance to moxifloxacin. This reinforces the importance of macrolide resistance testing to guide the treatment and reduce antibiotic pressure on MG strains.
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Affiliation(s)
- Angela Sandri
- Microbiology Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Maria Carelli
- Microbiology Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- School of Health Statistics and Biometrics, University of Verona, Verona, Italy
| | - Alessandro Visentin
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alessia Savoldi
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Gelinda De Grandi
- Microbiology Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Massimo Mirandola
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- School of Health Sciences, University of Brighton, Brighton, United Kingdom
| | - Maria M. Lleo
- Microbiology Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Caterina Signoretto
- Microbiology Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- *Correspondence: Caterina Signoretto,
| | - Maddalena Cordioli
- Infectious Diseases Division, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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23
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Böttcher M, Düngen HD, Corcea V, Donath F, Fuhr R, Gal P, Mikus G, Trenk D, Coenen M, Pires PV, Maschke C, Aliprantis AO, Besche N, Becker C. Vericiguat: A Randomized, Phase Ib, Placebo-Controlled, Double-Blind, QTc Interval Study in Patients with Chronic Coronary Syndromes. Am J Cardiovasc Drugs 2023; 23:145-155. [PMID: 36633816 PMCID: PMC10006255 DOI: 10.1007/s40256-022-00557-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Vericiguat is indicated for the treatment of symptomatic chronic heart failure in adult patients with reduced ejection fraction who are stabilized after a recent decompensation event. OBJECTIVE To investigate the effects of vericiguat on QT interval in patients with chronic coronary syndromes (CCS). METHODS This was a randomized, phase Ib, placebo-controlled, double-blind, double-dummy, multicenter study. Vericiguat once daily was up-titrated from 2.5 mg to 5 mg and then to 10 mg (treatments A, B, and C) at 14-day intervals. Positive control was moxifloxacin 400 mg (single dose on day 8 or day 50; placebo on other days [treatment D]). We evaluated the placebo-adjusted change from baseline of the Frederica-corrected QTc interval (QTcF), pharmacokinetics, safety, and tolerability of vericiguat. RESULTS In total, 74 patients with CCS, with mean (standard deviation) age 63.4 (8.0) years, were included and 72 patients completed the study. At each timepoint up to 7 h after administration, mean placebo-corrected change in QTcF from baseline was < 6 ms and the upper limit of the two-sided 90% confidence interval of the mean was below the 10-ms threshold for clinical relevance. Moxifloxacin confirmed the assay sensitivity. Median time of maximum concentration of vericiguat was 4.5 h post-dose. The adverse event profile of vericiguat was consistent with its mechanism of action, and the findings did not indicate any safety concerns. CONCLUSIONS As part of an integrative risk assessment, this study demonstrated no clinically relevant corrected QT prolongation with vericiguat 10 mg once daily at steady state. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov number, NCT03504982.
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Affiliation(s)
| | - Hans-Dirk Düngen
- Department of Internal Medicine, Cardiology, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Vasile Corcea
- Department of Cardiac Surgery, PMSI Clinical Republican Hospital "T. Mosneaga", Chisinau, Republic of Moldova
| | | | - Rainard Fuhr
- Early Phase Clinical Unit, Parexel, Berlin, Germany
| | - Pim Gal
- Centre for Human Drug Research, Leiden, The Netherlands
- Clinical Pharmacology and Toxicology Department, Leiden University Medical Center, Leiden, The Netherlands
| | - Gerd Mikus
- Department of Clinical Pharmacology and Pharmacoepidemiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dietmar Trenk
- Department University Heart Center Campus Bad Krozingen, Clinics of Cardiology and Angiology-Clinical Pharmacology, University Medical Center Freiburg, Freiburg, Germany
| | - Martin Coenen
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany
| | | | | | - Antonios Othon Aliprantis
- Translational Medicine, Merck & Co., Inc., Rahway, New Jersey, USA
- Pioneering Medicines, Flagship Pioneering, Boston, Massachusetts, USA
| | - Nina Besche
- Chrestos Concept GmbH & Co. KG, Essen, Germany
| | - Corina Becker
- Clinical Pharmacology, Bayer AG, Wuppertal, Germany.
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24
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Kiymaci ME, Topal GR, Esim O, Bacanli M, Ozkan CK, Erdem O, Savaser A, Ozkan Y. Evaluation of bacterial uptake, antibacterial efficacy against Escherichia coli, and cytotoxic effects of moxifloxacin-loaded solid lipid nanoparticles. Arh Hig Rada Toksikol 2022; 73:260-269. [PMID: 36607722 PMCID: PMC9985348 DOI: 10.2478/aiht-2022-73-3667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/01/2022] [Accepted: 11/01/2022] [Indexed: 01/07/2023] Open
Abstract
Moxifloxacin (MOX) is an important antibiotic commonly used in the treatment of recurrent Escherichia coli (E. coli) infections. The aim of this study was to investigate its antibacterial efficiency when used with solid lipid nanoparticles (SNLs) and nanostructured lipid carriers (NLCs) as delivery vehicles. For this purpose we designed two SLNs (SLN1 and SLN2) and two NLCs (NLC1 and NLC2) of different characteristics (particle size, size distribution, zeta potential, and encapsulation efficiency) and loaded them with MOX to determine its release, antibacterial activity against E. coli, and their cytotoxicity to the RAW 264.7 monocyte/macrophage-like cell line in vitro. With bacterial uptake of 57.29 %, SLN1 turned out to be significantly more effective than MOX given as standard solution, whereas SLN2, NLC1, and NLC2 formulations with respective bacterial uptakes of 50.74 %, 39.26 %, and 32.79 %, showed similar activity to standard MOX. Cytotoxicity testing did not reveal significant toxicity of nanoparticles, whether MOX-free or MOX-loaded, against RAW 264.7 cells. Our findings may show the way for a development of effective lipid carriers that reduce side effects and increase antibacterial treatment efficacy in view of the growing antibiotic resistance.
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Affiliation(s)
- Merve Eylul Kiymaci
- University of Health Sciences Turkey, Gülhane Faculty of Pharmacy, Department of Pharmaceutical Microbiology, Ankara, Turkey
| | - Gizem Ruya Topal
- University of Health Sciences Turkey, Gülhane Faculty of Pharmacy, Department of Pharmaceutical Biotechnology, Ankara, Turkey
| | - Ozgur Esim
- University of Health Sciences Turkey, Gülhane Faculty of Pharmacy, Department of Pharmaceutical Technology, Ankara, Turkey
| | - Merve Bacanli
- University of Health Sciences Turkey, Gülhane Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey
| | - Cansel Kose Ozkan
- University of Health Sciences Turkey, Gülhane Faculty of Pharmacy, Department of Pharmaceutical Technology, Ankara, Turkey
| | - Onur Erdem
- University of Health Sciences Turkey, Gülhane Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Ankara, Turkey
| | - Ayhan Savaser
- University of Health Sciences Turkey, Gülhane Faculty of Pharmacy, Department of Pharmaceutical Technology, Ankara, Turkey
| | - Yalcin Ozkan
- University of Health Sciences Turkey, Gülhane Faculty of Pharmacy, Department of Pharmaceutical Technology, Ankara, Turkey
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25
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Brankin AE, Fowler PW. Predicting antibiotic resistance in complex protein targets using alchemical free energy methods. J Comput Chem 2022; 43:1771-1782. [PMID: 36054249 PMCID: PMC9545121 DOI: 10.1002/jcc.26979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/26/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022]
Abstract
Drug resistant Mycobacterium tuberculosis, which mostly results from single nucleotide polymorphisms in antibiotic target genes, poses a major threat to tuberculosis treatment outcomes. Relative binding free energy (RBFE) calculations can rapidly predict the effects of mutations, but this approach has not been tested on large, complex proteins. We use RBFE calculations to predict the effects of M. tuberculosis RNA polymerase and DNA gyrase mutations on rifampicin and moxifloxacin susceptibility respectively. These mutations encompass a range of amino acid substitutions with known effects and include large steric perturbations and charged moieties. We find that moderate numbers (n = 3-15) of short RBFE calculations can predict resistance in cases where the mutation results in a large change in the binding free energy. We show that the method lacks discrimination in cases with either a small change in energy or that involve charged amino acids, and we investigate how these calculation errors may be decreased.
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Affiliation(s)
- Alice E. Brankin
- Nuffield Department of Medicine, John Radcliffe HospitalUniversity of OxfordOxfordUK
| | - Philip W. Fowler
- Nuffield Department of Medicine, John Radcliffe HospitalUniversity of OxfordOxfordUK
- National Institute of Health Research Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
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26
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Daneshfar S, Khosravi AD, Hashemzadeh M. Drug susceptibility profiling and genetic determinants of drug resistance in Mycobacterium simiae isolates obtained from regional tuberculosis reference laboratories of Iran. PLoS One 2022; 17:e0267320. [PMID: 35960778 PMCID: PMC9374208 DOI: 10.1371/journal.pone.0267320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/07/2021] [Accepted: 04/05/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Among Non-tuberculous mycobacteria (NTM) which generally cause opportunistic infections, especially in immunocompromised hosts, Mycobacterium simiae (M. simiae) is one of the most important NTM, associated with pulmonary disease. The main concern about M. simiae infections is the extreme resistance of this NTM to antibiotics. There are limited studies about drug susceptibility testing (DST) and the causes of drug resistance in M. simiae. Hence, the current study aimed to identify the M. simiae isolates and to assess the drug resistance of the isolates using phenotypic and molecular methods.
Materials and methods
In this study, 50 clinical pulmonary isolates suspected of NTM were collected from regional tuberculosis reference laboratories in Iran. The isolates were identified as M. simiae by using standard biochemical tests and molecular methods. DST was performed for identified M. simiae isolates and additional 35 M. simiae isolates from the department archive, against eight drugs. The mutations in gyrA, gyrB, and rrl genes in clarithromycin and moxifloxacin resistant isolates were investigated by polymerase chain reaction (PCR) followed by sequencing.
Results
Out of 50 suspected NTM isolates, 25 isolates were detected as M. simiae species based on the biochemical tests, and 18 isolates were verified based on the rpoB gene sequence analysis to achieve a total of 53 isolates when the archive isolates were included. DST results showed that all 53 isolates were resistant to isoniazid, rifampin, and clofazimine. The rate of resistance to ethambutol and linezolid were 34 (64%), and 40 (76%) respectively. The highest susceptibility rate was demonstrated for amikacin 53 (100%) and clarithromycin 45(85%), followed by moxifloxacin 35(66%). Sequence analysis showed mutations in positions 2058 and 2059 of the rrl gene, as well non-synonymous mutation at codons 389, 444, and 571 of the gyrB gene. Sequence analysis showed no mutation in the gyrA gene. drug-resistant isolates with mutations showed higher MICs compared to non-mutant resistant isolates.
Conclusions
This study revealed amikacin, clarithromycin, and moxifloxacin as the most effective antibiotics. However, since M. simiae exhibited a high level of antibiotic resistance in vitro, therefore, species identification and determining the antibiotic susceptibility pattern of the isolates are essential before treatment.
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Affiliation(s)
- Sara Daneshfar
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Azar Dokht Khosravi
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Iranian Study Group on Microbial Drug Resistance, Tehran, Iran
| | - Mohammad Hashemzadeh
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- * E-mail:
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27
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Januel C, Menduti G, Mamchaoui K, Martinat C, Artero R, Konieczny P, Boido M. Moxifloxacin rescues SMA phenotypes in patient-derived cells and animal model. Cell Mol Life Sci 2022; 79:441. [PMID: 35864358 PMCID: PMC9304069 DOI: 10.1007/s00018-022-04450-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/30/2022] [Accepted: 06/25/2022] [Indexed: 11/25/2022]
Abstract
Spinal muscular atrophy (SMA) is a genetic disease resulting in the loss of α-motoneurons followed by muscle atrophy. It is caused by knock-out mutations in the survival of motor neuron 1 (SMN1) gene, which has an unaffected, but due to preferential exon 7 skipping, only partially functional human-specific SMN2 copy. We previously described a Drosophila-based screening of FDA-approved drugs that led us to discover moxifloxacin. We showed its positive effect on the SMN2 exon 7 splicing in SMA patient-derived skin cells and its ability to increase the SMN protein level. Here, we focus on moxifloxacin's therapeutic potential in additional SMA cellular and animal models. We demonstrate that moxifloxacin rescues the SMA-related molecular and phenotypical defects in muscle cells and motoneurons by improving the SMN2 splicing. The consequent increase of SMN levels was higher than in case of risdiplam, a potent exon 7 splicing modifier, and exceeded the threshold necessary for a survival improvement. We also demonstrate that daily subcutaneous injections of moxifloxacin in a severe SMA murine model reduces its characteristic neuroinflammation and increases the SMN levels in various tissues, leading to improved motor skills and extended lifespan. We show that moxifloxacin, originally used as an antibiotic, can be potentially repositioned for the SMA treatment.
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Affiliation(s)
- Camille Januel
- INSERM/UEVE, UMR 861, Université Paris Saclay, I-STEM, AFM-Telethon, Rue Henri Desbruères, 91100, Corbeil-Essonnes, France
| | - Giovanna Menduti
- Department of Neuroscience "Rita Levi Montalcini", Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Regione Gonzole 10, Orbassano, 10043, Turin, TO, Italy
| | - Kamel Mamchaoui
- Sorbonne Université, Inserm, Institut de Myologie, Centre de Recherche en Myologie, 75013, Paris, France
| | - Cecile Martinat
- INSERM/UEVE, UMR 861, Université Paris Saclay, I-STEM, AFM-Telethon, Rue Henri Desbruères, 91100, Corbeil-Essonnes, France.
| | - Ruben Artero
- University Institute of Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Street Dr. Moliner, 50, 46100, Burjasot, Valencia, Spain.
- Translational Genomics Group, Incliva Biomedical Research Institute, Avenue Menéndez Pelayo 4 acc, 46010, Valencia, Spain.
| | - Piotr Konieczny
- University Institute of Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Street Dr. Moliner, 50, 46100, Burjasot, Valencia, Spain
- Translational Genomics Group, Incliva Biomedical Research Institute, Avenue Menéndez Pelayo 4 acc, 46010, Valencia, Spain
| | - Marina Boido
- Department of Neuroscience "Rita Levi Montalcini", Neuroscience Institute Cavalieri Ottolenghi, University of Turin, Regione Gonzole 10, Orbassano, 10043, Turin, TO, Italy
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Wan L, Wu Y, Zhang Y, Zhang W. Toxicity, biodegradation of moxifloxacin and gatifloxacin on Chlamydomonas reinhardtii and their metabolic fate. Ecotoxicol Environ Saf 2022; 240:113711. [PMID: 35653971 DOI: 10.1016/j.ecoenv.2022.113711] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/22/2022] [Accepted: 05/24/2022] [Indexed: 06/15/2023]
Abstract
The novel fourth-generation fluoroquinolones (FQs) were developed to improve the antimicrobial activity and their utilization has rapidly increased in recent years. However, knowledge of the ecotoxicity and microalgae-mediated biodegradation of these novel FQs is limited. In this research, the toxic effects of moxifloxacin (MOX) and gatifloxacin (GAT) on Chlamydomonas reinhardtii as well as their biodegradation and metabolic fate were investigated. The results showed that the toxicity of MOX to C. reinhardtii was higher than that of GAT, and increased with culture time. Chlorophyll fluorescence and pigment content analyses suggested that the decrease in photosynthetic efficiency was primarily caused by the inhibition of electron transport after QA in PSII complex. These FQs induced oxidative damage in cells, and the antioxidation mechanisms of C. reinhardtii were analyzed. The maximum MOX removal of 77.67% by C. reinhardtii was achieved at 1 mg/L MOX, whereas the maximum GAT removal of 34.04% was attained at 20 mg/L GAT. The different hydrophilicity and lipophilicity of these FQs resulted in distinct findings in biodegradation experiments. Identification of the transformation products suggested that the likely biodegradation pathways of FQs by C. reinhardtii were hydroxylation, demethylation, and ring cleavage.
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Affiliation(s)
- Liang Wan
- Hubei Key Laboratory of Ecological Restoration of Rivers-lakes and Algae Utilization, School of Civil Engineering, Architecture and Environment, Hubei University of Technology, Wuhan 430068, China; Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, School of Resource and Environmental Science, Wuhan University, Wuhan 430079, China.
| | - Yixiao Wu
- Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, School of Resource and Environmental Science, Wuhan University, Wuhan 430079, China; School of Chemical and Environmental Engineering, Wuhan Polytechnic University, Wuhan 430023, China
| | - Yan Zhang
- Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, School of Resource and Environmental Science, Wuhan University, Wuhan 430079, China
| | - Weihao Zhang
- Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, School of Resource and Environmental Science, Wuhan University, Wuhan 430079, China.
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Chrzanowska A, Struga M, Roszkowski P, Koliński M, Kmiecik S, Jałbrzykowska K, Zabost A, Stefańska J, Augustynowicz-Kopeć E, Wrzosek M, Bielenica A. The Effect of Conjugation of Ciprofloxacin and Moxifloxacin with Fatty Acids on Their Antibacterial and Anticancer Activity. Int J Mol Sci 2022; 23:ijms23116261. [PMID: 35682940 PMCID: PMC9181188 DOI: 10.3390/ijms23116261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/18/2022] [Accepted: 05/30/2022] [Indexed: 01/02/2023] Open
Abstract
Novel conjugates (CP) of moxifloxacin (MXF) with fatty acids (1m–16m) were synthesized with good yields utilizing amides chemistry. They exhibit a more pronounced cytotoxic potential than the parent drug. They were the most effective for prostate cancer cells with an IC50 below 5 µM for respective conjugates with sorbic (2m), oleic (4m), 6-heptenoic (10m), linoleic (11m), caprylic (15m), and stearic (16m) acids. All derivatives were evaluated against a panel of standard and clinical bacterial strains, as well as towards mycobacteria. The highest activity towards standard isolates was observed for the acetic acid derivative 14m, followed by conjugates of unsaturated crotonic (1m) and sorbic (2m) acids. The activity of conjugates tested against an expanded panel of clinical coagulase-negative staphylococci showed that the compound (14m) was recognized as a leading structure with an MIC of 0.5 μg/mL denoted for all quinolone-susceptible isolates. In the group of CP derivatives, sorbic (2) and geranic (3) acid amides exhibited the highest bactericidal potential against clinical strains. The M. tuberculosis Spec. 210 strain was the most sensitive to sorbic (2m) conjugate and to conjugates with medium- and long-chain polyunsaturated acids. To establish the mechanism of antibacterial action, selected CP and MXF conjugates were examined in both topoisomerase IV decatenation assay and the DNA gyrase supercoiling assay, followed by suitable molecular docking studies.
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Affiliation(s)
- Alicja Chrzanowska
- Chair and Department of Biochemistry, Medical University of Warsaw, Ul. Banacha 1, 02-097 Warsaw, Poland; (A.C.); (M.S.); (K.J.)
| | - Marta Struga
- Chair and Department of Biochemistry, Medical University of Warsaw, Ul. Banacha 1, 02-097 Warsaw, Poland; (A.C.); (M.S.); (K.J.)
| | - Piotr Roszkowski
- Faculty of Chemistry, University of Warsaw, Pasteura 1, 02-093 Warszawa, Poland
- Correspondence: (P.R.); (A.B.)
| | - Michał Koliński
- Bioinformatics Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego St., 02-106 Warsaw, Poland;
| | - Sebastian Kmiecik
- Biological and Chemical Research Centre, Faculty of Chemistry, University of Warsaw, 02-089 Warsaw, Poland;
| | - Karolina Jałbrzykowska
- Chair and Department of Biochemistry, Medical University of Warsaw, Ul. Banacha 1, 02-097 Warsaw, Poland; (A.C.); (M.S.); (K.J.)
| | - Anna Zabost
- Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, 01-138 Warsaw, Poland; (A.Z.); (E.A.-K.)
| | - Joanna Stefańska
- Centre for Preclinical Research, Department of Pharmaceutical Microbiology, Medical University of Warsaw, 02-097 Warszawa, Poland;
| | - Ewa Augustynowicz-Kopeć
- Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, 01-138 Warsaw, Poland; (A.Z.); (E.A.-K.)
| | - Małgorzata Wrzosek
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Anna Bielenica
- Chair and Department of Biochemistry, Medical University of Warsaw, Ul. Banacha 1, 02-097 Warsaw, Poland; (A.C.); (M.S.); (K.J.)
- Correspondence: (P.R.); (A.B.)
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Kaye S, McLean K, Foulkes DM, Sloniecka M, Byrne D, Haneef AS, Winstanley C, Berry NG, Fernig DG. P-18 Impact of fluoroquinolones and aminoglycosides on P . aeruginosa virulence factor production and cytotoxicity. BMJ Open Ophthalmol 2022; 7:A6. [PMID: 36161816 DOI: 10.1136/bmjophth-2022-bcm.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
UNLABELLED *Correspondence - Stephen Kaye: S.B.Kaye@liverpool.ac.uk INTRODUCTION: Pseudomonas aeruginosa injects toxins, ExoS or ExoU, into host cells via the type III secretion system (T3SS) which destroy cells and help evade the immune system. First-line fluoroquinolones demonstrate better in vitro activity against P. aeruginosa but in certain clinical situations aminoglycosides are more effective. We evaluate the effects of fluoroquinolones (moxifloxacin and ciprofloxacin) and aminoglycosides (tobramycin and gentamycin) on T3SS and toxin expression, and the associated toxicity in corneal epithelial cell infection models. METHODS Expression levels of pcrV (T3SS needle component) from ExoU-expressing PA103 and ExoS-expressing PA76026 after 16h incubation in each antimicrobial was detected using western blotting. qRT PCR detected mRNA levels of ExoU, ExoS, pcrV and ExsA (T3SS activating factor) after PA103 and PA76026 were exposed to tobramycin and moxifloxacin. LIVE/DEAD and LDH assays after 24h evaluated how the antimicrobials influenced acute cytotoxicity in a HCE-T cell scratch and infection model. RESULTS Tobramycin significantly reduced pcrV in both strains by 50.5-74.0% compared to the fluoroquinolones (p=0.001 and 0.003), even at low concentrations. Fluoroquinolones significantly increased pcrV by 57.0-81.8% (p=0.004 and 0.003). mRNA levels of ExoU, ExoS, pcrV and ExsA were reduced by tobramycin but moxifloxacin increased pcrV, ExsA and ExoS. Tobramycin, despite more bacterial expansion compared to the same relative concentrations of fluoroquinolones, reduced ExoU/ExoS cytotoxicity and allowed complete wound healing. DISCUSSION Tobramycin downregulates T3SS expression and reduces ExoS/ExoU mediated cytotoxicity which protects infected HCE-T cells even at low concentrations. Fluoroquinolones however upregulated T3SS and do not negate the cytotoxic effects.
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Affiliation(s)
- Stephen Kaye
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, UK
| | - Keri McLean
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, UK
| | - Daniel M Foulkes
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, UK
- Department of Biochemistry, Institute of Integrative Biology, University of Liverpool, UK
| | - Marta Sloniecka
- Department of Biochemistry, Institute of Integrative Biology, University of Liverpool, UK
| | - Dominic Byrne
- Department of Biochemistry, Institute of Integrative Biology, University of Liverpool, UK
| | - Atikah S Haneef
- Department of Eye and Vision Science, Institute of Ageing and Chronic Disease, University of Liverpool, UK
| | - Craig Winstanley
- Department of Clinical Infection, Institute of Infection and Global Health, University of Liverpool, UK
| | - Neil G Berry
- Department of Chemistry, University of Liverpool, UK
| | - David G Fernig
- Department of Biochemistry, Institute of Integrative Biology, University of Liverpool, UK
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Matern WM, Parker H, Danchik C, Hoover L, Bader JS, Karakousis PC. Genetic Determinants of Intrinsic Antibiotic Tolerance in Mycobacterium avium. Microbiol Spectr 2021; 9:e0024621. [PMID: 34523947 PMCID: PMC8557931 DOI: 10.1128/spectrum.00246-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/06/2021] [Indexed: 11/20/2022] Open
Abstract
The Mycobacterium avium complex (MAC) is one of the most prevalent causes of nontuberculous mycobacteria pulmonary infection in the United States, and yet it remains understudied. Current MAC treatment requires more than a year of intermittent to daily combination antibiotic therapy, depending on disease severity. In order to shorten and simplify curative regimens, it is important to identify the innate bacterial factors contributing to reduced antibiotic susceptibility, namely, antibiotic tolerance genes. In this study, we performed a genome-wide transposon screen to elucidate M. avium genes that play a role in the bacterium's tolerance to first- and second-line antibiotics. We identified a total of 193 unique M. avium mutants with significantly altered susceptibility to at least one of the four clinically used antibiotics we tested, including two mutants (in DFS55_00905 and DFS55_12730) with panhypersusceptibility. The products of the antibiotic tolerance genes we have identified may represent novel targets for future drug development studies aimed at shortening the duration of therapy for MAC infections. IMPORTANCE The prolonged treatment required to eradicate Mycobacterium avium complex (MAC) infection is likely due to the presence of subpopulations of antibiotic-tolerant bacteria with reduced susceptibility to currently available drugs. However, little is known about the genes and pathways responsible for antibiotic tolerance in MAC. In this study, we performed a forward genetic screen to identify M. avium antibiotic tolerance genes, whose products may represent attractive targets for the development of novel adjunctive drugs capable of shortening the curative treatment for MAC infections.
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Affiliation(s)
- William M. Matern
- High-Throughput Biology Center, Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Systems Approaches to Infectious Diseases (C-SAID), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Harley Parker
- Center for Systems Approaches to Infectious Diseases (C-SAID), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carina Danchik
- Center for Systems Approaches to Infectious Diseases (C-SAID), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Leah Hoover
- Center for Systems Approaches to Infectious Diseases (C-SAID), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joel S. Bader
- High-Throughput Biology Center, Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Systems Approaches to Infectious Diseases (C-SAID), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Petros C. Karakousis
- Center for Systems Approaches to Infectious Diseases (C-SAID), Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Tanner L, Mashabela GT, Omollo CC, de Wet TJ, Parkinson CJ, Warner DF, Haynes RK, Wiesner L. Intracellular Accumulation of Novel and Clinically Used TB Drugs Potentiates Intracellular Synergy. Microbiol Spectr 2021; 9:e0043421. [PMID: 34585951 PMCID: PMC8557888 DOI: 10.1128/spectrum.00434-21] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/19/2021] [Indexed: 12/13/2022] Open
Abstract
The therapeutic repertoire for tuberculosis (TB) remains limited despite the existence of many TB drugs that are highly active in in vitro models and possess clinical utility. Underlying the lack of efficacy in vivo is the inability of TB drugs to penetrate microenvironments inhabited by the causative agent, Mycobacterium tuberculosis, including host alveolar macrophages. Here, we determined the ability of the phenoxazine PhX1 previously shown to be active against M. tuberculosis in vitro to differentially penetrate murine compartments, including plasma, epithelial lining fluid, and isolated epithelial lining fluid cells. We also investigated the extent of permeation into uninfected and M. tuberculosis-infected human macrophage-like Tamm-Horsfall protein 1 (THP-1) cells directly and by comparing to results obtained in vitro in synergy assays. Our data indicate that PhX1 (4,750 ± 127.2 ng/ml) penetrates more effectively into THP-1 cells than do the clinically used anti-TB agents, rifampin (3,050 ± 62.9 ng/ml), moxifloxacin (3,374 ± 48.7 ng/ml), bedaquiline (4,410 ± 190.9 ng/ml), and linezolid (770 ± 14.1 ng/ml). Compound efficacy in infected cells correlated with intracellular accumulation, reinforcing the perceived importance of intracellular penetration as a key drug property. Moreover, we detected synergies deriving from redox-stimulatory combinations of PhX1 or clofazimine with the novel prenylated amino-artemisinin WHN296. Finally, we used compound synergies to elucidate the relationship between compound intracellular accumulation and efficacy, with PhX1/WHN296 synergy levels shown to predict drug efficacy. Collectively, our data support the utility of the applied assays in identifying in vitro active compounds with the potential for clinical development. IMPORTANCE This study addresses the development of novel therapeutic compounds for the eventual treatment of drug-resistant tuberculosis. Tuberculosis continues to progress, with cases of Mycobacterium tuberculosis (M. tuberculosis) resistance to first-line medications increasing. We assess new combinations of drugs with both oxidant and redox properties coupled with a third partner drug, with the focus here being on the potentiation of M. tuberculosis-active combinations of compounds in the intracellular macrophage environment. Thus, we determined the ability of the phenoxazine PhX1, previously shown to be active against M. tuberculosis in vitro, to differentially penetrate murine compartments, including plasma, epithelial lining fluid, and isolated epithelial lining fluid cells. In addition, the extent of permeation into human macrophage-like THP-1 cells and H37Rv-infected THP-1 cells was measured via mass spectrometry and compared to in vitro two-dimensional synergy and subsequent intracellular efficacy. Collectively, our data indicate that development of new drugs will be facilitated using the methods described herein.
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Affiliation(s)
- Lloyd Tanner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Gabriel T. Mashabela
- SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, DST/NRF Centre of Excellence for Biomedical TB Research, Department of Pathology and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Charles C. Omollo
- SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, DST/NRF Centre of Excellence for Biomedical TB Research, Department of Pathology and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Timothy J. de Wet
- SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, DST/NRF Centre of Excellence for Biomedical TB Research, Department of Pathology and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | | | - Digby F. Warner
- SAMRC/NHLS/UCT Molecular Mycobacteriology Research Unit, DST/NRF Centre of Excellence for Biomedical TB Research, Department of Pathology and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Wellcome Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa
| | - Richard K. Haynes
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Lubbe Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
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Kowalska J, Banach K, Beberok A, Rok J, Rzepka Z, Wrześniok D. The Biochemical and Molecular Analysis of Changes in Melanogenesis Induced by UVA-Activated Fluoroquinolones-In Vitro Study on Human Normal Melanocytes. Cells 2021; 10:cells10112900. [PMID: 34831123 PMCID: PMC8616096 DOI: 10.3390/cells10112900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/15/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022] Open
Abstract
Fluoroquinolones cause phototoxic reactions, manifested as different types of skin lesions, including hyperpigmentation. The disturbances of melanogenesis indicate that fluoroquinolones may affect cellular processes in melanocytes. It has been reported that these antibiotics may bind with melanin and accumulate in pigmented cells. The study aimed to examine the changes in melanogenesis in human normal melanocytes exposed to UVA radiation and treated with lomefloxacin and moxifloxacin, the most and the least fluoroquinolone, respectively. The obtained results demonstrated that both tested fluoroquinolones inhibited melanogenesis through a decrease in tyrosinase activity and down-regulation of tyrosinase and microphthalmia-associated transcription factor production. Only lomefloxacin potentiated UVA-induced melanogenesis. Under UVA irradiation lomefloxacin significantly enhanced melanin content and tyrosinase activity in melanocytes, although the drug did not cause an increased expression of tyrosinase or microphthalmia-associated transcription factor. The current studies revealed that phototoxic activity of fluoroquinolones is associated with alterations in the melanogenesis process. The difference in phototoxic potential of fluoroquinolones derivatives may be connected with various effects on UVA-induced events at a cellular level.
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Pinto RM, Monteiro C, Costa Lima SA, Casal S, Van Dijck P, Martins MCL, Nunes C, Reis S. N-Acetyl-l-cysteine-Loaded Nanosystems as a Promising Therapeutic Approach Toward the Eradication of Pseudomonas aeruginosa Biofilms. ACS Appl Mater Interfaces 2021; 13:42329-42343. [PMID: 34464076 DOI: 10.1021/acsami.1c05124] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Bacterial biofilms are a major health concern, mainly due to their contribution to increased bacterial resistance to well-known antibiotics. The conventional treatment of biofilms represents a challenge, and frequently, eradication is not achieved with long-lasting administration of antibiotics. In this context, the present work proposes an innovative therapeutic approach that is focused on the encapsulation of N-acetyl-l-cysteine (NAC) into lipid nanoparticles (LNPs) functionalized with d-amino acids to target and disrupt bacterial biofilms. The optimized formulations presented a mean hydrodynamic diameter around 200 nm, a low polydispersity index, and a high loading capacity. These formulations were stable under storage conditions up to 6 months. In vitro biocompatibility studies showed a low cytotoxicity effect in fibroblasts and a low hemolytic activity in human red blood cells. Nevertheless, unloaded LNPs showed a higher hemolytic potential than NAC-loaded LNPs, which suggests a safer profile of the latter. The in vitro antibiofilm efficacy of the developed formulations was tested against Staphylococcus epidermidis (Gram-positive) and Pseudomonas aeruginosa (Gram-negative) mature biofilms. The results showed that the NAC-loaded LNPs were ineffective against S. epidermidis biofilms, while a significant reduction of biofilm biomass and bacterial viability in P. aeruginosa biofilms were observed. In a more complex therapeutic approach, the LNPs were further combined with moxifloxacin, revealing a beneficial effect between the LNPs and the antibiotic against P. aeruginosa biofilms. Both alone and in combination with moxifloxacin, unloaded and NAC-loaded LNPs functionalized with d-amino acids showed a great potential to reduce bacterial viability, with no significant differences in the presence or absence of NAC. However, the presence of NAC in NAC-loaded functionalized LNPs shows a safer profile than the unloaded LNPs, which is beneficial for an in vivo application. Overall, the developed formulations present a potential therapeutic approach against P. aeruginosa biofilms, alone or in combination with antibiotics.
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Affiliation(s)
- Rita M Pinto
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto 4050-313, Portugal
- Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology KU Leuven, Leuven 3001, Belgium
- VIB KU Leuven Center for Microbiology, Leuven 3001, Belgium
| | - Claudia Monteiro
- i3S, Instituto de Investigação e Inovação em Saúde INEB, Instituto de Engenharia Biomédica, Universidade do Porto, Porto 4200-135, Portugal
| | - Sofia A Costa Lima
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto 4050-313, Portugal
| | - Susana Casal
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto 4050-313, Portugal
| | - Patrick Van Dijck
- Laboratory of Molecular Cell Biology, Institute of Botany and Microbiology KU Leuven, Leuven 3001, Belgium
- VIB KU Leuven Center for Microbiology, Leuven 3001, Belgium
| | - M Cristina L Martins
- Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto 4050-313, Portugal
- i3S, Instituto de Investigação e Inovação em Saúde INEB, Instituto de Engenharia Biomédica, Universidade do Porto, Porto 4200-135, Portugal
| | - Cláudia Nunes
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto 4050-313, Portugal
| | - Salette Reis
- LAQV, REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Porto 4050-313, Portugal
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Abidullah , Ahmad S, Ali N, Almarshad F, Nabi M, Rahman SU, Ullah S, Khan J, Hussain H, Bukhari SH. Moxifloxacin and gemifloxacin mediates its antispasmodic profile via ATP-sensitive potassium channels: An in-vitro bioassay study. Pak J Pharm Sci 2021; 34:1983-1988. [PMID: 34836870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Moxifloxacin and gemifloxacin were tested on isolated rabbits' jejunal preparations as little is known about its effects on gastrointestinal tissues. Moxifloxacin and gemifloxacin were tested in concentrations 0.01-10μg/mL for possible effect(s) on isolated rabbits' jejunal preparations. The drugs were applied on spontaneous, on low K+ (20mM)-induced contractions and on high K+ (80mM)-induced contractions. Response was plotted as % of its respective controls. EC50 for Moxifloxacin and Gemifloxacin on spontaneous (without Glibenclamide) contractions are 2.83±0.5μg/mL and 1.11±0.2μg/mL, respectively. Moxifloxacin and Gemifloxacin relaxed the low K+ (20mM) -induced contractions, which were inhibited in presence of Glibenclamide (3μM). Our result indicates that the relaxant activity of Moxifloxacin and Gemifloxacin is mediated possibly through activation of ATP-sensitive potassium channels (KATP). The relaxant effect of Moxifloxacin and Gemifloxacin is predominantly mediated by activation of ATP-Sensitive potassium channels (KATP), which could be cause of one of relaxing mechanisms.
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Affiliation(s)
- - Abidullah
- Department of Pharmacy, Shaheed Benazir Bhutto University Sheringal, Dir Upper, Khyber Pakhtunkhwa, Pakistan/ Department of Pharmacology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, KP, Pakistan
| | - Shujaat Ahmad
- Department of Pharmacy, Shaheed Benazir Bhutto University Sheringal, Dir Upper, Khyber Pakhtunkhwa, Pakistan
| | - Niaz Ali
- Department of Pharmacology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, KP, Pakistan/ College of Medicine, Shaqra University, Riyadh, Kingdom of Saudi Arabia
| | - Feras Almarshad
- College of Medicine, Shaqra University, Riyadh, Kingdom of Saudi Arabia
| | - Muhammad Nabi
- Department of Pharmacology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, KP, Pakistan
| | - Shafiq Ur Rahman
- Department of Pharmacy, Shaheed Benazir Bhutto University Sheringal, Dir Upper, Khyber Pakhtunkhwa, Pakistan
| | - Shakir Ullah
- Department of Pharmacology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, KP, Pakistan
| | - Jahangir Khan
- Department of Pharmacy, University of Malakand, Chakdara, Dir Lower, Khyber Pakhtunkhwa, Pakistan
| | - Haya Hussain
- Department of Pharmacy, Shaheed Benazir Bhutto University Sheringal, Dir Upper, Khyber Pakhtunkhwa, Pakistan
| | - Syeda Hajira Bukhari
- Department of Pharmacology, Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, KP, Pakistan
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Allen GP, Deao KM, Hill SA, Schipelliti SM, Tran T. In vitro evaluation of antimicrobial resistance selection in Neisseria gonorrhoeae. Int J Antimicrob Agents 2021; 58:106417. [PMID: 34391903 DOI: 10.1016/j.ijantimicag.2021.106417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/26/2021] [Accepted: 08/06/2021] [Indexed: 11/19/2022]
Abstract
Gonococcal infections represent an urgent public-health threat as >50% of cases caused by Neisseria gonorrhoeae strains display reduced susceptibility to at least one antimicrobial agent. We evaluated the pharmacodynamics of a number of antimicrobials against N. gonorrhoeae in order to assess the likelihood of mutant selection by these agents. The mutant prevention concentration (MPC) and mutant selection window (MSW) were determined for azithromycin, ceftriaxone, doxycycline, ertapenem, gentamicin, ciprofloxacin, levofloxacin and moxifloxacin against a wild-type strain of N. gonorrhoeae (ATCC 49226) and a gyrA mutant of ATCC 49226. Pharmacokinetic parameters, including peak concentration (Cmax), half-life (t1/2) and area under the plasma concentration-time curve over 24 h (AUC), associated with each agent were used to calculate the time within the MSW (TMSW, percentage of the dosing interval that antimicrobial concentrations fall within the MSW), Cmax/MPC ratio and AUC/MPC ratio for each antimicrobial agent. Concentrations of ceftriaxone (500 mg), ertapenem, ciprofloxacin, levofloxacin and moxifloxacin surpass the MPC for both strains. Results of pharmacodynamic analyses suggest that ertapenem, ciprofloxacin, levofloxacin and moxifloxacin may be most likely to prevent mutant selection in N. gonorrhoeae. Use of ceftriaxone, azithromycin, doxycycline or gentamicin for gonorrhoea is expected to lead to the ongoing emergence of resistance to these agents. There is a clear need to develop novel treatment regimens for gonococcal infections in order to limit the dissemination of resistance in N. gonorrhoeae.
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Affiliation(s)
- George P Allen
- School of Pharmacy, Westbrook College of Health Professions, University of New England, 716 Stevens Avenue, Portland, ME 04103, USA.
| | - Kristina M Deao
- School of Pharmacy, Westbrook College of Health Professions, University of New England, 716 Stevens Avenue, Portland, ME 04103, USA
| | - Stephanie A Hill
- School of Pharmacy, Westbrook College of Health Professions, University of New England, 716 Stevens Avenue, Portland, ME 04103, USA
| | - Sandra M Schipelliti
- School of Pharmacy, Westbrook College of Health Professions, University of New England, 716 Stevens Avenue, Portland, ME 04103, USA
| | - Thomas Tran
- School of Pharmacy, Westbrook College of Health Professions, University of New England, 716 Stevens Avenue, Portland, ME 04103, USA
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Pradhan A, Swaminath S, Jakkala K, Ajitkumar P. A method for the enrichment, isolation and validation of Mycobacterium smegmatis population surviving in the presence of bactericidal concentrations of rifampicin and moxifloxacin. FEMS Microbiol Lett 2021; 368:fnab090. [PMID: 34240144 DOI: 10.1093/femsle/fnab090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 07/06/2021] [Indexed: 11/14/2022] Open
Abstract
The bacterial populations surviving in the presence of antibiotics contain cells that have gained genetic resistance, phenotypic resistance and tolerance to antibiotics. Isolation of live bacterial population, surviving against antibiotics, from the milieu of high proportions of dead/damaged cells will facilitate the study of the cellular/molecular processes used by them for survival. Here we present a Percoll gradient centrifugation based method for the isolation of enriched population of Mycobacterium smegmatis surviving in the presence of bactericidal concentrations of rifampicin and moxifloxacin. From the time of harvest, throughout the enrichment and isolation processes, and up to the lysis of the cells for total RNA preparation, we maintained the cells in the presence of the antibiotic to avoid changes in their metabolic status. The total RNA extracted from the enriched population of live antibiotic-surviving population showed structural integrity and purity. We analysed the transcriptome profile of the antibiotic-surviving population and compared it with the orthologue genes of Mycobacterium tuberculosis that conferred antibiotic tolerance on tubercle bacilli isolated from the tuberculosis patients under treatment with four antitubercular antibiotics. Statistically significant comparability between the gene expression profiles of the antibiotic tolerance associated genes of M. smegmatis and M. tuberculosis validated the reliability/utility of the method.
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Affiliation(s)
- Atul Pradhan
- Department of Microbiology and Cell Biology, Indian Institute of Science, Malleswaram, Bangalore 560012, Karnataka, India
| | - Sharmada Swaminath
- Department of Microbiology and Cell Biology, Indian Institute of Science, Malleswaram, Bangalore 560012, Karnataka, India
| | - Kishor Jakkala
- Department of Microbiology and Cell Biology, Indian Institute of Science, Malleswaram, Bangalore 560012, Karnataka, India
| | - Parthasarathi Ajitkumar
- Department of Microbiology and Cell Biology, Indian Institute of Science, Malleswaram, Bangalore 560012, Karnataka, India
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Wan L, Wu Y, Zhang B, Yang W, Ding H, Zhang W. Effects of moxifloxacin and gatifloxacin stress on growth, photosynthesis, antioxidant responses, and microcystin release in Microcystis aeruginosa. J Hazard Mater 2021; 409:124518. [PMID: 33191018 DOI: 10.1016/j.jhazmat.2020.124518] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/05/2020] [Accepted: 11/05/2020] [Indexed: 06/11/2023]
Abstract
Moxifloxacin (MOX) and gatifloxacin (GAT) are fourth-generation fluoroquinolone antibiotics that are frequently detected in surface water environments and pose a threat to aquatic organisms. However, research into their toxicity to Microcystis aeruginosa, a cyanobacterium, has thus far been limited. In the present study, we investigated the effects of these antibiotics on M. aeruginosa growth, photosynthesis, oxidative stress, and microcystin (MC) release. The results of the 96 h EC50 values of MOX and GAT were 60.34 and 25.30 μg/L, respectively, and the risk quotients calculated indicated that these antibiotics could pose considerable ecological risks at actual environmental concentrations. Photosynthetic fluorescence intensity was shown to decline markedly, and Fv/Fm significantly decreased without any evidence of recovery, suggesting that the organism's photosystems were irreversibly damaged. Chlorophyll a and carotenoid content decreased, whereas the ratio of carotenoids to chlorophyll a increased, indicating that carotenoids were less susceptible to damage than chlorophyll a. The reactive oxygen species and malondialdehyde content significantly increased, as well as the superoxide dismutase and catalase activities, indicating that exposure caused serious oxidative stress. Additionally, MC release increased. These results demonstrate that the environmental risks posed by MOX and GAT should be given serious consideration, particularly as their use is increasing.
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Affiliation(s)
- Liang Wan
- School of Resource and Environmental Science, Wuhan University, Wuhan 430079, PR China
| | - Yixiao Wu
- School of Resource and Environmental Science, Wuhan University, Wuhan 430079, PR China
| | - Benhao Zhang
- School of Resource and Environmental Science, Wuhan University, Wuhan 430079, PR China
| | - Wenfeng Yang
- School of Resource and Environmental Science, Wuhan University, Wuhan 430079, PR China
| | - Huijun Ding
- Jiangxi Provincial Key Laboratory of Water Resources and Environment of Poyang Lake, Jiangxi Provincial Institute of Water Sciences, Nanchang 330029, PR China
| | - Weihao Zhang
- School of Resource and Environmental Science, Wuhan University, Wuhan 430079, PR China; Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, School of Resource and Environmental Science, Wuhan University, Wuhan 430079, PR China.
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Nair AB, Shah J, Jacob S, Al-Dhubiab BE, Sreeharsha N, Morsy MA, Gupta S, Attimarad M, Shinu P, Venugopala KN. Experimental design, formulation and in vivo evaluation of a novel topical in situ gel system to treat ocular infections. PLoS One 2021; 16:e0248857. [PMID: 33739996 PMCID: PMC7978349 DOI: 10.1371/journal.pone.0248857] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 09/14/2020] [Accepted: 03/06/2021] [Indexed: 12/30/2022] Open
Abstract
In situ gels have been extensively explored as ocular drug delivery system to enhance bioavailability and efficacy. The objective of present study was to design, formulate and evaluate ion-activated in situ gel to enhance the ocular penetration and therapeutic performance of moxifloxacin in ophthalmic delivery. A simplex lattice design was utilized to examine the effect of various factors on experimental outcomes of the in situ gel system. The influence of polymers (independent variables) such as gellan gum (X1), sodium alginate (X2), and HPMC (X3) on gel strength, adhesive force, viscosity and drug release after 10 h (Q10) were assessed. Selected formulation (MH7) was studied for ex vivo permeation, in vivo irritation and pharmacokinetics in rabbits. Data revealed that increase in concentration of polymers led to higher gel strength, adhesive force and viscosity, however, decreases the drug release. MH7 exhibited all physicochemical properties within acceptable limits and was stable for 6 months. Release profile of moxifloxacin from MH7 was comparable to the check point batches and followed Korsmeyer-Peppas matrix diffusion-controlled mechanism. Ocular irritation study signifies that selected formulation is safe and non-irritant for ophthalmic administration. In vivo pharmacokinetics data indicates significant improvement of moxifloxacin bioavailability (p < 0.0001) from MH7, as evidenced by higher Cmax (727 ± 56 ng/ml) and greater AUC (2881 ± 108 ng h/ml), when compared with commercial eye drops (Cmax; 503 ± 85 ng/ml and AUC; 978 ± 86 ng h/ml). In conclusion, developed in situ gel system (MH7) could offers a more effective and extended ophthalmic therapy of moxifloxacin in ocular infections when compared to conventional eye drops.
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Affiliation(s)
- Anroop B. Nair
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
- * E-mail:
| | - Jigar Shah
- Department of Pharmaceutics, Institute of Pharmacy, Nirma University, Ahmedabad, Gujarat, India
| | - Shery Jacob
- Department of Pharmaceutical Sciences, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Bandar E. Al-Dhubiab
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Nagaraja Sreeharsha
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Pharmaceutics, Vidya Siri College of Pharmacy, Bangalore, India
| | - Mohamed A. Morsy
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
- Faculty of Medicine, Department of Pharmacology, Minia University, El-Minia, Egypt
| | - Sumeet Gupta
- Department of Pharmacology, M. M. College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, India
| | - Mahesh Attimarad
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Pottathil Shinu
- Department of Biomedical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Katharigatta N. Venugopala
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Biotechnology and Food Technology, Durban University of Technology, Durban, South Africa
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Cahill C, O’Connell F, Gogan KM, Cox DJ, Basdeo SA, O’Sullivan J, Gordon SV, Keane J, Phelan JJ. The Iron Chelator Desferrioxamine Increases the Efficacy of Bedaquiline in Primary Human Macrophages Infected with BCG. Int J Mol Sci 2021; 22:ijms22062938. [PMID: 33805837 PMCID: PMC8001338 DOI: 10.3390/ijms22062938] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 12/18/2022] Open
Abstract
For over 50 years, patients with drug-sensitive and drug-resistant tuberculosis have undergone long, arduous, and complex treatment processes with several antimicrobials. With the prevalence of drug-resistant strains on the rise and new therapies for tuberculosis urgently required, we assessed whether manipulating iron levels in macrophages infected with mycobacteria offered some insight into improving current antimicrobials that are used to treat drug-resistant tuberculosis. We investigated if the iron chelator, desferrioxamine, can support the function of human macrophages treated with an array of second-line antimicrobials, including moxifloxacin, bedaquiline, amikacin, clofazimine, linezolid and cycloserine. Primary human monocyte-derived macrophages were infected with Bacillus Calmette-Guérin (BCG), which is pyrazinamide-resistant, and concomitantly treated for 5 days with desferrioxamine in combination with each one of the second-line tuberculosis antimicrobials. Our data indicate that desferrioxamine used as an adjunctive treatment to bedaquiline significantly reduced the bacterial load in human macrophages infected with BCG. Our findings also reveal a link between enhanced bactericidal activity and increases in specific cytokines, as the addition of desferrioxamine increased levels of IFN-γ, IL-6, and IL-1β in BCG-infected human monocyte-derived macrophages (hMDMs) treated with bedaquiline. These results provide insight, and an in vitro proof-of-concept, that iron chelators may prove an effective adjunctive therapy in combination with current tuberculosis antimicrobials.
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Affiliation(s)
- Christina Cahill
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, St James’s Hospital, 8 Dublin, Ireland; (C.C.); (K.M.G.); (D.J.C.); (S.A.B.); (J.K.)
| | - Fiona O’Connell
- Department of Surgery, Trinity Translational Medicine Institute, Trinity College Dublin, St James’s Hospital, 8 Dublin, Ireland; (F.O.); (J.O.)
| | - Karl M. Gogan
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, St James’s Hospital, 8 Dublin, Ireland; (C.C.); (K.M.G.); (D.J.C.); (S.A.B.); (J.K.)
| | - Donal J. Cox
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, St James’s Hospital, 8 Dublin, Ireland; (C.C.); (K.M.G.); (D.J.C.); (S.A.B.); (J.K.)
| | - Sharee A. Basdeo
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, St James’s Hospital, 8 Dublin, Ireland; (C.C.); (K.M.G.); (D.J.C.); (S.A.B.); (J.K.)
| | - Jacintha O’Sullivan
- Department of Surgery, Trinity Translational Medicine Institute, Trinity College Dublin, St James’s Hospital, 8 Dublin, Ireland; (F.O.); (J.O.)
| | - Stephen V. Gordon
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, 4 Dublin, Ireland;
| | - Joseph Keane
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, St James’s Hospital, 8 Dublin, Ireland; (C.C.); (K.M.G.); (D.J.C.); (S.A.B.); (J.K.)
| | - James J. Phelan
- TB Immunology Group, Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, St James’s Hospital, 8 Dublin, Ireland; (C.C.); (K.M.G.); (D.J.C.); (S.A.B.); (J.K.)
- Correspondence: ; Tel.: +353-18963265
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Haynes AM, Giacani L, Mayans MV, Ubals M, Nieto C, Pérez-Mañá C, Quintó L, Romeis E, Mitjà O. Efficacy of linezolid on Treponema pallidum, the syphilis agent: A preclinical study. EBioMedicine 2021; 65:103281. [PMID: 33721817 PMCID: PMC7973135 DOI: 10.1016/j.ebiom.2021.103281] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/10/2021] [Accepted: 02/26/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Penicillin G, the current standard treatment for syphilis, has important drawbacks, but virtually no preclinical or clinical studies have been performed to identify viable alternatives. We tested, both in vitro and in vivo, three marketed antibiotics with adequate pharmacological properties to treat syphilis. METHODS We used an in vitro culturing system of T. pallidum to perform drug susceptibility testing and applied quantitative PCR targeting the tp0574 gene to measure bacterial growth. To confirm in vivo efficacy, fifteen rabbits were infected intradermally with T. pallidum at eight sites each and randomly allocated to an experimental treatment (linezolid, moxifloxacin, clofazimine) or a control arm (benzathine penicillin G [BPG], untreated). The primary outcome was treatment efficacy defined as the time to lesion healing measured from the date of treatment start. Secondary outcomes were absence of treponemes or treponemal mRNA in injection sites, absence of seroconversion, and cerebrospinal fluid (CSF) abnormalities and negative rabbit infectivity tests (RIT). FINDINGS Linezolid showed in vitro bactericidal activity at concentrations of 0.5 µg/mL or higher. When administered orally to experimentally infected rabbits, it induced healing of early lesions at a time similar to BPG (hazard ratio 3.84; 95% CI 2.05-7.17; p < 0.0001 compared to untreated controls). In linezolid-treated animals, dark-field microscopy and qPCR assessment showed no presence of treponemes after day 3 post-treatment start, serologic test did not convert to positive, CSF had no abnormalities, and RIT was negative. Moxifloxacin and clofazimine failed to inhibit bacterial growth in vitro and could not cure the infection in the rabbit model. INTERPRETATION Linezolid, a low-cost oxazolidinone, has in vitro and in vivo activity against T. pallidum, with efficacy similar to BPG in treating treponemal lesions in the animal model. Our findings warrant further research to assess the efficacy of linezolid as an alternative to penicillin G to treat syphilis in human clinical trials. FUNDING European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program (Grant agreement No. 850450).
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Affiliation(s)
- Austin M Haynes
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Lorenzo Giacani
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA.
| | - Marti Vall Mayans
- Fight Aids and Infectious Diseases Foundation, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Maria Ubals
- Fight Aids and Infectious Diseases Foundation, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain; Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain
| | | | - Clara Pérez-Mañá
- Clinical Pharmacology Unit, Hospital, Universitari Germans Trias i Pujol, Institut de Recerca Germans Trias i Pujol (HUGTiP-IGTP), Badalona, Spain; Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Llorenç Quintó
- Barcelona Institute for Global Health, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Manhiça Health Research Institute (CISM), Maputo, Mozambique
| | - Emily Romeis
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Oriol Mitjà
- Fight Aids and Infectious Diseases Foundation, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain; Lihir Medical Centre-International SOS, Lihir Island, Papua New Guinea.
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Gao J, Du J, Shu W, Liu Y, Wang Y, Xue Z, Li L, Pang Y. Stepwise selection of mutation conferring fluroquinolone resistance: multisite MDR-TB cohort study. Eur J Clin Microbiol Infect Dis 2021; 40:1767-1771. [PMID: 33604720 DOI: 10.1007/s10096-021-04187-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/07/2021] [Indexed: 11/26/2022]
Abstract
In this study, we demonstrate that fluroquinolone (FQ) is at risk of acquired drug resistance after continuous exposure. The reduced susceptibility is observed in subsequent Mycobacterium tuberculosis isolates from patients without FQ exposure. The stepwise selection of mutation of increasing FQ resistance highlights the urgent need for monitoring FQ resistance in multidrug-resistant tuberculosis patients throughout the entire treatment course.
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Affiliation(s)
- Jingtao Gao
- Clinical Center on TB, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Jian Du
- Clinical Center on TB, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Wei Shu
- Clinical Center on TB, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Yuhong Liu
- Clinical Center on TB, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China
| | - Yufeng Wang
- Department of Laboratory Quality Control, Innovation Alliance on Tuberculosis Diagnosis and Treatment (Beijing), Beijing, People's Republic of China
| | - Zhongtan Xue
- Department of Laboratory Quality Control, Innovation Alliance on Tuberculosis Diagnosis and Treatment (Beijing), Beijing, People's Republic of China
| | - Liang Li
- Clinical Center on TB, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China.
| | - Yu Pang
- Department of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis & Thoracic Tumor Research Institute, No 9, Beiguan Street, Tongzhou District, Beijing, 101149, People's Republic of China.
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Alyami AM, Kaabia NM, AlQasim MA, Al Doghaim FS, Albehlal LB, Ahmed MA, Al Aidaroos AY, Al Odayani A. Chryseobacterium/Elizabethkingia species infections in Saudi Arabia. Saudi Med J 2021; 41:309-313. [PMID: 32114605 PMCID: PMC7841570 DOI: 10.15537/smj.2020.3.24985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To describe the epidemiological, clinical, and outcome data of patients infected or colonized with Chryseobacterium/Elizabethkingia spp including antibiotic susceptibility patterns. Methods: This retrospective study was conducted at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. All patients infected or colonized by Chryseobacterium /Elizabethkingia spp who were admitted between June 2013 and May 2019 were included. Data were extracted from patient electronic medical records. Results: We enrolled 27 patients (13 males and 14 females) with a mean age of 35.6 years. Chryseobacterium/Elizabethkingia spp were isolated from blood cultures (n=13, 48%) and tracheal aspirations (n=11, 41%). The most frequent species isolated was Elizabethkingia meningoseptica (n=22). Although 6 patients were considered colonized, the remaining 21 patients presented with ventilator associated pneumonia (n=9), central line associated bloodstream infection (n=4), septic shock (n=4), or isolated bacteremia (n=4). In 25 cases the infections were health-care related. Three patients (11%) died within 28 days. Twenty-six isolates (96.5%) were resistant to carbapenems. Moxifloxacin and cotrimoxazole were the most active antibiotics. Conclusion: Chryseobacterium/Elizabethkingia spp infection is rare, but can be responsible for severe hospital acquired infections. Cotrimoxazole and fluoroquinolone are the most effective antibiotic treatments.
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Affiliation(s)
- Abdulaziz M Alyami
- Infection Control and Prevention Department, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Pouroutzidou GK, Liverani L, Theocharidou A, Tsamesidis I, Lazaridou M, Christodoulou E, Beketova A, Pappa C, Triantafyllidis KS, Anastasiou AD, Papadopoulou L, Bikiaris DN, Boccaccini AR, Kontonasaki E. Synthesis and Characterization of Mesoporous Mg- and Sr-Doped Nanoparticles for Moxifloxacin Drug Delivery in Promising Tissue Engineering Applications. Int J Mol Sci 2021; 22:E577. [PMID: 33430065 PMCID: PMC7827177 DOI: 10.3390/ijms22020577] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 02/07/2023] Open
Abstract
Mesoporous silica-based nanoparticles (MSNs) are considered promising drug carriers because of their ordered pore structure, which permits high drug loading and release capacity. The dissolution of Si and Ca from MSNs can trigger osteogenic differentiation of stem cells towards extracellular matrix calcification, while Mg and Sr constitute key elements of bone biology and metabolism. The aim of this study was the synthesis and characterization of sol-gel-derived MSNs co-doped with Ca, Mg and Sr. Their physico-chemical properties were investigated by X-ray diffraction (XRD), scanning electron microscopy with energy dispersive X-ray analysis (SEM/EDX), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), X-ray fluorescence spectroscopy (XRF), Brunauer Emmett Teller and Brunauer Joyner Halenda (BET/BJH), dynamic light scattering (DLS) and ζ-potential measurements. Moxifloxacin loading and release profiles were assessed with high performance liquid chromatography (HPLC) cell viability on human periodontal ligament fibroblasts and their hemolytic activity in contact with human red blood cells (RBCs) at various concentrations were also investigated. Doped MSNs generally retained their textural characteristics, while different compositions affected particle size, hemolytic activity and moxifloxacin loading/release profiles. All co-doped MSNs revealed the formation of hydroxycarbonate apatite on their surface after immersion in simulated body fluid (SBF) and promoted mitochondrial activity and cell proliferation.
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Affiliation(s)
- Georgia K. Pouroutzidou
- School of Physics, Faculty of Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (G.K.P.); (I.T.)
| | - Liliana Liverani
- Department of Materials Science and Engineering, Institute of Biomaterials, University of Erlangen-Nuremberg, 91058 Erlangen, Germany; (L.L.); (A.R.B.)
| | - Anna Theocharidou
- School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.T.); (A.B.)
| | - Ioannis Tsamesidis
- School of Physics, Faculty of Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (G.K.P.); (I.T.)
- Pharmadev, UMR 152, Université de Toulouse, IRD, UPS, 31400 Toulouse, France
| | - Maria Lazaridou
- School of Chemistry, Faculty of Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (M.L.); (E.C.); (C.P.); (K.S.T.); (D.N.B.)
| | - Evi Christodoulou
- School of Chemistry, Faculty of Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (M.L.); (E.C.); (C.P.); (K.S.T.); (D.N.B.)
| | - Anastasia Beketova
- School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.T.); (A.B.)
| | - Christina Pappa
- School of Chemistry, Faculty of Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (M.L.); (E.C.); (C.P.); (K.S.T.); (D.N.B.)
| | - Konstantinos S. Triantafyllidis
- School of Chemistry, Faculty of Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (M.L.); (E.C.); (C.P.); (K.S.T.); (D.N.B.)
- Center for Interdisciplinary Research and Innovation (CIRI-AUTH), Balkan Center, 57001 Thessaloniki, Greece
| | - Antonios D. Anastasiou
- Department of Chemical Engineering and Analytical Science, University of Manchester, Manchester M1 3AL, UK;
| | - Lambrini Papadopoulou
- School of Geology, Faculty of Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Dimitrios N. Bikiaris
- School of Chemistry, Faculty of Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (M.L.); (E.C.); (C.P.); (K.S.T.); (D.N.B.)
| | - Aldo R. Boccaccini
- Department of Materials Science and Engineering, Institute of Biomaterials, University of Erlangen-Nuremberg, 91058 Erlangen, Germany; (L.L.); (A.R.B.)
| | - Eleana Kontonasaki
- School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.T.); (A.B.)
- Center for Interdisciplinary Research and Innovation (CIRI-AUTH), Balkan Center, 57001 Thessaloniki, Greece
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Chen X, He G, Lin S, Wang S, Sun F, Chen J, Zhang W. Analysis of Serial Multidrug-Resistant Tuberculosis Strains Causing Treatment Failure and Within-Host Evolution by Whole-Genome Sequencing. mSphere 2020; 5:e00884-20. [PMID: 33361124 PMCID: PMC7763549 DOI: 10.1128/msphere.00884-20] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/20/2020] [Indexed: 11/20/2022] Open
Abstract
The cure rate of multidrug-resistant tuberculosis (MDR-TB) is relatively low in China. The reasons for the treatment failure and within-host evolution during treatment have not been sufficiently studied. All MDR-TB patients receiving standard treatment from January 2014 to September 2016 at a designated TB Hospital in Zhejiang Province were retrospectively included and grouped according to their known treatment outcome. Clinical information was collected. Baseline strains of all patients and serial strains of treatment-failure patients were revived. Drug susceptibility tests (DSTs) of 14 drugs and single nucleotide polymorphism (SNP) analysis based on whole-genome sequencing (WGS) were performed. The genetic distance and within-host evolution were investigated based on SNPs. In total, 20 treatment failure patients and 74 patients who succeeded in treatment were included. The number of effective drugs for patients who failed treatment was no more than three. Eighteen (90.0%) treatment-failure patients were characterized by a continuous infection of the primary strain, of which 14 patients (77.8%) developed phenotypic or genotypic acquired drug resistance under ineffective treatment. Acquired resistance to amikacin and moxifloxacin (2.0 mg/ml) was detected most frequently, in 5 and 4 patients, respectively. The insufficient number of effective drugs in the combined treatment regimen was the main reason for MDR-TB treatment failure. The study emphasizes the importance of DST for second-line drugs when implementing the second-line drug regimen in MDR-TB patients. For patients with risk factors for MDR-TB, DST of second-line antituberculosis drugs should be performed at initiation of treatment. Second-line drugs should be selected based on the results of DST to avoid acquired resistance. WGS detects low-frequency resistance mutations and heterogeneous resistance with high sensitivity, which is of great significance for guiding clinical treatment and preventing acquired resistance.IMPORTANCE Few studies have focused on the reasons for the low cure rate of multidrug-resistant tuberculosis in China and within-host evolution during treatment, which is of great significance for improving clinical treatment regimens. Acquired resistance events were common during the ineffective treatment, among which resistance to amikacin and high-level moxifloxacin were the most common. The main reason for the treatment failure of MDR-TB patients was insufficient effective drugs, which may lead to higher levels of drug resistance in MDR-TB strains. Therefore, the study emphasizes the importance of DST in the development of second-line treatment regimen when there is a risk of MDR. By performing whole-genome sequencing of serial strains from patients with treatment failure, we found that WGS can detect low-frequency resistance mutations and heterogeneous resistance with high sensitivity. It is thus recommended to conduct drug susceptibility tests at the beginning of treatment and repeat the DST when the sputum bacteria remain positive.
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Affiliation(s)
- Xinchang Chen
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Guiqing He
- Department of Infectious Diseases, Wenzhou Central Hospital, Affiliated Dingli Clinical Institute of Wenzhou Medical University, Wenzhou, China
| | - Siran Lin
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Shiyong Wang
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Feng Sun
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiazhen Chen
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenhong Zhang
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
- State Key Laboratory of Genetic Engineering, School of Life Science, Fudan University, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Medical Molecular Virology (MOE/MOH) and Institutes of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai, China
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Kowalska J, Banach K, Rok J, Beberok A, Rzepka Z, Wrześniok D. Molecular and Biochemical Basis of Fluoroquinolones-Induced Phototoxicity-The Study of Antioxidant System in Human Melanocytes Exposed to UV-A Radiation. Int J Mol Sci 2020; 21:ijms21249714. [PMID: 33352719 PMCID: PMC7765951 DOI: 10.3390/ijms21249714] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/10/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022] Open
Abstract
Phototoxicity of fluoroquinolones is connected with oxidative stress induction. Lomefloxacin (8-halogenated derivative) is considered the most phototoxic fluoroquinolone and moxifloxacin (8-methoxy derivative) the least. Melanin pigment may protect cells from oxidative damage. On the other hand, fluoroquinolone–melanin binding may lead to accumulation of drugs and increase their toxicity to skin. The study aimed to examine the antioxidant defense system status in normal melanocytes treated with lomefloxacin and moxifloxacin and exposed to UV-A radiation. The obtained results demonstrated that UV-A radiation enhanced only the lomefloxacin-induced cytotoxic effect in tested cells. It was found that fluoroquinolones alone and with UV-A radiation decreased superoxide dismutase (SOD) activity and SOD1 expression. UV-A radiation enhanced the impact of moxifloxacin on hydrogen peroxide-scavenging enzymes. In turn, lomefloxacin alone increased the activity and the expression of catalase (CAT) and glutathione peroxidase (GPx), whereas UV-A radiation significantly modified the effects of drugs on these enzymes. Taken together, both analyzed fluoroquinolones induced oxidative stress in melanocytes, however, the molecular and biochemical studies indicated the miscellaneous mechanisms for the tested drugs. The variability in phototoxic potential between lomefloxacin and moxifloxacin may result from different effects on the antioxidant enzymes.
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Gong X, Hou C, Zhang Q, Li Y, Wang H. Thermochromic Hydrogel-Functionalized Textiles for Synchronous Visual Monitoring of On-Demand In Vitro Drug Release. ACS Appl Mater Interfaces 2020; 12:51225-51235. [PMID: 33164509 DOI: 10.1021/acsami.0c14665] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
In vitro drug release systems have recently received tremendous attention because they allow noninvasive, convenient, and prolonged administration of pharmacological agents. On-demand epidermal drug release systems can improve treatment efficiency, prevent multidrug resistance, and minimize drug toxicity to healthy cells. In addition, real-time monitoring of drug content is also essential for guiding the determination of drug dosage and replacing drug carriers in time. Therefore, it is important to integrate the above properties in one ideal epidermal patch. Herein, photonic crystals (PCs) based on Fe3O4@C nanoparticles were introduced into drug-loaded poly(N-isopropylacrylamide-co-acrylic acid) (P(NIPAM-AAc)) hydrogel-functionalized textiles. Drug loading and release depended on the expansion and contraction of the hydrogels. The lower critical solution temperature (LCST) of the hydrogels was adjusted to 40 °C, which is higher than the skin temperature, by varying the content of hydrophilic comonomer acrylic acid (AAc) to store the drug at room temperature, and on-demand release was achieved by mild thermal stimulation. Moreover, the lattice spacing (d) of PCs varied with the expansion and contraction of the hydrogels, which can cause the color of P(NIPAM-AAc) hydrogel-functionalized textiles to change. These synchronous thermoresponsive chromic drug uptake and release behaviors provided an effective method for visual and real-time monitoring of drug content. Furthermore, in view of the poor mechanical properties of hydrogel wound dressings, textile matrices were composited to prevent holistic breaking during the stretching process. Biological experiments proved that the drug-loaded P(NIPAM-AAc) hydrogel-functionalized textiles had good antibacterial properties and wound-healing effects.
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Affiliation(s)
- Xinbo Gong
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201600, China
| | - Chengyi Hou
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201600, China
| | - Qinghong Zhang
- Engineering Research Center of Advanced Glasses Manufacturing Technology, College of Materials Science and Engineering, Donghua University, Shanghai 201600, China
| | - Yaogang Li
- Engineering Research Center of Advanced Glasses Manufacturing Technology, College of Materials Science and Engineering, Donghua University, Shanghai 201600, China
| | - Hongzhi Wang
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201600, China
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Valenzuela MV, Domenech M, Mateos-Martínez P, González-Camacho F, de la Campa AG, García MT. Antibacterial activity of a DNA topoisomerase I inhibitor versus fluoroquinolones in Streptococcus pneumoniae. PLoS One 2020; 15:e0241780. [PMID: 33141832 PMCID: PMC7608930 DOI: 10.1371/journal.pone.0241780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/05/2020] [Accepted: 10/20/2020] [Indexed: 12/23/2022] Open
Abstract
The DNA topoisomerase complement of Streptococcus pneumoniae is constituted by two type II enzymes (topoisomerase IV and gyrase), and a single type I enzyme (topoisomerase I). These enzymes maintain the DNA topology, which is essential for replication and transcription. While fluoroquinolones target the type II enzymes, seconeolitsine, a new antimicrobial agent, targets topoisomerase I. We compared for the first time the in vitro effect of inhibition of topoisomerase I by seconeolitsine and of the type II topoisomerases by the fluoroquinolones levofloxacin and moxifloxacin. We used three isogenic non-encapsulated strains and five non-vaccine serotypes isolates belonging to two circulating pneumococcal clones, ST638 (2 strains) and ST1569V (3 strains). Each group contained strains with diverse susceptibility to fluoroquinolones. Minimal inhibitory concentrations, killing curves and postantibiotic effects were determined. Seconeolitsine demonstrated the fastest and highest bactericidal activity against planktonic bacteria and biofilms. When fluoroquinolone-susceptible planktonic bacteria were considered, seconeolitsine induced postantibiotic effects (1.00−1.87 h) similar than levofloxacin (1.00−2.22 h), but longer than moxifloxacin (0.39−1.71 h). The same effect was observed in sessile bacteria forming biofilms. Seconeolitsine induced postantibiotic effects (0.84−2.31 h) that were similar to those of levofloxacin (0.99−3.32 h) but longer than those of moxifloxacin (0.89−1.91 h). The greatest effect was observed in the viability and adherence of bacteria in the postantibiotic phase. Seconeolitsine greatly reduced the thickness of the biofilms formed in comparison with fluoroquinolones: 2.91 ± 0.43 μm (seconeolitsine), 7.18 ± 0.58 μm (levofloxacin), 17.08 ± 1.02 μm (moxifloxacin). When fluoroquinolone-resistant bacteria were considered, postantibiotic effects induced by levofloxacin and moxifloxacin, but not by seconeolitsine, were shorter, decreasing up to 5-fold (levofloxacin) or 2-fold (moxifloxacin) in planktonic cells, and up to 1.7 (levofloxacin) or 1.4-fold (moxifloxacin) during biofilm formation. Therefore, topoisomerase I inhibitors could be an alternative for the treatment of pneumococcal diseases, including those caused by fluoroquinolone-resistant isolates.
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Affiliation(s)
- Myriam V. Valenzuela
- Departamento de Genética, Unidad de Microbiología, Fisiología y Microbiología, Universidad Complutense, Madrid, Spain
| | - Mirian Domenech
- Unidad de Neumococos, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid; Spain
| | - Patricia Mateos-Martínez
- Departamento de Genética, Unidad de Microbiología, Fisiología y Microbiología, Universidad Complutense, Madrid, Spain
| | - Fernando González-Camacho
- Unidad de Neumococos, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid; Spain
| | - Adela G. de la Campa
- Unidad de Genética Bacteriana, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid; Spain
- Presidencia, Consejo Superior de Investigaciones Científicas, Madrid, Spain
- * E-mail: (MTG); (AGC)
| | - Maria Teresa García
- Departamento de Genética, Unidad de Microbiología, Fisiología y Microbiología, Universidad Complutense, Madrid, Spain
- * E-mail: (MTG); (AGC)
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Abstract
Lefamulin is a novel pleuromutilin antibiotic with potent in vitro activity against key community-acquired bacterial pneumonia (CABP) pathogens. However, the clinical efficacy and safety of lefamulin for treating CABP remains unclear.An integrated analysis of 2 phase III trials investigating the clinical efficacy and safety of lefamulin vs moxifloxacin in the treatment of CABP was conducted.A total of 1289 patients (lefamulin group: 646 and moxifloxacin group: 643) were included in this analysis. The early clinical response rate was 89.3% and 90.5% among lefamulin and moxifloxacin group, respectively. Lefamulin was noninferior to moxifloxacin (89.3% vs 90.5%, RR: 0.99, 95% CI: 0.95-1.02, I = 0%). In terms of clinical response at test of cure, no significant difference was observed between the lefamulin and moxifloxacin groups (for modified intention to treat population, RR: 0.98, 95% CI: 0.94-1.02, I = 0%; for clinically evaluable population, RR: 0.96, 95% CI: 0.93-1.00, I = 0%). In the subgroup analysis, the early clinical response rate at early clinical assessment and clinical response rate at test of cure of lefamulin was similar to that of moxifloxacin across different subgpopulations and all baseline CABP pathogens. Lefamulin was associated with a similar risk of adverse events as moxifloxacin.Clinical efficacy and tolerability for lefamulin in the treatment of CABP were similar to those for moxifloxacin.
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Affiliation(s)
| | - Jui-Hsiang Wang
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan
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Nie WJ, Xie ZY, Gao S, Teng TL, Zhou WQ, Shang YY, Jing W, Shi WH, Wang QF, Huang XR, Cai BY, Wang J, Wang J, Guo R, Ge QP, Nie LH, Han XQ, Du YD, Chu NH. Efficacy of Moxifloxacin against Mycobacterium abscessus in Zebrafish Model in vivo. Biomed Environ Sci 2020; 33:350-358. [PMID: 32553079 DOI: 10.3967/bes2020.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/11/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Moxifloxacin (MFX) shows good in vitro activity against Mycobacterium abscessus and can be a possible antibiotic therapy to treat M. abscessus infection; however, other studies have shown a lower or no activity. We aimed to evaluate MFX activity against M. abscessus using zebrafish (ZF) model in vivo. METHODS A formulation of M. abscessus labeled with CM-Dil was micro-injected into ZF. Survival curves were determined by recording dead ZF every day. ZF were lysed, and colony-forming units (CFUs) were enumerated. Bacteria dissemination and fluorescence intensity in ZF were analyzed. Inhibition rates of MFX and azithromycin (AZM, positive control) were determined and compared. RESULTS Significantly increased survival rate was observed with different AZM concentrations. However, increasing MFX concentration did not result in a significant decrease in ZF survival curve. No significant differences in bacterial burdens by CFU loads were observed between AZM and MFX groups at various concentrations. Bacterial fluorescence intensity in ZF was significantly correlated with AZM concentration. However, with increasing MFX concentration, fluorescence intensity decreased slightly when observed under fluorescence microscope. Transferring rates at various concentrations were comparable between the MFX and AZM groups, with no significant difference. CONCLUSION MFX showed limited efficacy against M . abscessus in vivo using ZF model. Its activity in vivo needs to be confirmed.
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Affiliation(s)
- Wen Juan Nie
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Zhong Yao Xie
- Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Shan Gao
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Tian Lu Teng
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Wen Qiang Zhou
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Yuan Yuan Shang
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Wei Jing
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Wen Hui Shi
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Qing Feng Wang
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Xue Rui Huang
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Bao Yun Cai
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Jun Wang
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Jing Wang
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Ru Guo
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Qi Ping Ge
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Li Hui Nie
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Xi Qin Han
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Ya Dong Du
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
| | - Nai Hui Chu
- Tuberculosis Department, Beijing Chest Hospital affiliated to Capital Medical University, Beijing 101149, China
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