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Antimicrobial Agents and Chemotherapy, October 2004, p. 3697-3701, Vol. 48, No. 10
0066-4804/04/$08.00+0 DOI: 10.1128/AAC.48.10.3697-3701.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.
Kenneth L. DenBleyker,1 Linda F. Discotto,1 Joan C. Fung-Tomc,1 and Yasutsugu Ueda2
Department of Microbiology,1 Department of Chemistry, Bristol-Myers Squibb Pharmaceutical Research Institute, Wallingford, Connecticut2
Received 30 March 2004/ Returned for modification 1 May 2004/ Accepted 3 June 2004
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BMS-249524 (nocathiacin I) (5, 12) is the prototype of a new nosiheptide-class of tricyclic peptide antibiotics called nocathiacins and was identified in a cell-based screen of natural product extracts with a multiply antibiotic-resistant strain of Enterococcus faecium as an indicator strain (14). This natural product lead compound was originally isolated from a Nocardia sp. (ATCC 202099) fermentation broth extraction. Previously reported related compounds in this class include thiostrepton and micrococcin (4, 13, 19, 23, 24, 27, 30) and more recently the thiazole antibiotics MJ347-81F4 A and B (25), GE2270A (9), and GE37468 A (26). The mode of action of the nocathiacins on bacterial protein synthesis is closely related to that of thiostrepton, as these antibiotics bind to the 23S rRNA of the 50S ribosomal subunit at the same site as the L11 ribosomal protein (13, 19-21, 24, 27, 29, 30). This prevents the normal conformational transition that occurs from 23S-L11 interaction and results in a stalling of translation affecting the elongation step of bacterial protein synthesis. These compounds, although possessing antibacterial activity and a unique mechanism of action, thus far have not been developed for use in humans due to pharmacokinetic and solubility issues (18). The nocathiacins described here, prototype BMS-249524 and the more water-soluble derivatives BMS-411886 and BMS-461996, possess potent in vitro activity against gram-positive bacteria, including many key antibiotic-resistant clinical pathogens. These compounds offer the potential for further development as a new class of antibiotics for serious gram-positive infections.
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In vitro susceptibility testing.
Whole-cell antibacterial activity was determined by broth microdilution according to methods recommended by NCCLS (17). Test compounds were dissolved in dimethyl sulfoxide and diluted 1:10 in water to produce a stock solution at 256 µg/ml. In a 96-well microtiter plate, 50 µl of the stock solution was serially diluted into cation-adjusted Mueller-Hinton broth (Becton-Dickinson, Cockeysville, Md.) except Haemophilus influenzae (Haemophilus test medium). After the compounds were diluted, 50-µl aliquots of the test organism (each,
5 x 105 CFU/ml) were added to the appropriate wells of the microtiter plate. Inoculated plates were incubated aerobically at 35°C for 18 to 24 h. The MIC was determined to be the lowest concentration of compound that inhibited visible growth. MICs were found to be equivalent in either Mueller-Hinton broth or brain heart infusion broth (BHI; Difco, Detroit, Mich.). Susceptibility tests for Mycobacterium spp. were performed by a macrodilution method in 7H9 broth (Difco) with a final inoculum concentration of 2 x 107 CFU/ml. Tubes were incubated at 35°C in 5% CO2. Inhibition of growth was monitored for 3 weeks. The MIC was defined as the lowest concentration of drug that inhibited visible growth after 3 weeks of incubation. All work involving mycobacteria was done under a biological safety cabinet in a high-containment facility. Susceptibility testing of Legionella pneumophila was done by agar (buffered starch yeast extract) dilution and incubated at 35°C for 24 h. The MICs for Chlamydia trachomatis were determined with McCoy (ATCC) and HL cells (Washington Research Foundation, Seattle, Wash.) in a microtiter format. Chlamydial suspensions prepared in a maintenance medium (Eagle's minimal essential medium [Gibco] supplemented with 10% fetal bovine serum) contained approximately 100 to 1,000 inclusion-forming units per ml, with 0.05 ml of the suspension added per well. The plates were centrifuged at 1,000 x g for 60 min. Twofold serial dilutions of compounds in maintenance medium were added (each dilution, 100 µl), and plates were incubated for 48 h in 5% CO2, fixed with methanol, and stained with 0.02 ml of fluorescein-conjugated monoclonal antibody specific to the chlamydial lipopolysaccharide. The presence of chlamydial inclusion bodies was detected with an inverted fluorescent microscope at 100x magnification. The MIC was defined as the lowest compound concentration with no observable inclusion bodies. MICs for Mycoplasma pneumoniae were performed by broth microdilution where the test medium was PPLO medium (Difco) supplemented with 2.5% yeast extract, 20% horse serum, and 1% dextrose. The inoculum contained 104 to 105 color-changing units (the minimum inoculum required for growth as indicated by a color change in 0.002% phenol red indicator) per ml and 100 µl of the diluted compound in each well. The MIC was defined as the lowest dilution of compound that inhibited growth as indicated by the lack of a color change, relative to the growth control with color change (7).
In vitro killing curve assay. The bacteriostatic and bactericidal effects of BMS-249524, BMS-411886, and BMS-461996 against Staphylococcus aureus A27223, a homogeneous methicillin-resistant clinical isolate, were determined by a time-kill assay. Cultures were grown overnight at 35°C in BHI broth with aeration, diluted into fresh BHI, and allowed to grow for several generations at 35°C with aeration until the cultures reached approximately 106 CFU/ml. At this point, 5-ml aliquots of culture were removed, and antibiotics were added at one, two, and four times the MIC, and the cultures were further incubated at 35°C with aeration. Samples of 100 µl (each) were withdrawn at 30-min intervals for 8 h, diluted, and plated in duplicate on BHI agar plates. Plates were incubated for 24 h at 35°C, and colonies on each plate were counted. The CFU per ml were calculated for each time interval at each drug concentration.
Mutation analyses. Mutants were isolated on BHI agar containing compound at two to four times the MIC. Mutations were determined by PCR cloning of the gene encoding the L11 ribosomal protein, followed by DNA sequence analyses of the PCR fragments. Chromosomal DNA was isolated from 2 ml of overnight culture grown in BHI broth. Cells were pelleted and washed with TES buffer (50 mM EDTA, 50 mM NaCl [pH 8.0]) and resuspended in 1 ml of TES. Lysostaphin (Sigma) was added to a final concentration of 20 µg/ml, RNase A (Sigma) was added to a final concentration of 200 µg/ml, and cells were incubated at 37°C for 60 min. This was followed by the addition of STEP buffer (0.5% sodium dodecyl sulfate, 50 mM Tris, 0.4 M EDTA, 1 mg of proteinase K [Sigma]/ml) and further incubation at 40°C for 60 min. Samples were then extracted twice with each of the following: phenol, phenol-chloroform, and chloroform. A 1/10 volume of 3 M sodium acetate and 2 volumes of ethanol were added to precipitate the chromosomal DNA. The DNA was spooled out with a glass rod and dissolved in water. The following primers flanking the staphylococcal L11 gene were used to PCR clone the gene: L11-R (5' AGTTAAGAGCAGACAACAGAAG 3') and L11-L (5' AGTGTTAAAATTATGTGGTCGCG 3'). Vent polymerase (New England Biolabs, Beverly, Mass.) was used to amplify the L11 sequences. The PCR products were purified with a Qiaquick PCR purification kit (QIAGEN, Valencia, Calif.) and sequenced with ABIprism BigDye (Perkin-Elmer, Wellesley, Mass.). DNA traces were analyzed with Lasergene software (DNASTAR, Madison, Wis.).
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FIG. 1. Chemical structures of the nocathiacins discussed in this work.
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TABLE 1. MICs of nocathiacins and vancomycin for selected bacterial pathogens
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TABLE 2. MICs of BMS-249524 and vancomycin for vancomycin-intermediate resistant S. aureus
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TABLE 3. MICs of BMS-259524 and trovafloxacin for selected anaerobic bacteria
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TABLE 4. MICs of BMS-249524 and other drugs for mycobacteria
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TABLE 5. MIC of nocathiacins and other drugs for M. pneumoniae and L. pneumoniae
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TABLE 6. MICs of nocathiacins and other drugs for C. trachomatisa
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FIG. 2. Time-kill curves of nocathiacin-treated S. aureus A27223. Experimental details are found in Materials and Methods. Addition of compound BMS-249524 was at time zero. Symbols: , untreated control culture; , one times the MIC (0.01 µg/ml); , two times the MIC (0.02 µg/ml); , four times the MIC (0.04 µg/ml).
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60 min in BHI broth (data not shown). These mutations were localized near several key proline residues present in the antibiotic binding cleft of the L11-23S rRNA region of the 50S ribosome (Fig. 3) in a region previously shown to be involved in thiostrepton binding (20, 29). |
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TABLE 7. RplK mutations found in nocathiacin-resistant mutants
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FIG. 3. Putative nocathiacin binding site on the 50S E. coli ribosome. Labeled amino acid residues and nucleotides indicate previously reported mutations that confer thiostrepton and micrococcin resistance. Mutations are clustered around a cleft (arrow) between RNA (left) and a proline-rich helix in the L11 N terminus (29). The figure was drawn with InsightII (Accelrys, San Diego, Calif.) with identification of secondary structures as previously described (11).
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The initial compound, BMS-249524, discovered from a screen against a multiply antibiotic-resistant E. faecium strain, was found to be extremely potent against gram-positive pathogens, including several antibiotic-resistant isolates. The aqueous solubility of BMS-249524 was found to be insufficient for use as an intravenous agent in humans. Therefore, an effort was made to investigate modifications of this class of compounds that would maintain the biological activity of nocathiacins while increasing their water solubility (Naidu et al., 224th Am. Chem. Soc. Nat. Meet.; 10). BMS-411886 and BMS-461996 represent examples of such compounds that display improved aqueous solubility profile while retaining good antibacterial activity.
All three nocathiacins described here show improved in vitro potency compared with vancomycin, currently an important antibiotic for the treatment of nosocomial gram-positive bacterial infections. Beginning in the 1980s, increased use of vancomycin resulted in the selection of resistant strains, initially of enterococci but recently of some S. aureus strains (28). The nocathiacins compared favorably in vitro with other classes of antibiotics including oxazolidinones, macrolides, fluoroquinolones, and ß-lactams against various pathogens including Mycobacteria spp., L. pneumophila, M. pneumoniae, and gram-positive anaerobes. Although most bacterial protein synthesis inhibitors described to date are bacteriostatic against staphylococci, these nocathiacins displayed bactericidal activity against staphylococci. However, as with many other antibacterials, bacteriostatic activity was observed against enterococci.
Nocathiacin-resistant staphylococcal and enterococcal mutants obtained were single-step, high-level resistant organisms. DNA sequence analyses revealed several different types of mutations that mapped to the rplK gene encoding the ribosomal L11 protein in the region of several key proline residues in the L11 binding domain, consistent with a region shown to be involved in thiostrepton binding (20, 29). These mutants were also cross-resistant with thiostrepton (data not shown). That the mutations were found predominantly in the rplK gene, resulting in a modified L11 protein, and not in the 23S rRNA may indicate some differences in the binding of these compounds versus that of thiostrepton and micrococcin. Mutant colonies were small in size and grew significantly more slowly in liquid medium than the wild-type strain. It is unclear at this point how quickly resistance would emerge in the clinic or if the lower growth rates is an indication of the cost that resistance imposes on the fitness of the bacteria.
We believe that the nocathiacins described here represent a novel group of compounds related to thiostrepton that inhibit bacterial protein synthesis and merit further investigation. They exhibit excellent potency against important gram-positive pathogens, including antibiotic-resistant strains. Because they target a region of the ribosome that is unique in comparison to currently used drugs, no cross-resistance to existing agents is likely. The nocathiacins have the potential to become new, effective agents for the treatment of serious gram-positive bacterial infections.
Present address: Merck Research Laboratories, Rahway, NJ 07065. ![]()
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