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Antimicrobial Agents and Chemotherapy, April 2009, p. 1427-1433, Vol. 53, No. 4
0066-4804/09/$08.00+0 doi:10.1128/AAC.00887-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Dilip J. Upadhyay,1
Kulvinder Singh Saini,3
Ashok Rattan,4 and
V. Samuel Raj1*
Department of Infectious Diseases,1 Department of Molecular Modeling,2 Department of Biotechnology, New Drug Discovery Research, Ranbaxy Research Laboratories, R & D III, Sector-18, Gurgaon 122 015, India,3 SRL Ranbaxy, Sector-18, Gurgaon 122 015, India4
Received 6 July 2008/ Returned for modification 18 September 2008/ Accepted 9 December 2008
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The oxazolidinones are a new class of antimicrobial agents that act against a wide spectrum of bacteria, primarily gram-positive pathogens (4, 9, 22). Earlier studies of the mechanism of action of oxazolidinones have shown effects on protein synthesis and no effect on DNA and RNA synthesis (8). The oxazolidinone binds to the 50S ribosomal subunit and competes with chloramphenicol and lincomycin (16). The oxazolidinones bind to the 50S subunit first and then interact with the 30S subunit to inhibit the formation of the initiation complex during bacterial translation by preventing the formation of the N-formyl-methionyl-tRNA-ribosome-mRNA ternary complex (28, 30). The nuclear magnetic resonance data presented by Zhou et al. suggest that only the 50S subunit is absolutely required for binding and that any interaction with the 30S subunit is probably indirect (30). Recently, Leach et al. reported that oxazolidinones interact with the A site of the bacterial ribosome, where they interfere with the placement of the aminoacyl-tRNA (15).
Linezolid is the first antibacterial drug in the oxazolidinone class used for the treatment of complicated skin and skin structure infections caused by S. aureus (MRSA and methicillin-susceptible S. aureus), Streptococcus pyogenes, or Streptococcus agalactiae; uncomplicated skin and soft tissue infections caused by S. aureus or S. pyogenes; hospital-acquired pneumonia caused by S. aureus; community-acquired pneumonia caused by Streptococcus pneumoniae or S. aureus; and vancomycin-resistant Enterococcus faecium infections (22). Further, many investigational oxazolidinones are reported across the globe and have shown a good spectrum of activity against gram-positive pathogens (1, 2, 4, 7, 9, 17, 27).
Ranbezolid, an investigational oxazolidinone, showed excellent in vitro activity against gram-positive pathogens, especially methicillin-susceptible S. aureus and MRSA, and also against methicillin-susceptible Staphylococcus epidermidis and methicillin-resistant S. epidermidis (MRSE) (5, 11, 19, 20). In addition, ranbezolid is the first oxazolidinone which showed similar activities against both gram-negative and gram-positive anaerobes (6, 11). Further, ranbezolid exhibited significant in vitro activity against slime-producing staphylococci and mycobacteria (18, 26). In this study, we have analyzed the properties of ranbezolid against staphylococci, and we report the mode of action and its interaction with ribosomes.
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Macromolecular synthesis in S. aureus and S. epidermidis. Macromolecular biosynthesis inhibition in S. aureus and S. epidermidis was studied as described by Oliva et al., with some modifications (23). The following radiolabeled precursors were added to cells for the macromolecular synthesis inhibition assays: protein assay, [14C]isoleucine; DNA assay, [3H]thymidine; RNA assay, [3H]uridine; cell wall assay, [3H]N-acetylglucosamine; and fatty acid assay, [14C]acetate. In brief, S. aureus 25923 and S. epidermidis 23760 were grown in Mueller-Hinton broth (MHB) medium, and radioactive precursors (1 µCi/ml for 3H-labeled and 0.1 µCi/ml for 14C-labeled compounds) were added during the early logarithmic phase (optical density at 600 nm [OD600] of 0.3). After 5 min, the inhibitors were added and their MICs determined by the microdilution method. The macromolecules (DNA, RNA, protein, cell wall, and fatty acid) were precipitated with ice-cold trichloroacetic acid (final concentration of 5% [wt/vol]) and filtered on glass fiber filters (1.0 µM A/B glass multiwell filter plates, Pall Corporation). The plates were dried overnight at 37°C, and quantification of radioactivity was done by using OptiPhase safe scintillation fluid and counting with a scintillation counter (Wallac Ltd.). For each set of experiments, an antibiotic known to specifically inhibit the macromolecule was included as a positive control.
Time-kill kinetic study against S. aureus and S. epidermidis.
A time-kill kinetics assay was performed as per Hoellman et al. (11). S. aureus 25923 was exposed to ranbezolid and linezolid at concentrations ranging from 1 µg/ml to 16 µg/ml. S. epidermidis 23760 was exposed to ranbezolid and linezolid at concentrations ranging from 0.25 to 8 µg/ml. Time-kill assays were analyzed by determining the reductions in viable count (log10 CFU/ml) at 2, 4, 8, 24, and 30 h and comparing those with that at 0 h. Antibiotics were considered bactericidal at the lowest concentration that reduced the original inoculum by
3 log10 CFU/ml (99.9% killing) at each time point and bacteriostatic if reduced by <3 log10 CFU/ml.
Cell membrane permeability study.
The BacLight kit from Molecular Probes was used to assess membrane damage with drugs, as described by Hilliard et al. (10). S. aureus 25923 as well as S. epidermidis 23760 was grown overnight in MHB medium at 37°C. The culture was diluted 1:100 in fresh MHB and grown up to an OD600 of 0.5 to 0.6. The bacterial suspension was centrifuged at 10,000 x g for 15 min, and the cell pellet was washed once in sterilized distilled water. The cell pellet was resuspended to one-tenth of the original volume and then diluted 1:20 into either water or water containing ranbezolid and linezolid at concentrations ranging from 1 to 8 µg/ml. For each set of membrane integrity experiments, the known membrane disrupting agent valinomycin and carbonyl cyanide m-chlorophenylhydrazone (CCCP) were used as positive controls. Bacteria and compounds were incubated at room temperature (
25°C) with continuous shaking for 15 to 30 min. The suspension was centrifuged at 10,000 x g for 10 min, washed with sterilized water, and resuspended to an OD670 of 0.325. A volume of 100 µl of the bacterial suspension was added to a 96-well black color Nunc tissue culture plate. BacLight reagent (3 µl/ml bacterial suspension) was then added to each well, and the plates were incubated in the dark for 15 min at room temperature. The plate was read at excitation/emission maxima of 480/500 nm (Syto 9) and 490/635 nm (propidium iodide) in a fluorescence microplate reader.
Cell-free transcription/translation assay. In vitro translation of the luciferase gene was done with bacterial or mammalian ribosome using commercially available Escherichia coli S30 and a TNT kit (Promega), as per the manufacturer's protocol. The percent inhibition of luciferase activity in the presence of various concentrations of drug was determined and compared with that for the control. The 50% inhibitory concentrations were calculated using Graph Pad Prism software.
Molecular modeling studies for interaction of ranbezolid with ribosome. Molecular docking studies were carried out using Surflex in the SYBYL7.3 molecular modeling package (version 7.3; Tripos Associates Inc., St. Louis, MO) installed on a Silicon Graphics Fuel workstation running on the IRIX 6.5 operating system (13, 14, 25). Surflex is a new docking module that employs an idealized active-site ligand, called a protomol, as a target to generate putative poses of molecules or molecular fragments. These putative poses are scored using the Hammerhead scoring function, which also serves as an objective function for local optimization of poses. The crystal structure of an E. coli 50S large subunit of ribosome (Protein Data Bank identification no. [PDB ID] 2AW4) was taken, and its working model was built using residues within 30 Å of A2541 by using information from Leach et al. (15). Charges were removed, and hydrogen atoms were added to the crystal structure. Amber FF99 charges were loaded on the ribosome crystal structure. Protomol (active site) and the sfxc files (surflex descriptor file) were generated in automatic mode. Threshold and bloat parameters were adjusted to best describe the active site. Linezolid and ranbezolid were drawn in SYBYL7.3, and Gasteiger-Hückel charges were added to them. Linezolid and ranbezolid were docked in the generated sfxc file.
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Macromolecular synthesis inhibition. The effect of ranbezolid and linezolid on the incorporation of radiolabeled precursors into protein, DNA, RNA, cell wall, and lipid was determined. Ranbezolid (1 µg/ml) and linezolid (2 µg/ml) were found to be potent inhibitors of protein synthesis in S. aureus 25923 as well as in S. epidermidis 23760 (Fig. 1 and 2). DNA and RNA synthesis was not inhibited by either ranbezolid or linezolid in S. aureus 25923 or in S. epidermidis 23760. Ranbezolid showed inhibition of cell wall and lipid synthesis in S. epidermidis 23760 at 60 min (Fig. 2a). Though there was inhibition of cell wall and lipid synthesis at 60 min by linezolid in S. epidermidis, the effect was less than that of ranbezolid. The control compounds demonstrated specific inhibition of the expected targets at their MICs compared to effects on other biosynthetic pathways (data not shown).
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FIG. 1. Macromolecular synthesis inhibition in S. aureus ATCC 25923 by (a) ranbezolid and (b) linezolid. The MICs determined by the microdilution method were 1 µg/ml for ranbezolid and 2 µg/ml for linezolid.
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FIG. 2. Macromolecular synthesis inhibition in S. epidermidis ATCC 23760 (MRSE) by (a) ranbezolid and (b) linezolid. The MICs were 1 µg/ml for ranbezolid and 2 µg/ml for linezolid.
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FIG. 3. (a) Time-kill kinetics of ranbezolid and linezolid against S. aureus ATCC 25923 ( , control; , ranbezolid at 4 µg/ml; , ranbezolid at 8 µg/ml; , ranbezolid at 16 µg/ml; , linezolid at 4 µg/ml; , linezolid at 8 µg/ml; , linezolid at 16 µg/ml). (b) Time-kill kinetics of ranbezolid and linezolid against S. epidermidis ATCC 23760 ( , control; , ranbezolid at 2 µg/ml; , ranbezolid at 4 µg/ml; , ranbezolid at 8 µg/ml; , linezolid at 4 µg/ml; , linezolid at 8 µg/ml).
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FIG. 4. Effect of ranbezolid (RAN) and linezolid (LNZ) on cell membrane integrity of (a) S. aureus 25923 and (b) S. epidermidis 23760. The BacLight bacterial viability kit (Molecular Probes) is composed of the green-fluorescent nucleic acid stain (Syto 9) and the red-fluorescent nucleic acid stain (propidium iodide). In this assay, the Syto 9 and propidium iodide stains compete for binding to the bacterial nucleic acid. Syto 9 labels cells with both damaged and intact membranes, whereas propidium iodide penetrates only cells with damaged membranes. The fluorescence ratio of Syto 9 (480/500 nm) to propidium iodide (490/635) was calculated and compared with that for controls.
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TABLE 1. IC50s for ranbezolid and linezolid in an in vitro transcription/translation system against bacterial and mammalian ribosomes
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FIG. 5. Active site residues of 50S ribosomes of E. coli for the interaction of linezolid and ranbezolid. (a) Overlay of docked conformation of linezolid in E. coli with the cocrystal structures of linezolid with bacterial 50S ribosomes. Critical active site residues of E. coli are shown in white-stick model; labels for E. coli, H. marismortui, and D. radiodurans are shown in red, orange, and green, respectively. Linezolid is shown in capped-stick model (magenta, E. coli; green, H. marismortui; and orange, D. radiodurans). (b) Two-dimensional chemical structures of linezolid (LNZ) and ranbezolid (RAN).
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FIG. 6. Binding conformation of ranbezolid and interactions with ribosome residues. (a) Putative binding conformation and preferred conformation of ranbezolid (yellow, capped-stick model) and its interactions with the 50S ribosome residues (atom type, stick model); putative binding conformation of linezolid is shown in magenta, line model. (b) Other low-scoring conformations of ranbezolid (violet, orange, cyan; stick model) in which methyl nitrofuran ring adopts different orientations within the active site. H bonds are shown in dotted black lines, with their corresponding distances given.
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In a BacLight assay, agents which produce permeability values of <40% of the control are considered to be membrane-damaging agents (10). The positive controls valinomycin (100 µM) and CCCP (15 µM) severely damaged the S. aureus membrane as well as the S. epidermidis membrane, with a BacLight assay value of <40% of the control. Ranbezolid and linezolid at 4 µg/ml had no effect on membrane integrity in S. aureus. So far, no reports regarding the bacterial membrane damage activity by oxazolidinones are available. However, ranbezolid showed additional membrane damage activity in S. epidermidis. The data suggest that certain structural features of ranbezolid may be affecting membrane integrity. Ranbezolid has a structure almost identical to that of linezolid, but the morpholine ring has been replaced with a piperazine ring and has an additional nitrofuran ring. The nitrofuran ring may contribute to the damage of membrane integrity in S. epidermidis. Since membrane integrity is damaged by ranbezolid even at 2 µg/ml (2x MIC) in S. epidermidis, it could be one of the reasons for its bactericidal activity. Linezolid did not show any membrane damage effect up to 8 µg/ml (4x MIC) against S. epidermidis and also showed a bacteriostatic effect against S. epidermidis in time-kill kinetics studies. So, membrane damage activity may be the reason for the bactericidal effect of ranbezolid against S. epidermidis.
Since ranbezolid specifically inhibits bacterial protein synthesis, the next foremost question to be answered was the binding mode of ranbezolid to bacterial ribosomes. As shown in Fig. 5b, ranbezolid is structurally similar to linezolid, whose piperazine ring makes van der Waals contacts with the sugar residues of A2451, C2452, and U2506. Figures 6a and 6b show the various conformations of ranbezolid generated through docking studies that indicate a possible hydrogen-bonding interaction between the nitrofuran moiety with the residues G2505, U2584, and G2583, indicating a dynamic H-bonding linkage, although one cannot fix one orientation through rigid body docking. The preferred and top-ranked conformation indicates the H-bonding interaction with G2583. Miller et al. reported that the conformations of the oxazolidinone rings were similar in both E. coli and S. aureus models, which have an aromatic ring stacked with the uracil base of U2504 and also feature a hydrogen bond between the amide NH and the 5' oxygen of G2505 (21). Overall, both ranbezolid and linezolid interact in similar fashions with ribosomes, while the additional van der Waals and H-bonding interactions made by the nitrofuran moiety of ranbezolid may offer a plausible explanation for its better antibacterial activity over that of linezolid.
Thus, ranbezolid has many advantages over linezolid in the oxazolidinone class of antibacterial drugs. Ranbezolid is a potent protein synthesis inhibitor with selectivity toward bacterial but not mammalian protein synthesis. Membrane integrity damage and additional inhibition of cell wall and lipid synthesis by ranbezolid against S. epidermidis could make ranbezolid potent as well as bactericidal. Additional binding-site interactions of ranbezolid with bacterial ribosomes explain its stronger interactions with the target pathogen. Thus, ranbezolid is a potent inhibitor against staphylococcus infection and has added advantages over linezolid.
The financial support for research from Ranbaxy Research Laboratories is acknowledged.
Published ahead of print on 15 December 2008. ![]()
Present address: Institute of Life Sciences, University of Hyderabad Campus, Gachibowli, Hyderabad 500 040, India. ![]()
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