Tackling recalcitrant Pseudomonas aeruginosa infections in critical illness via anti-virulence monotherapy.

Tackling recalcitrant Pseudomonas aeruginosa infections in critical illness via anti-virulence monotherapy.
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DOI:
10.1038/s41467-022-32833-9
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发表时间:
2022-08-30
影响因子:
16.6
通讯作者:
--
中科院分区:
综合性期刊1区
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--
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肠道屏障紊乱使肠道细菌及其产物转移到体循环。危重患者的铜绿假单胞菌(PA)叠加感染会增加肠道通透性并导致肠道驱动的败血症。由于多重耐药性 (MDR)、生物膜和/或抗生素耐受性,PA 感染具有挑战性。抑制群体感应转录调节因子 MvfR(PqsR) 是一种理想的抗 PA 抗毒力策略,因为 MvfR 控制多种急性和慢性毒力功能。在这里,我们表明 MvfR 促进肠道通透性,并报告了有效的抗 MvfR 化合物,即 N-芳基丙二酰胺 (NAM),这是通过广泛的结构-活性-关系研究和对 MvfR 控制的毒力功能抑制的全面评估得出的。此类抗毒力非天然配体药物具有纳摩尔范围内的半最大抑制浓度和强大的靶标结合能力。在单一疗法中使用 NAM 铅可以保护小鼠肠道屏障功能,消除 MvfR 调节的小分子,改善细菌传播,并降低炎症细胞因子。这项研究证明了 MvfR 在 PA 驱动的肠道通透性中的重要性。它强调了抗 MvfR 药物在维持肠道粘膜完整性方面的效用,这应该成为在危重疾病环境中预防/治疗 PA 感染和相关肠道源性败血症的任何成功策略的一部分。 NAM 为开发针对无法治疗的 MDR PA 感染的重要预防/治疗单一疗法提供了选择。由于抗菌素耐药性的发展,铜绿假单胞菌感染越来越难以治疗。在这里,作者描述了群体感应抑制剂的合成、表征和功效。
Intestinal barrier derangement allows intestinal bacteria and their products to translocate to the systemic circulation. Pseudomonas aeruginosa (PA) superimposed infection in critically ill patients increases gut permeability and leads to gut-driven sepsis. PA infections are challenging due to multi-drug resistance (MDR), biofilms, and/or antibiotic tolerance. Inhibition of the quorum-sensing transcriptional regulator MvfR(PqsR) is a desirable anti-PA anti-virulence strategy as MvfR controls multiple acute and chronic virulence functions. Here we show that MvfR promotes intestinal permeability and report potent anti-MvfR compounds, the N-Aryl Malonamides (NAMs), resulting from extensive structure-activity-relationship studies and thorough assessment of the inhibition of MvfR-controlled virulence functions. This class of anti-virulence non-native ligand-based agents has a half-maximal inhibitory concentration in the nanomolar range and strong target engagement. Using a NAM lead in monotherapy protects murine intestinal barrier function, abolishes MvfR-regulated small molecules, ameliorates bacterial dissemination, and lowers inflammatory cytokines. This study demonstrates the importance of MvfR in PA-driven intestinal permeability. It underscores the utility of anti-MvfR agents in maintaining gut mucosal integrity, which should be part of any successful strategy to prevent/treat PA infections and associated gut-derived sepsis in critical illness settings. NAMs provide for the development of crucial preventive/therapeutic monotherapy options against untreatable MDR PA infections. Pseudomonas aeruginosa infections are increasingly difficult to treat due to the development of antimicrobial resistance. Here, the authors describe the synthesis, characterisation and efficacy of a quorum sensing inhibitor.
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