Development of a gut microbe-targeted nonlethal therapeutic to inhibit thrombosis potential.

Development of a gut microbe-targeted nonlethal therapeutic to inhibit thrombosis potential.
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DOI:
10.1038/s41591-018-0128-1
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发表时间:
2018-09
期刊:
影响因子:
82.9
通讯作者:
Hazen SL
Hazen SL
中科院分区:
医学1区
文献类型:
--
作者:
Roberts AB;Gu X;Buffa JA;Hurd AG;Wang Z;Zhu W;Gupta N;Skye SM;Cody DB;Levison BS;Barrington WT;Russell MW;Reed JM;Duzan A;Lang JM;Fu X;Li L;Myers AJ;Rachakonda S;DiDonato JA;Brown JM;Gogonea V;Lusis AJ;Garcia-Garcia JC;Hazen SL

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Trimethylamine-N-oxide (TMAO), a microbiota-dependent metabolite derived from trimethylamine (TMA)-containing nutrients that are abundant in a Western diet, enhances both platelet responsiveness and in vivo thrombosis potential in animal models and predicts incident atherothrombotic event risks in clinical studies. Here, utilizing a mechanism-based inhibitor approach targeting a major microbial TMA-generating enzyme (CutC/D), we developed potent, time-dependent and irreversible inhibitors that do not affect commensal viability. In animal models, a single oral dose of a CutC/D inhibitor significantly reduced plasma TMAO levels for up to 3 days and rescued diet-induced enhanced platelet responsiveness and thrombus formation, without observable toxicity or increased bleeding risk. The inhibitor selectively accumulated within intestinal microbes to millimolar levels, a concentration over a million-fold higher than needed for a therapeutic effect. These studies reveal that mechanism-based inhibition of gut microbial TMA/TMAO production reduces thrombosis potential, a critical adverse complication in heart disease. They also offer a generalizable approach for the selective non-lethal targeting of gut microbial enzymes linked to host disease, while limiting systemic exposure of the inhibitor in the host.
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