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TB R&D Update: Semisynthetic antibiotic effective against sensitive and drug resistant tuberculosis in vitro

Richard E. Lee et al. Spectinamides: a new class of semisynthetic antituberculosis agents that overcome native drug efflux. Nature Medicine. 2014. March 6; 20(152). doi:10.1038/nm.3458

Abstract:

Although the classical antibiotic spectinomycin is a potent bacterial protein synthesis inhibitor, poor antimycobacterial activity limits its clinical application for treating tuberculosis. Using structure-based design, we generated a new semisynthetic series of spectinomycin analogs with selective ribosomal inhibition and excellent narrow-spectrum antitubercular activity. In multiple murine infection models, these spectinamides were well tolerated, significantly reduced lung mycobacterial burden and increased survival. In vitro studies demonstrated a lack of cross resistance with existing tuberculosis therapeutics, activity against multidrug-resistant (MDR) and extensively drug-resistant tuberculosis and an excellent pharmacological profile. Key to their potent antitubercular properties was their structural modification to evade the Rv1258c efflux pump, which is upregulated in MDR strains and is implicated in macrophage-induced drug tolerance. The antitubercular efficacy of spectinamides demonstrates that synthetic modifications to classical antibiotics can overcome the challenge of intrinsic efflux pump-mediated resistance and expands opportunities for target-based tuberculosis drug discovery.

Additional Coverage:

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Drug-resistant tuberculosis: a new shot on goal

New hope against tuberculosis: spectinamides

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