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Efflux Pumps of Mycobacterium tuberculosis Play a Significant Role in Antituberculosis Activity of Potential Drug Candidates

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TLDR
It is shown that these four efflux pump KO mutants of M. tuberculosis play a vital role in mediating efflux of different chemical scaffolds and inhibitors of one or several of these efflux pumps could have a significant impact in the treatment of tuberculosis.
Abstract
Active efflux of drugs mediated by efflux pumps that confer drug resistance is one of the mechanisms developed by bacteria to counter the adverse effects of antibiotics and chemicals. To understand these efflux mechanisms in Mycobacterium tuberculosis, we generated knockout (KO) mutants of four efflux pumps of the pathogen belonging to different classes. We measured the MICs and kill values of two different compound classes on the wild type (WT) and the efflux pump (EP) KO mutants in the presence and absence of the efflux inhibitors verapamil and l-phenylalanyl-l-arginyl-β-naphthylamide (PAβN). Among the pumps studied, the efflux pumps belonging to the ABC (ATP-binding cassette) class, encoded by Rv1218c, and the SMR (small multidrug resistance) class, encoded by Rv3065, appear to play important roles in mediating the efflux of different chemical classes and antibiotics. Efflux pumps encoded by Rv0849 and Rv1258c also mediate the efflux of these compounds, but to a lesser extent. Increased killing is observed in WT M. tuberculosis cells by these compounds in the presence of either verapamil or PAβN. The efflux pump KO mutants were more susceptible to these compounds in the presence of efflux inhibitors. We have shown that these four efflux pumps of M. tuberculosis play a vital role in mediating efflux of different chemical scaffolds. Inhibitors of one or several of these efflux pumps could have a significant impact in the treatment of tuberculosis. The identification and characterization of Rv0849, a new efflux pump belonging to the MFS (major facilitator superfamily) class, are reported.

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Mechanisms of resistance to aminoglycoside antibiotics: overview and perspectives

TL;DR: By far the most widespread mechanism of resistance to AGs is the inactivation of these antibiotics by AG-modifying enzymes, and an overview of these mechanisms is provided.
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Persisters and beyond: mechanisms of phenotypic drug resistance and drug tolerance in bacteria.

TL;DR: Mechanisms of phenotypic drug tolerance and resistance in bacteria are reviewed with the goal of providing a framework for understanding the similarities and differences in these cells.
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Molecular Epidemiology and Mechanisms of Tigecycline Resistance in Clinical Isolates of Acinetobacter baumannii from a Chinese University Hospital

TL;DR: This study showed that the active efflux pump AdeABC appeared to play important roles in the tigecycline resistance of A. baumannii, and phenyl-arginine-β-naphthylamide (PAβN) and carbonyl cyanide 3-chlorophenylhydrazone (CCCP) could partially reverse the resistance pattern of tigECYcline.
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Microbial Efflux Systems and Inhibitors: Approaches to Drug Discovery and the Challenge of Clinical Implementation

TL;DR: Advances in the path of EPI discovery are summarized, potential avenues of E PI implementation and development are discussed, and the need for highly informative and comprehensive translational approaches is underlined.
References
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Journal ArticleDOI

Characterization of tetracycline resistance mediated by the efflux pump Tap from Mycobacterium fortuitum

TL;DR: This study characterized the efflux pump Tap from Mycobacterium fortuitum and observed synergy between tetracycline and CPZ or reserpine, and antagonism with o-vanadate, which suggests that similar compounds could be used to overcome antibiotic resistance mediated by efflux pumps.
Journal ArticleDOI

Efflux in bacteria: what do we really know about it?

TL;DR: Inhibiting bacterial efflux with a non-antibiotic inhibitor would restore activity of an antibiotic subject to efflux (similar to the use of β-lactamase inhibitors to combat β- lactamases production by bacteria).
Journal ArticleDOI

The third-generation P-glycoprotein inhibitor tariquidar may overcome bacterial multidrug resistance by increasing intracellular drug concentration

TL;DR: It is concluded that tariquidar has potent inhibitory effect against certain bacterial efflux pumps in vitro, and high activity at clinically achievable concentrations might yield this class of drugs promising for future applications in infectious diseases.
Journal Article

Extensively drug-resistant (XDR) tuberculosis: an old and new threat.

TL;DR: How to fight XDR TB (extensively drug-resistant TB) is a high research and public health priority.
Journal ArticleDOI

Efflux pump inhibitors in bacteria

TL;DR: In conclusion, inhibition of efflux pumps appears to be a promising strategy to combat multi-drug resistance pathogens.
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