Development of 2nd generation aminomethyl spectinomycins that overcome native efflux in Mycobacterium abscessus

Gregory A. Phelps,Martin N. Cheramie,Dinesh M Fernando,P. Selchow,Christopher J Meyer,S. Waidyarachchi,Suresh Dharuman,Jiuyu Liu,Michael Meuli,M. D. Molin,Benjamin Y. Killam,Patricia A Murphy,S. Reeve,Laura A Wilt,Shelby M Anderson,Lei Yang,Robin. B. Lee,Zaid H. Temrikar,Pradeep B. Lukka,B. Meibohm,Y. Polikanov,S. Hobbie,Erik C. Böttger,Peter Sander,Richard E. Lee

Published 2024 in Proceedings of the National Academy of Sciences of the United States of America

ABSTRACT

Significance The emergence of naturally drug-resistant opportunistic pathogens, such as Mycobacterium abscessus (Mab), presents a growing and deeply concerning public health threat due to few effective therapeutic options and a limited drug development pipeline. This research addresses this critical gap by introducing a unique series of N-ethylene aminomethyl spectinomycin (eAmSPC) analogs that show impressive activity against Mab. We have successfully unraveled the intricate mechanism by which the eAmSPC analogs overcome TetV-mediated efflux, thus reactivating the activity of spectinomycin against Mab. These mechanistic insights are enhanced by extensive developmental endeavors, showcasing the promising potential of this series as treatments against Mab infections.

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