To address the emergence and spread of multi?drug resistant tuberculosis, a novel semisynthetic series of spectinomycin analogs was generated with bacterial selective ribosomal inhibition and excellent narrow?spectrum antitubercular activity. These analogs, the spectinamides, lack cross? resistance with existing tuberculosis therapeutics, maintain activity against MDR? and XDR? tuberculosis, retain spectinomycin?s high selectivity index, and synergistically reduce lung bacterial burdens in chronic in vivo mouse models when used in combination with other TB therapies. The potent antitubercular and selective properties of spectinamides is the result of their ability to avoid intrinsic efflux by the Rv1258c pump, demonstrating that synthetic modifications to classical antibiotics can overcome the challenge of intrinsic efflux pump?mediated resistance. Detailed SAR has been developed for protein synthesis inhibition and efflux avoidance, pharmacokinetics, and in vivo efficacy of the spectinamides. The most notable result is the synergy observed when spectinamides are combined with rifampin and pyrazinamide in C3HeB/FeJ mice bearing tubercular lesions with similar pathology to those found in humans. In this renewal, we aim focus the development of the spectinamides as combination agents capable of working synergistically with other TB agents to clear infections in necrotic lesions through 3 iterative aims: (i) Combination studies. The goal of this aim is to evaluate and define spectinamide combination treatments that specifically target synergistic activity in the necrotic granuloma. (ii) Generation of second generation antitubercular spectinomycin analogs. The design and synthesis of the next generation of spectinomycin antitubercular antibiotics with the primary goal of increasing the therapeutic window of lead compounds via improved host tolerability, bioavailability, distribution into the granuloma, and efflux avoidance. (iii) Evaluation of second generation spectinamides ? Compounds synthesized in aim 2 will progress through three iterative stages of tests that include microbial assessment, pharmacokinetic testing, toxicologic and in vivo efficacy experiments.

Public Health Relevance

In this study we propose to further develop a novel class of protein synthesis inhibitors to treat problematic multi?drug resistant tuberculosis infections. Compounds in this study are designed to be effective combination partners with existing and rising TB therapeutics, which act synergistically in the necrotic granuloma.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI090810-07
Application #
9666857
Study Section
Drug Discovery and Mechanisms of Antimicrobial Resistance Study Section (DDR)
Program Officer
Boyce, Jim P
Project Start
2010-07-06
Project End
2023-02-28
Budget Start
2019-03-01
Budget End
2020-02-29
Support Year
7
Fiscal Year
2019
Total Cost
Indirect Cost
Name
St. Jude Children's Research Hospital
Department
Type
DUNS #
067717892
City
Memphis
State
TN
Country
United States
Zip Code
38105
Liu, Jiuyu; Bruhn, David F; Lee, Robin B et al. (2017) Structure-Activity Relationships of Spectinamide Antituberculosis Agents: A Dissection of Ribosomal Inhibition and Native Efflux Avoidance Contributions. ACS Infect Dis 3:72-88
Robertson, Gregory T; Scherman, Michael S; Bruhn, David F et al. (2017) Spectinamides are effective partner agents for the treatment of tuberculosis in multiple mouse infection models. J Antimicrob Chemother 72:770-777
Madhura, Dora Babu; Trivedi, Ashit; Liu, Jiuyu et al. (2016) Tissue Penetration of a Novel Spectinamide Antibiotic for the Treatment of Tuberculosis. AAPS J 18:788-91
Hoagland, Daniel; Zhao, Ying; Lee, Richard E (2016) Advances in Drug Discovery and Development for Pediatric Tuberculosis. Mini Rev Med Chem 16:481-97
Madhura, Dora B; Liu, Juiyu; Meibohm, Bernd et al. (2016) Phase II Metabolic Pathways of Spectinamide Antitubercular Agents: A Comparative Study of the Reactivity of 4-Substituted Pyridines to Glutathione Conjugation. Medchemcomm 7:114-117
Rathi, Chetan; Lee, Richard E; Meibohm, Bernd (2016) Translational PK/PD of anti-infective therapeutics. Drug Discov Today Technol 21-22:41-49
Hoagland, Daniel T; Liu, Jiuyu; Lee, Robin B et al. (2016) New agents for the treatment of drug-resistant Mycobacterium tuberculosis. Adv Drug Deliv Rev 102:55-72
Bruhn, David F; Waidyarachchi, Samanthi L; Madhura, Dora B et al. (2015) Aminomethyl spectinomycins as therapeutics for drug-resistant respiratory tract and sexually transmitted bacterial infections. Sci Transl Med 7:288ra75
Bruhn, David F; Scherman, Michael S; Liu, Jiuyu et al. (2015) In vitro and in vivo Evaluation of Synergism between Anti-Tubercular Spectinamides and Non-Classical Tuberculosis Antibiotics. Sci Rep 5:13985
Lee, Richard E; Hurdle, Julian G; Liu, Jiuyu et al. (2014) Spectinamides: a new class of semisynthetic antituberculosis agents that overcome native drug efflux. Nat Med 20:152-158

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