Mycobacterium tuberculosis (Mtb) infects at least 30% of the world's population and causes an estimated 1.8 million deaths a year. The emergence of drug-resistant Mtb strains, which constitute 20% of previously treated tuberculosis (TB) cases, has exacerbated this already alarming epidemic. The inadequacies of present TB therapies demand the discovery of new agents to treat Mtb infection. We have discovered a role for the Mtb protein RelMtb that is essential for acute and chronic Mtb infection in mice. RelMtb both synthesizes and hydrolyzes an important bacterial signaling molecule termed (p)ppGpp. We have shown that it is specifically the (p)ppGpp hydrolase activity of RelMtb that is required for all stages of Mtb infection. This indicates that both active and chronic TB could be treated by inhibiting the RelMtb hydrolase domain with a small molecule antibiotic. Importantly, RelMtb has not yet been exploited as an antibacterial target and, therefore, drug-resistant Mtb strains with mutations in other drug targets will still be susceptible to chemical inhibitors of RelMtb. The objectives of the first phase of this project are to 1) develop assays to screen for inhibitors of RelMtb-mediated (p)ppGpp hydrolysis and 2) validate RelMtb as a druggable target. Specifically, we will pursue the following 3 Aims: R21-1. Develop non-radioactive high-throughput in vitro assays of RelMtb (p)ppGpp hydrolase activity. R21-2. Develop in vivo mycobacterial cell-based assays to screen for inhibitors of RelMtb activity. R21-3. Conduct pilot screens with small focused compound libraries to demonstrate suitability of assays for high throughput screening. The objectives of the second phase of this project are to 1) identify a lead compound, 2) optimize the lead compound, and 3) target RelMtb-mediated (p)ppGpp hydrolysis to inhibit Mtb viability and infection. Specifically, we will pursue the following 3 Aims: R33-1. Screen select compound libraries in our in vitro and in vivo assays. R33-2. Design chemical inhibitors to optimize activity against RelMtb based on the scaffold of successful inhibitors, selectivity against RelMtb, metabolic stability, and the RelMtb protein structure. R33-3. Demonstrate preclinical proof-of-concept for inhibitors to combat Mtb infection and the drug-resistance problem. Successful completion of these aims will lead to the development of a critically needed new strategy for TB therapy. RelMtb homologs are conserved in all bacteria, but not in animals, and thus our findings could impact the treatment of other pathogenic and notoriously drug-resistant bacteria including Enterococcus faecalis, Streptococcus pyogenes, and Staphylococcus aureus. Achievement of our aims will characterize and validate (p)ppGpp hydrolases as a target for therapeutic intervention against drug-resistant bacterial pathogens.

Public Health Relevance

The World Health Organization reported 8.7 million new cases of Tuberculosis (TB) in 2011, contributing to the 2 billion people infected with Mycobacterium tuberculosis worldwide and 1.4 million TB related deaths that year. This urgent health crisis is exacerbated by the alarming emergence of drug resistant strains. The experiments proposed will develop novel therapeutic strategies to combat both drug-sensitive and drug-resistant TB cases.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Exploratory/Developmental Grants (R21)
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Special Emphasis Panel (ZAI1-SM-M (J2))
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Boyce, Jim P
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Washington University
Schools of Medicine
Saint Louis
United States
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Flentie, Kelly; Garner, Ashley L; Stallings, Christina L (2016) Mycobacterium tuberculosis Transcription Machinery: Ready To Respond to Host Attacks. J Bacteriol 198:1360-73
Kimmey, Jacqueline M; Stallings, Christina L (2016) Bacterial Pathogens versus Autophagy: Implications for Therapeutic Interventions. Trends Mol Med 22:1060-1076