Researchers have discovered a compound found in soil
bacteria that could lead to new drugs to combat tuberculosis, a global disease
that is becoming increasingly resistant to current treatments. They have
produced synthetic versions of the natural compound and showed that they can
kill the tuberculosis bacterium in the laboratory.
The findings, published in the journal Nature
Communications, are the work of an international consortium led by the
University of Sydney in Australia and includes researchers from the United
Kingdom, the United States, and Canada.
Tuberculosis (TB) is a disease caused by the
bacterium Mycobacterium tuberculosis. While it can affect any organ
of the body, it is most commonly found in the lungs. Most cases are treatable
and curable, but people can die if they do not receive proper treatment.
According to the World Health Organization (WHO), TB is
globally one of the top 10 causes of
death: 10.4 million people became ill with it and 1.8 million people died from
it in 2015. Over 95 percent of TB-related deaths affect low- and middle-income
countries.
Huge progress has been made in the global fight against
TB. The WHO report that 49 million lives were saved through effective diagnosis
and treatment between 2000 and 2015.
Growing threat of resistant TB
However, there is a growing threat to continuing this
progress, in that the TB bacterium is becoming increasingly resistant to the
current drugs available to treat it - many of which have been in use for more
than 40 years.
There are two forms of drug-resistant TB:
multidrug-resistant (MDR-TB), and the much rarer form, extensively
drug-resistant TB (XDR-TB).
MDR-TB is resistant to at
least isoniazid and rifampin, two potent first-line drugs used to treat
everyone who falls ill with TB.
XDR-TB is resistant to isoniazid and rifampin, any
fluoroquinolone, and at least one second-line drug, leaving patients with few
effective treatment options.
In the U.S., the average direct cost of treating TB
ranges from $18,000 to treat drug-susceptible forms, to $494,000 to treat
XDR-TB.
These costs are even higher when they take into account
income losses experienced by patients while undergoing treatment.
The new study concerns a compound called
sansanmycin uridylpeptide, which is produced by soil bacteria and stops other
bacteria growing around them.
Compound stops TB bacterium building
a cell wall
The team used synthetic chemistry to produce a library
of more potent structural variations, or analogs, of the natural compound.
Laboratory tests showed that the sansanmycin natural
product analogs were effective killers of M. tuberculosis, the
bacterium that causes TB.
The compounds target an enzyme called Mtb phospho-MurNAc-pentapeptide
translocase, or MraY, which plays a key role in building the cell wall of the
TB bacterium.
Attacking this "Achilles heel" of the
bacterium prevents it from being able to build a cell wall.
Richard Payne, a professor in Sydney's School of
Chemistry and one of the lead investigators, says that the new analogs
effectively killed the TB bacteria inside macrophages - the host immune cells
that TB bacteria inhabit when they infect human lungs.
Prof. Payne says that their findings offer a starting
point for developing a new TB drug, and that further tests and safety studies
are already being planned.
Future work will also explore the underlying mechanism
through which the new compounds select their target, note the authors.
"Without a cell wall, the bacterium dies. This
wall-building protein is not targeted by currently available drugs."
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