Antibiotics Flashcards

1
Q

What is an antibiotic

A

A chemical substance produced by microbes that inhibits the growth of and even destroy other microbes

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2
Q

Selman Waksman

A

Suggested the modern use of the term antibiotic

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3
Q

Location of action of cell wall antimicrobials

A

The peptidoglycan precursors are synthesized into lipid II in the cytoplasm.

This is “flipped” across the membrane by the transport lipid (undecaprenyl phosphate).

The glycosyltransferase (GT51) catalyses polymerization of the nascent peptidoglycan chain from lipid II.

Vancomycin and teicoplanin bind to the terminal D-alanyl-D-alanine moieties of the NAM/NAG-peptides preventing peptidoglycan formation.

Nisin and teixobactin interact with the pyrophosphate of lipid II

Bacitracin affects the phosphorylation of C55-isoprenyl pyrophosphate and related bactoprenol pyrophosphate by binding to the pyrophosphate of these molecules.

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4
Q

Structures of representative β-lactams

A
  1. Penicillin scaffold.
  2. Cephalosporin scaffold.
  3. (1-methyl) Carbapenem scaffold.

Can be broad spectrum

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5
Q

Which anti microbials work on the binding of lipid II

A

Vancomycin
Teicoplanin
Nisin
Teixobactin

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6
Q

Mechanism of action of penicillin

A

Stops formation of amide bond in peptidoglycan

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7
Q

Mechanism of penicillin

A

The square-shaped beta-lactam ring is under strain

The nitrogen and sulphur atoms draw electrons away, makes the carbonyl carbon on the beta-lactam ring electrophilic.

The electrophilicity makes the beta-lactam ring extremely susceptible to hydrolysis,

The penicillin molecule comes into contact with the hydroxyl active site of the serine residue on the transpeptidase enzyme
It binds covalently (irreversibly).

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8
Q

Beta lactamase inhibitors

A

Clavulanic acid.
Avibactam.
Relebactam.
Vaborbactam.
Bicyclic boronate.

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9
Q

Teixobactin mechanism

A

Teixobactin binds to the peptidoglycan precursors lipid II and lipid III.
Teixobactin binding motif may be the highly conserved pyrophosphate

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10
Q

why is it hard to develop de-novo resistance against Arg 10 teixobactin ?

A

The Lipid II / Lipid III substrate is highly conserved and essential for peptidoglycan cell wall biosynthesis
Lipid II / Lipid III substrate modification may be “difficult” to evolve
Other mechanisms may include evolved proteases that can process DL amino acids?
Other unknown mechanisms ?
No compound is resistance proof

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11
Q

Koch’s postulates

A

(1) The suspected pathogen must be found in every case of disease and not be found in healthy individuals.

(2) The suspected pathogen can be isolated and grown in pure culture.

(3) A healthy test subject infected with the suspected pathogen must develop the same signs and symptoms of disease as seen in postulate 1.

(4) The pathogen must be re-isolated from the new host and must be identical to the pathogen from postulate 2.

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12
Q

What are Koch’s postulates

A

He identified the specific causative agents of tuberculosis, cholera, and anthrax and also gave experimental support for the concept of infectious disease,

These postulates, outline a method for linking cause and effect of an infectious disease

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13
Q

Antimicrobial mechanisms

A

Inhibition of cell wall synthesis
Inhibition of protein synthesis
Inhibition of DNA/RNA precursor synthesis
Inhibition of DNA/RNA synthesis
Disruption of membrane function

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14
Q

Mechanisms of beta lactam resistance

A

Beta lactamase
Changes ring structure of beta lactam so that serine cannot bind

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15
Q

How are beta lactamases classified

A

Classes A, B, C and D

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16
Q

Peptide antimicrobials mechanisms

A

Changes in membrane permeability
Metabolic genes and regulators
Antibiotic inactivation
Target modifications

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17
Q

Role of vancomycin

A

Inhibition of cell wall synthesis by binding to lipid II

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18
Q

Which antibiotics work on the pyrophosphate of lipid II

A

Nisin
Teixobactin

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19
Q
A
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20
Q

MIC

A

lowest concentration of an antimicrobial that will inhibit the visible growth of a microorganism after overnight incubation (measure of antibacterial activity)

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21
Q

Moenomycin A

A

Enzyme inhibitor

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22
Q
A
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23
Q

Categories of antimicrobials based on action

A

Inhibition of cell wall synthesis (Ed)
Damaging cell membrane
Disruption of nucleic acid synthesis
Disruption of protein synthesis
Blocking key metabolic pathways

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24
Q

Sources of folate

A

Humans and most animals obtain folate from diet
Bacteria synthesise it

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25
It what form is folate used
Hydrogenated to dihydro-folic acid or tetrahydro-folic acid
26
What inhibits dihydropteroate synthase activity
Sulfonamides
27
What do sulfonamides mimic
p-aminobenzoic acid (pABA)
28
Why is folate required
Synthesis of purines Synthesis of thymine by methylation of dUMP
29
What enzyme recycles folate in thymine synthesis
Dihydrofolate reductase
30
What enzymes are targeted in folate metabolism
DHFR DHPS
31
Type 1 topoisomerase enzymes
Catalyse the passage of a single stranded molecule through a single stranded gap
32
Type 2 topoisomerase enzyme
Catalyse the passage of a double stranded molecule through a double-stranded gap
33
Role of dna topoisomerase
Catalyses transient breakage of DNA Catalyse strand passage Removal of supercoils and torsional stresses to allow the replication fork to continue
34
Transesterification
between an enzyme tyrosyl and a DNA phosphate group leads to the breakage of a DNA backbone bond and the formation of a covalent enzyme–DNA intermediate. Rejoining of the DNA backbone bond occurs by the reversal of the reaction shown. In the reaction that is catalysed by a type IA or a type II enzyme, a 3′-OH is the leaving group and the active-site tyrosyl becomes covalently linked to a 5′-phosphoryl group, as depicted. In the reaction that is catalysed by a type IB enzyme, a 5′-OH is the leaving group and the active-site tyrosyl becomes covalently linked to a 3′-phosphoryl group.
35
T segment
Portion of DNA that transverses the temporary gap
36
G segment
Portion of DNA with the gap
37
What is required for strand passage and recreation of DNA
ATP and ARP hydrolase
38
DNA gyrase
Type 2 topoisomerase Removes torsional stresses in prokaryotic dna
39
Type 1b enzyme
Topoisomerase in eukaryotic cells The enzyme catalytic tyrosine is linked to the phosphate group on the 3’ end of the DNA; the 5’ OH is free. This is the topoisomerase activity that supports the removal of torsional stress in eukaryotes. Rotates the dna to relax the supercoiling
40
E.coli ParE TopoIV subunit structure complexed with novobiocin
The binding site overlaps with that of the ATP, which explains the competitive inhibitor nature of the drug
41
Which antibiotics target topoisomerase
Novobiocin Fluoroquinolone
42
Action of novobiocin class of antibiotics
Interferes with ATP binding to GryB
43
Side effects of novobiocin
mild diarrhea (37 per cent), skin rashes (8.9 per cent), fever (2 per cent), eosinophilia (high eosinophil count [500+/μl]; 1.47 per cent), gastrointestinal irritation with nausea (1.3 per cent) leukopenia (low white blood cell count; 0.6 per cent) yellowish discoloration of the skin and sclerae occasionally (0.6 per cent). The pigment is believed to be a degradation product of the drug and not related to hepatic dysfunction.
44
Why do novobiocin have bad side effects
Eukaryotes also have type 2 topoisomerase
45
46
Fluoroquinolone action
Bind to cleft between 2 subunits of topoisomerase - site of action for the enzyme Prevents religation of broken DNA Topoisomerase remains forever due to covalent bonds with broken DNA - permanent
47
Side effects of fluoroquinolones
may be damaging the mitochondria – a historical effect of the bacterial origin of mitochondria. But they don’t have type II topoisomerase in them! It may be causing oxidative stress There is also data that specific gene variants in sick people influence the metabolism of the drug and hence it may be toxic in these people
48
Structure of bacterial RNA polymerase
4 subunits 1 regulatory sigma subunit
49
Which class of antibiotics inhibit RNA synthesis
Ansamycins — Rifampicin
50
How does rifampicin work - it doesn’t
It doesn’t affect promoter binding Binding of the 1st nucleotide is unaffected So is the making of the 1st phosphodiester bond, that is the 1st dinucleotide It is at the stage of forming the 2nd or the 3rd phosphodiester bond when the inhibition kicks in Furthermore, when RIF is added once the RNAP engaged in processive RNA synthesis – elongation, it was also ineffective the antibiotic does not interfere with substrate binding, catalytic activity, or the intrinsic translocation mechanism of the RNAP
51
How does rifampicin work
RIF binds to exit pore of the rna polymerase so the growing RNA chain so that it cannot exit via the exit pore
52
Actinomycin D
Anti cancer drug Binds to DNA - intercalates between the bases Forms hydrogen bonds with the molecule
53
Which eukaryotic rna polymerase most sensitive to actinomycin D
RNA polymerase I
54
RNA polymerase I
Synthesises rRNA
55
50s ribosomal subunit inhibitors
block initiation Oxazolidinones block elongation macrolides such as lincosamide and streptogramin
56
30s ribosomal subunits inhibitors
block AA-tRNA entry to the A site tetracylines streptomycin spectinomycin aminoglycosides
57
Aminoglycosides
Bactericidal
58
Interaction of macrolides with the ribosome
Mainly active against Gram positives and Mycoplasmas It ‘plugs’ the peptidyl exit tunnel on the ribosome L-cladinose: a methylated hexose ring 1st and 2nd generation macrolides are considered safe and well tolerated. Some 3rd generation ones exhibit hepatotoxicity
59
Aminoglycosides
positively charged and attach to the negatively charged lipopolysaccharides on the outer membrane of Gram negative bacteria. This binding opens the outer membrane For passing the inner membrane it uses active bacterial transport mechanisms that are oxygen dependent. Consequently, aminoglycosides don’t work in anaerobs.
60
Aminoglycosides action
Freezing in the ON state permits the binding of other non-matching AA-tRNA molecules to the A site This will lead to misreading of the mRNA and a garbled protein Some aminoglycosides (spectinomycin and hygromycin, for example) also influence dynamic changes associated with translocation Streptomycin has a different binding site and interferes with the initial AA-tRNA selection
61
Tetracyclines
TETs travel through the outer membrane through OmpF and OmpC porin channels of Gram-negative bacteria complexed with a Me++ In the periplasm they dissociate and the TET molecule diffuses through the inner membrane Gram-positive uptake is similar (except passing the outer membrane, of course) Inside they are likely complexed with Me++ again They bind to the A site and interfere with AA-tRNA binding
62
63
A site molecular switch
Binding of the tRNA to the A site is a two-step event. The tRNA initially binds in the OFF state in a fast equilibrium reaction. Docking of the correct tRNA causes the flip to the ON state, which induces other conformational changes in the ribosome to induce a precise fit.
64
Salvarsan
Designed to treat the bacterium Treponema pallidum The compound atoxyl was an arsenic derived derivative that Ehrlich realised was too toxic, but that it contained an active ingredient, arsenic. He worked with synthetic chemists to create organo- arsenic compounds and came up with salvarsan. But actually, they didn’t fully understand the structure.
65
Process of drug production
Target identification and validation Assay development Virtual screening (VS) High throughput screening (HTS) Quantitative structure – activity relationship (QSAR) and refinement of compounds Characterisation of prospective drugs Testing on animals for activity and side- effects Clinical trials Licensing approval
66
67
Location of action of cell wall antimicrobials
The peptidoglycan precursors are synthesized into lipid II in the cytoplasm. This is “flipped” across the membrane by the transport lipid (undecaprenyl phosphate). The glycosyltransferase (GT51) catalyses polymerization of the nascent peptidoglycan chain from lipid II. Vancomycin and teicoplanin bind to the terminal D-alanyl-D-alanine moieties of the NAM/NAG-peptides preventing peptidoglycan formation. Nisin and teixobactin interact with the pyrophosphate of lipid II Bacitracin affects the phosphorylation of C55-isoprenyl pyrophosphate and related bactoprenol pyrophosphate by binding to the pyrophosphate of these molecules.
68
Structures of representative beta-lactams
1. Penicillin scaffold. 2. Cephalosporin scaffold. 3. (1-methyl) Carbapenem scaffold.
69
The therapeutic window
The ED50 (median effective dose) is the dose of a medication that produces a specific effect in 50% of the population that takes that dose The median toxic dose is the dose required to produce a defined toxic effect in 50% of subjects; The median lethal dose is the dose required to kill
70
Anti microbial development - in vitro antibacterial activity
Collection of environmental sample Plate out to culture diverse community Isolation of pire microorganisms for screening Liquid culture Extracts on disks
71
Scale up production and purification
Re screen fraction Identification of active compound - mass spectrometry/ NMR Consider producing synthetically Mode of action
72
MIC determination
Inhibitory Concentration is the lowest drug concentration that prevents visible microorganism growth after overnight incubation. The concentration normally given in µg/ml MIC tests are carried out in 96 well plates Tests are normally carried out in triplicate The concentration of antibiotic is diluted by half in each well across the plate Well 12 contains no antibiotic (control) The concentration starts at 256μg/ml Test again a number of strains (ESKAPE pathogens)
73
If any MIC values are lower than 32 ug/ml on any one of the ESKAPE pathogens ?
Consider toxicity testing
74
In vitro toxicity testing
Galleria mellonella (Wax moth Larvae) are used to study bacterial infections and antibiotic activity. They mimic the mammalian innate immune system so make a good substitute for mammalian models. They are easy to maintain and are low cost They don’t require the same ethical approval as vertebrate models Testing is easy to carry out, no specialist training is required
75
IC50
quantitative measure that indicates how much of a particular inhibitory substance (e.g. drug) is needed to inhibit, in vitro.