A FASII inhibitor prevents staphylococcal evasion of daptomycin by inhibiting phospholipid decoy production
File(s)
Author(s)
Pee, Carmen JE
Pader, Vera
Ledger, Elizabeth VK
Edwards, Andrew M
Type
Journal Article
Abstract
Daptomycin is a treatment of last resort for serious infections caused by drug-resistant Gram-positive pathogens such as methicillin-resistant Staphylococcus aureus. We have shown recently that S. aureus can evade daptomycin by releasing phospholipid decoys that sequester and inactivate the antibiotic, leading to treatment failure. Since phospholipid release occurs via an active process, we hypothesised that it could be inhibited, thereby increasing daptomycin efficacy. To identify opportunities for therapeutic interventions that block phospholipid release, we first determined how the host environment influenced the release of phospholipids and inactivation of daptomycin by S. aureus The addition of certain host-associated fatty acids to the growth medium enhanced phospholipid release. However, in serum, the sequestration of fatty acids by albumin restricted their availability to S. aureus sufficiently to prevent their use in the generation of released phospholipids. This finding implied that in host tissues S. aureus may be completely dependent upon endogenous phospholipid biosynthesis to generate lipids for release, providing a target for therapeutic intervention. To test this, we exposed S. aureus to AFN-1252, an inhibitor of the staphylococcal FASII fatty acid biosynthetic pathway, together with daptomycin. AFN-1252 efficiently blocked daptomycin-induced phospholipid decoy production, even in the case of isolates resistant to AFN-1252, which prevented the inactivation of daptomycin and resulted in sustained bacterial killing. In turn, daptomycin prevented the fatty acid-dependent emergence of AFN-1252-resistant isolates in vitro In summary, AFN-1252 significantly enhances daptomycin activity against S. aureusin vitro by blocking the production of phospholipid decoys, whilst daptomycin blocks the emergence of resistance to AFN-1252.
Date Issued
2019-02-04
Date Acceptance
2019-01-29
Citation
Antimicrobial Agents and Chemotherapy, 2019, 63 (4), pp.1-18
ISSN
0066-4804
Publisher
American Society for Microbiology
Start Page
1
End Page
18
Journal / Book Title
Antimicrobial Agents and Chemotherapy
Volume
63
Issue
4
Copyright Statement
© 2019 Pee et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license (https://creativecommons.org/licenses/by/4.0/).
Sponsor
Wellcome Trust
Medical Research Council (MRC)
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30718253
PII: AAC.02105-18
Grant Number
203812/Z/16/Z
MR/P028225/1
Subjects
Science & Technology
Life Sciences & Biomedicine
Microbiology
Pharmacology & Pharmacy
AFN-1252
Staphylococcus aureus
antibiotic resistance
daptomycin
experimental therapeutics
phospholipids
ACCESSORY GENE REGULATOR
FABI INHIBITOR
AUREUS
RESISTANT
INFECTION
EFFICACY
SERUM
PHARMACOKINETICS
SUSCEPTIBILITY
AFN-1252
Staphylococcus aureus
antibiotic resistance
daptomycin
experimental therapeutics
phospholipids
0605 Microbiology
1108 Medical Microbiology
1115 Pharmacology and Pharmaceutical Sciences
Microbiology
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2019-02-04