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Liu Y, Zhou Q, Huo Y, Sun X, Hu J. Recent advances in developing modified C14 side chain pleuromutilins as novel antibacterial agents. Eur J Med Chem 2024; 269:116313. [PMID: 38503168 DOI: 10.1016/j.ejmech.2024.116313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
Owing to the increasing resistance to most existing antimicrobial drugs, research has shifted towards developing novel antimicrobial agents with mechanisms of action distinct from those of current clinical options. Pleuromutilins are antibiotics known for their distinct mechanism of action, inhibiting bacterial protein synthesis by binding to the peptidyl transferase center of the ribosome. Recent studies have revealed that pleuromutilin derivatives can disrupt bacterial cell membranes, thereby enhancing antibacterial efficacy. Both marketed pleuromutilin derivatives and those in clinical trials have been developed by structurally modifying the pleuromutilin C14 side chain to improve their antimicrobial activity. Therefore, this review aims to review advancement in the chemical structural characteristics, antibacterial activities, and structure-activity relationship studies of pleuromutilins, specifically focusing on modifications made to the C14 side chain in recent years. These findings provide a valuable reference for future research and development of pleuromutilins.
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Affiliation(s)
- Yue Liu
- Shandong Second Medical University, No.7166 Baotong Road, Weifang, 261053, PR China
| | - Qinjiang Zhou
- Shandong Second Medical University, No.7166 Baotong Road, Weifang, 261053, PR China
| | - Yiwen Huo
- Shandong Second Medical University, No.7166 Baotong Road, Weifang, 261053, PR China
| | - Xiujuan Sun
- Shandong Second Medical University, No.7166 Baotong Road, Weifang, 261053, PR China
| | - Jinxing Hu
- Shandong Second Medical University, No.7166 Baotong Road, Weifang, 261053, PR China.
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2
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Ehrnström B, Haugan MS, Andreasen JB, Ellingsen A. Immunocompromised teenager with meningitis caused by Ureaplasma parvum. BMJ Case Rep 2024; 17:e257261. [PMID: 38453229 PMCID: PMC10921514 DOI: 10.1136/bcr-2023-257261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
Infection in the immunocompromised patient is often challenging on multiple levels. It can be difficult to distinguish between manifestations of the underlying disease, infection or malignancy. Symptoms may be vague or even absent, deviations in the common inflammatory parameters discrete, imaging findings scarce and the causative microbe may be a true pathogen as well as opportunistic. Here, we report an immunosuppressed female in her late teens with a purulent meningitis due to Ureaplasma parvum-a very rare cause of infection in the central nervous system of adults. We wish to highlight the relevance of intracellular pathogens and the need to actively search for these microbes, especially when response to broad-spectrum antibiotic treatment is absent. Furthermore, we emphasise the need for adequate molecular microbial diagnostics in search of microbes that are difficult to identify by culture and where serology and antigen tests may be absent or unreliable due to immune suppression.
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Affiliation(s)
- Birgitta Ehrnström
- Department of Infectious Diseases, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Maria Schei Haugan
- Department of Medical Microbiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jo Bønding Andreasen
- Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Thoracic Intensive Care Unit, Aalborg Universitetshospital, Aalborg, Denmark
| | - Asbjørn Ellingsen
- Department of Infectious Diseases, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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3
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Zhang D, Chen S, Wang Y, Hou D, Chen C, Wang L, Tang X, Chen X, Tong L, Zhang Y, Jiang J, Song Y. The evaluation of next‐generation sequencing assisted pathogenic detection in immunocompromised hosts with pulmonary infection: A retrospective study. THE CLINICAL RESPIRATORY JOURNAL 2022; 16:793-801. [DOI: 10.1111/crj.13542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 07/26/2022] [Accepted: 08/15/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Donghui Zhang
- Department of Pulmonary Medicine, Zhongshan Hospital Fudan University Shanghai China
- Shanghai Respiratory Research Institute Shanghai China
| | - Shujing Chen
- Department of Pulmonary Medicine, Zhongshan Hospital Fudan University Shanghai China
- Shanghai Respiratory Research Institute Shanghai China
| | - Ying Wang
- Department of Critical Care Medicine, Zhongshan Hospital Fudan University Shanghai China
| | - Dongni Hou
- Department of Pulmonary Medicine, Zhongshan Hospital Fudan University Shanghai China
- Shanghai Respiratory Research Institute Shanghai China
| | - Cuicui Chen
- Department of Pulmonary Medicine, Zhongshan Hospital Fudan University Shanghai China
- Shanghai Respiratory Research Institute Shanghai China
| | - Linlin Wang
- Department of Pulmonary Medicine, Zhongshan Hospital Fudan University Shanghai China
- Shanghai Respiratory Research Institute Shanghai China
| | - Xinjun Tang
- Department of Pulmonary Medicine, Zhongshan Hospital Fudan University Shanghai China
- Shanghai Respiratory Research Institute Shanghai China
| | - Xiaoyan Chen
- Department of Pulmonary Medicine, Zhongshan Hospital Fudan University Shanghai China
- Shanghai Respiratory Research Institute Shanghai China
| | - Lin Tong
- Department of Pulmonary Medicine, Zhongshan Hospital Fudan University Shanghai China
- Shanghai Respiratory Research Institute Shanghai China
| | - Yuye Zhang
- Department of Pulmonary Medicine, Zhongshan Hospital Fudan University Shanghai China
- Shanghai Respiratory Research Institute Shanghai China
| | - Jinjun Jiang
- Department of Pulmonary Medicine, Zhongshan Hospital Fudan University Shanghai China
- Shanghai Respiratory Research Institute Shanghai China
| | - Yuanlin Song
- Department of Pulmonary Medicine, Zhongshan Hospital Fudan University Shanghai China
- Shanghai Respiratory Research Institute Shanghai China
- Shanghai Institute of Infectious Disease and Biosecurity Shanghai China
- National Clinical Research Center for Aging and Medicine, Huashan Hospital Fudan University Shanghai China
- Shanghai Key Laboratory of Lung Inflammation and Injury Shanghai China
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4
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Gómez Rufo D, García Sánchez E, García Sánchez JE, García Moro M. [Clinical implications of the genus Mycoplasma]. REVISTA ESPANOLA DE QUIMIOTERAPIA 2021; 34:169-184. [PMID: 33735544 PMCID: PMC8179937 DOI: 10.37201/req/014.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dentro del género Mycoplasma, las especies que tradicionalmente se han relacionado con cuadros infecciosos han sido principalmente M. pneumoniae, M. genitalium, M. hominis o U. urealyticum. Sin embargo, existen otras muchas que están implicadas y, que muchas veces, son desconocidas para los profesionales sanitarios. El objetivo de esta revisión es identificar todas las especies del género Mycoplasma que se han aislado en el hombre y determinar su participación en la patología infecciosa humana.
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Affiliation(s)
| | - E García Sánchez
- Enrique García Sánchez, Departamento de Ciencias Biomédicas. Facultad de Medicina. Universidad de Salamanca. Spain.
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5
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Munson E, Carroll KC. Summary of Novel Bacterial Isolates Derived from Human Clinical Specimens and Nomenclature Revisions Published in 2018 and 2019. J Clin Microbiol 2021; 59:e01309-20. [PMID: 32967902 PMCID: PMC8111135 DOI: 10.1128/jcm.01309-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Knowledge of novel prokaryotic taxon discovery and nomenclature revisions is of importance to clinical microbiology laboratory practice, infectious disease epidemiology, and studies of microbial pathogenesis. Relative to bacterial isolates derived from human clinical specimens, we present an in-depth summary of novel taxonomic designations and revisions to prokaryotic taxonomy that were published in 2018 and 2019. Included are several changes pertinent to former designations of or within Propionibacterium spp., Corynebacterium spp., Clostridium spp., Mycoplasma spp., Methylobacterium spp., and Enterobacteriaceae Future efforts to ascertain clinical relevance for many of these changes may be augmented by a document development committee that has been appointed by the Clinical and Laboratory Standards Institute.
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Affiliation(s)
- Erik Munson
- College of Health Sciences, Marquette University, Milwaukee, Wisconsin, USA
| | - Karen C Carroll
- Division of Medical Microbiology, Department of Pathology, the Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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6
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Jhaveri VV, Lasalvia MT. Invasive Ureaplasma Infection in Patients Receiving Rituximab and Other Humoral Immunodeficiencies-A Case Report and Review of the Literature. Open Forum Infect Dis 2019; 6:ofz399. [PMID: 31660361 PMCID: PMC6790395 DOI: 10.1093/ofid/ofz399] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/05/2019] [Indexed: 11/14/2022] Open
Abstract
Ureaplasma species are small, fastidious bacteria that frequently colonize the lower reproductive tract of asymptomatic hosts. These organisms have been well described to cause chorioamnionitis, neonatal infection, and urethritis, and to a lesser degree surgical site infection and infection in transplant recipients. Outside of these settings, invasive Ureaplasma infections are rare. We describe the case of a young woman receiving rituximab for multiple sclerosis who presented with fever and bilateral renal abscesses due to Ureaplasma spp., which was successfully treated with oral doxycycline. We searched the literature for cases of invasive Ureaplasma infection and found a patient population that predominates with humoral immunodeficiency, either congenital or iatrogenic. Diagnostic and therapeutic interventions are discussed.
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Affiliation(s)
- Vimal V Jhaveri
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Mary T Lasalvia
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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7
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Goethe O, Heuer A, Ma X, Wang Z, Herzon SB. Antibacterial properties and clinical potential of pleuromutilins. Nat Prod Rep 2019; 36:220-247. [PMID: 29979463 DOI: 10.1039/c8np00042e] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Covering: up to 2018Pleuromutilins are a clinically validated class of antibiotics derived from the fungal diterpene (+)-pleuromutilin (1). Pleuromutilins inhibit bacterial protein synthesis by binding to the peptidyl transferase center (PTC) of the ribosome. In this review we summarize the biosynthesis and recent total syntheses of (+)-pleuromutilin (1). We review the mode of interaction of pleuromutilins with the bacterial ribosome, which involves binding of the C14 extension and the tricyclic core to the P and A sites of the PTC, respectively. We provide an overview of existing clinical agents, and discuss the three primary modes of bacterial resistance (mutations in ribosomal protein L3, Cfr methylation, and efflux). Finally we collect structure-activity relationships from publicly available reports, and close with some forward looking statements regarding future development.
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Affiliation(s)
- Olivia Goethe
- Department of Chemistry, Yale University, New Haven, Connecticut 06520, USA.
| | - Abigail Heuer
- Department of Chemistry, Yale University, New Haven, Connecticut 06520, USA.
| | - Xiaoshen Ma
- Department of Chemistry, Yale University, New Haven, Connecticut 06520, USA.
| | - Zhixun Wang
- Department of Chemistry, Yale University, New Haven, Connecticut 06520, USA.
| | - Seth B Herzon
- Department of Chemistry, Yale University, New Haven, Connecticut 06520, USA. and Department of Pharmacology, Yale School of Medicine, New Haven, Connecticut 06520, USA
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8
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Baumann U, Routes JM, Soler-Palacín P, Jolles S. The Lung in Primary Immunodeficiencies: New Concepts in Infection and Inflammation. Front Immunol 2018; 9:1837. [PMID: 30147696 PMCID: PMC6096054 DOI: 10.3389/fimmu.2018.01837] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/25/2018] [Indexed: 12/12/2022] Open
Abstract
Immunoglobulin replacement therapy (IGRT) has contributed critically to the management of primary antibody deficiencies (PAD) and the decrease in pneumonia rate. However, despite adequate IGRT and improved prognosis, patients with PAD continue to experience recurrent respiratory tract infections, leading to bronchiectasis and continuing decline in lung function with a severe impact on their quality of life. Moreover, non-infectious inflammatory and interstitial lung complications, such as granulomatous-lymphocytic interstitial lung disease, contribute substantially to the overall morbidity of PAD. These conditions develop much more often than appreciated and represent a major therapeutic challenge. Therefore, a regular assessment of the structural and functional condition of the lung and the upper airways with appropriate treatment is required to minimize the deterioration of lung function. This work summarizes the knowledge on lung complications in PAD and discusses the currently available diagnostic tools and treatment options.
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Affiliation(s)
- Ulrich Baumann
- Department of Paediatric Pulmonology, Allergy and Neonatology, Hannover Medical School, Hannover, Germany
| | - John M Routes
- Division of Asthma, Allergy and Clinical Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Pere Soler-Palacín
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Stephen Jolles
- Immunodeficiency Centre for Wales, University Hospital of Wales, Cardiff, United Kingdom
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9
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Sun F, Zhang H, Gonzales GB, Zhou J, Li Y, Zhang J, Jin Y, Wang Z, Li Y, Cao X, Zhang S, Yang S. Unraveling the Metabolic Routes of Retapamulin: Insights into Drug Development of Pleuromutilins. Antimicrob Agents Chemother 2018; 62:e02388-17. [PMID: 29358298 PMCID: PMC5913982 DOI: 10.1128/aac.02388-17] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 01/09/2018] [Indexed: 12/11/2022] Open
Abstract
Retapamulin, a semisynthetic pleuromutilin derivative, is exclusively used for the topical short-term medication of impetigo and staphylococcal infections. In the present study, we report that retapamulin is adequately and rapidly metabolized in vitro via various metabolic pathways, such as hydroxylation, including mono-, di-, and trihydroxylation, and demethylation. Like tiamulin and valnemulin, the major metabolic routes of retapamulin were hydroxylation at the 2β and 8α positions of the mutilin moiety. Moreover, in vivo metabolism concurred with the results of the in vitro assays. Additionally, we observed significant interspecies differences in the metabolism of retapamulin. Until now, modifying the side chain was the mainstream method for new drug discovery of the pleuromutilins. This approach, however, could not resolve the low bioavailability and short efficacy of the drugs. Considering the rapid metabolism of the pleuromutilins mediated by cytochrome P450 enzymes, we propose that blocking the active metabolic site (C-2 and C-8 motif) or administering the drug in combination with cytochrome P450 enzyme inhibitors is a promising pathway in the development of novel pleuromutilin drugs with slow metabolism and long efficacy.
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Affiliation(s)
- Feifei Sun
- College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
- Institute of Apicultural Research, Chinese Academy of Agricultural Sciences, Key Laboratory of Bee Products for Quality and Safety Control, Laboratory of Risk Assessment for Quality and Safety of Bee Products, Bee Product Quality Supervision and Testing Center, Ministry of Agriculture, Beijing, People's Republic of China
| | - Huiyan Zhang
- College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
- Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Gerard Bryan Gonzales
- Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jinhui Zhou
- Institute of Apicultural Research, Chinese Academy of Agricultural Sciences, Key Laboratory of Bee Products for Quality and Safety Control, Laboratory of Risk Assessment for Quality and Safety of Bee Products, Bee Product Quality Supervision and Testing Center, Ministry of Agriculture, Beijing, People's Republic of China
| | - Yi Li
- Institute of Apicultural Research, Chinese Academy of Agricultural Sciences, Key Laboratory of Bee Products for Quality and Safety Control, Laboratory of Risk Assessment for Quality and Safety of Bee Products, Bee Product Quality Supervision and Testing Center, Ministry of Agriculture, Beijing, People's Republic of China
| | - Jinzhen Zhang
- Institute of Apicultural Research, Chinese Academy of Agricultural Sciences, Key Laboratory of Bee Products for Quality and Safety Control, Laboratory of Risk Assessment for Quality and Safety of Bee Products, Bee Product Quality Supervision and Testing Center, Ministry of Agriculture, Beijing, People's Republic of China
| | - Yue Jin
- Institute of Apicultural Research, Chinese Academy of Agricultural Sciences, Key Laboratory of Bee Products for Quality and Safety Control, Laboratory of Risk Assessment for Quality and Safety of Bee Products, Bee Product Quality Supervision and Testing Center, Ministry of Agriculture, Beijing, People's Republic of China
| | - Zhanhui Wang
- College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Yanshen Li
- College of Life Science, Yantai University, Yantai, Shandong, People's Republic of China
| | - Xingyuan Cao
- College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Suxia Zhang
- College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Shupeng Yang
- Institute of Apicultural Research, Chinese Academy of Agricultural Sciences, Key Laboratory of Bee Products for Quality and Safety Control, Laboratory of Risk Assessment for Quality and Safety of Bee Products, Bee Product Quality Supervision and Testing Center, Ministry of Agriculture, Beijing, People's Republic of China
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10
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Sun F, Fan R, Wang J, Xiong L, Shen J, Zhang S, Cao X. Pharmacokinetics of valnemulin after intravenous, intramuscular, and oral administration in layer chickens. J Vet Pharmacol Ther 2017; 40:415-418. [PMID: 28205246 DOI: 10.1111/jvp.12389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/20/2016] [Indexed: 11/26/2022]
Abstract
The pharmacokinetic characteristics of valnemulin in layer chickens were studied after single intravenous, intramuscular, and oral administration at a dose of 15 mg/kg body weight. Plasma samples at certain time points were collected and the drug concentrations in them by ultra high-performance liquid chromatography tandem mass spectrometry (UHPLC-MS). The concentration-time data for each individual were plotted by noncompartmental analysis for the whole three routes. Following intravenous administration, the plasma concentration showed tiny fluctuation. The elimination half-life (T1/2λz), total body clearance (Cl), and area under the plasma concentration-time curve (AUC) were 1.85 ± 0.43 h, 2.2 ± 0.9 L/h, and 7.52 ± 2.46 μg·h/mL, respectively. Following intramuscular administration, the peak concentration (Cmax , 1.40 ± 0.43 μg/mL) was achieved at the time of 0.34 h. A multiple-peak phenomenon existed after oral administration, and the first peak and secondary peak were at 10 min and during 2-4 h, respectively, while the tertiary peak appeared during 5-15 h. The bioavailability (F %) for intramuscular and oral administration was 68.60% and 52.64%, respectively. In present study, the detailed pharmacokinetic profiles showed that this drug is widely distributed and rapidly eliminated, however has a low bioavailability, indicating that valnemulin is likely to be a favorable choice in the clinical practice.
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Affiliation(s)
- F Sun
- Department of Veterinary Pharmacology and Toxicology, China Agricultural University, Beijing, China.,Key Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing, China.,Laboratory of Quality & Safety Risk Assessment for Animal Products on Chemical Hazards (Beijing), Ministry of Agriculture, Beijing, China
| | - R Fan
- Department of Veterinary Pharmacology and Toxicology, China Agricultural University, Beijing, China
| | - J Wang
- Department of Veterinary Pharmacology and Toxicology, China Agricultural University, Beijing, China.,Key Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing, China.,Laboratory of Quality & Safety Risk Assessment for Animal Products on Chemical Hazards (Beijing), Ministry of Agriculture, Beijing, China
| | - L Xiong
- Department of Veterinary Pharmacology and Toxicology, China Agricultural University, Beijing, China
| | - J Shen
- Department of Veterinary Pharmacology and Toxicology, China Agricultural University, Beijing, China.,Key Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing, China.,Laboratory of Quality & Safety Risk Assessment for Animal Products on Chemical Hazards (Beijing), Ministry of Agriculture, Beijing, China
| | - S Zhang
- Department of Veterinary Pharmacology and Toxicology, China Agricultural University, Beijing, China
| | - X Cao
- Department of Veterinary Pharmacology and Toxicology, China Agricultural University, Beijing, China.,Key Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing, China.,Laboratory of Quality & Safety Risk Assessment for Animal Products on Chemical Hazards (Beijing), Ministry of Agriculture, Beijing, China
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11
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Waites KB, Crabb DM, Duffy LB, Jensen JS, Liu Y, Paukner S. In Vitro Activities of Lefamulin and Other Antimicrobial Agents against Macrolide-Susceptible and Macrolide-Resistant Mycoplasma pneumoniae from the United States, Europe, and China. Antimicrob Agents Chemother 2017; 61:e02008-16. [PMID: 27855075 PMCID: PMC5278710 DOI: 10.1128/aac.02008-16] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 11/09/2016] [Indexed: 11/20/2022] Open
Abstract
Lefamulin, an investigational pleuromutilin, was tested against a collection of 18 macrolide-susceptible and 42 macrolide-resistant Mycoplasma pneumoniae strains, and the results were compared with those of azithromycin, erythromycin, tetracycline, doxycycline, and moxifloxacin testing. Lefamulin was highly active against all strains tested, with all MICs at ≤0.008 μg/ml. The lefamulin MIC90 (0.002 μg/ml) for macrolide-resistant strains was the lowest among all drugs tested. Minimum bactericidal concentrations were within 2 dilutions of the MIC values, indicating a bactericidal effect.
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Affiliation(s)
- Ken B Waites
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Donna M Crabb
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lynn B Duffy
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jorgen S Jensen
- Sexually Transmitted Bacterial Infections, Research and Development, Statens Serum Institut, Copenhagen, Denmark
| | - Yang Liu
- Institute of Antibiotics, Huashan Hospital, Fudan University, and China Key Laboratory of Clinical Pharmacology of Antibiotics, Ministry of Health, Shanghai, China
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12
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Paukner S, Riedl R. Pleuromutilins: Potent Drugs for Resistant Bugs-Mode of Action and Resistance. Cold Spring Harb Perspect Med 2017; 7:a027110. [PMID: 27742734 PMCID: PMC5204327 DOI: 10.1101/cshperspect.a027110] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pleuromutilins are antibiotics that selectively inhibit bacterial translation and are semisynthetic derivatives of the naturally occurring tricyclic diterpenoid pleuromutilin, which received its name from the pleuromutilin-producing fungus Pleurotus mutilus Tiamulin and valnemulin are two established derivatives in veterinary medicine for oral and intramuscular administration. As these early pleuromutilin drugs were developed at a time when companies focused on major antibacterial classes, such as the β-lactams, and resistance was not regarded as an issue, interest in antibiotic research including pleuromutilins was limited. Over the last decade or so, there has been a resurgence in interest to develop this class for human use. This has resulted in a topical derivative, retapamulin, and additional derivatives in clinical development. The most advanced compound is lefamulin, which is in late-stage development for the intravenous and oral treatment of community-acquired bacterial pneumonia and acute bacterial skin infections. Overall, pleuromutilins and, in particular, lefamulin are characterized by potent activity against Gram-positive and fastidious Gram-negative pathogens as well as against mycoplasmas and intracellular organisms, such as Chlamydia spp. and Legionella pneumophila Pleuromutilins are unaffected by resistance to other major antibiotic classes, such as macrolides, fluoroquinolones, tetracyclines, β-lactam antibiotics, and others. Furthermore, pleuromutilins display very low spontaneous mutation frequencies and slow, stepwise resistance development at sub-MIC in vitro. The potential for resistance development in clinic is predicted to be slow as confirmed by extremely low resistance rates to this class despite the use of pleuromutilins in veterinary medicine for >30 years. Although rare, resistant strains have been identified in human- and livestock-associated environments and as with any antibiotic class, require close monitoring as well as prudent use in veterinary medicine. This review focuses on the structural characteristics, mode of action, antibacterial activity, and resistance development of this potent and novel antibacterial class for systemic use in humans.
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13
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14
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Ouyang J, Wang J, Wang Y, Yin Q, Hao H. Thermodynamic study on dynamic water and organic vapor sorption on amorphous valnemulin hydrochloride. Front Chem Sci Eng 2016. [DOI: 10.1007/s11705-015-1460-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Yuan LG, Tang YZ, Zhang YX, Sun J, Luo XY, Zhu LX, Zhang Z, Wang R, Liu YH. Dosage assessment of valnemulin in pigs based on population pharmacokinetic and Monte Carlo simulation. J Vet Pharmacol Ther 2015; 38:400-9. [PMID: 25604162 DOI: 10.1111/jvp.12199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 11/21/2014] [Indexed: 11/27/2022]
Abstract
To estimate the valnemulin pharmacokinetic profile in a swine population and to assess a dosage regimen for increasing the likelihood of optimization. This study was, respectively, performed in 22 sows culled by p.o. administration and in 80 growing-finishing pigs by i.v. administration at a single dose of 10 mg/kg to develop a population pharmacokinetic model and Monte Carlo simulation. The relationships among the plasma concentration, dose, and time of valnemulin in pigs were illustrated as C(i,v) = X(0 )(8.4191 × 10(-4) × e(-0.2371t) + 1.2788 × 10(-5) × e(-0.0069t)) after i.v. and C(p.o) = X(0) (-8.4964 × 10(-4) × e(-0.5840t) + 8.4195 × e(-0.2371t) + 7.6869 × 10(-6) × e(-0.0069t)) after p.o. Monte Carlo simulation showed that T(>MIC) was more than 24 h when a single daily dosage at 13.5 mg/kg BW in pigs was administrated by p.o., and MIC was 0.031 mg/L. It was concluded that the current dosage regimen at 10-12 mg/kg BW led to valnemulin underexposure if the MIC was more than 0.031 mg/L and could increase the risk of treatment failure and/or drug resistance.
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Affiliation(s)
- L G Yuan
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, China.,Guangdong Provincial Key Laboratory of Prevention and Control for Severe Clinical Animal Diseases, Guangzhou, Guangdong Province, China
| | - Y Z Tang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, China.,Guangdong Provincial Key Laboratory of Prevention and Control for Severe Clinical Animal Diseases, Guangzhou, Guangdong Province, China
| | - Y X Zhang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, China.,Guangdong Provincial Key Laboratory of Prevention and Control for Severe Clinical Animal Diseases, Guangzhou, Guangdong Province, China
| | - J Sun
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, China
| | - X Y Luo
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, China
| | - L X Zhu
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, China
| | - Z Zhang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, China
| | - R Wang
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, China
| | - Y H Liu
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province, China
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16
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Yang S, Shi W, Hu D, Zhang S, Zhang H, Wang Z, Cheng L, Sun F, Shen J, Cao X. In vitro and in vivo metabolite profiling of valnemulin using ultraperformance liquid chromatography-quadrupole/time-of-flight hybrid mass spectrometry. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2014; 62:9201-10. [PMID: 25156794 PMCID: PMC4166035 DOI: 10.1021/jf5012402] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Valnemulin, a semisynthetic pleuromutilin derivative related to tiamulin, is broadly used to treat bacterial diseases of animals. Despite its widespread use, metabolism in animals has not yet been fully investigated. To better understand valnemulin biotransformation, in this study, metabolites of valnemulinin in in vitro and in vivo rats, chickens, swines, goats, and cows were identified and elucidated using ultraperformance liquid chromatography-quadrupole/time-of-flight hybrid mass spectrometry (UPLC-Q/TOF-MS). As a result, there were totally 7 metabolites of valnemulin identified in vitro and 75, 61, and 74 metabolites detected in in vivo rats, chickens, and swines, respectively, and the majority of metabolites were reported for the first time. The main metabolic pathways of valnemulin were found to be hydroxylation in the mutilin part (the ring system) and the side chain, oxidization on the sulfur of the side chain to form S-oxides, hydrolysis of the amido bond, and acetylization in the amido of the side chain. In addition, hydroxylation in the mutilin part was proposed to be the primary metabolic route. Furthermore, the results revealed that 2β-hydroxyvalnemulin (V1) and 8α-hydroxyvalnemulin (V2) were the major metabolites for rats and swines and S-oxides (V6) in chickens.
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Affiliation(s)
- Shupeng Yang
- College
of Veterinary Medicine, China Agricultural University, Beijing Laboratory for Food Quality and Safety and
Beijing Key Laboratory of Detection Technology for Animal-Derived
Food Safety, Beijing 100193, People’s Republic of China
- Key
Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing 100193, People’s Republic of China
| | - Weimin Shi
- College
of Veterinary Medicine, China Agricultural University, Beijing Laboratory for Food Quality and Safety and
Beijing Key Laboratory of Detection Technology for Animal-Derived
Food Safety, Beijing 100193, People’s Republic of China
- Key
Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing 100193, People’s Republic of China
| | - Dingfei Hu
- Department
of Civil and Environmental Engineering, The University of Iowa, Iowa City, Iowa 52242, United States
| | - Suxia Zhang
- College
of Veterinary Medicine, China Agricultural University, Beijing Laboratory for Food Quality and Safety and
Beijing Key Laboratory of Detection Technology for Animal-Derived
Food Safety, Beijing 100193, People’s Republic of China
- Key
Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing 100193, People’s Republic of China
| | - Huiyan Zhang
- College
of Veterinary Medicine, China Agricultural University, Beijing Laboratory for Food Quality and Safety and
Beijing Key Laboratory of Detection Technology for Animal-Derived
Food Safety, Beijing 100193, People’s Republic of China
- Key
Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing 100193, People’s Republic of China
| | - Zhanhui Wang
- College
of Veterinary Medicine, China Agricultural University, Beijing Laboratory for Food Quality and Safety and
Beijing Key Laboratory of Detection Technology for Animal-Derived
Food Safety, Beijing 100193, People’s Republic of China
- Key
Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing 100193, People’s Republic of China
| | - Linli Cheng
- College
of Veterinary Medicine, China Agricultural University, Beijing Laboratory for Food Quality and Safety and
Beijing Key Laboratory of Detection Technology for Animal-Derived
Food Safety, Beijing 100193, People’s Republic of China
- Key
Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing 100193, People’s Republic of China
| | - Feifei Sun
- College
of Veterinary Medicine, China Agricultural University, Beijing Laboratory for Food Quality and Safety and
Beijing Key Laboratory of Detection Technology for Animal-Derived
Food Safety, Beijing 100193, People’s Republic of China
- Key
Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing 100193, People’s Republic of China
| | - Jianzhong Shen
- College
of Veterinary Medicine, China Agricultural University, Beijing Laboratory for Food Quality and Safety and
Beijing Key Laboratory of Detection Technology for Animal-Derived
Food Safety, Beijing 100193, People’s Republic of China
- Key
Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing 100193, People’s Republic of China
| | - Xingyuan Cao
- College
of Veterinary Medicine, China Agricultural University, Beijing Laboratory for Food Quality and Safety and
Beijing Key Laboratory of Detection Technology for Animal-Derived
Food Safety, Beijing 100193, People’s Republic of China
- Key
Laboratory of Detection for Veterinary Drug Residue and Illegal Additive, Ministry of Agriculture, Beijing 100193, People’s Republic of China
- (X.C.) Phone: +86-10-6273-1201. Fax: +86-10-6273-1032. E-mail:
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17
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Detková D, Español T. An update on treatment strategies for common variable immunodeficiency. Expert Rev Clin Immunol 2014; 5:381-90. [DOI: 10.1586/eci.09.22] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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18
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Ling Y, Wang X, Wang H, Yu J, Tang J, Wang D, Chen G, Huang J, Li Y, Zheng H. Design, synthesis, and antibacterial activity of novel pleuromutilin derivatives bearing an amino thiazolyl ring. Arch Pharm (Weinheim) 2012; 345:638-46. [PMID: 22532317 DOI: 10.1002/ardp.201100430] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Revised: 02/26/2012] [Accepted: 02/29/2012] [Indexed: 11/08/2022]
Abstract
A series of novel pleuromutilin derivatives containing the amino thiazolyl ring were designed, synthesized, and evaluated for their antibacterial activities in vitro against Gram-positive clinical bacteria. All the target compounds showed better aqueous solubility compared with the lead compound (10). Most compounds displayed strong antibacterial activities against both susceptible and resistant bacteria, particularly for the compound (12f) which showed extraordinary antibacterial properties superior to amoxicillin and tiamulin. Molecular docking studies revealed that the amino thiazolyl ring, the side chains of the pleuromutilin derivatives, can be adopted in the binding pocket of the 50S ribosomal subunit near the mutilin core. Therefore, our novel findings may provide new insights into the design of novel pleuromutilin derivatives and lay the basis for further studies on these promising antibiotics for human clinical use.
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Affiliation(s)
- Yong Ling
- Department of Pharmacy, School of Medical, Nantong University, Nantong, P. R. China
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19
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Sun J, Yuan L, Zhu L, He L, Luo X, Wang R, Liu Y. Pharmacokinetics and bioavailability of valnemulin in Muscovy ducks (Cairina moschata). Br Poult Sci 2012; 53:374-8. [DOI: 10.1080/00071668.2012.703776] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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20
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WANG R, YUAN LG, HE LM, ZHU LX, LUO XY, ZHANG CY, YU JJ, FANG BH, LIU YH. Pharmacokinetics and bioavailability of valnemulin in broiler chickens. J Vet Pharmacol Ther 2011; 34:247-51. [DOI: 10.1111/j.1365-2885.2010.01215.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Chen Z, Zhang X, Chu X, Zhang X, Song K, Jiang Y, Yu L, Deng X. Preventive effects of valnemulin on lipopolysaccharide-induced acute lung injury in mice. Inflammation 2010; 33:306-14. [PMID: 20221680 DOI: 10.1007/s10753-010-9186-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Valnemulin reportedly regulates inflammatory responses in addition to its in vitro antibacterial activity. In this study, we established a mouse model of lipopolysaccharide (LPS)-induced inflammatory lung injury and investigated the effect of valnemulin (100 mg/kg) on acute lung injury (ALI) 8 h after LPS challenge. We prepared bronchoalveolar lavage fluid (BALF) for measuring protein concentrations, cytokine levels, and superoxidase dismutase (SOD) activity, and collected lungs for assaying wet-to-dry weight (W/D) ratios, myeloperoxidase (MPO) activity, cytokine mRNA expression, and histological change. We found that the pre-administration of valnemulin significantly decreases the W/D ratio of lungs, protein concentrations, and the number of total cells, neutrophils, macrophages, and leukomonocytes, and histologic analysis indicates that valnemulin significantly attenuates tissue injury. Furthermore, valnemulin significantly increases LPS-induced SOD activity in BALF and decreases lung MPO activity as well. In addition, valnemulin also inhibits the production of tumor necrosis factor-alpha, interleukin-6, and interleukin-1beta, which is consistent with mRNA expression in lung. The results showed that valnemulin had a protective effect on LPS-induced ALI in mice.
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Affiliation(s)
- Zhibao Chen
- Department of Veterinary Pharmacology, College of Animal Science and Veterinary Medicine, Jilin University, Changchun, Jilin 130062, People's Republic of China
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22
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Li BB, Shen JZ, Cao XY, Wang Y, Dai L, Huang SY, Wu CM. Mutations in 23S rRNA gene associated with decreased susceptibility to tiamulin and valnemulin in Mycoplasma gallisepticum. FEMS Microbiol Lett 2010; 308:144-9. [DOI: 10.1111/j.1574-6968.2010.02003.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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23
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Hartley AJ, de Mattos-Shipley K, Collins CM, Kilaru S, Foster GD, Bailey AM. Investigating pleuromutilin-producing Clitopilus species and related basidiomycetes. FEMS Microbiol Lett 2009; 297:24-30. [PMID: 19527297 DOI: 10.1111/j.1574-6968.2009.01656.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Pleuromutilin is a broad-spectrum antibiotic that has been used in veterinary medicine for over 20 years, but is now gaining interest as a human therapeutic. The compound is a fungal secondary metabolite, but there is some degree of confusion within the literature concerning which species may produce pleuromutilin, with several differently named fungi reported to make the compound. Here, we describe a taxonomic survey of publicly available cultures known to produce pleuromutilin, and other similar species. The pleuromutilin production of these strains was assessed and a phylogenetic assessment was carried out based on the sequence of the nuclear rRNA internal transcribed spacer region. Eleven strains were confirmed as being pleuromutilin producers and all of these isolates appear to fall within a discrete clade of the genus Clitopilus. The phylogenetic analysis also highlights the need for a revision of the taxonomic status of these fungi.
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Affiliation(s)
- Amanda J Hartley
- School of Biological Sciences, University of Bristol, Bristol, UK
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24
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Cordtz J, Jensen JS. Disseminated Ureaplasma urealyticum infection in a hypo-gammaglobulinaemic renal transplant patient. ACTA ACUST UNITED AC 2009; 38:1114-7. [PMID: 17148091 DOI: 10.1080/00365540600675734] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report of a case of severe disseminated U. urealyticum infection in a 35-y-old kidney transplanted patient with CVID. Routine microbiological tests were negative. Six weeks after admission, abscess material was grown on Mycoplasma culture medium yielding U. urealyticum in high titres. The patient responded promptly to appropriate antibiotics.
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Affiliation(s)
- Joakim Cordtz
- Department of Nephrology, Rigshospitalet, Copenhagen, Denmark.
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25
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Valnemulin downregulates nitric oxide, prostaglandin E2, and cytokine production via inhibition of NF-kappaB and MAPK activity. Int Immunopharmacol 2009; 9:810-6. [PMID: 19293003 DOI: 10.1016/j.intimp.2009.02.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2009] [Revised: 02/22/2009] [Accepted: 02/27/2009] [Indexed: 11/20/2022]
Abstract
Valnemulin is a pleuromutilin antibiotic used in clinics for the treatment of various infections. We studied the in vitro anti-inflammatory effects of valnemulin and associated signal transduction mechanisms in lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages. We found that valnemulin inhibited nitric oxide (NO), prostaglandin E2 (PGE2), tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6), and increased interleukin-10 (IL-10) production. Inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) protein expression were also inhibited by valnemulin. We further observed that valnemulin prevented the LPS-induced NF-kappaB translocation from the cytoplasm into the nucleus. Valnemulin also blocked phosphorylation of three mitogen-activated protein kinases (MAPKs): extracellular signal receptor-activated kinase (ERK) 1/2, p38, and c-Jun N-terminal kinase (JNK). Our data indicate that valnemulin may have therapeutic anti-inflammatory effects independent of its antibacterial activity.
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26
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Long KS, Poehlsgaard J, Hansen LH, Hobbie SN, Böttger EC, Vester B. Single 23S rRNA mutations at the ribosomal peptidyl transferase centre confer resistance to valnemulin and other antibiotics in Mycobacterium smegmatis by perturbation of the drug binding pocket. Mol Microbiol 2009; 71:1218-27. [PMID: 19154331 DOI: 10.1111/j.1365-2958.2009.06596.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Tiamulin and valnemulin target the peptidyl transferase centre (PTC) on the bacterial ribosome. They are used in veterinary medicine to treat infections caused by a variety of bacterial pathogens, including the intestinal spirochetes Brachyspira spp. Mutations in ribosomal protein L3 and 23S rRNA have previously been associated with tiamulin resistance in Brachyspira spp. isolates, but as multiple mutations were isolated together, the roles of the individual mutations are unclear. In this work, individual 23S rRNA mutations associated with pleuromutilin resistance at positions 2055, 2447, 2504 and 2572 (Escherichia coli numbering) are introduced into a Mycobacterium smegmatis strain with a single rRNA operon. The single mutations each confer a significant and similar degree of valnemulin resistance and those at 2447 and 2504 also confer cross-resistance to other antibiotics that bind to the PTC in M. smegmatis. Antibiotic footprinting experiments on mutant ribosomes show that the introduced mutations cause structural perturbations at the PTC and reduced binding of pleuromutilin antibiotics. This work underscores the fact that mutations at nucleotides distant from the pleuromutilin binding site can confer the same level of valnemulin resistance as those at nucleotides abutting the bound drug, and suggests that the former function indirectly by altering local structure and flexibility at the drug binding pocket.
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Affiliation(s)
- Katherine S Long
- Department of Biology, University of Copenhagen, Ole Maaløes Vej 5, DK-2200 Copenhagen N, Denmark.
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27
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Abstract
Antibody deficiencies may arise as primary disorders or secondary to a variety of diseases, drugs and other environmental/iatrogenic factors. Significant primary antibody deficiencies are relatively rare but, collectively, account for the majority of primary immunodeficiency syndromes encountered in clinical practice. The genetic basis of a number of primary deficiencies has been clarified, although there is considerable genotype/phenotype heterogeneity and the role of gene/environment interactions has yet to be fully elucidated. Primary antibody deficiency can present at any age. The hallmark clinical presentation is recurrent bacterial infection, but these disorders are also associated with a wide variety of other infectious and non-infectious complications and with a high incidence of chronic, structural tissue damage, particularly in the respiratory tract. Clinical recognition of primary antibody deficiency is frequently delayed with consequent increased morbidity, diminished quality of life and early mortality. Clinical laboratories can contribute to improved and timely detection through awareness of routine test results which may be overtly or indirectly suggestive of antibody deficiency. Secondary deficiency is associated with increased awareness, better recognition and earlier diagnosis than in primary disorders. Early liaison and referral of patients with suspected antibody deficiency for specialist opinion and prompt, appropriate therapy is central to the achievement of good clinical outcomes.
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28
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Lolk L, Pøhlsgaard J, Jepsen AS, Hansen LH, Nielsen H, Steffansen SI, Sparving L, Nielsen AB, Vester B, Nielsen P. A click chemistry approach to pleuromutilin conjugates with nucleosides or acyclic nucleoside derivatives and their binding to the bacterial ribosome. J Med Chem 2008; 51:4957-67. [PMID: 18680270 DOI: 10.1021/jm800261u] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pleuromutilin and its derivatives are antibacterial drugs that inhibit protein synthesis in bacteria by binding to ribosomes. To promote rational design of pleuromutilin based drugs, 19 pleuromutilin conjugates with different nucleoside fragments as side chain extensions were synthesized by a click chemistry protocol. Binding was assessed by chemical footprinting of nucleotide U2506 in 23S rRNA, and all conjugates bind to varying degree reflecting their binding affinity to the peptidyl transferase center. The side chain extensions also show various protections at position U2585. Docking studies of the conjugates with the highest affinities support the conclusion that despite the various conjugations, the pleuomutilin skeleton binds in the same binding pocket. The conjugated triazole moiety is well accommodated, and the nucleobases are placed in different pockets in the 50S ribosomal subunit. The derivative showing the highest affinity and a significantly better binding than pleuromutilin itself contains an adenine-9-ylpropylene triazole conjugate to pleuromutilin C-22.
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Affiliation(s)
- Line Lolk
- Nucleic Acid Center, Department of Physics and Chemistry, University of Southern Denmark, 5230 Odense M, Denmark
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29
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Abstract
PURPOSE OF REVIEW To describe the incidence and management of various infectious arthritides in selected primary immunodeficiency states. RECENT FINDINGS Joint complications have been a well recognized finding in patients with primary immunodeficiencies for many years. Many are clearly infectious in etiology, but other apparently noninfectious joint abnormalities similar to rheumatoid arthritis have been shown to be due to an underlying infectious trigger. In humoral immunodeficiencies such as common variable immunodeficiency and X-linked agammaglobulinemia, bacterial organisms are the most common causes of infectious arthritis, but mycoplasmas and ureaplasmas are also of particular importance. In nonhumoral immunodeficiencies, noninfectious inflammatory arthritides are more prevalent, although microbiologic organisms have been reported in some cases of arthritis. Lack of appropriate culturing techniques and documentation of infectious agents may underestimate the prevalence of low-virulence infections in these patients. SUMMARY Infectious arthritis is a significant comorbidity associated with primary immunodeficiencies and can be the presenting feature for some patients. Prompt examination for common as well as atypical organisms is not only important for the treatment but also crucial to the understanding of the exact etiology of arthritides as a whole in these disorders.
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30
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Phillips OA, Sharaf LH. Pleuromutilin antibacterial agents: patent review 2001 – 2006. Expert Opin Ther Pat 2007. [DOI: 10.1517/13543776.17.4.429] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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31
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Long KS, Hansen LH, Jakobsen L, Vester B. Interaction of pleuromutilin derivatives with the ribosomal peptidyl transferase center. Antimicrob Agents Chemother 2006; 50:1458-62. [PMID: 16569865 PMCID: PMC1426994 DOI: 10.1128/aac.50.4.1458-1462.2006] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2005] [Revised: 11/02/2005] [Accepted: 01/13/2006] [Indexed: 11/20/2022] Open
Abstract
Tiamulin is a pleuromutilin antibiotic that is used in veterinary medicine. The recently published crystal structure of a tiamulin-50S ribosomal subunit complex provides detailed information about how this drug targets the peptidyl transferase center of the ribosome. To promote rational design of pleuromutilin-based drugs, the binding of the antibiotic pleuromutilin and three semisynthetic derivatives with different side chain extensions has been investigated using chemical footprinting. The nucleotides A2058, A2059, G2505, and U2506 are affected in all of the footprints, suggesting that the drugs are similarly anchored in the binding pocket by the common tricyclic mutilin core. However, varying effects are observed at U2584 and U2585, indicating that the side chain extensions adopt distinct conformations within the cavity and thereby affect the rRNA conformation differently. An Escherichia coli L3 mutant strain is resistant to tiamulin and pleuromutilin, but not valnemulin, implying that valnemulin is better able to withstand an altered rRNA binding surface around the mutilin core. This is likely due to additional interactions made between the valnemulin side chain extension and the rRNA binding site. The data suggest that pleuromutilin drugs with enhanced antimicrobial activity may be obtained by maximizing the number of interactions between the side chain moiety and the peptidyl transferase cavity.
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Affiliation(s)
- Katherine S Long
- Institute of Molecular Biology and Physiology, University of Copenhagen, Sølvgade 83 H, DK-1307 Copenhagen K, Denmark.
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32
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Stenske KA, Bemis DA, Hill K, Krahwinkel D. Acute Polyarthritis and Septicemia fromMycoplasma edwardiiafter Surgical Removal of Bilateral Adrenal Tumors in a Dog. J Vet Intern Med 2005. [DOI: 10.1111/j.1939-1676.2005.tb02760.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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33
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Abstract
This review aims to summarise our current understanding of the role of mycoplasmas in domestic dogs. Canine mycoplasmology is a small field, with less than 50 publications in the past 40 years. In this time we have gained knowledge about the number of species and have made associations with infections in dogs. However much evidence is still lacking. The importance of all canine mycoplasmas remains unknown, yet certain species are associated with canine anaemia (Mycoplasma haemocanis), respiratory disease (Mycoplasma cynos) and urogenital tract infections (Mycoplasma canis). Mycoplasmas can be isolated in pure culture from canine clinical specimens and it is hoped that this review will stimulate veterinarians to consider mycoplasmas as a potential cause of disease in dogs, especially when antibiotic therapy is failing.
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Affiliation(s)
- V J Chalker
- Department of Pathology & Infectious Diseases, Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA, UK.
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34
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Hecker SJ, Boggs AF. A tour of recent patent applications addressing antibacterial resistance. Expert Opin Ther Pat 2005. [DOI: 10.1517/13543776.12.8.1159] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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35
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Abstract
The treatment of common variable immunodeficiency (CVID) is currently based on the early recognition of the condition and replacement immunoglobulin combined with prompt treatment of infections and complications. The route of administration, dose and frequency of administration of immunoglobulin still vary between centres and countries. Other interventions aimed at overcoming the immunological defects in CVID such as interleukin-2 therapy are being studied but there is as yet insufficient evidence to support their routine use. The treatment of complications such as suppurative lung disease uses principles broadly similar to those used for cystic fibrosis, whereas the granulomatous complications involving the lungs and other organ systems are in need of much more research to define optimum therapies.
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Affiliation(s)
- W A Carrock Sewell
- Path Links Immunology, Scunthorpe General Hospital, Scunthorpe, Lincolnshire, UK
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36
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Cazzola M, Sanduzzi A, Matera MG. Novelties in the field of antimicrobial compounds for the treatment of lower respiratory tract infections. Pulm Pharmacol Ther 2003; 16:131-45. [PMID: 12749829 DOI: 10.1016/s1094-5539(03)00050-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Emergence of antimicrobial resistance is a growing problem and a public health threat. New drugs must be designed with emerging needs in mind: specific resistant and hard-to-treat organisms. But the difficulty to find real new drugs is a major problem. Only the oxazolidinones, the cationic peptides and the lipopeptide antibiotics can be truly regarded as structurally novel drugs, although the peptide deformylase inhibitors and, possibly, the pleuromutilins can be considered a potential advancement in the field. Obviously, these antibiotics must be reserved only to cases of documented ineffectiveness of the common antimicrobial agents.
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Affiliation(s)
- Mario Cazzola
- Department of Respiratory Medicine, Unit of Pneumology and Allergology, A. Cardarelli Hospital, Via del Parco Margherita 24, 80121 Naples, Italy.
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