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Werner J, Umstätter F, Hertlein T, Mühlberg E, Beijer B, Wohlfart S, Zimmermann S, Haberkorn U, Ohlsen K, Fricker G, Mier W, Uhl P. Oral Delivery of the Vancomycin Derivative FU002 by a Surface-Modified Liposomal Nanocarrier. Adv Healthc Mater 2024:e2303654. [PMID: 38387090 DOI: 10.1002/adhm.202303654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/29/2024] [Indexed: 02/24/2024]
Abstract
Oral delivery of peptide therapeutics faces multiple challenges due to their instability in the gastrointestinal tract and low permeation capability. In this study, the aim is to develop a liposomal nanocarrier formulation to enable the oral delivery of the vancomycin-peptide derivative FU002. FU002 is a promising, resistance-breaking, antibiotic which exhibits poor oral bioavailability, limiting its potential therapeutic use. To increase its oral bioavailability, FU002 is incorporated into tetraether lipid-stabilized liposomes modified with cyclic cell-penetrating peptides on the liposomal surface. This liposomal formulation shows strong binding to Caco-2 cells without exerting cytotoxic effects in vitro. Pharmacokinetics studies in vivo in rats reveal increased oral bioavailability of liposomal FU002 when compared to the free drug. In vitro and in vivo antimicrobial activity of FU002 are preserved in the liposomal formulation. As a highlight, oral administration of liposomal FU002 results in significant therapeutic efficacy in a murine systemic infection model. Thus, the presented nanotechnological approach provides a promising strategy for enabling oral delivery of this highly active vancomycin derivative.
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Affiliation(s)
- Julia Werner
- Department of Nuclear Medicine, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Florian Umstätter
- Department of Nuclear Medicine, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Tobias Hertlein
- Institute for Molecular Infection Biology, University of Würzburg, 97080, Würzburg, Germany
| | - Eric Mühlberg
- Institute of Pharmacy and Molecular Biotechnology, Heidelberg University, 69120, Heidelberg, Germany
| | - Barbro Beijer
- Department of Nuclear Medicine, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Sabrina Wohlfart
- Department of Nuclear Medicine, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Stefan Zimmermann
- Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Uwe Haberkorn
- Department of Nuclear Medicine, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Knut Ohlsen
- Institute for Molecular Infection Biology, University of Würzburg, 97080, Würzburg, Germany
| | - Gert Fricker
- Institute of Pharmacy and Molecular Biotechnology, Heidelberg University, 69120, Heidelberg, Germany
| | - Walter Mier
- Department of Nuclear Medicine, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Philipp Uhl
- Institute of Pharmacy and Molecular Biotechnology, Heidelberg University, 69120, Heidelberg, Germany
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Werner J, Umstätter F, Hertlein T, Beijer B, Kleist C, Mühlberg E, Zimmermann S, Haberkorn U, Ohlsen K, Fricker G, Mier W, Uhl P. Improved pharmacokinetics and enhanced efficacy of the vancomycin derivative FU002 using a liposomal nanocarrier. Nanomedicine 2024; 56:102731. [PMID: 38158147 DOI: 10.1016/j.nano.2023.102731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/25/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
Antibiotic resistance still represents a global health concern which diminishes the pool of effective antibiotics. With the vancomycin derivative FU002, we recently reported a highly potent substance active against Gram-positive bacteria with the potential to overcome vancomycin resistance. However, the translation of its excellent antimicrobial activity into clinical efficiency could be hampered by its rapid elimination from the blood stream. To improve its pharmacokinetics, we encapsulated FU002 in PEGylated liposomes. For PEG-liposomal FU002, no relevant cytotoxicity on liver, kidney and red blood cells was observed. Studies in Wistar rats revealed a significantly prolonged blood circulation of the liposomal antibiotic. In microdilution assays it could be demonstrated that encapsulation does not diminish the antimicrobial activity against staphylococci and enterococci. Highlighting its great potency, liposomal FU002 exhibited a superior therapeutic efficacy when compared to the free form in a Galleria mellonella larvae infection model.
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Affiliation(s)
- Julia Werner
- Heidelberg University Hospital, Department of Nuclear Medicine, Heidelberg, Germany
| | - Florian Umstätter
- Heidelberg University Hospital, Department of Nuclear Medicine, Heidelberg, Germany
| | - Tobias Hertlein
- University of Würzburg, Institute for Molecular Infection Biology, Würzburg, Germany
| | - Barbro Beijer
- Heidelberg University Hospital, Department of Nuclear Medicine, Heidelberg, Germany
| | - Christian Kleist
- Heidelberg University Hospital, Department of Nuclear Medicine, Heidelberg, Germany
| | - Eric Mühlberg
- Heidelberg University Hospital, Department of Nuclear Medicine, Heidelberg, Germany
| | - Stefan Zimmermann
- Heidelberg University Hospital, Department of Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg, Germany
| | - Uwe Haberkorn
- Heidelberg University Hospital, Department of Nuclear Medicine, Heidelberg, Germany
| | - Knut Ohlsen
- University of Würzburg, Institute for Molecular Infection Biology, Würzburg, Germany
| | - Gert Fricker
- Heidelberg University, Institute of Pharmacy and Molecular Biotechnology, Heidelberg, Germany
| | - Walter Mier
- Heidelberg University Hospital, Department of Nuclear Medicine, Heidelberg, Germany
| | - Philipp Uhl
- Heidelberg University Hospital, Department of Nuclear Medicine, Heidelberg, Germany; Heidelberg University, Institute of Pharmacy and Molecular Biotechnology, Heidelberg, Germany.
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Mühlberg E, Burtscher M, Umstätter F, Fricker G, Mier W, Uhl P. Trends in liposomal nanocarrier strategies for the oral delivery of biologics. Nanomedicine (Lond) 2021; 16:1813-1832. [PMID: 34269068 DOI: 10.2217/nnm-2021-0177] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The number of approved macromolecular drugs such as peptides, proteins and antibodies steadily increases. Since drugs with high molecular weight are commonly not suitable for oral delivery, research on carrier strategies enabling oral administration is of vital interest. In past decades, nanocarriers, in particular liposomes, have been exhaustively investigated as oral drug-delivery platform. Despite their successful application as parenteral delivery vehicles, liposomes have up to date not succeeded for oral administration. However, a plenitude of approaches aiming to increase the oral bioavailability of macromolecular drugs administered by liposomal formulations has been published. Here, we summarize the strategies published in the last 10 years (vaccine strategies excluded) with a main focus on strategies proven efficient in animal models.
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Affiliation(s)
- Eric Mühlberg
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, Heidelberg, 69120, Germany
| | - Mira Burtscher
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, Heidelberg, 69120, Germany
| | - Florian Umstätter
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, Heidelberg, 69120, Germany
| | - Gert Fricker
- Department of Pharmaceutical Technology & Biopharmacy, Institute for Pharmacy & Molecular Biotechnology, Ruprecht-Karls University, Im Neuenheimer Feld 329, Heidelberg, 69120, Germany
| | - Walter Mier
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, Heidelberg, 69120, Germany
| | - Philipp Uhl
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, Heidelberg, 69120, Germany
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Umstätter F, Domhan C, Hertlein T, Ohlsen K, Mühlberg E, Kleist C, Zimmermann S, Beijer B, Klika KD, Haberkorn U, Mier W, Uhl P. Berichtigung: Überwindung von Vancomycinresistenzen durch Modifikation mit polykationischen Peptiden. Angew Chem Int Ed Engl 2020. [DOI: 10.1002/ange.202007022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Umstätter F, Domhan C, Hertlein T, Ohlsen K, Mühlberg E, Kleist C, Zimmermann S, Beijer B, Klika KD, Haberkorn U, Mier W, Uhl P. Corrigendum: Vancomycin Resistance is Overcome by Conjugation of Polycationic Peptides. Angew Chem Int Ed Engl 2020. [DOI: 10.1002/anie.202007022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Umstätter F, Domhan C, Hertlein T, Ohlsen K, Mühlberg E, Kleist C, Zimmermann S, Beijer B, Klika KD, Haberkorn U, Mier W, Uhl P. Vancomycin Resistance Is Overcome by Conjugation of Polycationic Peptides. Angew Chem Int Ed Engl 2020; 59:8823-8827. [PMID: 32190958 PMCID: PMC7323874 DOI: 10.1002/anie.202002727] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Indexed: 01/09/2023]
Abstract
Multidrug-resistant bacteria represent one of the biggest challenges facing modern medicine. The increasing prevalence of glycopeptide resistance compromises the efficacy of vancomycin, for a long time considered as the last resort for the treatment of resistant bacteria. To reestablish its activity, polycationic peptides were conjugated to vancomycin. By site-specific conjugation, derivatives that bear the peptide moiety at four different sites of the antibiotic were synthesized. The most potent compounds exhibited an approximately 1000-fold increased antimicrobial activity and were able to overcome the most important types of vancomycin resistance. Additional blocking experiments using d-Ala-d-Ala revealed a mode of action beyond inhibition of cell-wall formation. The antimicrobial potential of the lead candidate FU002 for bacterial infection treatments could be demonstrated in an in vivo study. Molecular imaging and biodistribution studies revealed that conjugation engenders superior pharmacokinetics.
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Affiliation(s)
- Florian Umstätter
- Department of Nuclear MedicineHeidelberg University HospitalIm Neuenheimer Feld 40069120HeidelbergGermany
| | - Cornelius Domhan
- Institute of Pharmacy and Molecular BiotechnologyHeidelberg UniversityGermany
| | - Tobias Hertlein
- Institute for Molecular Infection Biology (IMIB)University of WürzburgGermany
| | - Knut Ohlsen
- Institute for Molecular Infection Biology (IMIB)University of WürzburgGermany
| | - Eric Mühlberg
- Department of Nuclear MedicineHeidelberg University HospitalIm Neuenheimer Feld 40069120HeidelbergGermany
| | - Christian Kleist
- Department of Nuclear MedicineHeidelberg University HospitalIm Neuenheimer Feld 40069120HeidelbergGermany
| | - Stefan Zimmermann
- Medical Microbiology and HygieneHeidelberg University HospitalGermany
| | - Barbro Beijer
- Department of Nuclear MedicineHeidelberg University HospitalIm Neuenheimer Feld 40069120HeidelbergGermany
| | - Karel D. Klika
- German Cancer Research Center (DKFZ)NMR Spectroscopy Analysis UnitGermany
| | - Uwe Haberkorn
- Department of Nuclear MedicineHeidelberg University HospitalGermany
- Clinical Cooperation Unit Nuclear MedicineGerman Cancer Research Center (DKFZ)Germany
- Translational Lung Research Center Heidelberg (TLRC)German Center for Lung Research (DZL)Germany
| | - Walter Mier
- Department of Nuclear MedicineHeidelberg University HospitalIm Neuenheimer Feld 40069120HeidelbergGermany
| | - Philipp Uhl
- Department of Nuclear MedicineHeidelberg University HospitalIm Neuenheimer Feld 40069120HeidelbergGermany
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Umstätter F, Domhan C, Hertlein T, Ohlsen K, Mühlberg E, Kleist C, Zimmermann S, Beijer B, Klika KD, Haberkorn U, Mier W, Uhl P. Innenrücktitelbild: Überwindung von Vancomycinresistenzen durch Modifikation mit polykationischen Peptiden (Angew. Chem. 23/2020). Angew Chem Int Ed Engl 2020. [DOI: 10.1002/ange.202004925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Florian Umstätter
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
| | - Cornelius Domhan
- Institut für Pharmazie und Molekulare Biotechnologie Universität Heidelberg Deutschland
| | - Tobias Hertlein
- Institut für Molekulare Infektionsbiologie Universität Würzburg Deutschland
| | - Knut Ohlsen
- Institut für Molekulare Infektionsbiologie Universität Würzburg Deutschland
| | - Eric Mühlberg
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
| | - Christian Kleist
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
| | - Stefan Zimmermann
- Zentrum für Infektiologie Universitätsklinikum Heidelberg Deutschland
| | - Barbro Beijer
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
| | - Karel D. Klika
- Deutsches Krebsforschungszentrum (DKFZ) NMR-Analytik Deutschland
| | - Uwe Haberkorn
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Deutschland
- Klinische Kooperationseinheit Nuklearmedizin Deutsches Krebsforschungszentrum Deutschland
- Translational Lung Research Center Heidelberg (TLRC) Deutsches Zentrum für Lungenforschung (DZL) Deutschland
| | - Walter Mier
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
| | - Philipp Uhl
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
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Umstätter F, Domhan C, Hertlein T, Ohlsen K, Mühlberg E, Kleist C, Zimmermann S, Beijer B, Klika KD, Haberkorn U, Mier W, Uhl P. Überwindung von Vancomycinresistenzen durch Modifikation mit polykationischen Peptiden. Angew Chem Int Ed Engl 2020. [DOI: 10.1002/ange.202002727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Florian Umstätter
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
| | - Cornelius Domhan
- Institut für Pharmazie und Molekulare Biotechnologie Universität Heidelberg Deutschland
| | - Tobias Hertlein
- Institut für Molekulare Infektionsbiologie Universität Würzburg Deutschland
| | - Knut Ohlsen
- Institut für Molekulare Infektionsbiologie Universität Würzburg Deutschland
| | - Eric Mühlberg
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
| | - Christian Kleist
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
| | - Stefan Zimmermann
- Zentrum für Infektiologie Universitätsklinikum Heidelberg Deutschland
| | - Barbro Beijer
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
| | - Karel D. Klika
- Deutsches Krebsforschungszentrum (DKFZ) NMR-Analytik Deutschland
| | - Uwe Haberkorn
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Deutschland
- Klinische Kooperationseinheit Nuklearmedizin Deutsches Krebsforschungszentrum Deutschland
- Translational Lung Research Center Heidelberg (TLRC) Deutsches Zentrum für Lungenforschung (DZL) Deutschland
| | - Walter Mier
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
| | - Philipp Uhl
- Abteilung Nuklearmedizin Universitätsklinikum Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Deutschland
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Umstätter F, Domhan C, Hertlein T, Ohlsen K, Mühlberg E, Kleist C, Zimmermann S, Beijer B, Klika KD, Haberkorn U, Mier W, Uhl P. Inside Back Cover: Vancomycin Resistance Is Overcome by Conjugation of Polycationic Peptides (Angew. Chem. Int. Ed. 23/2020). Angew Chem Int Ed Engl 2020. [DOI: 10.1002/anie.202004925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Florian Umstätter
- Department of Nuclear Medicine Heidelberg University Hospital Im Neuenheimer Feld 400 69120 Heidelberg Germany
| | - Cornelius Domhan
- Institute of Pharmacy and Molecular Biotechnology Heidelberg University Germany
| | - Tobias Hertlein
- Institute for Molecular Infection Biology (IMIB) University of Würzburg Germany
| | - Knut Ohlsen
- Institute for Molecular Infection Biology (IMIB) University of Würzburg Germany
| | - Eric Mühlberg
- Department of Nuclear Medicine Heidelberg University Hospital Im Neuenheimer Feld 400 69120 Heidelberg Germany
| | - Christian Kleist
- Department of Nuclear Medicine Heidelberg University Hospital Im Neuenheimer Feld 400 69120 Heidelberg Germany
| | - Stefan Zimmermann
- Medical Microbiology and Hygiene Heidelberg University Hospital Germany
| | - Barbro Beijer
- Department of Nuclear Medicine Heidelberg University Hospital Im Neuenheimer Feld 400 69120 Heidelberg Germany
| | - Karel D. Klika
- German Cancer Research Center (DKFZ) NMR Spectroscopy Analysis Unit Germany
| | - Uwe Haberkorn
- Department of Nuclear Medicine Heidelberg University Hospital Germany
- Clinical Cooperation Unit Nuclear Medicine German Cancer Research Center (DKFZ) Germany
- Translational Lung Research Center Heidelberg (TLRC) German Center for Lung Research (DZL) Germany
| | - Walter Mier
- Department of Nuclear Medicine Heidelberg University Hospital Im Neuenheimer Feld 400 69120 Heidelberg Germany
| | - Philipp Uhl
- Department of Nuclear Medicine Heidelberg University Hospital Im Neuenheimer Feld 400 69120 Heidelberg Germany
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Mühlberg E, Umstätter F, Domhan C, Hertlein T, Ohlsen K, Krause A, Kleist C, Beijer B, Zimmermann S, Haberkorn U, Mier W, Uhl P. Vancomycin-Lipopeptide Conjugates with High Antimicrobial Activity on Vancomycin-Resistant Enterococci. Pharmaceuticals (Basel) 2020; 13:ph13060110. [PMID: 32485876 PMCID: PMC7345083 DOI: 10.3390/ph13060110] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 12/18/2022] Open
Abstract
Multidrug-resistant bacteria represent one of the most important health care problems worldwide. While there are numerous drugs available for standard therapy, there are only a few compounds capable of serving as a last resort for severe infections. Therefore, approaches to control multidrug-resistant bacteria must be implemented. Here, a strategy of reactivating the established glycopeptide antibiotic vancomycin by structural modification with polycationic peptides and subsequent fatty acid conjugation to overcome the resistance of multidrug-resistant bacteria was followed. This study especially focuses on the structure-activity relationship, depending on the modification site and fatty acid chain length. The synthesized conjugates showed high antimicrobial potential on vancomycin-resistant enterococci. We were able to demonstrate that the antimicrobial activity of the vancomycin-lipopeptide conjugates depends on the chain length of the attached fatty acid. All conjugates showed good cytocompatibility in vitro and in vivo. Radiolabeling enabled the in vivo determination of pharmacokinetics in Wistar rats by molecular imaging and biodistribution studies. An improved biodistribution profile in comparison to unmodified vancomycin was observed. While vancomycin is rapidly excreted by the kidneys, the most potent conjugate shows a hepatobiliary excretion profile. In conclusion, these results demonstrate the potential of the structural modification of already established antibiotics to provide highly active compounds for tackling multidrug-resistant bacteria.
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Affiliation(s)
- Eric Mühlberg
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (E.M.); (F.U.); (A.K.); (C.K.); (B.B.); (U.H.); (W.M.)
| | - Florian Umstätter
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (E.M.); (F.U.); (A.K.); (C.K.); (B.B.); (U.H.); (W.M.)
| | - Cornelius Domhan
- Institute of Pharmacy and Molecular Biotechnology, Heidelberg University, Im Neuenheimer Feld 364, 69120 Heidelberg, Germany;
| | - Tobias Hertlein
- Institute for Molecular Infection Biology, University of Würzburg, Josef-Schneider-Straße 2/D15, 97080 Würzburg, Germany; (T.H.); (K.O.)
| | - Knut Ohlsen
- Institute for Molecular Infection Biology, University of Würzburg, Josef-Schneider-Straße 2/D15, 97080 Würzburg, Germany; (T.H.); (K.O.)
| | - Andreas Krause
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (E.M.); (F.U.); (A.K.); (C.K.); (B.B.); (U.H.); (W.M.)
| | - Christian Kleist
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (E.M.); (F.U.); (A.K.); (C.K.); (B.B.); (U.H.); (W.M.)
| | - Barbro Beijer
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (E.M.); (F.U.); (A.K.); (C.K.); (B.B.); (U.H.); (W.M.)
| | - Stefan Zimmermann
- Department of Medical Microbiology and Hygiene, Heidelberg University Hospital, Im Neuenheimer Feld 324, 69120 Heidelberg Germany;
| | - Uwe Haberkorn
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (E.M.); (F.U.); (A.K.); (C.K.); (B.B.); (U.H.); (W.M.)
- Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Centre (DKFZ), Im Neuenheimer Feld 260, 69120 Heidelberg, Germany
| | - Walter Mier
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (E.M.); (F.U.); (A.K.); (C.K.); (B.B.); (U.H.); (W.M.)
| | - Philipp Uhl
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (E.M.); (F.U.); (A.K.); (C.K.); (B.B.); (U.H.); (W.M.)
- Correspondence: ; Tel.: +49-6221-56-7726
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Mühlberg E, Umstätter F, Kleist C, Domhan C, Mier W, Uhl P. Renaissance of vancomycin: approaches for breaking antibiotic resistance in multidrug-resistant bacteria. Can J Microbiol 2020; 66:11-16. [DOI: 10.1139/cjm-2019-0309] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The emergence of multidrug-resistant bacteria demands innovations in the development of new antibiotics. For decades, the glycopeptide antibiotic vancomycin has been considered as the “last resort” treatment of severe infections caused by Gram-positive bacteria. Since the discovery of the first vancomycin-resistant enterococci strains in the late 1980s, the number of resistances has been steadily rising, with often life-threatening consequences. As an alternative to the generation of completely new substances, novel approaches focus on structural modifications of established antibiotics such as vancomycin to overcome these resistances. Here, we provide an overview of several promising modifications of vancomycin to restore its efficacy against vancomycin-resistant enterococci.
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Affiliation(s)
- Eric Mühlberg
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Florian Umstätter
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Christian Kleist
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Cornelius Domhan
- Institute of Pharmacy and Molecular Biotechnology, Heidelberg University, Im Neuenheimer Feld 364, 69120 Heidelberg, Germany
| | - Walter Mier
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Philipp Uhl
- Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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