Optimization of Acetazolamide-Based Scaffold as Potent Inhibitors of Vancomycin-Resistant Enterococcus

J Med Chem. 2020 Sep 10;63(17):9540-9562. doi: 10.1021/acs.jmedchem.0c00734. Epub 2020 Aug 11.

Abstract

Vancomycin-resistant enterococci (VRE) are the second leading cause of hospital-acquired infections (HAIs) attributed to a drug-resistant bacterium in the United States, and resistance to the frontline treatments is well documented. To combat VRE, we have repurposed the FDA-approved carbonic anhydrase drug acetazolamide to design potent antienterococcal agents. Through structure-activity relationship optimization we have arrived at two leads possessing improved potency against clinical VRE strains from MIC = 2 μg/mL (acetazolamide) to MIC = 0.007 μg/mL (22) and 1 μg/mL (26). Physicochemical properties were modified to design leads that have either high oral bioavailability to treat systemic infections or low intestinal permeability to treat VRE infections in the gastrointestinal tract. Our data suggest the intracellular targets for the molecules are putative α-carbonic and γ-carbonic anhydrases, and homology modeling and molecular dynamics simulations were performed. Together, this study presents potential anti-VRE therapeutic options to provide alternatives for problematic VRE infections.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetazolamide / chemistry*
  • Acetazolamide / pharmacokinetics
  • Acetazolamide / pharmacology*
  • Acetazolamide / toxicity
  • Animals
  • Anti-Bacterial Agents / chemistry*
  • Anti-Bacterial Agents / pharmacokinetics
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / toxicity
  • Caco-2 Cells
  • Carbonic Anhydrases / chemistry
  • Carbonic Anhydrases / metabolism
  • Drug Design*
  • Humans
  • Mice
  • Microbial Sensitivity Tests
  • Models, Molecular
  • Protein Conformation
  • Structure-Activity Relationship
  • Tissue Distribution
  • Vancomycin-Resistant Enterococci / drug effects*

Substances

  • Anti-Bacterial Agents
  • Carbonic Anhydrases
  • Acetazolamide