Para-aminosalicylic acid acts as an alternative substrate of folate metabolism in Mycobacterium tuberculosis

Science. 2013 Jan 4;339(6115):88-91. doi: 10.1126/science.1228980. Epub 2012 Nov 1.

Abstract

Folate biosynthesis is an established anti-infective target, and the antifolate para-aminosalicylic acid (PAS) was one of the first anti-infectives introduced into clinical practice on the basis of target-based drug discovery. Fifty years later, PAS continues to be used to treat tuberculosis. PAS is assumed to inhibit dihydropteroate synthase (DHPS) in Mycobacterium tuberculosis by mimicking the substrate p-aminobenzoate (PABA). However, we found that sulfonamide inhibitors of DHPS inhibited growth of M. tuberculosis only weakly because of their intracellular metabolism. In contrast, PAS served as a replacement substrate for DHPS. Products of PAS metabolism at this and subsequent steps in folate metabolism inhibited those enzymes, competing with their substrates. PAS is thus a prodrug that blocks growth of M. tuberculosis when its active forms are generated by enzymes in the pathway they poison.

Publication types

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

MeSH terms

  • Aminosalicylic Acid / metabolism*
  • Aminosalicylic Acid / pharmacology
  • Antitubercular Agents / metabolism*
  • Antitubercular Agents / pharmacology
  • Dihydropteroate Synthase / antagonists & inhibitors
  • Dihydropteroate Synthase / metabolism*
  • Folic Acid / metabolism*
  • Molecular Mimicry
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / metabolism*
  • Prodrugs / metabolism*
  • Prodrugs / pharmacology
  • Substrate Specificity

Substances

  • Antitubercular Agents
  • Prodrugs
  • Aminosalicylic Acid
  • Folic Acid
  • Dihydropteroate Synthase