A trimethoprim derivative impedes antibiotic resistance evolution

Nat Commun. 2021 May 19;12(1):2949. doi: 10.1038/s41467-021-23191-z.

Abstract

The antibiotic trimethoprim (TMP) is used to treat a variety of Escherichia coli infections, but its efficacy is limited by the rapid emergence of TMP-resistant bacteria. Previous laboratory evolution experiments have identified resistance-conferring mutations in the gene encoding the TMP target, bacterial dihydrofolate reductase (DHFR), in particular mutation L28R. Here, we show that 4'-desmethyltrimethoprim (4'-DTMP) inhibits both DHFR and its L28R variant, and selects against the emergence of TMP-resistant bacteria that carry the L28R mutation in laboratory experiments. Furthermore, antibiotic-sensitive E. coli populations acquire antibiotic resistance at a substantially slower rate when grown in the presence of 4'-DTMP than in the presence of TMP. We find that 4'-DTMP impedes evolution of resistance by selecting against resistant genotypes with the L28R mutation and diverting genetic trajectories to other resistance-conferring DHFR mutations with catalytic deficiencies. Our results demonstrate how a detailed characterization of resistance-conferring mutations in a target enzyme can help identify potential drugs against antibiotic-resistant bacteria, which may ultimately increase long-term efficacy of antimicrobial therapies by modulating evolutionary trajectories that lead to resistance.

Publication types

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

MeSH terms

  • Amino Acid Substitution
  • Anti-Bacterial Agents / chemistry
  • Anti-Bacterial Agents / pharmacology
  • Crystallography, X-Ray
  • Directed Molecular Evolution
  • Drug Design
  • Escherichia coli / drug effects
  • Escherichia coli / enzymology
  • Escherichia coli / genetics
  • Escherichia coli Infections / drug therapy*
  • Escherichia coli Infections / microbiology*
  • Escherichia coli Proteins / chemistry
  • Escherichia coli Proteins / genetics
  • Folic Acid Antagonists / chemistry
  • Folic Acid Antagonists / pharmacology
  • Genes, Bacterial
  • Genotype
  • Humans
  • Models, Molecular
  • Mutation
  • Tetrahydrofolate Dehydrogenase / chemistry
  • Tetrahydrofolate Dehydrogenase / genetics
  • Trimethoprim / analogs & derivatives*
  • Trimethoprim / chemistry
  • Trimethoprim / pharmacology
  • Trimethoprim Resistance / genetics*

Substances

  • Anti-Bacterial Agents
  • Escherichia coli Proteins
  • Folic Acid Antagonists
  • Trimethoprim
  • Tetrahydrofolate Dehydrogenase