Targeting Vancomycin-Resistant Enterococci (VRE) Infections and Van Operon-Mediated Drug Resistance Using Dimeric Cholic Acid-Peptide Conjugates

J Med Chem. 2022 Nov 24;65(22):15312-15326. doi: 10.1021/acs.jmedchem.2c01293. Epub 2022 Nov 4.

Abstract

Emergence of vancomycin resistance in Gram-positive bacteria and the prevalence of vancomycin-resistant Enterococci (VRE) infections are highly alarming as very limited antibiotic options are available against VRE infections. Here, we present the synthesis of cholic acid-derived dimeric amphiphiles where two cholic acid moieties are tethered through carboxyl terminals using different alkylene spacers. Our investigations revealed that dimer 5 possessing a propylene spacer and glycine-valine peptides tethered on hydroxyl groups is the most effective antimicrobial against VRE. Dimer 5 can permeabilize bacterial membranes, generate reactive oxygen species, and clear preformed biofilms. We further demonstrate that dimer 5 downregulates vancomycin-mediated transcriptional activation of the vanHAX gene cluster and does not allow VSE to develop vancomycin resistance until 100 generations. Therefore, this study, for the first time, presents a bacterial membrane-targeting amphiphile that can mitigate VRE infections and inhibit the emergence of vancomycin resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Cholic Acid / pharmacology
  • Drug Resistance, Bacterial / genetics
  • Gram-Positive Bacterial Infections* / microbiology
  • Humans
  • Microbial Sensitivity Tests
  • Operon
  • Vancomycin / pharmacology
  • Vancomycin Resistance / genetics
  • Vancomycin-Resistant Enterococci* / genetics

Substances

  • Anti-Bacterial Agents
  • Cholic Acid
  • Vancomycin