Optimization of Ethoxzolamide Analogs with Improved Pharmacokinetic Properties for In Vivo Efficacy against Neisseria gonorrhoeae

J Med Chem. 2024 Sep 12;67(17):15537-15556. doi: 10.1021/acs.jmedchem.4c01187. Epub 2024 Aug 14.

Abstract

Drug-resistant gonorrhea is caused by the bacterial pathogen Neisseria gonorrhoeae, for which there is no recommended oral treatment. We have demonstrated that the FDA-approved human carbonic anhydrase inhibitor ethoxzolamide potently inhibits N. gonorrhoeae; however, is not effective at reducing N. gonorrhoeae bioburden in a mouse model. Thus, we sought to optimize the pharmacokinetic properties of the ethoxzolamide scaffold. These efforts resulted in analogs with improved activity against N. gonorrhoeae, increased metabolic stability in mouse liver microsomes, and improved Caco-2 permeability compared to ethoxzolamide. Improvement in these properties resulted in increased plasma exposure in vivo after oral dosing. Top compounds were investigated for in vivo efficacy in a vaginal mouse model of gonococcal genital tract infection, and they significantly decreased the gonococcal burden compared to vehicle and ethoxzolamide controls. Altogether, results from this study provide evidence that ethoxzolamide-based compounds have the potential to be effective oral therapeutics against gonococcal infection.

MeSH terms

  • Animals
  • Anti-Bacterial Agents* / chemical synthesis
  • Anti-Bacterial Agents* / chemistry
  • Anti-Bacterial Agents* / pharmacokinetics
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Caco-2 Cells
  • Carbonic Anhydrase Inhibitors / chemical synthesis
  • Carbonic Anhydrase Inhibitors / chemistry
  • Carbonic Anhydrase Inhibitors / pharmacokinetics
  • Carbonic Anhydrase Inhibitors / pharmacology
  • Carbonic Anhydrase Inhibitors / therapeutic use
  • Ethoxzolamide* / chemical synthesis
  • Ethoxzolamide* / chemistry
  • Ethoxzolamide* / pharmacokinetics
  • Ethoxzolamide* / pharmacology
  • Female
  • Gonorrhea / drug therapy
  • Humans
  • Mice
  • Microbial Sensitivity Tests
  • Microsomes, Liver / metabolism
  • Neisseria gonorrhoeae* / drug effects
  • Structure-Activity Relationship

Substances

  • Ethoxzolamide
  • Anti-Bacterial Agents
  • Carbonic Anhydrase Inhibitors