Cerastecin Inhibition of the Lipooligosaccharide Transporter MsbA to Combat Acinetobacter baumannii: From Screening Impurity to In Vivo Efficacy

J Med Chem. 2024 Sep 12;67(17):15620-15675. doi: 10.1021/acs.jmedchem.4c01277. Epub 2024 Aug 22.

Abstract

Acinetobacter baumannii, a commonly multidrug-resistant Gram-negative bacterium responsible for large numbers of bloodstream and lung infections worldwide, is increasingly difficult to treat and constitutes a growing threat to human health. Structurally novel antibacterial chemical matter that can evade existing resistance mechanisms is essential for addressing this critical medical need. Herein, we describe our efforts to inhibit the essential A. baumannii lipooligosaccharide (LOS) ATP-binding cassette (ABC) transporter MsbA. An unexpected impurity from a phenotypic screening was optimized as a series of dimeric compounds, culminating with 1 (cerastecin D), which exhibited antibacterial activity in the presence of human serum and a pharmacokinetic profile sufficient to achieve efficacy against A. baumannii in murine septicemia and lung infection models.

MeSH terms

  • ATP-Binding Cassette Transporters* / antagonists & inhibitors
  • ATP-Binding Cassette Transporters* / metabolism
  • Acinetobacter Infections* / drug therapy
  • Acinetobacter Infections* / microbiology
  • Acinetobacter baumannii* / drug effects
  • Acinetobacter baumannii* / metabolism
  • Animals
  • Anti-Bacterial Agents* / chemistry
  • Anti-Bacterial Agents* / pharmacology
  • Bacterial Proteins* / antagonists & inhibitors
  • Bacterial Proteins* / metabolism
  • Humans
  • Lipopolysaccharides* / antagonists & inhibitors
  • Lipopolysaccharides* / metabolism
  • Mice
  • Microbial Sensitivity Tests

Substances

  • Anti-Bacterial Agents
  • Lipopolysaccharides
  • lipid-linked oligosaccharides
  • Bacterial Proteins
  • ATP-Binding Cassette Transporters
  • MsbA protein, Bacteria