Zosurabalpin has defeated strains of pneumonia and
sepsis in mice, raising hopes for human trials.
11:00 EST Wednesday,
03 January 2024
Scientists have discovered an entirely new class of antibiotic
that appears to kill one of three bacteria considered to pose the greatest threat to human health because
of their extensive drug-resistance.
Zosurabalpin defeated highly drug-resistant strains
of Carbapenem-resistant Acinetobacter baumannii (Crab) in
mouse models of pneumonia and sepsis, and was being tested in human trials. Crab
is classified as a priority 1 critical pathogen by the World Health
Organization, alongside two other drug-resistant forms of bacteria – Pseudomonas aeruginosa and Enterobacteriaceae.
“Crab is a significant cause of infection in hospitals,
particularly in people who are on ventilators,” said Dr Andrew Edwards,
a senior lecturer in molecular microbiology at Imperial College London, who was
not involved in the research. “While it is not an aggressive pathogen it is
resistant to multiple different antibiotics, making it very difficult to treat.
“Unfortunately, development of new treatments
against this bacterium has been extremely challenging because it is very adept
at keeping antibiotics from getting past its outer cell layer. Therefore, this
work is really exciting, and provides confidence that the approaches being used
to find new antibiotics can bear fruit.”
Antibiotic-resistant infections pose an urgent
threat to human health – particularly those caused by a large group of bacteria
known as Gram-negative bacteria, which are protected by an outer shell
containing a substance called lipopolysaccharide (LPS).
“LPS allows bacteria to live in harsh environments,
and it also allows them to evade attack by our immune system,” said Dr Michael
Lobritz, the global head of infectious diseases at Roche Pharma Research and
Early Development in Basel Switzerland, which developed the new drug. No new
antibiotic for Gram-negative bacteria have been approved in more than 50 years.
Roche had previously identified Zosurabalpin as capable of
blocking the growth of A baumannii but it was not clear how it
worked, or if it would be effective in animals with Crab-related infections.
Through a series of experiments published in Nature,
Prof Daniel Kahne at Harvard University in Cambridge, US, and colleagues showed
that the drug prevented LPS from being transported to the outer membrane of the
bacterium, killing it. They also found that Zosurabalpin considerably reduced
levels of bacteria in mice with Crab-induced pneumonia and prevented the death
of those with Crab-related sepsis.
Lobritz said: “This is the first time we’ve found
anything that operates in this way, so it is unique in its chemical makeup and
mechanism of action.”
While he stressed that this molecule alone would not
solve the public health threat of antimicrobial resistant infections, the
discovery could lay the foundations for future efforts to drug the same
transport system in other bacteria.
Edwards said a different type of antibiotic that was
being developed, known as murepavadin, similarly targeted LPS transport –
though through a different mechanism. “It has been shown to be active against a
bacterium called Pseudomonas aeruginosa, suggesting that it may be
possible to expand this work to other multi-antibiotic resistant bacteria such
as Klebsiella and E coli,” he said. However, he
cautioned that the progression of new drugs from animal studies into humans
could be extremely difficult.
Meanwhile, the UK’s science, innovation and technology committee
has called for steps to develop the potential of bacteria-killing viruses –
called bacteriophages – that could provide an alternative to antibiotics for
resistant infections.
In a report published on Wednesday, the committee said development of phage therapies
had hit an impasse because in order to enter clinical trials they needed to be
manufactured to certain standards, yet investment in manufacturing plants
hinged on successful clinical trials.
It recommended that the government should consider
establishing a small facility at the mothballed Rosalind Franklin laboratory in
the West Midlands, which was originally set up to process Covid tests during
the pandemic.
-The Guardian
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