Discovery of Dap-3 polymyxin analogues for the treatment of multidrug-resistant Gram-negative nosocomial infections

J Med Chem. 2013 Jun 27;56(12):5079-93. doi: 10.1021/jm400416u. Epub 2013 Jun 18.

Abstract

We report novel polymyxin analogues with improved antibacterial in vitro potency against polymyxin resistant recent clinical isolates of Acinetobacter baumannii and Pseudomonas aeruginosa . In addition, a human renal cell in vitro assay (hRPTEC) was used to inform structure-toxicity relationships and further differentiate analogues. Replacement of the Dab-3 residue with a Dap-3 in combination with a relatively polar 6-oxo-1-phenyl-1,6-dihydropyridine-3-carbonyl side chain as a fatty acyl replacement yielded analogue 5x, which demonstrated an improved in vitro antimicrobial and renal cytotoxicity profiles relative to polymyxin B (PMB). However, in vivo PK/PD comparison of 5x and PMB in a murine neutropenic thigh model against P. aeruginosa strains with matched MICs showed that 5x was inferior to PMB in vivo, suggesting a lack of improved therapeutic index in spite of apparent in vitro advantages.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / chemistry
  • Anti-Bacterial Agents / pharmacokinetics
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / toxicity
  • Cross Infection / drug therapy*
  • Dogs
  • Drug Discovery*
  • Drug Resistance, Multiple / drug effects*
  • Female
  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacteria / physiology
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Polymyxins / chemistry*
  • Polymyxins / pharmacokinetics
  • Polymyxins / pharmacology*
  • Polymyxins / toxicity
  • Rats
  • beta-Alanine / analogs & derivatives*
  • beta-Alanine / chemistry

Substances

  • Anti-Bacterial Agents
  • Polymyxins
  • beta-Alanine
  • 2,3-diaminopropionic acid