Natural Product as Efflux Pump Inhibitors Against MRSA Efflux Pumps: An Update

2022 ◽  
pp. 577-605
Author(s):  
Pallavi Ahirrao ◽  
Ritu Kalia ◽  
Sanjay M. Jachak
Keyword(s):  
Natural Product ◽  
Efflux Pump ◽  
Efflux Pumps ◽  
Efflux Pump Inhibitors

QSAR Studies on Bacterial Efflux Pump Inhibitors

2015 ◽  
pp. 238-268 ◽  
Author(s):  
Khac-Minh Thai ◽  
Trong-Nhat Do ◽  
Thuy-Viet-Phuong Nguyen ◽  
Duc-Khanh-Tho. Nguyen ◽  
Thanh-Dao Tran
Keyword(s):  
Bacterial Resistance ◽  
Efflux Pump ◽  
Current Knowledge ◽  
Efflux Pumps ◽  
Quantitative Structure Activity Relationship ◽  
Antimicrobial Drug Resistance ◽  
Qsar Studies ◽  
Hospital Stays ◽  
Efflux Pump Inhibitors

Antimicrobial drug resistance occurs when bacteria undergo certain modifications to eliminate the effectiveness of drugs, chemicals, or other agents designed to cure infections. To date, the burden of resistance has remained one of the major clinical concerns as it renders prolonged and complicated treatments, thereby increasing the medical costs with lengthier hospital stays. Of complex causes for bacterial resistance, there has been increasing evidence that proved the significant role of efflux pumps in antibiotic resistance. Coadministration of Efflux Pump Inhibitors (EPIs) with antibiotics has been considered one of the promising ways not only to improve the efficacy but also to extend the clinical utility of existing antibiotics. This chapter begins with outlining current knowledge about bacterial efflux pumps and drug designs applied in identification of their modulating compounds. Following, the chapter addresses and provides a discussion on Quantitative Structure-Activity Relationship (QSAR) analyses in search of novel and potent efflux pump inhibitors.

scholarly journals An alkylaminoquinazoline restores antibiotic activity in Gram-negative resistant isolates

Microbiology ◽  
2011 ◽  
Vol 157 (2) ◽  
pp. 566-571 ◽  
Author(s):  
Abdallah Mahamoud ◽  
Jacqueline Chevalier ◽  
Milad Baitiche ◽  
Elissavet Adam ◽  
Jean-Marie Pagès
Keyword(s):  
Efflux Pump ◽  
Bacterial Species ◽  
Efflux Pumps ◽  
Multidrug Resistant ◽  
Side Chain ◽  
Structural Class ◽  
Gram Negative ◽  
Activity Spectrum ◽  
Efflux Pump Inhibitors ◽  
Drug Efflux Pump

To date, various bacterial drug efflux pump inhibitors (EPIs) have been described. They exhibit variability in their activity spectrum with respect to antibiotic structural class and bacterial species. Among the various 4-alkylaminoquinazoline derivatives synthesized and studied in this work, one molecule, 1167, increased the susceptibility of important human-pathogenic, resistant, Gram-negative bacteria towards different antibiotic classes. This 4-(3-morpholinopropylamino)-quinazoline induced an increase in the activity of chloramphenicol, nalidixic acid, norfloxacin and sparfloxacin, which are substrates of the AcrAB-TolC and MexAB-OprM efflux pumps that act in these multidrug-resistant isolates. In addition, 1167 increased the intracellular concentration of chloramphenicol in efflux pump-overproducing strains. The rate of restoration depended on the structure of the antibiotic, suggesting that different sites in the efflux pumps may be involved. A molecule exhibiting a morpholine functional group and a propyl extension of the side chain was more active.

scholarly journals Antimicrobial Activity of a Library of Thioxanthones and Their Potential as Efflux Pump Inhibitors

2021 ◽  
Vol 14 (6) ◽  
pp. 572
Author(s):  
Fernando Durães ◽  
Andreia Palmeira ◽  
Bárbara Cruz ◽  
Joana Freitas-Silva ◽  
Nikoletta Szemerédi ◽  
...  
Keyword(s):  
Quorum Sensing ◽  
Mammalian Cells ◽  
Efflux Pump ◽  
Efflux Pumps ◽  
Major Facilitator Superfamily ◽  
Design And Synthesis ◽  
Resistance Nodulation Division ◽  
Efflux Pump Inhibitors ◽  
Major Facilitator

The overexpression of efflux pumps is one of the causes of multidrug resistance, which leads to the inefficacy of drugs. This plays a pivotal role in antimicrobial resistance, and the most notable pumps are the AcrAB-TolC system (AcrB belongs to the resistance-nodulation-division family) and the NorA, from the major facilitator superfamily. In bacteria, these structures can also favor virulence and adaptation mechanisms, such as quorum-sensing and the formation of biofilm. In this study, the design and synthesis of a library of thioxanthones as potential efflux pump inhibitors are described. The thioxanthone derivatives were investigated for their antibacterial activity and inhibition of efflux pumps, biofilm formation, and quorum-sensing. The compounds were also studied for their potential to interact with P-glycoprotein (P-gp, ABCB1), an efflux pump present in mammalian cells, and for their cytotoxicity in both mouse fibroblasts and human Caco-2 cells. The results concerning the real-time ethidium bromide accumulation may suggest a potential bacterial efflux pump inhibition, which has not yet been reported for thioxanthones. Moreover, in vitro studies in human cells demonstrated a lack of cytotoxicity for concentrations up to 20 µM in Caco-2 cells, with some derivatives also showing potential for P-gp modulation.

scholarly journals Role of efflux pump inhibitor in decreasing antibiotic cross-resistance of Pseudomonas aeruginosa in a burn hospital in Iran

2016 ◽  
Vol 10 (06) ◽  
pp. 600-604 ◽  
Author(s):  
Mahshid Talebi-Taher ◽  
َAli Majidpour ◽  
Abbas Gholami ◽  
Samira Rasouli-Kouhi ◽  
Maryam Adabi
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Efflux Pump ◽  
Efflux Pumps ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Cross Resistance ◽  
Beta Lactams ◽  
Efflux Pump Inhibitor ◽  
Efflux Pump Inhibitors

Introduction: Multidrug resistance in Pseudomonas aeruginosa may be due to efflux pump overexpression. This study phenotypically examined the role of efflux pump inhibitors in decreasing antibiotic cross-resistance between beta-lactams, fluoroquinolones, and aminoglycosides in P. aeruginosa isolates from burn patients in Iran. Methodology: A total of 91 phenotypically and genotypically confirmed P. aeruginosa samples were studied. Multidrug cross-resistance was determined using the disk diffusion method and minimum inhibitory concentration (MIC) test. The contribution of efflux pumps was determined by investigating MIC reduction assay to markers of beta-lactams, fluoroquinolones, and aminoglycosides in the absence and presence of an efflux pump inhibitor. All the isolates were also tested by polymerase chain reaction for the presence of mexA, mexC, and mexE efflux genes. Results: Of the isolates, 81 (89%) and 83 (91.2%) were multidrug resistant according to the disk diffusion and MIC method, respectively. Cross-resistance was observed in 67 (73.6%) and 68 (74.7%) of isolates according to the disk diffusion and MIC method, respectively. In the presence of the efflux pump inhibitor, twofold or higher MIC reduction to imipenem, cefepime, ciprofloxacin, and gentamicin was observed in 59, 65, 55, and 60 isolates, respectively. Except for two isolates that were negative for mexC, all isolates were positive for mexA, mexC, and mexE genes simultaneously. Conclusion: Efflux pumps could cause different levels of resistance based on their expression in clinical isolates. Early detection of different efflux pumps in P. aeruginosa could allow the use of other antibiotics and efflux pump inhibitors in combination with antibiotic therapy.

scholarly journals EFFLUX PUMP OVEREXPRESSION PROFILING IN ACINETOBACTER BAUMANNII AND STUDY OF NEW 1-(1-NAPHTHYLMETHYL)-PIPERAZINE ANALOGS AS POTENTIAL EFFLUX INHIBITORS

2021 ◽  
Author(s):  
Morgane Choquet ◽  
Elodie Lohou ◽  
Etienne Pair ◽  
Pascal Sonnet ◽  
Catherine Mullie
Keyword(s):  
Antibiotic Resistance ◽  
Acinetobacter Baumannii ◽  
Inhibitory Activity ◽  
Efflux Pump ◽  
Parent Compound ◽  
Efflux Pumps ◽  
Quinoline Derivative ◽  
Genes Encoding ◽  
Efflux Pump Inhibitors ◽  
Therapeutic Alternatives

Overexpression of efflux pumps extruding antibiotics currently used for the treatment of Acinetobacter baumannii infections has been described as an important mechanism causing antibiotic resistance. The first aim of this work was to phenotypically evaluate the overexpression of efflux pumps on a collection of 124 ciprofloxacin resistant A. baumannii strains. An overexpression of genes encoding one or more efflux pumps was obtained for 19 out of the 34 strains with a positive phenotypic efflux (56%). The most frequent genes overexpressed were those belonging to the RND family, with adeJ being the most prevalent (50%). Interestingly, efflux pump genes coding for MATE and MFS families were also overexpressed quite frequently: abeM (32%) and abaQ (26%). The second aim was to synthesize 1-(1-NaphthylMethyl)-Piperazine analogs as potential new efflux pump inhibitors and biologically evaluate them against strains with a positive phenotypic efflux. Quinoline and pyridine analogs were found to be more effective than their parent compound 1-(1-NaphthylMethyl)-Piperazine. Stereochemistry also played an important part in the inhibitory activity as quinoline derivative ( R )-3a was identified as being the most effective and less cytotoxic. Its inhibitory activity was also correlated to the number of efflux pumps expressed by a strain. The results obtained in this work suggest that quinoline analogs of 1-(1-NaphthylMethyl)-Piperazine are promising leads in the development of new anti- Acinetobacter baumannii therapeutic alternatives, in combination with antibiotics for which an efflux-mediated resistance is suspected.

scholarly journals Medicinal Chemistry Updates on Bacterial Efflux Pump Modulators

2019 ◽  
Vol 25 (42) ◽  
pp. 6030-6069 ◽  
Author(s):  
Fernando Durães ◽  
Madalena Pinto ◽  
Emília Sousa
Keyword(s):  
Energy Source ◽  
Antibiotic Resistance ◽  
Efflux Pump ◽  
Efflux Pumps ◽  
The Other ◽  
Drug Uptake ◽  
Health Issues ◽  
Gram Positive ◽  
Gram Positive Bacteria ◽  
Efflux Pump Inhibitors

Antibiotic resistance is one of the most pressing health issues of our days. It can arise due to a multiplicity of factors, such as target modification, decrease in the drug uptake, changes in the metabolic pathways and activation of efflux pumps. The overexpression of efflux pumps is responsible for the extrusion of drugs, making antibiotic therapy fail, as the quantity of intracellular antibiotic is not enough to provide the desired therapeutic effect. Efflux pumps can be included in five families according to their composition, nature of substrates, energy source, and number of transmembrane spanning regions. The ABC superfamily is mainly found in Gram-positive bacteria, use ATP as an energy source, and only a limited number of ABC pumps confer multidrug resistance (MDR). On the other hand, the MFS family, most present in Gram-positive bacteria, and the RND family, characteristic of Gram-negative bacteria, are most associated with antibiotic resistance. A wide variety of inhibitors have been disclosed for both families, from either natural or synthetic sources, or even drugs that are currently in therapy for other diseases. The other two families are the SMR, which are the smallest drug efflux proteins known, and the MATE family, whose pumps can also resort to the sodium gradient as an energy source. In this review, it is intended to present a comprehensive review of the classes of efflux pump inhibitors from the various sources, highlighting their structure-activity relationships, which can be useful for medicinal chemists in the pursuit of novel efflux pump inhibitors.

scholarly journals Efflux Pump Mediated Antimicrobial Resistance by Staphylococci in Health-Related Environments: Challenges and the Quest for Inhibition

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1502
Author(s):  
Abolfazl Dashtbani-Roozbehani ◽  
Melissa H. Brown
Keyword(s):  
Antimicrobial Resistance ◽  
Antimicrobial Agents ◽  
Efflux Pump ◽  
Current Knowledge ◽  
Efflux Pumps ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Multidrug Efflux Pump ◽  
New Antibiotics ◽  
Efflux Pump Inhibitors

The increasing emergence of antimicrobial resistance in staphylococcal bacteria is a major health threat worldwide due to significant morbidity and mortality resulting from their associated hospital- or community-acquired infections. Dramatic decrease in the discovery of new antibiotics from the pharmaceutical industry coupled with increased use of sanitisers and disinfectants due to the ongoing COVID-19 pandemic can further aggravate the problem of antimicrobial resistance. Staphylococci utilise multiple mechanisms to circumvent the effects of antimicrobials. One of these resistance mechanisms is the export of antimicrobial agents through the activity of membrane-embedded multidrug efflux pump proteins. The use of efflux pump inhibitors in combination with currently approved antimicrobials is a promising strategy to potentiate their clinical efficacy against resistant strains of staphylococci, and simultaneously reduce the selection of resistant mutants. This review presents an overview of the current knowledge of staphylococcal efflux pumps, discusses their clinical impact, and summarises compounds found in the last decade from plant and synthetic origin that have the potential to be used as adjuvants to antibiotic therapy against multidrug resistant staphylococci. Critically, future high-resolution structures of staphylococcal efflux pumps could aid in design and development of safer, more target-specific and highly potent efflux pump inhibitors to progress into clinical use.

scholarly journals Inactivation of Efflux Pumps Abolishes Bacterial Biofilm Formation

2008 ◽  
Vol 74 (23) ◽  
pp. 7376-7382 ◽  
Author(s):  
Malin Kvist ◽  
Viktoria Hancock ◽  
Per Klemm
Keyword(s):  
Health Care ◽  
Biofilm Formation ◽  
Efflux Pump ◽  
Efflux Pumps ◽  
Bacterial Biofilm ◽  
Bacterial Biofilms ◽  
Toxic Substances ◽  
Highly Active ◽  
Efflux Pump Inhibitors ◽  
New Treatments

ABSTRACT Bacterial biofilms cause numerous problems in health care and industry; notably, biofilms are associated with a large number of infections. Biofilm-dwelling bacteria are particularly resistant to antibiotics, making it hard to eradicate biofilm-associated infections. Bacteria rely on efflux pumps to get rid of toxic substances. We discovered that efflux pumps are highly active in bacterial biofilms, thus making efflux pumps attractive targets for antibiofilm measures. A number of efflux pump inhibitors (EPIs) are known. EPIs were shown to reduce biofilm formation, and in combination they could abolish biofilm formation completely. Also, EPIs were able to block the antibiotic tolerance of biofilms. The results of this feasibility study might pave the way for new treatments for biofilm-related infections and may be exploited for prevention of biofilms in general.

scholarly journals Efflux Pumps and These Inhibitors

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Thai Khac Minh ◽  
Tran Thanh Dao ◽  
Phan Thien Vy ◽  
Do Tran Giang Son ◽  
Hoang Tung ◽  
...  
Keyword(s):  
Efflux Pump ◽  
Efflux Pumps ◽  
Community Acquired Pneumonia ◽  
Asia Pacific ◽  
Decompensated Cirrhosis ◽  
Great Promise ◽  
Viet Nam ◽  
Plant Metabolites ◽  
Efflux Pump Inhibitors ◽  
The Cost

 In this era of multi-drug resistance, efflux pump is one of the major problems which is increasingly concerned by scientists. The structure and mechanism activity of the efflux pumps on both bacteria and eurakyotes that are gradually being clarified. Since then, efflux pump inhibitors have also been studied and initially applied in clinic, that makes an important contribution to preventing the outbreak of multi-resistant infections and cancers. Efflux pump inhibitors are often small synthetic molecules or plant metabolites that show great promise in inhibiting multi- resistant in both bacteria and cancerous cells. Keywords Efflux pump, EPI, bacteria, cancer, MRD. References [1] Ministry of pulic health, Decision on Guidelines for the Management of Community-Based Pneumonia in children 2014 (in Vietnamese).[2] UNICEF Viet Nam, The top two fatal diseases for children in the Asia-Pacific region and Viet Nam, 2012 (in Vietnamese).[3] Nguyen Van Quang, Analysis of the cost of treating decompensated cirrhosis due to hepatitis C at Ho Chi Minh Tropical Hospital and Bach Mai Hospital in Ha Noi 2015 University graduation thesis in pharmacy (2017) (in Vietnamese).[4] Duc Anh Dang, Kah Kee Tan, Ki Hwan Kim, Cissy Kartasasmita, et al, Burden of hospitalized childhood community-acquired pneumonia: A retrospective cross-sectional study in Vietnam, Malaysia, Indonesia and the Republic of Korea, Human vaccin Immunother 14 (1) (2018) 95-105. https://doi.org/10.1080/21645515.2017.1375073.[5] Philip Ayieko, Ulla Griffiths, Angela Oloo Akumu, Mike English, The economic burden of inpatient paediatric care in Kenya: household and provider costs for Treatment of pneumonia, malaria and meningitis.; Cost Effectiveness and Resource Allocation 7(3) (2009) 1-13. https://doi.org/10.1186/1478-7547-7-3.[6] Nguyen Ngoc Tu, Analyze the direct cost of treating community-acquired pneumonia at Thai Nguyen tuberculosis and lung disease year 2015, Master's thesis in pharmacy (2017) (in Vietnamese).[7] Bui Thi Quyen, Analyze the cost of treating community-acquired pneumonia at the children's hospital in Nam Dinh province 2015, Grade 1 specialized pharmacist thesis (2016) (in Vietnamese).[8] Hamidah Hussain, Hugh Waters, Aamir J Khan, Saad B Omer, et al, Economic analysis of childhood pneumonia in Northern Pakistan, Heatlh policy plan 23(6) (2008) 438-444. https://doi.org/10.1093/heapol/czn033.        

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