Glycobiology

糖生物学
  • 文章类型: Journal Article
    骨发育具有复杂的调节机制,包括信号转导和转录因子相关通路,糖生物学过程,细胞相互作用,运输机制,and,重要的是,羟基磷灰石产生的化学形成。骨骼发育过程中的任何异常调节都会导致骨骼系统相关问题。在某种程度上,软骨和骨的无血管性使药物输送比软组织更具挑战性。最近的研究已经实施了许多新颖的骨靶向方法来克服缺点。然而,这些策略都不能完全纠正骨骼功能障碍,特别是与生长板相关的。虽然直接重组酶(例如,Vimizim代表Morquio,高彻的谷物酶,猎人的行动,用于Sly疾病的Mepsevii)或激素输注(用于骨质疏松症和骨关节炎的雌激素),传统的基因传递(例如,直接输注病毒或非病毒载体,衣壳上没有修饰,信封,或纳米粒子),和细胞治疗策略(健康骨髓或造血干细胞移植)部分改善骨病变,必须解决新的递送方法关于靶特异性,免疫原性较低,和循环持续时间。除了改善骨输送,还利用了涉及受体调节途径的骨发育机制的潜在调节。使用有机和无机化合物的靶向药物递送在大多数临床前环境和未来临床转化中是有希望的方法。这篇综述全面总结了当前基于骨结构和重塑概念的骨靶向策略,同时强调了未来骨靶向系统的潜在方法。
    Bone development is characterized by complex regulation mechanisms, including signal transduction and transcription factor-related pathways, glycobiological processes, cellular interactions, transportation mechanisms, and, importantly, chemical formation resulting from hydroxyapatite. Any abnormal regulation in the bone development processes causes skeletal system-related problems. To some extent, the avascularity of cartilage and bone makes drug delivery more challenging than that of soft tissues. Recent studies have implemented many novel bone-targeting approaches to overcome drawbacks. However, none of these strategies fully corrects skeletal dysfunction, particularly in growth plate-related ones. Although direct recombinant enzymes (e.g., Vimizim for Morquio, Cerezyme for Gaucher, Elaprase for Hunter, Mepsevii for Sly diseases) or hormone infusions (estrogen for osteoporosis and osteoarthritis), traditional gene delivery (e.g., direct infusion of viral or non-viral vectors with no modifications on capsid, envelope, or nanoparticles), and cell therapy strategies (healthy bone marrow or hematopoietic stem cell transplantation) partially improve bone lesions, novel delivery methods must be addressed regarding target specificity, less immunogenicity, and duration in circulation. In addition to improvements in bone delivery, potential regulation of bone development mechanisms involving receptor-regulated pathways has also been utilized. Targeted drug delivery using organic and inorganic compounds is a promising approach in mostly preclinical settings and future clinical translation. This review comprehensively summarizes the current bone-targeting strategies based on bone structure and remodeling concepts while emphasizing potential approaches for future bone-targeting systems.
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  • 文章类型: Journal Article
    粘蛋白结构域糖蛋白的特征在于其高密度的糖基化丝氨酸和苏氨酸残基,这使得他们的质谱分析变得复杂。密集的糖基化使得蛋白质骨架无法接触到像胰蛋白酶这样的主力蛋白酶,糖基化的巨大异质性通常会导致未修饰肽的离子抑制,搜索算法难以自信地分析和定位O-糖位点。我们在应对这些挑战方面取得了一些进展,第一次使粘液组学成为可能。这里,我们总结了这些贡献,并提供了粘蛋白结构域糖蛋白质谱分析的详细方案。©2024Wiley期刊有限责任公司。基本方案1:粘蛋白结构域糖蛋白的富集基本方案2:粘蛋白结构域糖蛋白的酶消化基本方案3:O-糖肽的质谱数据收集基本方案4:O-糖肽的质谱数据分析。
    Mucin-domain glycoproteins are characterized by their high density of glycosylated serine and threonine residues, which complicates their analysis by mass spectrometry. The dense glycosylation renders the protein backbone inaccessible to workhorse proteases like trypsin, the vast heterogeneity of glycosylation often results in ion suppression from unmodified peptides, and search algorithms struggle to confidently analyze and site-localize O-glycosites. We have made a number of advances to address these challenges, rendering mucinomics possible for the first time. Here, we summarize these contributions and provide a detailed protocol for mass spectrometric analysis of mucin-domain glycoproteins. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Enrichment of mucin-domain glycoproteins Basic Protocol 2: Enzymatic digestion of mucin-domain glycoprotein(s) Basic Protocol 3: Mass spectrometry data collection for O-glycopeptides Basic Protocol 4: Mass spectrometry data analysis of O-glycopeptides.
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  • 文章类型: Journal Article
    糖基化缺陷的中国仓鼠卵巢(CHO)细胞系在N-糖基化机制的发现中发挥了重要作用。然而,Lec5和Lec9突变体中糖基化缺陷的分子原因一直难以捉摸,即使对于这两种细胞系,以前都已建立了聚丙炔醇形成多力酚的缺陷。我们最近发现,由聚丙炔醇合成的多利康醇发生在三个步骤中,包括通过DHRSX将聚丙炔醇转化为聚丙炔醇,SRD5A3将多基因还原为dolichal,将dolichal还原为dolichol,再次由DHRSX。这导致我们研究了Lec5和Lec9细胞中缺陷的dolichol合成。两种细胞系都显示出增加的多烯醇及其衍生物水平,伴随着dolichol和衍生物水平的降低,但是多核水平没有变化,提示DHRSX缺乏。因此,通过与人DHRSX而不是SRD5A3互补来校正N-聚糖合成和聚异戊二烯水平的变化。此外,来自Lec5和Lec9细胞的膜制剂中不存在DHRSX的典型的多普瑞诺脱氢酶和dolichal还原酶活性,虽然将多基因减少为dolichal,SRD5A3催化,不受影响。Lec5和Lec9细胞的长读全基因组测序没有发现SRD5A3的ORF突变,但含有DHRSX的基因组区域不存在。最后,我们建立了中国仓鼠DHRSX的序列,并验证了该蛋白具有与人类酶相似的动力学特性。因此,我们的工作确定了CHOLec5和Lec9细胞中dolichol合成缺陷的基础。
    Glycosylation-deficient Chinese hamster ovary (CHO) cell lines have been instrumental in the discovery of N-glycosylation machinery. Yet, the molecular causes of the glycosylation defects in the Lec5 and Lec9 mutants have been elusive, even though for both cell lines a defect in dolichol formation from polyprenol was previously established. We recently found that dolichol synthesis from polyprenol occurs in three steps consisting of the conversion of polyprenol to polyprenal by DHRSX, the reduction of polyprenal to dolichal by SRD5A3 and the reduction of dolichal to dolichol, again by DHRSX. This led us to investigate defective dolichol synthesis in Lec5 and Lec9 cells. Both cell lines showed increased levels of polyprenol and its derivatives, concomitant with decreased levels of dolichol and derivatives, but no change in polyprenal levels, suggesting DHRSX deficiency. Accordingly, N-glycan synthesis and changes in polyisoprenoid levels were corrected by complementation with human DHRSX but not with SRD5A3. Furthermore, the typical polyprenol dehydrogenase and dolichal reductase activities of DHRSX were absent in membrane preparations derived from Lec5 and Lec9 cells, while the reduction of polyprenal to dolichal, catalyzed by SRD5A3, was unaffected. Long-read whole genome sequencing of Lec5 and Lec9 cells did not reveal mutations in the ORF of SRD5A3, but the genomic region containing DHRSX was absent. Lastly, we established the sequence of Chinese hamster DHRSX and validated that this protein has similar kinetic properties to the human enzyme. Our work therefore identifies the basis of the dolichol synthesis defect in CHO Lec5 and Lec9 cells.
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  • 文章类型: Journal Article
    细胞和包膜病毒的表面都涂有碳水化合物,这些碳水化合物在感染和免疫中起着多种作用。所有生命王国的生物体都利用了各种各样的单糖亚基,糖苷键,和分支模式来编码聚糖内的信息。因此,糖模式酶和聚糖结合蛋白在细胞和生物体生物学中起着不可或缺的作用,从内质网内的糖蛋白质量控制到淋巴细胞迁移,凝血,炎症,和组织稳态。毫不奇怪,参与产生和识别寡糖模式的基因是进化冲突的场所,这些冲突在跨物种相互作用中比比皆是,以作为毒素的无数植物凝集素为例。在脊椎动物中,带有酸性九碳糖的聚糖称为唾液酸是免疫反应的关键调节剂。各种细菌和真菌病原体在唾液酸中装饰它们的细胞,这些唾液酸要么模仿它们的宿主,要么从它们那里被偷走。然而,病毒如何命令宿主糖模式酶来阻止免疫反应的研究还很少。这里,我们回顾了与唾液酸结合免疫球蛋白样凝集素(Siglecs)相互作用的病毒的例子,一个调节toll样受体信号并控制糖免疫检查点的免疫细胞受体家族,同时突出了值得调查的知识差距。阐明病毒如何利用聚糖依赖的检查点的努力可能会转化为新的临床治疗方法,通过去除或掩盖免疫抑制的唾液酸聚糖来掩盖病毒抗原和受感染的细胞表面,或通过抑制诱导其生物合成的病毒基因产物。这种方法可能具有释放免疫系统以清除长期棘手的慢性病毒感染的潜力。
    The surfaces of cells and enveloped viruses alike are coated in carbohydrates that play multifarious roles in infection and immunity. Organisms across all kingdoms of life make use of a diverse set of monosaccharide subunits, glycosidic linkages, and branching patterns to encode information within glycans. Accordingly, sugar-patterning enzymes and glycan binding proteins play integral roles in cell and organismal biology, ranging from glycoprotein quality control within the endoplasmic reticulum to lymphocyte migration, coagulation, inflammation, and tissue homeostasis. Unsurprisingly, genes involved in generating and recognizing oligosaccharide patterns are playgrounds for evolutionary conflicts that abound in cross-species interactions, exemplified by the myriad plant lectins that function as toxins. In vertebrates, glycans bearing acidic nine-carbon sugars called sialic acids are key regulators of immune responses. Various bacterial and fungal pathogens adorn their cells in sialic acids that either mimic their hosts\' or are stolen from them. Yet, how viruses commandeer host sugar-patterning enzymes to thwart immune responses remains poorly studied. Here, we review examples of viruses that interact with sialic acid-binding immunoglobulin-like lectins (Siglecs), a family of immune cell receptors that regulate toll-like receptor signaling and govern glycoimmune checkpoints, while highlighting knowledge gaps that merit investigation. Efforts to illuminate how viruses leverage glycan-dependent checkpoints may translate into new clinical treatments that uncloak viral antigens and infected cell surfaces by removing or masking immunosuppressive sialoglycans, or by inhibiting viral gene products that induce their biosynthesis. Such approaches may hold the potential to unleash the immune system to clear long intractable chronic viral infections.
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  • 文章类型: Journal Article
    T细胞是在消除癌细胞方面非常有效的免疫细胞亚群。癌症免疫疗法赋予T细胞功能,并在癌症治疗中占有重要地位。响应率,然而,相对较低(<30%)。免疫疗法的功效高度依赖于T细胞浸润到肿瘤微环境(TME)中以及这些浸润的T细胞维持其在TME内的功能的能力。更好地了解TME对T细胞的抑制作用对于改善癌症免疫疗法至关重要。肿瘤细胞被很好地描述为它们转变为有氧糖酵解(Warburg效应),导致高葡萄糖消耗和代谢上不同的TME。相反,糖基化,蛋白质的主要翻译后修饰,也依赖于葡萄糖分子。T细胞受体的正确糖基化影响T细胞和肿瘤细胞之间的免疫突触,从而影响T细胞效应子功能,包括其细胞溶解和细胞抑制活性。这篇综述探讨了肿瘤葡萄糖代谢和T细胞糖萼之间复杂的相互作用。阐明TME如何诱导T细胞糖萼的改变,这随后会影响T细胞靶向和消除肿瘤细胞的能力。
    The T cell is an immune cell subset highly effective in eliminating cancer cells. Cancer immunotherapy empowers T cells and occupies a solid position in cancer treatment. The response rate, however, remains relatively low (<30%). The efficacy of immunotherapy is highly dependent on T cell infiltration into the tumor microenvironment (TME) and the ability of these infiltrated T cells to sustain their function within the TME. A better understanding of the inhibitory impact of the TME on T cells is crucial to improve cancer immunotherapy. Tumor cells are well described for their switch into aerobic glycolysis (Warburg effect), resulting in high glucose consumption and a metabolically distinct TME. Conversely, glycosylation, a predominant posttranslational modification of proteins, also relies on glucose molecules. Proper glycosylation of T cell receptors influences the immunological synapse between T cells and tumor cells, thereby affecting T cell effector functions including their cytolytic and cytostatic activities. This review delves into the complex interplay between tumor glucose metabolism and the glycocalyx of T cells, shedding light on how the TME can induce alterations in the T cell glycocalyx, which can subsequently influence the T cell\'s ability to target and eliminate tumor cells.
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  • 文章类型: Journal Article
    蛋白质O-连接的甘露糖(O-Man)糖基化是一种进化保守的翻译后修饰(PTM),其在胚胎发育过程中发挥重要的生物学作用。三个非冗余酶家族,POMT1/POMT2,TMTC1-4和TMEM260选择性地协调蛋白质O-Man糖基化在不同类型的跨膜蛋白上的起始,包括α-营养不良聚糖,钙黏着蛋白和丛蛋白受体。然而,缺乏对其底物特异性的系统研究,部分是由于O-Man糖基转移酶在细胞中的普遍表达,这排除了在蛋白质组范围内对途径特异性O-Man糖基化的分析。这里,我们在五种人类细胞系中应用了膜糖蛋白质组学的靶向工作流程,以广泛定位O-Man底物,并通过O-Man糖基转移酶基因的个体和组合敲除(KO)基因解构O-Man起始。我们建立了人类细胞文库,用于通过定量糖蛋白质组学分析单个O-Man起始途径的底物特异性。我们的结果鉴定了180个O-Man糖蛋白,证明了POMT1/POMT2途径的新蛋白质靶标,并表明TMTC1-4和TMEM260途径广泛靶向参与细胞-细胞和细胞-细胞外基质相互作用的质膜蛋白的不同Ig样蛋白质结构域。在Ig样折叠上鉴定O-Man增加了对结构域特异性O-Man糖基化的新兴概念的进一步了解,这为O-Man糖基化粘附分子和受体的功能研究打开了大门。
    Protein O-linked mannose (O-Man) glycosylation is an evolutionary conserved posttranslational modification that fulfills important biological roles during embryonic development. Three nonredundant enzyme families, POMT1/POMT2, TMTC1-4, and TMEM260, selectively coordinate the initiation of protein O-Man glycosylation on distinct classes of transmembrane proteins, including α-dystroglycan, cadherins, and plexin receptors. However, a systematic investigation of their substrate specificities is lacking, in part due to the ubiquitous expression of O-Man glycosyltransferases in cells, which precludes analysis of pathway-specific O-Man glycosylation on a proteome-wide scale. Here, we apply a targeted workflow for membrane glycoproteomics across five human cell lines to extensively map O-Man substrates and genetically deconstruct O-Man initiation by individual and combinatorial knockout of O-Man glycosyltransferase genes. We established a human cell library for the analysis of substrate specificities of individual O-Man initiation pathways by quantitative glycoproteomics. Our results identify 180 O-Man glycoproteins, demonstrate new protein targets for the POMT1/POMT2 pathway, and show that TMTC1-4 and TMEM260 pathways widely target distinct Ig-like protein domains of plasma membrane proteins involved in cell-cell and cell-extracellular matrix interactions. The identification of O-Man on Ig-like folds adds further knowledge on the emerging concept of domain-specific O-Man glycosylation which opens for functional studies of O-Man-glycosylated adhesion molecules and receptors.
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  • 文章类型: Journal Article
    N-聚糖的结构变化对于糖蛋白功能的调节至关重要。GalNAcβ1-4GlcNAc(LacdiNAc或LDN),由B4GALNT3或B4GALNT4合成的独特的亚末端聚糖结构参与从血液中清除N-糖蛋白和维持细胞干细胞性。LDN对糖蛋白功能的这种调节与显性亚末端结构的调节有很大不同,N-乙酰乳糖胺(Galβ1-4GlcNAc,LacNAc)。然而,B4GALNT活性受调控的机制以及LDN如何与LacNAc发挥不同作用尚不清楚.这里,我们发现B4GALNT3和4具有包含非催化PA14结构域的独特结构域结构,这是一个推定的聚糖结合模块。缺乏该结构域的突变体会大大降低对各种底物的活性,如N-聚糖,O-GalNAc聚糖,和糖蛋白,表明该结构域对于酶活性是必需的并且形成催化区的一部分。此外,为了阐明LDN和LacNAc之间功能差异的潜在机制,我们研究了LDN对N-聚糖成熟的影响,重点关注B4GALNT上游和下游的相关糖基转移酶。我们透露,与LacNAc合成不同,在N-聚糖中形成二等分GlcNAc几乎完全抑制B4GALNT3的LDN合成。此外,LDN的存在对许多糖基转移酶末端修饰的作用产生负面影响,包括唾液酸化,岩藻糖基化,和人类自然杀手-1(HNK-1)合成。这些发现表明,LDN对N-聚糖成熟的影响与LacNAc完全不同,这可能有助于获得调节复杂N-聚糖生物合成的系统的全面概述。
    Structural variation of N-glycans is essential for the regulation of glycoprotein functions. GalNAcβ1-4GlcNAc (LacdiNAc or LDN), a unique subterminal glycan structure synthesized by B4GALNT3 or B4GALNT4, is involved in the clearance of N-glycoproteins from the blood and maintenance of cell stemness. Such regulation of glycoprotein functions by LDN is largely different from that by the dominant subterminal structure, N-acetyllactosamine (Galβ1-4GlcNAc, LacNAc). However, the mechanisms by which B4GALNT activity is regulated and how LDN plays different roles from LacNAc remain unclear. Here, we found that B4GALNT3 and four have unique domain organization containing a noncatalytic PA14 domain, which is a putative glycan-binding module. A mutant lacking this domain dramatically decreases the activity toward various substrates, such as N-glycan, O-GalNAc glycan, and glycoproteins, indicating that this domain is essential for enzyme activity and forms part of the catalytic region. In addition, to clarify the mechanism underlying the functional differences between LDN and LacNAc, we examined the effects of LDN on the maturation of N-glycans, focusing on the related glycosyltransferases upstream and downstream of B4GALNT. We revealed that, unlike LacNAc synthesis, prior formation of bisecting GlcNAc in N-glycan almost completely inhibits LDN synthesis by B4GALNT3. Moreover, the presence of LDN negatively impacted the actions of many glycosyltransferases for terminal modifications, including sialylation, fucosylation, and human natural killer-1 synthesis. These findings demonstrate that LDN has significant impacts on N-glycan maturation in a completely different way from LacNAc, which could contribute to obtaining a comprehensive overview of the system regulating complex N-glycan biosynthesis.
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  • 文章类型: Journal Article
    控制蛋白质和细胞器自噬的机制已经得到了很好的研究,但是其他细胞质成分如RNA和多糖是如何降解的仍然是未知的。在这项研究中,我们检查糖原的自噬,葡萄糖的储存形式。我们发现,在氮饥饿期间,细胞在细胞质中积累糖原,并且在自噬体和自噬体中很少观察到这种碳水化合物。然而,在长期氮饥饿后观察到通过自噬螯合糖原。我们确定了一个尚未表征的开放阅读框架,Yil024c(此处为Atg45),编码介导糖原自噬的胞浆受体蛋白(glycophagy)。此外,我们证明,在孢子形成期间,Atg45高度表达并且与糖吞噬的增加有关。我们的结果表明,细胞通过控制Atg45的表达水平来调节出糖活性。
    The mechanisms governing autophagy of proteins and organelles have been well studied, but how other cytoplasmic components such as RNA and polysaccharides are degraded remains largely unknown. In this study, we examine autophagy of glycogen, a storage form of glucose. We find that cells accumulate glycogen in the cytoplasm during nitrogen starvation and that this carbohydrate is rarely observed within autophagosomes and autophagic bodies. However, sequestration of glycogen by autophagy is observed following prolonged nitrogen starvation. We identify a yet-uncharacterized open reading frame, Yil024c (herein Atg45), as encoding a cytosolic receptor protein that mediates autophagy of glycogen (glycophagy). Furthermore, we show that, during sporulation, Atg45 is highly expressed and is associated with an increase in glycophagy. Our results suggest that cells regulate glycophagic activity by controlling the expression level of Atg45.
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  • 文章类型: Journal Article
    哮喘已经达到流行水平,然而,开发特定疗法的进展缓慢。造成这种情况的主要原因之一是哮喘是各种不同子集的总称。由于其高度的异质性,很难为每个哮喘亚组建立生物标志物,也很难提出针对内生型的治疗方法.本文综述了蛋白质糖基化作为在哮喘中激活的过程以及利用它开发新的生物标志物和治疗方法。我们讨论已知和相关的糖蛋白,其功能控制疾病的发展。糖蛋白在哮喘不可或缺的过程中的关键作用,比如炎症,组织重塑,修复,证明了我们在糖生物学领域的兴趣和研究。改变导致哮喘的蛋白质的糖基化状态可以改变我们以前未能抑制的病理过程。特别强调的是壳三糖苷酶1(CHIT1),能够修饰含有LacNAc和LacdiNAc的聚糖的酶。CHIT1的表达和活性在人类患病的肺中被诱导,其病理作用已被遗传和药理学方法证明。我们建议研究哮喘中糖基化模式和参与糖基化的酶可以帮助患者分层和开发个性化治疗。
    Asthma has reached epidemic levels, yet progress in developing specific therapies is slow. One of the main reasons for this is the fact that asthma is an umbrella term for various distinct subsets. Due to its high heterogeneity, it is difficult to establish biomarkers for each subset of asthma and to propose endotype-specific treatments. This review focuses on protein glycosylation as a process activated in asthma and ways to utilize it to develop novel biomarkers and treatments. We discuss known and relevant glycoproteins whose functions control disease development. The key role of glycoproteins in processes integral to asthma, such as inflammation, tissue remodeling, and repair, justifies our interest and research in the field of glycobiology. Altering the glycosylation states of proteins contributing to asthma can change the pathological processes that we previously failed to inhibit. Special emphasis is placed on chitotriosidase 1 (CHIT1), an enzyme capable of modifying LacNAc- and LacdiNAc-containing glycans. The expression and activity of CHIT1 are induced in human diseased lungs, and its pathological role has been demonstrated by both genetic and pharmacological approaches. We propose that studying the glycosylation pattern and enzymes involved in glycosylation in asthma can help in patient stratification and in developing personalized treatment.
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  • 文章类型: Journal Article
    梅毒,由螺旋体梅毒螺旋体亚种引起。苍白球(以下称为苍白球),正在重新成为一种世界性的性传播感染。单次肌内剂量的苄星青霉素G是优选的梅毒治疗选择。供应短缺的担忧和获得的抗生素耐药性的可能性都进一步需要扩大梅毒疗法的范围。我们推断,其他β-内酰胺可能同样或更有效地靶向致病因子,梅毒螺旋体,但由于以前缺乏连续的体外培养系统,尚未发现。在体外梅毒螺旋体繁殖方面的最新技术进步使我们能够对近100种β-内酰胺进行高通量筛选。使用我们开发或改编的几种分子和细胞方法,我们确定并证实了几种β-内酰胺的疗效与现行标准相似或优于现行标准,这些选择目前用于治疗细菌感染或者是天然存在的化合物的合成衍生物。我们的研究不仅确定了解决梅毒的其他潜在治疗方法,但是提供了研究梅毒螺旋体复杂生物学的技术。梅毒螺旋体已经困扰了几个世纪。
    Syphilis, caused by the spirochete Treponema pallidum subsp. pallidum (hereafter called T. pallidum), is re-emerging as a worldwide sexually transmitted infection. A single intramuscular dose of benzathine penicillin G is the preferred syphilis treatment option. Both supply shortage concerns and the potential for acquired antibiotic resistance further the need to broaden the repertoire of syphilis therapeutics. We reasoned that other β-lactams may be equally or more effective at targeting the disease-causing agent, Treponema pallidum, but have yet to be discovered due to a previous lack of a continuous in vitro culture system. Recent technical advances with respect to in vitro T. pallidum propagation allowed us to conduct a high-throughput screen of almost 100 β-lactams. Using several molecular and cellular approaches that we developed or adapted, we identified and confirmed the efficacy of several β-lactams that were similar to or outperformed the current standard, benzathine penicillin G. These options are either currently used to treat bacterial infections or are synthetic derivatives of naturally occurring compounds. Our studies not only identified additional potential therapeutics in the resolution of syphilis, but provide techniques to study the complex biology of T. pallidum-a spirochete that has plagued human health for centuries.
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