ABSTRACT
New therapeutic strategies against multidrug-resistant (MDR) and extensively drug-resistant (XDR)
Mycobacterium tuberculosis
are urgently required to combat the global tuberculosis (TB) threat. Toward this end, we previously reported the identification of 1,4-azaindoles, a promising class of compounds with potent antitubercular activity through noncovalent inhibition of decaprenylphosphoryl-β-
d
-ribose 2′-epimerase (DprE1). Further, this series was optimized to improve its physicochemical properties and pharmacokinetics in mice. Here, we describe the short-listing of a potential clinical candidate, compound 2, that has potent cellular activity, drug-like properties, efficacy in mouse and rat chronic TB infection models, and minimal
in vitro
safety risks. We also demonstrate that the compounds, including compound 2, have no antagonistic activity with other anti-TB drugs. Moreover, compound 2 shows synergy with PA824 and TMC207
in vitro
, and the synergy effect is translated
in vivo
with TMC207. The series is predicted to have a low clearance in humans, and the predicted human dose for compound 2 is ≤1 g/day. Altogether, our data suggest that a 1,4-azaindole (compound 2) is a promising candidate for the development of a novel anti-TB drug.
摘要
针对耐多药(MDR)和广泛耐药(XDR)结核分枝杆菌的新治疗策略
结核分枝杆菌
迫切需要新的治疗策略来应对全球结核病(TB)的威胁。为此,我们以前曾报道过发现了 1,4-氮杂吲哚,这是一类很有希望的化合物,通过非共价方式抑制癸烯丙基磷酰-β-
d
-核糖 2′-epimerase (DprE1)。此外,还对该系列进行了优化,以改善其理化性质和在小鼠体内的药代动力学。在此,我们描述了潜在临床候选化合物 2 的候选短名单,该化合物具有强大的细胞活性、类药物特性、在小鼠和大鼠慢性结核感染模型中的疗效以及最小的
体外
安全性。我们还证明,包括化合物 2 在内的这些化合物与其他抗结核药物没有拮抗活性。此外,化合物 2 与 PA824 和 TMC207 在体外实验中显示出协同作用
在体外
而且这种协同作用在
在体内
与 TMC207 的协同作用。据预测,该系列药物在人体中的清除率较低,化合物 2 的预计人体剂量为≤1 克/天。总之,我们的数据表明,1,4-氮杂吲哚(化合物 2)是开发新型抗结核药物的理想候选物质。