Conspectus
This Account describes fundamental chemistry
that promoted the
discovery of new antibiotics. Specifically, the NH acidity of simple
hydroxamic acid derivatives facilitated the syntheses of novel β-lactams
(oxamazins and monobactams), siderophore mimics that limit bacterial
iron uptake and bacterially targeted sideromycins (siderophore-antibiotic
conjugates). The development of resistance to our current limited
set of antibiotic scaffolds has created a dire medical situation.
As recently stated, “if you weren’t taking antibiotic
resistance seriously before, now would be a good time to start.”
A project commissioned by the British government () has
released estimates of the near-future global toll of antibiotic resistance
that are jaw-dropping in their seriousness and scale: 10 million deaths
per year and at least $100 trillion in sacrificed gross national product.
The 2020 COVID pandemic confirmed that infectious disease problems
are no longer localized but worldwide. Many classical antibiotics,
especially β-lactams, previously provided economical cures,
but the evolution of antibiotic destructive enzymes (i.e., β-lactamases),
efflux pumps, and bacterial cell wall permeability barriers has made
many types of bacteria, especially Gram-negative strains, resistant.
Still, and in contrast to other therapies, the public expectation
is that any new antibiotic must be inexpensive. This creates market
limitations that have caused most major pharmaceutical companies to
abandon antibiotic research. Much needs to be done to address this
significant problem.
The critical need for bacteria to sequester
essential iron provides
an Achilles’ heel for new antibiotic development. Although
ferric iron is extremely insoluble, bacteria need micromolar intracellular
concentrations for growth and virulence. To this end, they biosynthesize
siderophores (Gr. iron bearer) and excrete them into their environment,
where they bind iron with high affinity. The iron complexes are recognized
by specific outer-membrane transporters, and once actively internalized,
the iron is released for essential processes. To conserve biosynthetic
energy, some bacteria recognize and utilize siderophores made by competing
strains. As a counter-revolution in the never-ending fight for survival,
bacteria have also evolved sideromycins, which are siderophores conjugated
to warheads that are lethal to rogue bacteria. While none are now
used therapeutically, natural sideromycins called albomycins have
been used clinically, and others have been shown to be well tolerated
and active in animal infection models. Herein we describe practical
methods to synthesize new antibiotics and artificial sideromycins
with the generalized structure shown above (siderophore-linker drug).
Utilizing the molecular-recognition-based siderophore/sideromycin
bacterial assimilation processes, it is possible to design both broad
spectrum and exquisitely narrow spectrum (targeted) sideromycins and
even repurpose older or more classical antibiotics. Relevant microbiological
assays, ...