8. Medicinal Chemistry of Antimicrobials Flashcards

1
Q

Antibiotics - History

A
  • Rich history of bacterial treatments dating back thousands of years
    + Chinese used mouldy soyabean curd to treat boils
    + Honey used to prevent infection of arrow wounds in the Middle Ages
  • Paul Ehrlich developed the 1st purely synthetic antimicrobial in 1910 as part of a SAR study
  • In 1928 Alexander Fleming discovered penicillin – marking the beginning of the “Golden Age of Antibiotics”
    + Awarded the Nobel Prize in Physiology or Medicine, 1945, along with Sir Howard Florey & Sir Ernst Chain “for the discovery of penicillin & its curative effect in various infectious diseases”
  • Dorothy Hodgkin later confirmed the structure of penicillin using X-ray crystallography
    +Awarded Nobel Prize in Chemistry, 1964, for this & other work
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bacterial cell targets

A

Ribosomes:

  • Chloramphenicol
  • Streptomycin
  • Tetracyclines

Nuclear material (DNA/RNA):

  • Rifampicins
  • Quinolones

Outer membrane (gram negative)

Cell wall (peptidoglycan)

  • Penicillins
  • Cephalosporins

Plasma membrane:
- Polymyxins

Enzymes:
- Sulfonamides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mechanism of action: Bacterial cellular targets

A
  1. Inhibition of cell metabolism – antimetabolites inhibit an enzyme-catalysed reaction which is unique to bacterial cells (e.g. folate biosynthesis)
  2. Inhibition of cell wall biosynthesis – causes bacterial cell lysis & death
    - Plasma membrane interactions – affects membrane permeability
  3. Disruption of protein synthesis – essential proteins & enzymes cannot be made
  4. Inhibition of nucleic acid transcription/replication – prevents cell division
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Mechanism of Action: Bacterial cell wall

A
  • Bacterial cell wall has a peptidoglycan structure
    + Made up of parallel series of sugar backbones [N-acetylmuramic acid (NAM or MurNAc) & N-acetylglucosamine (NAG or GlcNAc)]
    + NAM is bound to short peptide chains
    + Cross-linking between peptide chains confers strength & rigidity to the 3D structure
  • Transpeptidase enzyme recognises the terminal D-Ala-D-Ala motif of one peptide chain, & cleaves the terminal D-Ala residue
  • Terminal glycine of another peptide chain then enters active site & forms a peptide bond to the alanine -> cross link to reinforce cell wall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Penicillins - key structural features

A
  • Acyl side chain
  • Thiazolidine ring
  • Beta lactam ring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Penicillins - Mechanism of action

A
  • Penicillin has similar conformation to the D-Ala-D-Ala substrate
  • Penicillin binds in active site & beta-lactam reacts with serine in active site
    + Cyclic so this reaction doesn’t release from the active site
    + Blocks the pentaglycine chain (or water) from entering & cleaving penicillin from the active site
  • By inhibiting the transpeptidase enzyme, bacterial cell walls can no longer form cross links -> weakened cell wall swells & bursts (cell lysis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Properties of penicillin G

A
  • Inactive against beta-lactamase producing organisms e.g. 95% of S. aureus strains now produce beta-lactamase enzymes
    + Beta-lactamases are mutated forms of transpeptidase enzyme – bind & cleave beta-lactam of penicillin using serine residue in active site
    + Able to hydrolyse the ester link between penicillin & the active site, so ring-opened penicillin is released very rapidly from the enzyme
  • Acid sensitive so cannot be taken orally
  • Only active against a narrow range of Gram-positive & negative bacteria
  • Can improve properties through modification of amino acyl side chain only!
    + Rest of structure is important
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Beta-lactamase resistant penicillins

A

Use of steric bulk on acyl side chain to block penicillins from binding the beta-lactamase active sites

  • Steric shield cannot be too bulky, or it cannot bind the target transpeptidase enzyme active site
  • Difficult to find balance in size of amino acyl group
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Reduction of acid sensitivities

A
  • Under acidic conditions (e.g. in stomach) the acyl sidechain of penicillin G can open up the beta-lactam ring, rendering it ineffective – “inbuilt self-destruct mechanism”
  • Remedy this by using an electron withdrawing group on acyl side chain
  • Reduces nucleophilic character of carbonyl oxygen – better acid stability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Broad spectrum penicillins

A
  • Hydrophobic groups on side chain favour activity against Gram-positive bacteria, but have poor activity against Gram-negative bacteria e.g. penicillin G
  • Hydrophilic groups have little effect on Gram-positive bacteria, but have increased activity against Gram-negative bacteria e.g. penicillin T
  • Hydrophilic groups in alpha-position to acyl carbonyl group have greatest enhancement of Gram-negative activity -> allows passage through porins in outer membrane e.g. amoxicillin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ampicillin prodrugs

A
  • Ampicillin has a electrophilic EWG so is acid stable
  • However, it is zwitterionic at physiological pH so poorly absorbed through gut wall
  • Masking charged carboxylic acid as an ester gives improved absorption in the GI tract
  • Ester is cleaved by esterase enzymes to give the active broad-spectrum antibiotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Penicillins - SAR studies

A

Cis stereochemistry:
- Relative stereochemistry between bicyclic ring & amino acyl side chain important

Sulfur atom:
- Common but not essential

Bicyclic system essential:
- Confers greater ring strain on Beta-lactam

Carboxylate essential:

  • Carboxylate binds charged lysine in active site
  • Esters useful as prodrugs

Beta-lactam:
- Strained beta-lactam ring is essential

Aminoacyl side chain is essential:

  • EWGs reduce acid sensitivity
  • Bulky groups con fer resistance to beta-lactamases
  • Hydrophilic groups improve activity against Gram-negative bacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Glycopeptides

A

Inhibitors of cell wall synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Properties of vancomycin

A
  • Vancomycin is a narrow-spectrum antibiotic produced by streptomyces orientalis - Major last line of defence against MRSA & other drug resistant infections
  • No activity against Gram-negative bacteria - Large molecule so unable to cross outer cell membrane of Gram-negative bacteria
  • Large & lipophilic so cannot cross GI mucosa
    + IV administration required for most infections
    + Can be administered orally for treatment of gut infections e.g. C. difficile

Adverse effects include:

  • Fever, rashes & local phlebitis at the site of injection
  • Nephrotoxicity & ototoxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Features of vancomycin

A
  • Heptapeptide backbone is responsible for binding target

- Cyclisation between aromatic rings makes the heptapeptide backbone extremely rigid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Vancomycin - mechanism of action

A

Vancomycin has a pocket where the D-Ala-D-Ala tail of the cell wall building block fits

  • 5 H-bonds hold building block in vancomycin pocket
  • Dimerisation then occurs where 2 peptide-bound vancomycin units H-bond to each other
  • Vancomycin forms steric shield, preventing D-Ala-D-Ala interacting with transpeptidase -> No cross linking
17
Q

Vancomycin analogues (Teicoplanin)

A
  • Teicoplanin is similar to vancomycin but longer lasting & less toxic
  • Possesses a long alkyl chain which anchors it to the surface of the cell membrane -> perfectly positioned to interact with cell wall building blocks
  • Unable to form dimers
18
Q

Viral replication

A
  1. Binding
  2. Fusion
  3. Location to nucleus
  4. Replication
  5. Transcription
  6. Translation
  7. Assembly
  8. Budding
  9. Release
19
Q

DNA replication

A
  1. Helicase unwinds the DNA double helix
  2. DNA polymerase “reads” the DNA strand
    - Adds nucleoside triphosphate building blocks to the 3’ end of the DNA chains
    - Creates 2 identical DNA duplexes from the original double stranded DNA
20
Q

Nucleoside analogue

A
  • Most of the drugs with activity against DNA viruses have been developed against herpesviruses – nucleoside analogues particularly effective
    + Used for treatment of cold sores, shingles, genital herpes, glandular fever etc
    + Also useful treatments for Burkitt’s lymphoma & Kaposi’s sarcoma

Aciclovir (Zovirax) discovered by compound screening - An analogue of the nucleoside deoxyguanosine

  • Normally incorporated into DNA during DNA replication (as triphosphate)
  • Catalysed by DNA polymerase
21
Q

Nucleoside analogues - mechanism of action

A

Aciclovir is a prodrug -> first needs to be converted to triphosphate

  • This only occurs in infected cells (using viral thymidine kinase for first P)
  • Host cell thymidine kinase is 100x less effective at producing monophosphate

Aciclovir is then converted to the triphosphate, which binds to DNA polymerase

  • Competitive inhibition – prevents normal nucleotide binding
  • No sugar unit so growing DNA chain cannot be extended
22
Q

Improvement of oral bioavailability

A

Aciclovir is very polar, so has low oral bioavailability (15-30%)
- (pre)prodrugs have improved bioavailability

Valaciclovir 3-5 fold improved bioavailability

  • Transported across cell membranes of gut wall by hPEPT-1 & HPT-1 transporter proteins
  • Hydrolysed to aciclovir in liver/gut wall
23
Q

Improvement of activity spectrum

A

Some viruses lack thymidine kinase (or the enzyme acts very slowly)
- Normal nucleoside analogues inactive against these viruses as they cannot be activated in infected cells

Ganciclovir is an analogue of acyclovir, similar structure

  • BUT can also be converted to the monophosphorylated nucleotide by kinases other than thymidine kinase
  • Can be used for treatment of viruses that do not encode thymidine kinase, e.g. cytomegalovirus (CMV)
  • Low oral bioavailability can again be improved by use of (pre)prodrug strategy, i.e. valganciclovir

ProTide (Prodrug nucleotide) approach -> first phosphate already attached

  • Charged phosphate is masked with an amino ester & an aryl group
  • Following absorption, enzymatic cleavage reveals the nucleotide
24
Q

SARS-CoV-2

A

Remdesivir is a ProTide nucleotide with a very broad spectrum of activity

  • Targets viral RNA-dependent RNA polymerase (RdRp); has some activity against RNA viruses, e.g. West Nile virus, Lassa fever virus, MERS-COV, SARS-CoV, Ebola virus etc
  • Addition of 1’ cyano group improved selectivity for viral rather than mitochondrial RNA polymerase
  • FDA issued emergency use authorisation for hospitalised COVID-19 patients on May 1st 2020
  • Clinical studies have since shown little benefit