Synthesis and Development of Antibiotic Adjuvants to Restore Antimicrobial Activity Against Resistant Gram-Negative Pathogens

Abstract

Widespread antimicrobial resistance, particularly in Gram-negative pathogens, is a serious threat facing the global community. Aminoglycosides are inactivated by enzymes such as aminoglycoside N-acetyltransferase-3 (AAC(3)) and O-nucleotidyltransferase-2” (ANT(2”)), while the New Delhi metallo-b- lactamase-1 (NDM-1) degrades carbapenems. Inhibition of these enzymes should result in bacteria becoming once again susceptible to aminoglycosides and carbapenems. This thesis describes the development of inhibitors to these enzymes, in an effort to rescue the utility of aminoglycoside and carbapenem drug classes through adjuvant therapy. High-throughput screening of protein kinase libraries identified two AAC(3)-Ia inhibitors with a common 3-benzylidene-2-indolinone core. New methods for purification of AAC(3)-Ia and monitoring its activity were developed. A chemical library was built around this scaffold and assessed for SAR. It was found that the initial hit (Z)-methyl 3-(3,5-dibromo-4-hydroxybenzylidene)-2- oxoindoline-5-carboxylate was the most active against AAC(3)-Ia, and alterations to either the 3,5-dibromo-4-hydroxybenzyl warhead or methyl ester substituent resulted in a decrease in activity. Previous whole-cell screening had identified two protein kinase inhibitors with a biphenyl isonicotinamide scaffold as inhibitors of ANT(2”)-Ia. A convergent parallel synthesis was developed, involving Suzuki and amide couplings and protecting group strategies. This methodology was used to assemble a focused chemical library for SAR analysis. Stepwise removal of extraneous complexity from the initial hits yielded a selective ANT(2”)-Ia inhibitor which demonstrated in vivo synergy with gentamicin. Aspergillomarasmine A (AMA) is a natural product with activity against NDM-1. Several derivatives of AMA have been synthesized to assess SAR, but the specific contributions of individual carboxylic acids have yet to determined due to difficulties accessing position 6. A synthetic approach was developed via reductive amination using Garner’s aldehyde as a serine equivalent. This strategy was used to synthesize an AMA analog with a hydroxyl group in place of the carboxylic acid in position 6. Additionally, an imine-promoted isomeric resolution was discovered.