Dual inhibition of the terminal oxidases eradicates antibiotic-tolerant Mycobacterium tuberculosis

Academic Article


  • The approval of bedaquiline has placed energy metabolism in the limelight as an attractive target space for tuberculosis antibiotic development. While bedaquiline inhibits the mycobacterial F F ATP synthase, small molecules targeting other components of the oxidative phosphorylation pathway have been identified. Of particular interest is Telacebec (Q203), a phase 2 drug candidate inhibitor of the cytochrome bcc:aa terminal oxidase. A functional redundancy between the cytochrome bcc:aa and the cytochrome bd oxidase protects M.┬átuberculosis from Q203-induced death, highlighting the attractiveness of the bd-type terminal oxidase for drug development. Here, we employed a facile whole-cell screen approach to identify the cytochrome bd inhibitor ND-011992. Although ND-011992 is ineffective on its own, it inhibits respiration and ATP homeostasis in combination with Q203. The drug combination was bactericidal against replicating and antibiotic-tolerant, non-replicating mycobacteria, and increased efficacy relative to that of a single drug in a mouse model. These findings suggest that a cytochrome bd oxidase inhibitor will add value to a drug combination targeting oxidative phosphorylation for tuberculosis treatment. 1 0 3 3
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    Digital Object Identifier (doi)

    Author List

  • Lee BS; Hards K; Engelhart CA; Hasenoehrl EJ; Kalia NP; Mackenzie JS; Sviriaeva E; Chong SMS; Manimekalai MSS; Koh VH
  • Volume

  • 13
  • Issue

  • 1