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  • Despite its effectiveness, bedaquiline's clinical use is limited due to safety issues.
  • Researchers investigated changes in the quinoline ring of bedaquiline to create safer variants.
  • They found that substituting the quinoline structure with pyridine still retained anti-tubercular activity, leading to new opportunities for developing better treatments.

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The first FDA approved, MDR-TB inhibitory drug bedaquiline (BDQ), entraps the c-ring of the proton-translocating F region of enzyme ATP synthase of , thus obstructing successive ATP production. Present-day BDQ-resistance has been associated with cardiotoxicity and mutation(s) in the atpE gene encoding the c subunit of ATP synthase (ATPc) generating five distinct ATPc mutants: Ala63→Pro, Ile66→Met, Asp28→Gly, Asp28→Val and Glu61→Asp. We created three discrete libraries, first by repurposing bedaquiline via scaffold hopping approach, second one having natural plant compounds and the third being experimentally derived analogues of BDQ to identify one drug candidate that can inhibit ATPc activity more efficiently with less toxic properties.

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Article Synopsis
  • * First-line treatments are being challenged by resistance, leading to the need for more toxic second-line drugs, but new agents and treatment regimens, like the BPaLM protocol, show promise for better efficacy and shorter treatment times.
  • * Emerging strategies, including immunotherapy and cell therapies, aim to boost the immune response against TB, but significant obstacles remain in reaching the WHO's goal to end TB, especially due to resource diversion from the COVID-
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Structural toxicity relationship (STR) of linezolid to mitigate myelosuppression and serotonergic toxicity.

Bioorg Med Chem

November 2024

Division of Computer Aided Drug Design, Department of Pharmaceutical Chemistry, R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Dhule 425405, Maharashtra, India. Electronic address:

Article Synopsis
  • * Linezolid is an effective drug in the BPaL regimen for treating these resistant TB strains, but its use can be limited due to side effects like myelosuppression and MAO inhibition.
  • * Research is focusing on modifying Linezolid and its analogues to reduce toxic effects while maintaining their antibacterial effectiveness, leading to the development of safer alternatives for treating drug-resistant TB.
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Inhibition of M. tuberculosis and human ATP synthase by BDQ and TBAJ-587.

Nature

July 2024

State Key Laboratory of Medicinal Chemical Biology and College of Life Sciences, Nankai University, Tianjin, China.

Bedaquiline (BDQ), a first-in-class diarylquinoline anti-tuberculosis drug, and its analogue, TBAJ-587, prevent the growth and proliferation of Mycobacterium tuberculosis by inhibiting ATP synthase. However, BDQ also inhibits human ATP synthase. At present, how these compounds interact with either M.

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As an obligate aerobe, relies on its branched electron transport chain (ETC) for energy production through oxidative phosphorylation. Regimens targeting ETC exhibit promising potential to enhance bactericidal activity against and hold the prospect of shortening treatment duration. Our previous research demonstrated that the bacteriostatic drug candidate TB47 (T) inhibited the growth of by targeting the cytochrome complex and exhibited synergistic activity with clofazimine (C).

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