Carbohydrate receptor mimicry as a basis for antibacterial therapy

In the world of microbial pathogens, successful colonization of mucosal surfaces frequently involves initial binding interactions between proteinaceous attachment factors, called adhesins, lectins or hemagglutinins, expressed on the surface of the microorganism and complex carbohydrate sequences, or receptors, on host epithelial cell membranes. Many bacterial exotoxins also employ a strategy of lectin-like binding to host cell carbohydrate receptors in order to cause their pathophysiological effects. It is these specific lectin-carbohydrate interactions that often determine the species or tissue tropism for a particular pathogen. Conceptually, therefore, it should be possible to use analogs of carbohydrate receptors to competitively inhibit microbial colonization of host tissues and this hypothesis is the basis for carbohydrate-based anti-infective drugs. This review will summarize some of the past and present thinking related to the feasibility, problems and potential benefits of such novel carbohydrate-based agents.