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Updated: Aug 2, 2025

Antibiotic Dereplication Using the Antibiotic Resistance Platform
Published on: October 17, 2019
Repurposing drugs with specific activity against L-form bacteria
Kaveh Emami1,2, Peter Banks2, Ling Juan Wu1,2
1Centre for Bacterial Cell Biology, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
Abstract:
Cell wall deficient "L- form" bacteria are of growing medical interest as a possible source of recurrent or persistent infection, largely because of their complete resistance to cell wall active antibiotics such as β-lactams. Antibiotics that specifically kill L-forms would be of potential interest as therapeutics, but also as reagents with which to explore the role of L-forms in models of recurrent infection. To look for specific anti-L-form antibiotics, we screened a library of several hundred FDA-approved drugs and identified compounds highly selective for L-form killing. Among the compounds identified were representatives of two different classes of calcium channel blockers: dihydropyridines, e.g., manidipine; and diphenylmethylpiperazine, e.g., flunarizine. Mode of action studies suggested that both classes of compound work by decreasing membrane fluidity. This leads to a previously recognized phenotype of L-forms in which the cells can continue to enlarge but fail to divide. We identified a considerable degree of variation in the activity of different representatives of the two classes of compounds, suggesting that it may be possible to modify them for use as drugs for L-form-dependent infections.
Insights
New research identifies calcium channel blockers as potential drugs to combat persistent bacterial infections. These compounds effectively kill cell wall deficient bacteria, offering hope for treating recurrent infections resistant to traditional antibiotics.
Area of Science:
- Microbiology
- Pharmacology
- Infectious Diseases
Background:
- Cell wall deficient bacteria, known as L-forms, are implicated in persistent and recurrent infections.
- L-forms exhibit complete resistance to conventional cell wall active antibiotics like β-lactams.
- There is a critical need for novel therapeutic agents targeting L-form bacteria.
Purpose of the Study:
- To identify and characterize FDA-approved drugs with specific activity against L-form bacteria.
- To explore the potential of these identified compounds as novel therapeutic agents for L-form-dependent infections.
- To investigate the mechanism of action of anti-L-form compounds.
Main Methods:
- Screening of a library comprising several hundred FDA-approved drugs.
- Identification of compounds exhibiting selective L-form killing activity.
- Mode of action studies to elucidate the cellular targets and effects of active compounds.
Main Results:
- Several FDA-approved drugs, including dihydropyridines (e.g., manidipine) and diphenylmethylpiperazines (e.g., flunarizine), demonstrated potent L-form killing activity.
- Mechanism of action studies indicated that these calcium channel blockers reduce bacterial membrane fluidity, inhibiting cell division.
- Significant variation in efficacy among different drug analogues suggests potential for optimization.
Conclusions:
- Calcium channel blockers represent a promising class of compounds for developing new treatments against L-form bacterial infections.
- Targeting bacterial membrane fluidity offers a viable strategy for combating antibiotic-resistant L-forms.
- Further modification of these compounds may lead to optimized drugs for L-form-dependent infectious diseases.
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