The Biosynthesis of Cis-Carbapenems and the Development of Penem Antibiotics for the Treatment of Tuberculosis

Total Page:16

File Type:pdf, Size:1020Kb

The Biosynthesis of Cis-Carbapenems and the Development of Penem Antibiotics for the Treatment of Tuberculosis THE BIOSYNTHESIS OF CIS-CARBAPENEMS AND THE DEVELOPMENT OF PENEM ANTIBIOTICS FOR THE TREATMENT OF TUBERCULOSIS by Evan P. Lloyd A dissertation submitted to Johns Hopkins University in conformity with the requirements for the degree of Doctor of Philosophy Baltimore, Maryland February, 2017 © 2017 Evan P. Lloyd All Rights Reserved Abstract Inspired by their naturally occurring members, the carbapenem class of β-lactam antibiotics have been heavily researched over the past forty years, resulting in the development of a set of broad-spectrum, β-lactamase resistant, last resort antibiotics for the treatment of severe bacterial infections. Manufactured by total synthesis, carbapenems are limited to their use in the first world due to their high cost. As antibacterial resistance increases, the need for these drugs is rising. To combat the high price of manufacture, fermentation or semi-synthetic methods that take advantage of the enzymatic machinery of their biosynthesis to assemble the carbapenem core would reduce the number of synthetic steps and ultimately the cost of production. The key biosynthetic steps to assemble the carbapenem core, however, remain unknown. In this dissertation, we studied the MM 4550 biosynthetic gene cluster to examine how carbapenems are made by comparative genomics and we uncovered clues about how cis-carbapenems might diverge from thienamycin. Total syntheses of cis-carbapenems were completed for activity assays with newly discovered enzymes in the MM 4550 gene cluster; CmmSu, Cmm17 and CmmPah. Additionally, 2-thioalkyl carbapenam substrates were synthesized for assays with ThnK in vitro, which was found to perform sequential double methylation of carbapenam substrates for the installation of the 6-ethyl sidechain of thienamycin. The function of ThnK has provided a path forward to uncovering the remaining biosynthetic steps carries out by the function of ThnL and ThnP. In collaboration with Prof. Gyanu Lamichhane at the Johns Hopkins Medical Institute, a new class of cell wall crosslinking transpeptidases in Mycobacteria, L,D- ii transpeptidases (Ldts), was screened for their inhibition by commercially available β- lactam antibiotics using intact protein analysis electrospray ionization high-resolution mass spectrometry. We found that carbapenems form covalent adducts with Ldts and through efficient inhibition are potent drugs against Mycobacterium tuberculosis. Faropenem was found to be the most potent inhibitor of Ldts, however, unlike carbapenems, was unsuccessful against Tuberculosis infection in vivo. As a result, we synthesized new penems that take advantage of the best carbapenem structural features with the goal to retain both the high potency of penems but the in vivo success of carbapenems. Our lead compound has been found to have highly potent antibacterial activity, as evidenced by MIC90 data against M. tuberculosis and other pathogenic bacteria. The results of in vivo tests in an animal model of the disease will be forthcoming. Thesis advisor: Professor Craig A. Townsend, Department of Chemistry Dissertation Committee: Professor John P. Toscano, Department of Chemistry Professor John D. Tovar, Department of Chemistry iii Acknowledgements I have many people to thank for helping me along my journey through graduate school. I must first thank Dr. Craig Townsend. Dr. Townsend has taught me how to study problems with a critical eye. Through his encouragement, I’ve learned how to conduct scientific research at a high level using all the resources at my disposal. I especially thank him for his patience and unwavering support for me in my career. He has always been understanding of my needs scientifically and personally, and I can’t thank him enough for his hard work every day. I’d also like to thank our collaborators, Dr. Gyanu Lamichhane and Dr. Squire Booker. Gyanu has provided me with many opportunities to contribute to his great project, and through collaboration with his lab we have learned a lot about the power of synthetic chemistry for drug discovery. Dr. Booker was so welcoming to us each time visiting his lab and provided us with his expertise and facilities without which we would have never learned anything about ThnK, There is nobody I know other than Dr. Rongfeng Li who has as much knowledge and expertise in biological research. He has helped me throughout my graduate career with a unique perspective. Rongfeng is always excited to talk about research with me and has been a big influence in my education as a chemical biologist. My work with Dr. Daniel Marous on ThnK was my favorite project during my Ph.D. Due to his friendship, I had fun on our trips to Penn State even though those weeks were some of the longest hours I spend in lab. Dr. Kristos Moshos was a very patient mentor when I first joined the lab. Through his guidance I quickly refined my synthetic skills during my summer rotation in 2010, and without his help I wouldn’t have accomplished much in my first few years. iv Dr. Andrew Buller, Dr. Courtney Hastings and Dr. Jesse Li helped mentor me as a scientist and a young professional early in my Ph.D. Darcie Long, Doug Cohen, Ryan Oliver and Jacob Kravitz have become my best friends in the lab, and besides talking at length about science, I appreciate the time I spent with them outside of lab. I also thank the next generation of graduate students, particularly Hunter Batchelder, Erica Sinner and Trevor Zandi who will continue the projects I worked on for so many years. I wish Hunter luck with the cis-carbapenem biosynthesis project, Trevor with the Tuberculosis collaboration, and Erica with the radical SAMs. Their future work will solve the remaining mysteries of carbapenem biosynthesis and generate important new drugs. Without the Johns Hopkins chemistry department staff I wouldn’t be able to conduct the experiments needed to make any of the progress discussed in this dissertation. I thank Dr. Phil Mortimer for keeping the mass spectrometers up and running, and Dr. Cathy Moore, Dr. Joel Tang, Dr. Chuck Long, and Dr. Ananya Majumdar for their help with NMR spectroscopy. As administrative staff, Rosalie Elder, Lauren McGhee, Jean Goodwin and John Kidwell were always generous with providing help when I needed it. Our facilities manager Boris Steinberg works as hard as anyone in the department and his enthusiasm and broad skill set has solved a lot of technical issues needed to keep our work moving forward, from tracking down missing packages to assisting me with using the drill press in the machine shop. Most of all, I have to thank my family. Without my wife Christina, none of the work described here would be possible. She has encouraged me through the frustrating times and celebrated with me every success. I can’t wait to begin the next chapter of my v life with Christina and our son, Darren. My parents and sister, Emma, have always been confident in my abilities even when I wasn’t, and I am grateful that I know I can lean on them whenever necessary. My best friends Spencer and Drew provided much needed relief and relaxation, and their perspective on the world outside of lab keeps me grounded. Nobody can accomplish anything worth achieving without support from their friends, family and coworkers. The best lesson I learned was to never be afraid to ask for help; whether it’s from a fellow student in lab or a professor at a different university. I’ve come to appreciate collaboration with others, and working with people to solve complex problems using our combined experiences and skill sets is my favorite aspect of scientific research. I am fortunate to have worked with all of those listed in the above paragraphs; a few words cannot describe how grateful I am for each person who has influenced my education. vi For Christina “People who work together will win, whether it be against complex football defenses, or the problems of modern society” -Vince Lombardi- vii Publications Drawing Upon This Thesis 1. R. Li, E.P. Lloyd, K.A. Moshos, C.A. Townsend. “Identification and characterization of the carbapenem MM 4550 and its gene cluster in Streptomyces argenteolus ATCC 11009.” ChemBioChem, 2014, 15 (2), 320-31. 2. M.J. Bodner, R.M. Phelan, M.F. Freeman, K.A. Moshos, E.P. Lloyd, C.A. Townsend. “Definition of the common and divergent steps in carbapenem β-lactam antibiotic biosynthesis.” ChemBioChem, 2011, 12 (14), 2159-65. 3. D.R. Marous, E.P. Lloyd, A.R. Buller, T.L. Grove, A.J. Blaszczyk, S.J. Booker, C.A. Townsend. “Consecutive radical S-adenosylmethionine methylations form the ethyl side chain in thienamycin biosynthesis.” Proc. Natl. Acad. Sci. U.S.A., 2015, 112 (33), 10354-8. 4. L.A. Basta, A Ghosh, Y. Pan, J Jean, E.P. Lloyd, C.A. Townsend, G. Lamichhane, M.A. Bianchet. “Loss of a functionally and structurally distinct L,D-transpeptidase LdtMt5, compromises cell wall integrity in Mycobacterium tuberculosis.” J. Biol. Chem., 2015, 290 (42), 25670-85. 5. P. Kumar, A. Kaushik, E.P. Lloyd, S-G. Li, R. Mattoo, N. Ammerman, D. Bell, A. Perryman, T. Zandi, S. Ekins, S. Ginell, C.A. Townsend, J. Freundlich, G. Lamichhane. “Non-classical transpeptidases yield insight into new antibacterials.” Nat. Chem. Biol., 2017, 13, 54-61. 6. R. Mattoo, E.P. Lloyd, A. Kaushik, P. Kumar, J.L. Brunelle, C.A. Townsend, G. Lamichhane. “A molecular vulnerability in Mycobacterium avium: L,D- transpeptidase orthologue in Mycobacterium avium is constitutively expressed and inhibited by carbapenems.” Future Microbiol., 2017 in press. Submitted or In Preparation: 7. Y.H. Pan, L.A. Basta, H.G. Saaverdra, E.P. Lloyd, P. Kumar, R. Mattoo, C.A. Townsend, M.A. Bianchet, G. Lamichhane. “Structural insight into the mechanism of inhibition of Mycobacterium tuberculosis L,D-transpeptidase 2 by Biapenem and Tebipenem.” Manuscript submitted for review.
Recommended publications
  • In Vitro and in Vivo Study of Fosfomycin in Methicillin-Resistant Staphylococcus Aureus Septicaemia
    J. Ilyg., Camb. (1980), 96, 419-423 419 Printed in Great Britain In vitro and in vivo study of fosfomycin in methicillin-resistant Staphylococcus aureus septicaemia BY W. Y. LAU, C. H. TEOH-CHAN,* S. T. FAN AND K. F. LAU* Government Surgical Unit, Queen Mary Hospital, and * Department of Microbiology, University of Hong Kong {Received 15 October 19S5; accepted 12 December 19S5) SUMMARY Five hundred strains of methicillin-resistant Staphylococcus aureus were tested against various anti-staphylococcal agents. Vancomycin, fusidic acid and fosfo- mycin were found to be the most effective. Only 1 strain out of 500 was resistant to fosfomycin. Three patients with methicillin-resistant Staphylococcus aureus septicaemia were successfully treated by fosfomycin. We conclude that fosfomycin could be the drug of choice for methicillin-resistant Staphylococcns aureus infection. INTRODUCTION Outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) infection are causing increasing problems in centres all over the world (Thompson & Wenzel, 1982; Editorial, 1983). There has been a gradual increase in the incidence of MRSA in our hospital in Hong Kong from 317 in 1982 (18-7% of all S. aureus isolated) to 511 in 1983 (32-7%) and 833 in 1984 (34-9%). In vitro, resistance of MRSA is often demonstrated to many anti-staphylococcal agents including the penicillins, first-generation cephalosporins, aminoglycosides, erythromycin, clindamycin and chloramphenicol (Peacock et al. 1981). Second- and third-generation cephalosporins also have poor activity in vitro (Thompson, Fisher & Wenzel, 1982) though many MRSA strains have been found to be susceptible to rifampicin, trimethoprim- sulphamethoxazole and fusidic acid (Watanakunakorn, 1983). However, clinical experience of treating serious staphylococeal infection with rifampicin and trimethoprim-siilphamethoxazole is limited (Guenther & Wenzel, 1984) and fully resistant organisms may emerge rapidly after exposure to fusidic acid in vitro and in vivo (Watanakunakorn, 1983).
    [Show full text]
  • Penicillin Skin Testing
    Penicillin Skin Testing Penicillin Skin Testing: Frequently Asked Questions Benzylpenicilloyl Polylysine (Pre-Pen®) and Diluted Penicillin G June 2012 VA Pharmacy Benefits Management Services, Medical Advisory Panel and VISN Pharmacist Executives Benzylpenicilloyl polylysine (Pre-Pen®) was FDA approved in 2009 for the assessment of sensitization to penicillin in those patients suspected, based upon previous experience, of having a clinical hypersensitivity to penicillin. Penicillin skin testing is the most reliable way to evaluate patients for IgE-mediated penicillin allergy. Skin testing is conducted using benzylpenicilloyl polylysine (major determinant), penicillin G diluted with normal saline to 10,000 units/ml (minor determinant), a positive and negative control. Testing with both the major and minor determinant of penicillin can identify up to 97% of patients with an immediate hypersensitivity to penicillin. The intent of this document is to help guide appropriate use of penicillin skin testing. 1. WHEN IS PENICILLIN SKIN TESTING INDICATED? Penicillin skin testing can be considered in those patients with a prior history of hypersensitivity to penicillin or allergy to penicillin in situations where the provider considers penicillin the drug of choice or prefers treatment with penicillin. If skin testing is indicated, the patient should be referred to a VA Allergy Specialist or other appropriately trained physician who is experienced in the application and interpretation of PCN skin testing, as locally designated. Although approximately 10% of patients will remain allergic to penicillin their entire lives, a large majority will stop expressing penicillin-specific IgE-mediated antibodies and can be safely treated with penicillin. Skin testing with benzylpenicilloyl polylysine is contraindicated in patients who are known to be extremely hypersensitive to penicillin and in those patients who have experienced a systemic or marked local reaction to prior administration of benzylpenicilloyl polylysine.
    [Show full text]
  • Thienamycin (Imipenem)
    1520 THE JOURNAL OF ANTIBIOTICS OCT. 1989 CONVERSION OF OA-6129 B2 INTO OA-6129 B2, a fermentation carbapenem product, (5i?,6^)-6-[(i?)- l -FLUOROETHYL]-7- into optically active 88617, an 8-fluorinated OXO- 3 -[(7V,Ar,Ar-TRIM ETHYL- carbapenem derivative which improved antimicro- CARBAMIMIDOYL)METHYL]THIO- bial activity and dehydropeptidase-I stability. l -AZABICYCLO[3.2.0]HEPT-2-ENE- Treatment of OA-6129B2 sodium salt 1 with 2-CARBOXYLIC ACID (88617)t /7-nitrobenzyl (PNB) bromide or pivaloyloxymethyl chloride in DMFgave /?NB ester 2 or pivaloyl- Takeo Yoshioka, AzumaWatanabe, oxymethyl (POM) ester 3 of OA-6129 B2 (Fig. 1). Noritaka Chida and Yasuo Fukagawa The two hydroxyl groups in the pantoyl moiety of OA-6129B2 were protected by isopropylidena- Central Research Laboratories, tion for differentiation from the C-8 hydroxyl Sanraku Incorporated, 4-9-1 Johnan, Fujisawa 251, Japan group. The protected compound4 or 5 was allowed to (Received for publication May 25, 1989) react with 1.2 equiv of diethylaminosulfur trifluoride (DAST)11} at -68°C in methylene chloride for 10 minutes. After the reaction mixture was diluted with Since the epoch-making discovery of thienamy- methylene chloride and washed with a saturated cin2), a numberof extensive studies have been carried aqueous sodium bicarbonate solution, silica gel out on the development of clinically useful car- column chromatography of the organic layer pro- bapenem compounds. As a result, formimidoyl- vided the desired fluorinated compound 6 or 7 thienamycin (imipenem) has recently been put on having a fluorine atom in the R configuration at C-8 the market as a combination drug (Primaxin)3) in 43 or 49% yield, respectively.
    [Show full text]
  • Empiric Treatment with Antibiotic Combination Therapy Compared with Monotherapy for Adult Patients with Septic Shock of Unknown
    REPORT 2020 SYSTEMATIC REVIEW: Empiric treatment with antibiotic combination therapy compared with monotherapy for adult patients with septic shock of unknown pathogen and origin Utgitt av Norwegian Institute of Public Health Division for Health Services Title Empiric treatment with antibiotic combination therapy compared with monotherapy for adult patients with septic shock of unknown pathogen and origin: a systematic review Norwegian title Hva er effekten av empirisk kombinasjonsbehandling med antibiotika sammen- lignet med monoterapi for voksne pasienter med septisk sjokk forårsaket av ukjent patogen og ukjent opprinnelse: en systematisk oversikt Responsible Camilla Stoltenberg, Director General Authors Jan PW Himmels, project leader, seniorrådgiver, Norwegian Institute of Public Health Gunn Elisabeth Vist, seniorforsker, Norwegian Institute of Public Health Liv Giske, seniorforsker, Norwegian Institute of Public Health Eva Helene Arentz-Hansen, seniorforsker, Norwegian Institute of Public Health Gyri Hval, bibliotekar, Norwegian Institute of Public Health ISBN 978-82-8406-084-2 Project number RL035 Type of report Systematic Review No. of pages 26 (32 inklusiv vedlegg) Client Helsedirektoratet Subject Septic shock, antibiotic dual treatment, antibiotic monotherapy, antimicrobi- heading(MeSH) otic ressistance (AMR) Citation Himmels JPW, Vist GE, Giske L, Arentz-Hansen EH, Hval G. Empiric treatment with antibiotic combination therapy compared with monotherapy for adult patients with septic shock of unknown pathogen and origin: a systematic
    [Show full text]
  • Profile Profile Profile Uses and Administration
    Gramicidin/lmipenem 309 Graneodin N; Graneodin; Gripaben Caramelos; Kenacomb; t Incompatibility and stability. Intipenem is unstable at Nasomicina; Neo Coltirot; Pantometilt; Proetztotal; Tosedrin �-�P.�.�� ����---········································································· alkaline or acidic pH and the commercially available injec­ (details are given in Volume B) NF; Austral.: Kenacomb; Neosporint; Otocomb Otic; Otodex; ProprielaryPreparations tion of intipenem with cilastatin sodium for intravenous Sofradex; Soframycint; Austria: Volon A antibiotikahaltigt; V alpeda. use is buffered to provide, when reconstituted, a solution Belg. : Mycolog; Polyspectran Granticidinet; Braz.: Fonergin; Single-ingredient Preparations. UK: with pH 6.5 to 7.5. Licensed product information advises Londerm-Nt; Mud; Neolon D; Omcilon-A M; Oncibel; Oncileg; against mixing with other antibacterials. Onciplust; Canad.: Ak Spor; Antibiotic Cream; Antibiotic Plus; Complete Antibiotic Ointment; Diosporint; Neosporin; Opti­ lbafloxacin (BAN, USAN, r/NN) References. cort; Optimyxin Plus; Optimyxin; Polysporin Complete; Poly­ 1. Bigley FP, et al. Compatibility of imipenem-dlastatin sodium with Am Hosp Phann 1986; 43: 2803- sporin For Kids; Polysporin Plus Pain Relief; Polysporin Triple commonly used intravenous solutions. 9. J Antibiotic; Polysporin; Polytopic; ratio-Tria comb; Sofracort; 2. Smith GB, et al. Stability and kinetics of degradation of imipenem in Soframycin; Soframycin; Triple Antibiotic Ointment; Viaderm­ Pharm 1990; 79: 732-40. aqueous
    [Show full text]
  • Radical Sam Enzymes in Thienamycin Biosynthesis
    RADICAL SAM ENZYMES IN THIENAMYCIN BIOSYNTHESIS by Daniel Roe Marous A dissertation submitted to The Johns Hopkins University in conformity with the requirements for the degree of Doctor of Philosophy Baltimore, Maryland December, 2015 ©Daniel Roe Marous 2015 All rights reserved Abstract Despite its broad anti-infective activity, the biosynthesis of the paradigm carbapenem antibiotic, thienamycin, remains largely unknown. Apart from the first two biosynthetic steps shared with a simple carbapenem, the pathway sharply diverges to the more structurally complex members of this class of β-lactam antibiotics like thienamycin. Existing evidence points to three putative cobalamin-dependent, radical S- adenosylmethionine (RS) enzymes, ThnK, ThnL and ThnP, potentially being responsible for assembly of the ethyl side chain at C6, bridgehead epimerization at C5, installation of the C2-thioether side chain and C2/3-desaturation. The C2 substituent has been demonstrated to be derived from stepwise truncation of coenzyme A, but the timing of these events with respect to C2—S bond formation is not known. Using in vitro reactions with synthetically-accessed substrates, we show that ThnK of the three apparent cobalamin-dependent RS enzymes performs sequential methylations to build out the C6- ethyl side chain in a stereocontrolled manner. This enzymatic reaction produced the expected RS methylase coproducts S-adenosylhomocysteine (SAH) and 5’- deoxyadenosine (5’-dA) by LC-MS and was also found to require cobalamin. For double methylation to occur, the carbapenam substrate must bear a coenzyme A-derived C2- thioether side chain, implying the activity of a prior sulfur insertion by an unidentified enzyme. Heterologous expression of thienamycin biosynthetic enzymes in Streptomyces combined with a competition bioassay now implicates ThnL in attachment of the thioether.
    [Show full text]
  • Computational Antibiotics Book
    Andrew V DeLong, Jared C Harris, Brittany S Larcart, Chandler B Massey, Chelsie D Northcutt, Somuayiro N Nwokike, Oscar A Otieno, Harsh M Patel, Mehulkumar P Patel, Pratik Pravin Patel, Eugene I Rowell, Brandon M Rush, Marc-Edwin G Saint-Louis, Amy M Vardeman, Felicia N Woods, Giso Abadi, Thomas J. Manning Computational Antibiotics Valdosta State University is located in South Georgia. Computational Antibiotics Index • Computational Details and Website Access (p. 8) • Acknowledgements (p. 9) • Dedications (p. 11) • Antibiotic Historical Introduction (p. 13) Introduction to Antibiotic groups • Penicillin’s (p. 21) • Carbapenems (p. 22) • Oxazolidines (p. 23) • Rifamycin (p. 24) • Lincosamides (p. 25) • Quinolones (p. 26) • Polypeptides antibiotics (p. 27) • Glycopeptide Antibiotics (p. 28) • Sulfonamides (p. 29) • Lipoglycopeptides (p. 30) • First Generation Cephalosporins (p. 31) • Cephalosporin Third Generation (p. 32) • Fourth-Generation Cephalosporins (p. 33) • Fifth Generation Cephalosporin’s (p. 34) • Tetracycline antibiotics (p. 35) Computational Antibiotics Antibiotics Covered (in alphabetical order) Amikacin (p. 36) Cefempidone (p. 98) Ceftizoxime (p. 159) Amoxicillin (p. 38) Cefepime (p. 100) Ceftobiprole (p. 161) Ampicillin (p. 40) Cefetamet (p. 102) Ceftoxide (p. 163) Arsphenamine (p. 42) Cefetrizole (p. 104) Ceftriaxone (p. 165) Azithromycin (p.44) Cefivitril (p. 106) Cefuracetime (p. 167) Aziocillin (p. 46) Cefixime (p. 108) Cefuroxime (p. 169) Aztreonam (p.48) Cefmatilen ( p. 110) Cefuzonam (p. 171) Bacampicillin (p. 50) Cefmetazole (p. 112) Cefalexin (p. 173) Bacitracin (p. 52) Cefodizime (p. 114) Chloramphenicol (p.175) Balofloxacin (p. 54) Cefonicid (p. 116) Cilastatin (p. 177) Carbenicillin (p. 56) Cefoperazone (p. 118) Ciprofloxacin (p. 179) Cefacetrile (p. 58) Cefoselis (p. 120) Clarithromycin (p. 181) Cefaclor (p.
    [Show full text]
  • PRIMAXIN (Imipenem and Cilastatin)
    • Known hypersensitivity to any component of PRIMAXIN (4) HIGHLIGHTS OF PRESCRIBING INFORMATION These highlights do not include all the information needed to use ----------------------- WARNINGS AND PRECAUTIONS ----------------------­ PRIMAXIN safely and effectively. See full prescribing information • Hypersensitivity Reactions: Serious and occasionally fatal for PRIMAXIN. hypersensitivity (anaphylactic) reactions have been reported in patients receiving therapy with beta-lactams. If an allergic reaction PRIMAXIN® (imipenem and cilastatin) for Injection, for to PRIMAXIN occurs, discontinue the drug immediately (5.1). intravenous use • Seizure Potential: Seizures and other CNS adverse reactions, such Initial U.S. Approval: 1985 as confusional states and myoclonic activity, have been reported during treatment with PRIMAXIN. If focal tremors, myoclonus, or --------------------------- RECENT MAJOR CHANGES --------------------------­ seizures occur, patients should be evaluated neurologically, placed Indications and Usage (1.9) 12/2016 on anticonvulsant therapy if not already instituted, and the dosage of Dosage and Administration (2) 12/2016 PRIMAXIN re-examined to determine whether it should be decreased or the antibacterial drug discontinued (5.2). ----------------------------INDICATIONS AND USAGE ---------------------------­ • Increased Seizure Potential Due to Interaction with Valproic Acid: PRIMAXIN for intravenous use is a combination of imipenem, a penem Co-administration of PRIMAXIN, to patients receiving valproic acid antibacterial, and cilastatin, a renal dehydropeptidase inhibitor, or divalproex sodium results in a reduction in valproic acid indicated for the treatment of the following serious infections caused by concentrations. The valproic acid concentrations may drop below designated susceptible bacteria: the therapeutic range as a result of this interaction, therefore • Lower respiratory tract infections. (1.1) increasing the risk of breakthrough seizures. The concomitant use of • Urinary tract infections.
    [Show full text]
  • The Use of Natural Product Substrates for the Synthesis of Libraries of Biologically Active, New Chemical Entities
    University of Montana ScholarWorks at University of Montana Graduate Student Theses, Dissertations, & Graduate School Professional Papers 2010 The seU of Natural Product Substrates for the Synthesis of Libraries of Biologically Active, New Chemical Entities Joshua Bryant Phillips The University of Montana Let us know how access to this document benefits ouy . Follow this and additional works at: https://scholarworks.umt.edu/etd Recommended Citation Phillips, Joshua Bryant, "The sU e of Natural Product Substrates for the Synthesis of Libraries of Biologically Active, New Chemical Entities" (2010). Graduate Student Theses, Dissertations, & Professional Papers. 1100. https://scholarworks.umt.edu/etd/1100 This Dissertation is brought to you for free and open access by the Graduate School at ScholarWorks at University of Montana. It has been accepted for inclusion in Graduate Student Theses, Dissertations, & Professional Papers by an authorized administrator of ScholarWorks at University of Montana. For more information, please contact [email protected]. THE USE OF NATURAL PRODUCT SUBSTRATES FOR THE SYNTHESIS OF LIBRARIES OF BIOLOGICALLY ACTIVE, NEW CHEMICAL ENTITIES by Joshua Bryant Phillips B.S. Chemistry, Northern Arizona University, 2002 B.S. Microbiology (health pre-professional), Northern Arizona University, 2002 Presented in partial fulfillment of the requirements for the degree of Doctor of Philosophy Chemistry The University of Montana June 2010 Phillips, Joshua Bryant Ph.D., June 2010 Chemistry THE USE OF NATURAL PRODUCT SUBSTRATES FOR THE SYNTHESIS OF LIBRARIES OF BIOLOGICALLY ACTIVE, NEW CHEMICAL ENTITIES Advisor: Dr. Nigel D. Priestley Chairperson: Dr. Bruce Bowler ABSTRACT Since Alexander Fleming first noted the killing of a bacterial culture by a mold, antibiotics have revolutionized medicine, being able to treat, and often cure life-threatening illnesses and making surgical procedures possible by eliminating the possibility of opportunistic infection.
    [Show full text]
  • A Thesis Entitled an Oral Dosage Form of Ceftriaxone Sodium Using Enteric
    A Thesis entitled An oral dosage form of ceftriaxone sodium using enteric coated sustained release calcium alginate beads by Darshan Lalwani Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Master of Science Degree in Pharmaceutical Sciences with Industrial Pharmacy Option _________________________________________ Jerry Nesamony, Ph.D., Committee Chair _________________________________________ Sai Hanuman Sagar Boddu, Ph.D, Committee Member _________________________________________ Youssef Sari, Ph.D., Committee Member _________________________________________ Patricia R. Komuniecki, PhD, Dean College of Graduate Studies The University of Toledo May 2015 Copyright 2015, Darshan Narendra Lalwani This document is copyrighted material. Under copyright law, no parts of this document may be reproduced without the expressed permission of the author. An Abstract of An oral dosage form of ceftriaxone sodium using enteric coated sustained release calcium alginate beads by Darshan Lalwani Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Master of Science Degree in Pharmaceutical Sciences with Industrial Pharmacy option The University of Toledo May 2015 Purpose: Ceftriaxone (CTZ) is a broad spectrum semisynthetic, third generation cephalosporin antibiotic. It is an acid labile drug belonging to class III of biopharmaceutical classification system (BCS). It can be solvated quickly but suffers from the drawback of poor oral bioavailability owing to its limited permeability through
    [Show full text]
  • Mechanisms of Β- Lactamase Inhibition And
    MECHANISMS OF β- LACTAMASE INHIBITION AND HETEROTROPIC ALLOSTERIC REGULATION OF AN ENGINEERED β- LACTAMASE-MBP FUSION PROTEIN By WEI KE Submitted in partial fulfillment of the requirements For the degree of Doctor of Philosophy. Dissertation Advisor: Dr. Focco ven den Akker Department of Biochemistry CASE WESTERN RESERVE UNIVERSITY May, 2011 CASE WESTERN RESERVE UNVERISTY SCHOOL OF GRADUATE STUDIES We hereby approve the thesis/dissertation of Wei Ke . candidate for the Ph.D degree*. (signed)Paul Carey . (chair of the committee) Focco van den Akker . Menachem Shoham . Robert A. Bonomo . Marion Skalweit . ___________________________________________ (date) 23 March, 2011 *We also certify that written approval has been obtained for any proprietary material contained therein. TABLE OF CONTENTS LIST OF TABLES ………………………………………………………………………8 LIST OF FIGURES ………………………………...…………………………………9 ACKNOWLEDGEMENTS ...………………………………………………………..13 LIST OF ABBREVIATIONS …………………...……………………………………15 ABSTRACT ……………………………….………………………………………...17 CHAPTER 1 Background and Significance …………………………………………....18 1.1 Antibiotic Resistance Crisis……………….…………………………….…...18 1.2 β-lactamases overview……………………………………………………….19 1.3 β-Lactam antibiotics and β-lactamase inhibitors ……………………………23 1.4 Structures of class A β –lactamases …………………………………………25 CHAPTER 2 Crystal Structures of SHV-1 β-Lactamase in Complex with Boronic Acid Transition State Inhibitors …………………………………………………...…….32 2.1 Introduction ………………………………………………………………….32 2.2 Materials and Methods ………………………………………………….…...34 2.2.1.
    [Show full text]
  • Nethmap-Maran 2014
    NethMap 2014 MARAN 2014 Consumption of antimicrobial agents and Monitoring of Antimicrobial Resistance antimicrobial resistance among and Antibiotic Usage in Animals medically important bacteria in the Netherlands in 2013 in the Netherlands Autoriteit Diergeneesmiddelen Autoriteit Diergeneesmiddelen Autoriteit Diergeneesmiddelen Autoriteit Diergeneesmiddelen PART 1: NethMap 2014 pg 1 - 98 Part 2: MARAN 2014 pg 1 - 68 NethMap 2014 Consumption of antimicrobial agents and antimicrobial resistance among medically important bacteria in The Netherlands in 2013 June 2014 NethMap 2014 1 Colophon This report is published under the acronym NethMap by the SWAB, the Dutch Foundation of the Working Party on Antibiotic Policy, in collaboration with the Centre for Infectious disease control (CIb) of the RIVM, the National Institute for Public Health and the Environment of the Netherlands. SWAB is fully supported by a structural grant from CIb, on behalf of the Ministry of Health, Welfare and Sports of the Netherlands. The information presented in NethMap is based on data from ongoing surveillance systems on the use of antimicrobial agents in human medicine and on the prevalence of resistance to relevant antimicrobial agents among medically important bacteria isolated from healthy individuals and patients in the community and from hospitalized patients. The document was produced on behalf of the SWAB by the Studio of the RIVM. NethMap can be ordered from the SWAB secretariat, c/o Secretariaat SWAB p/a Universitair Medisch Centrum St Radboud Medische Microbiologie, Huispost 777, route 777 Postbus 9101, 6500 HB Nijmegen, Tel.: (024) 36 19041/14356 or by email to [email protected]. NethMap 2014 and earlier versions are also available from the website of the SWAB: www.swab.nl.
    [Show full text]