Bacterial Programmed Cell Death Systems As Targets for Antibiotics
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Opinion TRENDS in Microbiology Vol.12 No.2 February 2004 Bacterial programmed cell death systems as targets for antibiotics Hanna Engelberg-Kulka, Boaz Sat, Myriam Reches, Shahar Amitai and Ronen Hazan Department of Molecular Biology, The Hebrew University-Hadassah Medical School, Jerusalem 91120, Israel Growing experimental evidence has revealed the exist- encodes a labile antitoxin that interferes with the lethal ence of programmed cell death (PCD) systems in bac- action of the toxin. Such genetic toxin–antitoxin (TA) teria. Among these is the mazEF system, which is a systems for bacterial PCD have been studied in several regulable suicide module located on the chromosome laboratories, including those of Yarmolinsky [6], Couturier of E. coli and of some other bacteria, including patho- [7] and Gerdes [8]. The TA systems have been found gens. Several well-known antibiotics have recently mainly in E. coli on low-copy number plasmids (and some been found to cause cell death in E. coli by indirectly other extrachromosomal elements) where they are respon- activating this built-in suicide module. These antibiotics sible for the post-segregational killing effect [8]: the death belong to two groups: (i) inhibitors of transcription of cells from which these extra-chromosomal elements and/or translation; and (ii) inhibitors of folic acid metab- have been lost. Such a genetic unit has been termed an olism resulting in thymine starvation. These data, ‘addiction module’: it causes the cells to be ‘addicted’ to the together with the recent elucidation of the crystal struc- short-lived antitoxin product because its de novo synthesis ture of mazEF-directed components, hold promise for a is essential for cell survival [6]. Therefore, these modules rational chemical design of a new class of antibiotics have been implicated as having a role in maintaining the that directly activate chromosomal suicide modules by stability of the extra-chromosomal elements in the host on interacting with their components. Because multi-drug which they are borne [6–9]. resistance among bacterial pathogens is becoming Over the past decade, pairs of genes homologous to some more widespread, the results obtained might be useful of these extrachromosomally borne addiction modules as a basis for producing alternative drugs. have been found on the chromosome of E. coli and of various other bacteria [10–17]. The first addiction module From the late 1940s, the use of antibiotics to treat carried on a bacterial chromosome that was described as infectious diseases in humans and animals has drastically regulable and responsible for PCD was the E. coli mazEF disturbed microbial ecology [1,2]. In response to the threat module [13]. The mazEF system was described as a suicide of extinction, microbes have found genetic and biochemical module on the basis of its properties [18,19]. This module routes to develop resistance to every anti-microbial agent consists of two adjacent genes, mazE and mazF, located used to date. Resistance to these agents might develop downstream from the relA gene in the rel operon [10]. The through mutations of target sites or the acquisition of mazEF suicide module [13,20] has all the basic properties novel biochemical functions [1,2]. Therefore, the develop- that are required to be an addiction module: (i) MazF is ment of bacterial resistance to antibiotics can be seen as toxic and MazE is antitoxic; (ii) MazF is long-lived, the price that we are paying for medical progress. Perhaps whereas MazE is a labile protein degraded in vivo by the the only way that we might be permitted to continue to rely ATP-dependent ClpPA serine protease; (iii) MazE and on antibiotic therapy is through persistent efforts to MazF interact; (iv) MazE and MazF are co-expressed; and discover new antibiotics, and to identify additional (v) mazEF is negatively auto-regulated at the level of biochemical pathways as novel targets for their action. transcription by the combined action of both MazE and Here we describe the process of programmed cell death MazF proteins. Moreover, the mazEF chromosomal suicide (PCD) in bacteria as a newly discovered target for the module has unique characteristics that were not pre- action of antibiotics. viously described for the extrachromosomal addiction modules. Initially, it was found that mazEF transcription 0 0 Programmed cell death in bacteria is inhibited by guanosine 3 ,5 -bispyrophosphate (ppGpp) PCD refers to any form of cell death mediated by an [13], which is synthesized by the RelA protein under intracellular death program, no matter what triggers it conditions of extreme amino acid starvation [21]. On the and whether or not it displays all the characteristics of basis of these combined properties and the requirement for apoptosis [3–5]. In bacteria, one of the most studied PCD the continuous expression of MazE to prevent cell death, a systems is mediated through a unique genetic unit that model was proposed for PCD under conditions of nutrient consists of a pair of genes that specify two components. The starvation (Figure 1) [13]. This model was supported by second gene encodes a stable toxin, and the first gene results that showed that mazEF-mediated cell death is triggered by the artificial overproduction of ppGpp [13,22]. Corresponding author: Hanna Engelberg-Kulka ([email protected]). The other unique characteristics will be described below. www.sciencedirect.com 0966-842X/$ - see front matter q 2003 Elsevier Ltd. All rights reserved. doi:10.1016/j.tim.2003.12.008 Opinion TRENDS in Microbiology Vol.12 No.2 February 2004 67 Transcription P2 mazE mazF Translation ppGpp Toxin Antitoxin Antibiotics ClpPA protease Cell death TRENDS in Microbiology Figure 1. The ‘suicide module’ mazEF and how it can be activated. ppGpp (guanosine 30,50-bispyrophosphate) and antibiotics that inhibit transcription and/or translation triggers mazEF-dependent death. In each case, mazEF-expression is inhibited. Because MazE is a labile protein, its cellular concentration is reduced below the level required to antagonize the toxic MazF. Antibiotics that inhibit transcription and/or translation MazE falls so low that there is not enough to prevent the trigger mazEF-mediated cell death stable MazF from killing the cells (Figure 1). The described model for the activation of the mazEF suicide module was subsequently broadened to include Antibiotics that cause thymine starvation trigger the conditions under which RNA and protein synthesis is mazEF system and lead to cell death inhibited [18,23]. First, the effects on the system of several Recently, an additional group of antibiotics that induce antibiotics, including rifampicin, chloramphenicol and mazEF- mediated cell death was found [26]. These spectinomycin, were tested. Rifampicin inhibits RNA antibiotics, trimethoprim and the sulfonamide drugs synthesis (and subsequently protein synthesis) by binding cause thymine starvation. The effect of thymine starvation to the b-subunit of RNA polymerase [2]. Chloramphenicol on bacterial PCD deserves special attention because of its and spectinomycin inhibit protein synthesis by binding to wide implications and also its historical significance. As the A site of the 50S ribosomal subunit [2,24,25]. In wild- early as 1954, Cohen and Barner [27] discovered that a type cells, it was found that even briefly inhibiting thymine auxotrophic mutant (thyA)ofE. coli undergoes transcription and/or translation by these antibiotics was cell death in response to thymine starvation. This sufficient to induce mazEF-mediated death. By contrast, phenomenon, called thymineless death (TLD), is also deleting mazEF from the bacterial chromosome prevented found in many other organisms ranging from prokaryotes cell death in the presence of these antibiotics [18,19].It to eukaryotes [28]. TLD is a unique effect as starvation of should be noted that mazEF-dependent bacteriocidity of bacteria to other growth factors is bacteriostatic but not chloramphenicol and spectinomycin was observed when bactericidal. Although TLD has been investigated inten- cells were growing on a minimal but not a rich medium sively for almost 50 years, its molecular mechanism [18]. Therefore, it appears that the bacteriocidity of this remains unclear [28]. However, thymidine metabolism antibiotic depends on the environmental conditions. The and the coupled folic acid metabolism are well known proposal that the inhibition of translation triggers (Figure 2). Thymine starvation in E. coli can be induced in mazEF-mediated death was further supported by the several ways that inhibit the synthesis of thymidylate, results of experiments in which the phd-doc addiction either directly or indirectly, by interfering with folate module, borne on the P1 plasmid prophage, was used. It metabolism [28]. The synthetic antibacterial agents, was found that Doc protein, the toxic product of this trimethoprim and the sulfonamides, inhibit specific steps module, is a general inhibitor of translation and a trigger in the biosynthesis of tetrahydrofolate (Figure 2). of mazEF-mediated death [23]. Therefore, inhibiting As was recently described in E. coli, thymine starvation protein synthesis either by antibiotics or the Doc protein triggers mazEF-mediated cell death [26] (Figure 3). In triggers E. coli mazEF-mediated death; when the trans- these experiments, thymine starvation was induced in an lation of mazEF mRNA is inhibited, the level of the labile E. coli thyA auxotroph by omitting thymine from the www.sciencedirect.com 68 Opinion TRENDS in Microbiology Vol.12 No.2 February 2004 include sulfonamide drugs and trimethoprim, which by p-amino benzoic acid (PABA) inhibiting folic acid metabolism induce thymine starvation Sulfonamides leading to cell death. Dihydropteroic acid (DHPA) On the basis of the results showing that TLD depends on mazEF in E. coli, a model for the induction of mazEF-mediated cell death by thymine starvation was Folic acid suggested [26]. Previous research has shown that thymine starvation provokes DNA damage that involves a unique breaking or twisting of the chromosome into a configur- Dihydrofolic acid (DHFA) Trimethoprim ation that defies all the repair and protective mechanisms of the cell [29].