Abstract

Multidrug resistance (MDR) transporters of the major facilitator superfamily (MFS) were previously believed to drive the extrusion of multiple antimicrobial drugs through the coupling to proton translocation. Here, we present the identification of the first Na+-coupled MFS-MDR transporter, MdrP, which also can achieve H+-coupled drug efflux independently of Na+. Importantly, we propose that MdrP can extrude norfloxacin in a mode of drug/Na+ antiport, which has not yet been reported in any MFS member. On this basis, we further provide the insights into a novel Na+ and H+ coupling mechanism of MFS-MDR transporters, even for all secondary transporters. The most important finding lies in that D223 should mainly act as a key determinant in the Na+ translocation coupled to norfloxacin efflux. Furthermore, our results partially modify the knowledge of the conformational stability-related residues in the motif A of MFS transporters and imply the importance of a new positively charged residue, R361, for the stabilization of outward-facing conformation of MFS transporters. These novel findings positively contribute to the knowledge of MFS-MDR transporters, especially about Na+ and H+ coupling mechanism. This study is based mainly on measurements in intact cells or everted membranes, and a biochemical assay with a reconstituted MdrP protein should be necessary to come to conclusion to be assured.

Highlights

  • The extrusion of clinically relevant antimicrobial drugs mediated by multidrug resistance (MDR) transporters is a major mechanism causing multidrug resistance, which seriously and continuingly threatens medical treatment by bacterial infections (Higgins, 2007; Fluman and Bibi, 2009)

  • D233 could mainly act as a key determinant in the Na+ translocation coupled to norfloxacin efflux, whereas D127 and D244 may be involved in H+ or/and Na+ translocation

  • Considering that norfloxacin resistance of MdrP was significantly stimulated by the addition of NaCl (Figure 1B), MdrP may function as a Na+coupled norfloxacin efflux transporter

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Summary

Introduction

The extrusion of clinically relevant antimicrobial drugs mediated by multidrug resistance (MDR) transporters is a major mechanism causing multidrug resistance, which seriously and continuingly threatens medical treatment by bacterial infections (Higgins, 2007; Fluman and Bibi, 2009). These MDR transporters are classified into six families/superfamilies including ATP-binding cassette (ABC) superfamily (Lubelski et al, 2007), resistance–nodulation–division (RND) family (Tseng et al, 1999), small multidrug resistance (SMR) family (Bay et al, 2008), multidrug and toxic compound extrusion (MATE) family (Brown et al, 1999; Kuroda and Tsuchiya, 2009), proteobacterial antimicrobial compound efflux (PACE) family (Hassan et al, 2015), and major facilitator superfamily (MFS) (Reddy et al, 2012). Na+-coupled symporters are rarely found in the families within MFS, with the exception of the anion:cation symporter (ACS) family and glycoside–pentoside–hexuronide:cation symporter (GPH) family (Shi, 2013; Ethayathulla et al, 2014)

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