Abstract

Folates are required for the de novo biosynthesis of purines, thymine, methionine, glycine, and pantothenic acid, key metabolites that bacterial cells cannot survive without. Sulfonamides, which inhibit bacterial folate biosynthesis and are generally considered as bacteriostats, have been extensively used as broad-spectrum antimicrobials for decades. Here we show that, deleting relA in Escherichia coli and other bacterial species converted sulfamethoxazole from a bacteriostat into a bactericide. Not as previously assumed, the bactericidal effect of SMX was not caused by thymine deficiency. When E. coli ∆relA was treated with SMX, reactive oxygen species and ferrous ion accumulated inside the bacterial cells, which caused extensive DNA double-strand breaks without the involvement of incomplete base excision repair. In addition, sulfamethoxazole showed bactericidal effect against E. coli O157 ∆relA in mice, suggesting the possibility of designing new potentiators for sulfonamides targeting RelA. Thus, our study uncovered the previously unknown bactericidal effects of sulfonamides, which advances our understanding of their mechanisms of action, and will facilitate the designing of new potentiators for them.

Highlights

  • Folate species are one-carbon units involved in the biosynthesis of purines, thymidine, glycine, methionine, and pantothenic acid in both prokaryotes and eukaryotes (Cossins, 2000; Kompis et al, 2005)

  • We found that deleting relA allowed SMX to exert its bactericidal effect on multiple bacterial species, including E. coli, Salmonella enterica, and Mycobacterium tuberculosis

  • Our results show that the increased accumulation of endogenous reactive oxygen species (ROS) and ferrous ion play crucial roles in the bactericidal effect of SMX, resulting in extensive DNA double-strand breaks (DSBs)

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Summary

Introduction

Folate species are one-carbon units involved in the biosynthesis of purines, thymidine, glycine, methionine, and pantothenic acid in both prokaryotes and eukaryotes (Cossins, 2000; Kompis et al, 2005). While most microbes are unable to obtain folates from the external environment and must synthesize them de novo, mammals can only obtain folate from their diet (Henderson and Huennekens, 1986) The dichotomy of this essential biosynthetic pathway in humans and microbial pathogens makes it an attractive drug target (Bermingham and Derrick, 2002). Sulfonamides, i.e., compounds targeting the enzyme dihydropteroate synthase (DHPS) that is involved in the bacterial folate biosynthesis pathway, in common use since the Revitalize the Sulfonamides. Resistance to TMP has already emerged (Murray et al, 1982; Toulouse et al, 2020; Manna et al, 2021; Schnetterle et al, 2021), novel potentiators are urgently required to improve the efficacy of SMX and expand its clinical use

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