Mode-of-action profiling reveals glutamine synthetase as a collateral metabolic vulnerability of M. tuberculosis to bedaquiline.

TitleMode-of-action profiling reveals glutamine synthetase as a collateral metabolic vulnerability of M. tuberculosis to bedaquiline.
Publication TypeJournal Article
Year of Publication2019
AuthorsWang Z, Soni V, Marriner G, Kaneko T, Boshoff HIM, Barry CE, Rhee KY
JournalProc Natl Acad Sci U S A
Volume116
Issue39
Pagination19646-19651
Date Published2019 09 24
ISSN1091-6490
KeywordsAntitubercular Agents, Bacterial Proteins, Diarylquinolines, Glutamate-Ammonia Ligase, Microbial Sensitivity Tests, Mycobacterium tuberculosis, Tuberculosis
Abstract

Combination chemotherapy can increase treatment efficacy and suppress drug resistance. Knowledge of how to engineer rational, mechanism-based drug combinations, however, remains lacking. Although studies of drug activity have historically focused on the primary drug-target interaction, growing evidence has emphasized the importance of the subsequent consequences of this interaction. Bedaquiline (BDQ) is the first new drug for tuberculosis (TB) approved in more than 40 y, and a species-selective inhibitor of the Mycobacterium tuberculosis (Mtb) ATP synthase. Curiously, BDQ-mediated killing of Mtb lags significantly behind its inhibition of ATP synthase, indicating a mode of action more complex than the isolated reduction of ATP pools. Here, we report that BDQ-mediated inhibition of Mtb's ATP synthase triggers a complex metabolic response indicative of a specific hierarchy of ATP-dependent reactions. We identify glutamine synthetase (GS) as an enzyme whose activity is most responsive to changes in ATP levels. Chemical supplementation with exogenous glutamine failed to affect BDQ's antimycobacterial activity. However, further inhibition of Mtb's GS synergized with and accelerated the onset of BDQ-mediated killing, identifying Mtb's glutamine synthetase as a collateral, rather than directly antimycobacterial, metabolic vulnerability of BDQ. These findings reveal a previously unappreciated physiologic specificity of ATP and a facet of mode-of-action biology we term collateral vulnerability, knowledge of which has the potential to inform the development of rational, mechanism-based drug combinations.

DOI10.1073/pnas.1907946116
Alternate JournalProc Natl Acad Sci U S A
PubMed ID31501323
PubMed Central IDPMC6765305
Grant ListU19 AI111143 / AI / NIAID NIH HHS / United States