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Targeting cholesterol metabolism to fight tuberculosis: are we on the right track?

“The greatest and most dangerous disease and the one that proved fatal to the greatest number, is consumption” (Hyppocrates)

Tuberculosis (TB) is one of the deadliest infectious diseases worldwide that is spread in the air like the common cold. TB is caused by the bacterium Mycobacterium tuberculosis (Mtb) and it killed at least 1.5 million deaths in 2021. Mtb will usually attack the lungs but can attack any part of the body. Drug-resistant TB strains are spreading and present a major concern. New work and a paper by a team of scientists from Manchester, Cambridge and Huddersfield Universities using a structure-guided approach, combined with biophysical characterization obtained a series of compounds with activity against clinically relevant drug-resistant isolates. These will support further development of much-needed additional treatment options against Mtb. During infection the TB bacteria can utilize lipids (cholesterol and fatty acids) from the human host to act as nutrients to maintain and fuel the infectious state.

With the emergence of extensive drug resistance, novel therapeutic agents are urgently needed, and continued drug discovery efforts required.  Host-derived lipids such as cholesterol support Mtb growth, and are also suspected to function in immunomodulation, with links to persistence and immune evasion. Mtb cytochrome P450 (CYP) enzymes facilitate key steps in cholesterol catabolism and thus present potential targets for inhibition. The authors present a series of compounds based on an ethyl 5-(pyridin-4-yl)-1H-indole-2-carboxylate pharmacophore which bind strongly to both Mtb cholesterol oxidases CYP125 and CYP142. CYP142 binds tightly to cholesterol and its oxidized derivative cholest-4-en-3-one, catalyzing either their 27-hydroxylation, or generates 5-cholestenoic acid/cholest-4-en-3-one-27-oic acid from these substrates by successive sterol oxidations.

The M. tuberculosis genome has genes that code for twenty cytochrome P450 enzymes. The CYP450 proteins produced heterologously by nine of these genes have received particular attention. Dr Kirsty McLean Senior Lecturer in Cell Biology at the University of Huddersfield explained that these enzyme structures are used to design inhibitor molecules that can bind to the enzymes and prevent them doing their job – essential for TB infection. The inhibitors molecules initially came from screening a library of small chemical compounds and were then gradually built up and synthesized chemically designing them to sit specifically into the enzyme structure. This process iteratively combines protein structure knowledge and chemical synthesis to design a succession of better inhibitors. The leading compounds were tested against clinically active and drug-resistant strains of Mycobacterium tuberculosis and revealed anti-TB activity.

Using a structure-guided approach, combined with biophysical characterization, compounds with micromolar range in-cell activity against clinically relevant drug-resistant isolates were obtained. These will support further development of much-needed additional treatment options and provide routes to probe the role of CYP125 and CYP142 in Mtb pathogenesis. This study should incite further development of an alternative range of anti-TB inhibitors”. Dave Hall, Science Group Leader for Diamond’s Macromolecular Crystallography Group concluded: “Much of the team’s X-ray diffraction data was collected and managed using tools for remote access to our beamlines and new shift modes. Our staff worked closely with the group across various of our beamlines including I03, I04, I04-1 and I24. We are delighted to have helped move this important research on to the next stage.”

  • Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in Clinical Biochemistry.

Scientific references

Katariya MM et al. Chemistry. 2023 Mar 13; e202203868.

Ortiz de Montellano PR. J Inorg Biochem. 2018; 180:235.

Brengel C et al. ChemMedChem. 2016; 11(21):2385-2391.

McLean KJ et al. Future Med Chem. 2010; 2(8):1339-53.

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Dott. Gianfrancesco Cormaci
Dott. Gianfrancesco Cormaci
Laurea in Medicina e Chirurgia nel 1998; specialista in Biochimica Clinica dal 2002; dottorato in Neurobiologia nel 2006; Ex-ricercatore, ha trascorso 5 anni negli USA (2004-2008) alle dipendenze dell' NIH/NIDA e poi della Johns Hopkins University. Guardia medica presso la casa di Cura Sant'Agata a Catania. Medico penitenziario presso CC.SR. Cavadonna (SR) Si occupa di Medicina Preventiva personalizzata e intolleranze alimentari. Detentore di un brevetto per la fabbricazione di sfarinati gluten-free a partire da regolare farina di grano. Responsabile della sezione R&D della CoFood s.r.l. per la ricerca e sviluppo di nuovi prodotti alimentari, inclusi quelli a fini medici speciali.

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