ABSTRACT
CRS3123 is a novel small molecule that potently inhibits methionyl-tRNA synthetase of Clostridioides difficile, inhibiting C. difficile toxin production and spore formation. CRS3123 has been evaluated in a multiple-ascending-dose placebo-controlled phase 1 trial. Thirty healthy subjects, ages 18 to 45 years, were randomized into three cohorts of 10 subjects each, receiving either 200, 400, or 600 mg of CRS3123 (8 subjects per cohort) or placebo (2 subjects per cohort) by oral administration twice daily for 10 days. CRS3123 was generally safe and well tolerated, with no serious adverse events (SAEs) or severe treatment-emergent adverse events (TEAEs) reported. All subjects completed their assigned treatment and follow-up visits, and there were no trends in systemic, vital sign, or laboratory TEAEs. There were no QTcF interval changes or any clinically significant changes in other electrocardiogram (ECG) intervals or morphology. CRS3123 showed limited but detectable systemic uptake; although absorption increased with increasing dose, the increase was less than dose proportional. Importantly, the bulk of the oral dose was not absorbed, and fecal concentrations were substantially above the MIC90 value of 1 µg/ml at all dosages tested. Subjects receiving either of the two lower doses of CRS3123 exhibited minimal disruption of normal gut microbiota after 10 days of twice-daily dosing. CRS3123 was inactive against important commensal anaerobes, including Bacteroides, bifidobacteria, and commensal clostridia. Microbiome data showed favorable differentiation compared to other CDI therapeutics. These results support further development of CRS3123 as an oral agent for the treatment of CDI. (This study has been registered at Clinicaltrials.gov under identifier NCT02106338.).
Subject(s)
Anti-Bacterial Agents/administration & dosage , Benzopyrans/administration & dosage , Clostridioides difficile/drug effects , Gastrointestinal Microbiome/drug effects , Thiophenes/administration & dosage , Administration, Oral , Adolescent , Adult , Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/pharmacokinetics , Benzopyrans/adverse effects , Benzopyrans/pharmacokinetics , Clostridioides difficile/enzymology , Clostridioides difficile/genetics , Clostridium Infections/drug therapy , Cohort Studies , Dose-Response Relationship, Drug , Double-Blind Method , Drug Administration Schedule , Electrocardiography , Enzyme Inhibitors/administration & dosage , Enzyme Inhibitors/adverse effects , Enzyme Inhibitors/pharmacokinetics , Female , Healthy Volunteers , Humans , Male , Methionine-tRNA Ligase/antagonists & inhibitors , Methionine-tRNA Ligase/genetics , Microbial Sensitivity Tests , Middle Aged , Thiophenes/adverse effects , Thiophenes/pharmacokinetics , Young AdultABSTRACT
PolC is the polymerase responsible for genome duplication in many Gram-positive bacteria and represents an attractive target for antibacterial development. We have determined the 2.4-A resolution crystal structure of Geobacillus kaustophilus PolC in a ternary complex with DNA and dGTP. The structure reveals nascent base pair interactions that lead to highly accurate nucleotide incorporation. A unique beta-strand motif in the PolC thumb domain contacts the minor groove, allowing replication errors to be sensed up to 8 nt upstream of the active site. PolC exhibits the potential for large-scale conformational flexibility, which could encompass the catalytic residues. The structure suggests a mechanism by which the active site can communicate with the rest of the replisome to trigger proofreading after nucleotide misincorporation, leading to an integrated model for controlling the dynamic switch between replicative and repair polymerases. This ternary complex of a cellular replicative polymerase affords insights into polymerase fidelity, evolution, and structural diversity.
Subject(s)
Bacillaceae/enzymology , Bacterial Proteins/chemistry , DNA-Directed DNA Polymerase/chemistry , Amino Acid Motifs/physiology , Bacterial Proteins/metabolism , Catalytic Domain/physiology , Crystallography, X-Ray , DNA-Directed DNA Polymerase/metabolism , Genome, Bacterial/physiology , Protein Structure, Quaternary/physiology , Protein Structure, Tertiary/physiology , Structure-Activity RelationshipABSTRACT
In 1974, M. Newman conjectured that for any root of unity ζ, the matrix group generated by ( 1 ζ 0 1 ) and ( 1 0 ζ 1 ) is non-free. This conjecture is proved here.
