Exploring the inhibitory potential of the antiarrhythmic drug amiodarone against Clostridioides difficile toxins TcdA and TcdB

The intestinal pathogen Clostridioides difficile is the leading cause of antibiotic-associated diarrhea and pseudomembranous colitis in humans. The symptoms of C. difficile-associated diseases (CDADs) are directly associated with the pathogen's toxins TcdA and TcdB, which enter host cells and inactivate Rho and/or Ras GTPases by glucosylation. Membrane cholesterol is crucial during the intoxication process of TcdA and TcdB, and likely involved during pore formation of both toxins in endosomal membranes, a key step after cellular uptake for the translocation of the glucosyltransferase domain of both toxins from endosomes into the host cell cytosol. The licensed drug amiodarone, a multichannel blocker commonly used in the treatment of cardiac dysrhythmias, is also capable of inhibiting endosomal acidification and, as shown recently, cholesterol biosynthesis. Thus, we were keen to investigate in vitro with cultured cells and human intestinal organoids, whether amiodarone preincubation protects from TcdA and/or TcdB intoxication. Amiodarone conferred protection against both toxins independently and in combination as well as against toxin variants from the clinically relevant, epidemic C. difficile strain NAP1/027. Further mechanistic studies suggested that amiodarone's mode-of-inhibition involves also interference with the translocation pore of both toxins. Our study opens the possibility of repurposing the licensed drug amiodarone as a novel pan-variant antitoxin therapeutic in the context of CDADs.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:15

Enthalten in:

Gut microbes - 15(2023), 2 vom: 26. Dez., Seite 2256695

Sprache:

Englisch

Beteiligte Personen:

Schumacher, Judith [VerfasserIn]
Nienhaus, Astrid [VerfasserIn]
Heber, Sebastian [VerfasserIn]
Matylitsky, Jauheni [VerfasserIn]
Chaves-Olarte, Esteban [VerfasserIn]
Rodríguez, César [VerfasserIn]
Barth, Holger [VerfasserIn]
Papatheodorou, Panagiotis [VerfasserIn]

Links:

Volltext

Themen:

Amiodarone
Anti-Arrhythmia Agents
Antibodies, Bacterial
Bacterial Toxins
Clostridioides difficile infection
Drug repositioning
Drug repurposing
Journal Article
Membrane cholesterol
N3RQ532IUT
Research Support, Non-U.S. Gov't
Toxin inhibitor

Anmerkungen:

Date Completed 27.09.2023

Date Revised 05.10.2023

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1080/19490976.2023.2256695

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM362462593