NIAID RESEARCHERS SHOW HOW PROMISING TB DRUG WORKS

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U.S. Department of Health and Human Services 
NATIONAL INSTITUTES OF HEALTH 
NIH News 
National Institute of Allergy and Infectious Diseases (NIAID) 
http://www3.niaid.nih.gov/

EMBARGOED FOR RELEASE: Monday, December 26, 2005; 5:00 p.m. ET  

CONTACT: Anne A. Oplinger, 301-402-1663, aoplinger@xxxxxxxxxxxxx
 
NIAID RESEARCHERS SHOW HOW PROMISING TB DRUG WORKS 

Scientists from the National Institute of Allergy and Infectious
Diseases (NIAID), part of the National Institutes of Health, have
determined how a promising drug candidate attacks the bacterium that
causes tuberculosis (TB). Published online this week in "Proceedings of
the National Academy of Sciences", the finding may help scientists
optimize the drug candidate, PA-824, which targets "Mycobacterium
tuberculosis" ("M. tb"). 

"PA-824, now in early stage clinical trials, holds promise for
shortening the TB treatment regimen, which is currently cumbersome and
lengthy," says NIAID Director Anthony S. Fauci, M.D. "This new finding
will allow a streamlined approach for making improved versions of the
drug." 

"Previously, we were flying blind in trying to optimize PA-824 in a
rational way because we didn't know which "M. tb" protein was the target
of PA-824's action," says NIAID scientist Clifton Barry, III, Ph.D., who
headed the research team. 

In preclinical testing, PA-824 showed evidence of being effective
against both actively dividing and slow-growing "M. tb", giving rise to
optimism that the compound may be useful in treating both active and
latent TB. (For information about the first clinical trial of PA-824,
see June 14, 2005, NIAID press release:
http://www3.niaid.nih.gov/news/newsreleases/2005/tb_pa_824.htm.) 

PA-824 must be chemically activated in the bacterium before it exerts
its anti-tubercular effect, notes Dr. Barry. Earlier research had
sketched out the first few steps in this process, but Dr. Barry and his
colleagues wanted to pinpoint the precise protein that binds PA-824 and
transforms it into a lethal molecule for TB. 

The scientists approached the problem indirectly by searching for "M.
tb" mutants that resisted the killing power of PA-824. The team
confirmed previous research suggesting that resistance usually occurs
when "M. tb" lacks components called FGD1 and F420, neither of which
interacts directly with the drug. 

Next, the investigators screened for PA-824-resistant "M. tb" that
retained sensitivity to a close relative of PA-824. Within this subgroup
of PA-824-resistant bacteria, the team identified those mutant strains
with FGD1 and F420. The investigators reasoned that resistance to PA-824
in mutants possessing FGD1 and F420 must be due to a mutation in the "M.
tb" protein that directly interacts with PA-824. 

But determining exactly which of "M. tb"'s thousands of proteins was
changed in these mutants proved difficult, says Dr. Barry. Conventional
genetic techniques for comparing normal and mutant strains of "M. tb"
failed, so the team turned to a specially modified microarray-based
technique, called comparative genome sequencing, developed by NimbleGen
Systems, Inc. (Madison, WI). This was the first time the technique has
been used to identify a protein involved in TB drug resistance, notes
Dr. Barry. 

Using the NimbleGen technique, which effectively re-sequences the entire
genome of the bacterium, the scientists quickly pinpointed the protein
altered in the PA-824-resistant mutant strains of "M. tb". In the past,
such a complete genome comparison might have taken many months of work;
this new technology enables scientists to zero in on the specific
genetic difference between mutant and normal bacterial strains in just
days, says Dr. Barry. 

The scientists found a total of four PA-824-resistant mutant strains:
two lacked the newly described "M. tb" protein altogether, while the
remaining two mutants evidently acquired resistance to PA-824 through a
mutation that made the protein unable to bind to the drug, Dr. Barry
says. 

With the discovery of the specific protein that interacts with PA-824,
Dr. Barry and colleagues, including researchers at the Novartis
Institute for Tropical Diseases in Singapore, have information they can
use to produce improved PA-824 relatives and accelerate the pace of new
TB drug development. 

NIAID is a component of the National Institutes of Health, an agency of
the U.S. Department of Health and Human Services. NIAID supports basic
and applied research to prevent, diagnose and treat infectious diseases
such as HIV/AIDS and other sexually transmitted infections, influenza,
tuberculosis, malaria and illness from potential agents of bioterrorism.
NIAID also supports research on transplantation and immune-related
illnesses, including autoimmune disorders, asthma and allergies. 

The National Institutes of Health (NIH) -- "The Nation's Medical
Research Agency" -- includes 27 Institutes and Centers and is a
component of the U. S. Department of Health and Human Services. It is
the primary Federal agency for conducting and supporting basic,
clinical, and translational medical research, and it investigates the
causes, treatments, and cures for both common and rare diseases. For
more information about NIH and its programs, visit http://www.nih.gov.
  
##

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Reference: UH Manjunatha et al. Identification of a
nitroimidazo-oxazine-specific protein involved in PA-824 resistance in
"Mycobacterium tuberculosis". "Proceedings of the National Academy of
Sciences" (2005) DOI: 10.1073/pnas.0508392102.
----------------------------------------------
 
This NIH News Release is available online at:
http://www.nih.gov/news/pr/dec2005/niaid-26.htm.

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