A team of researchers at Case Western Reserve University (CWRU),
Massachusetts Institute of Technology, and Universidad Nacional de Rosario and
the National Research Council (CONICET) from Argentina have identified a
bacterial mechanism that stabilizes certain MBLs in cell membranes and enables
their spread into the environment. This mechanism clarifies one way certain
bacteria are outsmarting the immune system and becoming extremely
antibiotic-resistant. The work was led in part by Robert Bonomo, MD, professor
of medicine, pharmacology, molecular biology, and microbiology at Case Western
Reserve University School of Medicine and chief of medical service at the Louis
Stokes Cleveland Veterans Affairs Medical Center.
"One of the most serious problems facing medicine today is the
emergence of multi-drug resistant bacteria," according to Bonomo.
"MBLs are the most concerning as they make bacteria resistant to the 'last
resort' antibiotics, carbapenems." Carbapenems are used to combat
infections for which there are no other antibiotic options.
Clinically relevant MBLs are found between layers of bacterial cell
membranes. In contrast to other types of carbapenemases, MBL enzymes rely on
zinc ions to properly function. The immune system produces proteins that hide
zinc ions and starve bacteria of zinc in an effort to combat infection. The
researchers discovered that most MBLs produced by bacteria during zinc-limited
conditions are unstable and are rapidly degraded by the bacteria.
One recently identified form of MBL, called New Delhi
metallo-β-lactamase (NDM-1) can retain its function even without zinc. Bonomo
and colleagues showed that NDM-1 resists destruction triggered by low zinc by
anchoring itself in bacterial membranes. A fatty tail at one end of the NDM-1 protein
sticks into the outer membrane of potentially harmful bacteria such as
Escherichia coli and Pseudomonas aeruginosa. This tail has a protective effect
and is thought to help NDM-1 avoid destructive enzymes between bacterial
membranes. Similar mechanisms have been observed in other bacterial species,
but have not previously been linked to an evolutionary advantage to escape the
action of antibiotics.
The research team also observed that bacteria with NDM-1 in their
membranes are able to shed "outer-membrane vesicles" containing the
enzyme. These membrane-bound sacs bud off from bacteria. As the vesicles
disperse into the bacterial microenvironment, NDM-1 enzymes in them can protect
neighboring bacteria that might be otherwise susceptible to antibiotics.
Outer-membrane vesicles may also be a vehicle by which the NDM-1 gene and
enzyme can spread between bacteria.
Bacteria producing NDM-1 are highly antibiotic resistant and represent a
major public health concern as they cause infections for which there is no
cure. The gene encoding NDM-1 is quickly spreading across bacterial species and
has been found in water samples from India, Bangladesh, and China in a region
encompassing almost 40% of the world population. According to Alejandro Vila,
PhD, director of the Instituto de Biología Molecular y Celular at Universidad
Nacional de Rosario and co-senior author on the published research, "this
dissemination has been favored by membrane anchoring of the protein. This
finding reveals a potential Achilles' heel; interfering with membrane anchoring
could thwart the worldwide dissemination of superbugs."
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Posted by Dr. Tim Sandle
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