An Oral Fluorouracil Prodrug, Capecitabine, Mitigates a Gram-Positive Systemic Infection in Mice

ABSTRACT New classes of antibiotics are needed to fight bacterial infections, and repurposing existing drugs as antibiotics may enable rapid deployment of new treatments. Screens for antibacterials have been traditionally performed in standard laboratory media, but bacterial pathogens experience ver...

Full description

Bibliographic Details
Main Authors: Jack R. McLeod, Pamela A. Harvey, Corrella S. Detweiler
Format: Article
Language:English
Published: American Society for Microbiology 2021-09-01
Series:Microbiology Spectrum
Subjects:
Online Access:https://journals.asm.org/doi/10.1128/Spectrum.00275-21
_version_ 1818755150557216768
author Jack R. McLeod
Pamela A. Harvey
Corrella S. Detweiler
author_facet Jack R. McLeod
Pamela A. Harvey
Corrella S. Detweiler
author_sort Jack R. McLeod
collection DOAJ
description ABSTRACT New classes of antibiotics are needed to fight bacterial infections, and repurposing existing drugs as antibiotics may enable rapid deployment of new treatments. Screens for antibacterials have been traditionally performed in standard laboratory media, but bacterial pathogens experience very different environmental conditions during infection, including nutrient limitation. To introduce the next generation of researchers to modern drug discovery methods, we developed a course-based undergraduate research experience (CURE) in which undergraduate students screened a library of FDA-approved drugs for their ability, in a nutrient-poor medium, to prevent the growth of the human Gram-negative bacterial pathogen Salmonella enterica serovar Typhimurium. The nine drugs identified all disrupt DNA metabolism in bacteria and eukaryotes. One of the hit compounds, capecitabine, is a well-tolerated oncology drug that is administered orally, a preferred treatment route. We demonstrated that capecitabine is more effective at inhibiting S. Typhimurium growth in nutrient-limited than in standard rich microbiological broth, an explanation for why the antibiotic activity of this compound has not been previously recognized. Capecitabine is enzymatically converted to the active pyrimidine analogue, fluorouracil (5-FU), and Gram-positive bacteria, including Staphylococcus aureus, are significantly more sensitive to 5-FU than Gram-negative bacteria. We therefore tested capecitabine for efficacy in a murine model of S. aureus peritonitis. Oral capecitabine administration reduced the colonization of tissues and increased animal survival in a dose-responsive manner. Since capecitabine is inexpensive, orally available, and relatively safe, it may have utility for treatment of intractable Gram-positive bacterial infections. IMPORTANCE As bacterial infections become increasingly insensitive to antibiotics, whether established, off-patent drugs could treat infections becomes an important question. At the same time, basic research has revealed that during infection, mammals starve pathogens for nutrients and, in response, bacteria dramatically alter their biology. Therefore, it may be fruitful to search for drugs that could be repurposed as antibiotics using bacteria grown with limited nutrients. This approach, executed with undergraduate student researchers, identified nine drugs known to interfere with the production and/or function of DNA. We further explored one of these drugs, capecitabine, a well-tolerated human oncology drug. Oral administration of capecitabine reduced infection with the human pathogen Staphylococcus aureus and increased survival in mice. These data suggest that capecitabine has potential as a therapy for patients with otherwise untreatable bacterial infections.
first_indexed 2024-12-18T05:34:34Z
format Article
id doaj.art-95b22421b9244d01997106a1b4d601cf
institution Directory Open Access Journal
issn 2165-0497
language English
last_indexed 2024-12-18T05:34:34Z
publishDate 2021-09-01
publisher American Society for Microbiology
record_format Article
series Microbiology Spectrum
spelling doaj.art-95b22421b9244d01997106a1b4d601cf2022-12-21T21:19:21ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972021-09-019110.1128/Spectrum.00275-21An Oral Fluorouracil Prodrug, Capecitabine, Mitigates a Gram-Positive Systemic Infection in MiceJack R. McLeod0Pamela A. Harvey1Corrella S. Detweiler2Department of Molecular Cellular and Developmental Biology, University of Colorado, Boulder, Colorado, USADepartment of Molecular Cellular and Developmental Biology, University of Colorado, Boulder, Colorado, USADepartment of Molecular Cellular and Developmental Biology, University of Colorado, Boulder, Colorado, USAABSTRACT New classes of antibiotics are needed to fight bacterial infections, and repurposing existing drugs as antibiotics may enable rapid deployment of new treatments. Screens for antibacterials have been traditionally performed in standard laboratory media, but bacterial pathogens experience very different environmental conditions during infection, including nutrient limitation. To introduce the next generation of researchers to modern drug discovery methods, we developed a course-based undergraduate research experience (CURE) in which undergraduate students screened a library of FDA-approved drugs for their ability, in a nutrient-poor medium, to prevent the growth of the human Gram-negative bacterial pathogen Salmonella enterica serovar Typhimurium. The nine drugs identified all disrupt DNA metabolism in bacteria and eukaryotes. One of the hit compounds, capecitabine, is a well-tolerated oncology drug that is administered orally, a preferred treatment route. We demonstrated that capecitabine is more effective at inhibiting S. Typhimurium growth in nutrient-limited than in standard rich microbiological broth, an explanation for why the antibiotic activity of this compound has not been previously recognized. Capecitabine is enzymatically converted to the active pyrimidine analogue, fluorouracil (5-FU), and Gram-positive bacteria, including Staphylococcus aureus, are significantly more sensitive to 5-FU than Gram-negative bacteria. We therefore tested capecitabine for efficacy in a murine model of S. aureus peritonitis. Oral capecitabine administration reduced the colonization of tissues and increased animal survival in a dose-responsive manner. Since capecitabine is inexpensive, orally available, and relatively safe, it may have utility for treatment of intractable Gram-positive bacterial infections. IMPORTANCE As bacterial infections become increasingly insensitive to antibiotics, whether established, off-patent drugs could treat infections becomes an important question. At the same time, basic research has revealed that during infection, mammals starve pathogens for nutrients and, in response, bacteria dramatically alter their biology. Therefore, it may be fruitful to search for drugs that could be repurposed as antibiotics using bacteria grown with limited nutrients. This approach, executed with undergraduate student researchers, identified nine drugs known to interfere with the production and/or function of DNA. We further explored one of these drugs, capecitabine, a well-tolerated human oncology drug. Oral administration of capecitabine reduced infection with the human pathogen Staphylococcus aureus and increased survival in mice. These data suggest that capecitabine has potential as a therapy for patients with otherwise untreatable bacterial infections.https://journals.asm.org/doi/10.1128/Spectrum.00275-21antibioticscapecitabinecourse-based undergraduate research experience (CURE)5-fluorouracil (5-FU)nucleoside analogrepurposing
spellingShingle Jack R. McLeod
Pamela A. Harvey
Corrella S. Detweiler
An Oral Fluorouracil Prodrug, Capecitabine, Mitigates a Gram-Positive Systemic Infection in Mice
Microbiology Spectrum
antibiotics
capecitabine
course-based undergraduate research experience (CURE)
5-fluorouracil (5-FU)
nucleoside analog
repurposing
title An Oral Fluorouracil Prodrug, Capecitabine, Mitigates a Gram-Positive Systemic Infection in Mice
title_full An Oral Fluorouracil Prodrug, Capecitabine, Mitigates a Gram-Positive Systemic Infection in Mice
title_fullStr An Oral Fluorouracil Prodrug, Capecitabine, Mitigates a Gram-Positive Systemic Infection in Mice
title_full_unstemmed An Oral Fluorouracil Prodrug, Capecitabine, Mitigates a Gram-Positive Systemic Infection in Mice
title_short An Oral Fluorouracil Prodrug, Capecitabine, Mitigates a Gram-Positive Systemic Infection in Mice
title_sort oral fluorouracil prodrug capecitabine mitigates a gram positive systemic infection in mice
topic antibiotics
capecitabine
course-based undergraduate research experience (CURE)
5-fluorouracil (5-FU)
nucleoside analog
repurposing
url https://journals.asm.org/doi/10.1128/Spectrum.00275-21
work_keys_str_mv AT jackrmcleod anoralfluorouracilprodrugcapecitabinemitigatesagrampositivesystemicinfectioninmice
AT pamelaaharvey anoralfluorouracilprodrugcapecitabinemitigatesagrampositivesystemicinfectioninmice
AT correllasdetweiler anoralfluorouracilprodrugcapecitabinemitigatesagrampositivesystemicinfectioninmice
AT jackrmcleod oralfluorouracilprodrugcapecitabinemitigatesagrampositivesystemicinfectioninmice
AT pamelaaharvey oralfluorouracilprodrugcapecitabinemitigatesagrampositivesystemicinfectioninmice
AT correllasdetweiler oralfluorouracilprodrugcapecitabinemitigatesagrampositivesystemicinfectioninmice