Semisynthetic aminoglycoside antibiotics : toward biomimetic synthesis, evasion of bacterial resistance and reduced toxicity
Aminoglycosides are valuable and effective broad-spectrum bactericidal antibiotics against Gram-positive and Gram-negative pathogens, with several members of natural and semisynthetic origin occupying prominent roles in clinical practice since 1950. Nobel-prize winning crystallographic studies on the ribosome have revealed how their diverse polyaminated sugar framework is tailored to target a RNA helix within the decoding centre of the bacterial 30S subunit. By interfering with the affinity and kinetics of the tRNA selection and proof-reading steps, they induce error-prone protein synthesis, and translocation inhibition and lead to a lethal cycle of antibiotic uptake and membrane stress. In retaliation, bacterial pathogens have evolved and disseminated a number of enzymatic and efflux resistance mechanisms. These include N acetyl-transferases, O phosphotransferases and O nucleotidyltransferases, which target the core hydroxyl and amino groups of aminoglycosides promiscuously; methyltransferases, which target the ribosomal binding-site; and energy-dependent drug efflux pumps for aminoglycoside-selective elimination, in Gram-negative pathogens.  The most problematic infectious pathogens which are currently resilient to most unrelated antibiotic classes and in the verge of pan-resistance have been defined ‘ESKAPE’ bacteria, a mnemonic for Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacteriaceae. The world-wide spread of aminoglycoside resistance to current clinical standards, such as tobramycin, amikacin and gentamicin, ranges from 20 to 60% of clinical isolates. Hence, the contemporary 4,6-disubstituted-2-deoxystreptamine aminoglycosides are currently inadequate as broad-spectrum anti-infective therapies. The 4,5-disubstituted class of aminoglycosides are a challenging framework for medicinal chemistry, which includes butirosin, neomycin and paromomycin. Exploring the potential of these alternatives, colleagues in the Hanessian group and collaborators of Achaogen Inc. have demonstrated that paromomycin and neomycin analogs modified by deoxygenation of positions 3' and 4', as well as N1-substituted analogs possesing the α hydroxy-γ-aminobutyryl amide (HABA) chain of butirosin, could produce promising antibiotics. Chapter 4 of this dissertation features the conception and development of an expedient semi-synthetic strategy to access novel aminoglycosides of the 4,5 disubstituted class, inspired from biosynthetic modifications of the sisomicin subfamily, that surmount the wide-spread bacterial resistance mechanisms. This synthetic methodology relies on a novel Tsuji palladium-catalyzed hydrogenolysis developed on model monosaccharides, which was applied to generate a library of aminoglycosides comprising ring A hybrids of the neomycin and sisomicin families. The structure-activity relationships of this new class were assessed against a panel of 26 bacterial strains expressing modifying enzymes and efflux systems to provide an overview of ESKAPE pathogens. Two novel hybrid aminoglycoside analogs exhibited excellent antibacterial coverage, and may be promising candidates for preclinical development. Aminoglycoside therapy is also invariably associated with a probability of nephrotoxic complications. Aminoglycoside toxicity has been largely correlated with the number of amino groups, and more loosely with the extent of deoxygenation. A long standing hypothesis in the field states that because the foremost interactions are effected by ammonium group salts, the tuning of pKa parameters could provide a higher target dissociation rate, more effective clearance and overall less nephrotoxic analogs. Chapter 5 in this dissertation features the conception and asymmetric synthesis of isosteric β substituted N1 HABA chains, modified by mono- and bis-fluorination. These chains covering a range of γ-N pKa values from 10 to 7.5 were applied to advanced tetra-deoxygenated neomycin antibiotics. In spite of the important reduction in γ N pKa, broad spectrum antimicrobial activity was not significantly disrupted for isosteric fluorinated analogs. Furthermore, structure-toxicity relationships, assessed by Achaogen’s proprietary luciferase-coupled apoptosis assay, revealed that the novel β,β difluoro-N1-HABA chain is less harmful in a Human Kidney 2 cell-line model and promising for the development as new generation neomycin antibiotics with improved therapeutic properties. The final chapter in this dissertation features the proposal and validation of the concise biomimetic synthesis and self-assembly of aminoglycoside 66-40C, a remarkable C2-symmetric 16 membered macrocyclic bis-imine dimer. The proposed structure was spectroscopically characterized as an anti-parallel s-trans-bis-azadiene macrocyclic system. Calculations indicate the anomeric effect of the α glycosidic bond between rings A and B is important for pre-organization of the monomeric sisomicin 6' aldehyde and favors the observed macrocycle product. Self-assembly in aqueous solutions was studied through the dimerization of three diverse analogs and cross-over experiments, which demonstrated the generality and stability of the macrocyclic motif of aminoglycoside 66-40C.
Aminoglycoside HABA Fluorination Aminoglycoside Antibiotic Neomycin Sisomicin Deoxygenation Tsuji  hydrogenolysis HABA Fluorination Biomimetic Self-assembly