Tuberculosis (TB) remains the leading cause of death due to a single infectious agent with more than 1.5 million people killed each year. In 2018, the World Health Organization (WHO) estimated that one third of the world’s population was infected with Mycobacterium tuberculosis (Mtb), the pathogen responsible for the disease.In 2000, EthR, a mycobacterial transcriptional repressor, was identified as a key modulator of ethionamide (ETH) bioactivation. ETH is one of the main second-line drugs used to treat drug-resistant strains and it is a prodrug that is activated in Mtb by the mono-oxygenase EthA and then inhibits InhA, an enzyme involved in the mycolic acid biosynthesis. In 2009, it was demonstrated that co-administration of ETH with the drug-like inhibitors of EthR was able to boost ETH activity by a factor three in a mouse-model of TB-infection, thus validating EthR protein as a target for a new therapeutic strategy. The first part of this thesis deals with the validation and deep characterization of the solved EthR-ligand structures based on all analysis of how each ligand bind to the EthR. In this section, based on the study of both co-crystal structures and the physicochemical properties of the ligands, we have rationalized the information currently available and understood the interaction of all EthR inhibitors in order to lead to more effective inhibitor design.More recently, another mycobaterial repressor, denoted EthR2, was identified as a putative target that appears to be functionally comparable to EthR (then the locus has been termed EthA2/EthR2, due to its similarity to the EthA/EthR locus). Furthermore, a spiroisoxazoline family of small-molecules, generically denoted as SMARt, has been identified as effective ligand of EthR2. However, according to the data present in the literature, this spiroisoxazoline family can also bind to the former EthR. In order to investigate this proposition, I have solved these small molecules in complex with EthR and compared their binding interactions to the EthR2 protein as well. The opportunity for the design small-molecules is capable of targeting both repressors, thereby opening the way to a dual-target approach.Finally, the third part of this thesis is devoted to the mycobacterial transcriptional factor MabR (Rv2242). Several studies identified this protein as a regulatory transcription factor of the fatty acid synthase II operon, which is mainly responsible for the mycolic acid biosynthesis in Mtb. I therefore purified to homogeneity and characterized the MabR protein as well as I determined the crystal structure of its C-terminal part. Finally, the functional role of MabR is largely discussed, and the way on how to interfere with its DNA binding ability is commented with respect to our results. / Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie) / info:eu-repo/semantics/nonPublished

En 1993, l’Organisation Mondiale de la Santé déclarait que la tuberculose était « une urgence de santé publique mondiale ». Plus de 20 ans après, cette maladie infectieuse causée par Mycobacterium tuberculosis, reste toujours un problème à l’échelle de la planète. Malgré des progrès très importants enregistrés dans la lutte contre la tuberculose dans le monde, l’OMS estime que 9 millions de personnes ont contracté cette maladie en 2013 et que 1,5 million sont morts durant cette même année. De plus, l'émergence de la tuberculose multirésistante nécessite le développement de nouveaux outils et de nouvelles stratégies thérapeutiques. Récemment, deux nouveaux composés, bedaquiline et delamanid ont reçu une autorisation temporaire d’utilisation dans le but de renforcer l’arsenal thérapeutique. Néanmoins, il existe toujours la possibilité que la bactérie puisse rapidement développer des résistances liées au mécanisme d’action de ces nouveaux médicaments. C’est pour toutes ces raisons que l’arsenal thérapeutique doit être renforcé. Ce travail de thèse repose sur la découverte et l'optimisation de nouveaux composés antituberculeux selon des approches dont le point de départ commun est le criblage de petites molécules appelées fragments.La première partie de ce manuscrit présente la continuité d’un travail démarré au cours de la thèse de Baptiste Villemagne et qui a pour but de potentialiser l’activité de l'éthionamide, un médicament antituberculeux utilisé pour le traitement de seconde intention. Le répresseur transcriptionnel EthR a été validé comme élément clé dans la bioactivation de l’éthionamide. Les inhibiteurs de cette cible, développés selon une approche par fragments ont permis de potentialiser l'activité de l'éthionamide in vitro. Cependant, la faible stabilité microsomale de ces composés a limité leur utilisation in vivo. L’étude de la métabolisation du composé tête de série et la modification structurale de ce dernier a permis le développement des nouveaux inhibiteurs d’EthR présentant des propriétés pharmacocinétiques et physico-chimiques désormais acceptables pour la réalisation de tests in vivo.La deuxième partie de cette thèse s’est concentrée sur la synthèse d’inhibiteurs de MabA, une β-cétoacyl-ACP réductase mycobactérienne participant à la synthèse des acides gras à longue chaîne, précurseurs des acides mycoliques qui sont les constituants majeurs de la paroi mycobactérienne. Cette enzyme a été montrée comme étant indispensable à la survie de la bactérie mais aucun inhibiteur à ce jour n’a été identifié. Le criblage d’une chimiothèque de fragments sur MabA a été réalisé via deux tests différents (un test d’affinité pour la cible (TSA) et un test enzymatique). Les hits ainsi identifiés ont été resynthétisés et testés dans un test fonctionnel. Les étapes d’optimisation de l’activité des hits reconfirmés sont ainsi décrites. Ces résultats ont permis de développer des composés présentant des activités de l’ordre du micromolaire. Dans la troisième partie, un travail de conception et de synthèse de nouveaux fragments, visant à compléter la chimiothèque actuelle a été effectué. Les fragments originaux contenant un motif isoxazoline ont été synthétisés à partir d’alcènes et d’aldoximes utilisés en tant que synthons de départ, selon une réaction de cycloaddition 1,3-dipolaire. L’analyse conformationnelle de ces fragments a permis de montrer que ces structures venaient enrichir l’espace de la diversité, notamment par l’introduction d'un motif permettant le déploiement des substituants dans les trois dimensions de l’espace. La solubilité expérimentale de ces fragments a été également mesurée et nous avons pu montrer que ces molécules étaient adaptées au criblage. / In 1993, the World Health Organization (WHO) declared Tuberculosis (TB) as a global public health emergency. Over 20 years later, this infectious disease caused by Mycobacterium tuberculosis, remains a major public health problem. Despite the significant progress in the fight against TB worldwide, WHO estimates that 9 million people contracted the disease in 2013 and 1.5 million died in that year. In addition, the emergence of multidrug-resistant tuberculosis (MDR-TB) requires the development of new tools and new therapeutic strategies. Recently, two new compounds, bedaquiline and delamanid were approved in MDR-TB treatment in order to strengthen the actual MDR-TB chemotherapy. Nevertheless, there is always the possibility that the tubercle bacillus can quickly develop resistance related to the mechanism of action of these new drugs. Therefore, the actual therapeutic arsenal must be strengthened. This thesis is based on the discovery and optimization of new anti-TB compounds starting from the screening of small molecules called fragments.The first part of this thesis is the continuation of the research project which was started during the thesis of Baptiste Villemagne. This work aims to develop compounds that can boost the activity of ethionamide, a second-line drug used to treat MDR-TB. The transcriptional repressor EthR has been validated as a key element in the bioactivation of ethionamide. EthR inhibitors were identified using a fragment-based approach and were optimized to potentiate the activity of ethionamide in vitro. However, the low microsomal stability of the lead compound has limited its use in vivo. The metabolism study of the lead compound and key structural modifications allowed a development of new potent EthR inhibitors having acceptable pharmacokinetic and physico-chemical properties for in vivo testing.The second part of this thesis focused on the synthesis of MabA inhibitors. MabA is a mycobacterial β-ketoacyl-ACP reductase involved in the synthesis of long-chain fatty acids, precursors of mycolic acids, which are major constituents of the mycobacterial cell wall. This enzyme has been shown to be essential for the survival of the bacteria but until now no inhibitor has been identified. Screening of a library of fragment molecules on MabA was performed via two different assays (affinity assay using TSA and an enzymatic assay). The identified hits were re-synthesized and tested in a functionnal assay. The optimization steps to improve the activity of the hits are also described. Compounds with activity in the micromolar range were discovered.In the third part, a design and synthesis of new fragments is described. The aim of this project is to build a collection of original fragments showing a 3D-structure scaffold amenable for rapid derivatization. The fragments that contain an original isoxazoline motif were synthesized from alkenes and aldoxime as starting building-blocks by using 1,3-dipolar cycloaddition. The conformational analysis of these structures has shown that they were, as expected, able to deploy substituents in the 3D space. The experimental solubility of these fragments was also measured and the results demonstrated that these molecules are suitable for the screening against new biological targets to help kick-start hit discovery program.

Tuberculosis affects millions of people worldwide every year. The current treatment for TB is divided into a regimen of both first- and second-line drugs, where first-line treatments are more tolerated and require shorter treatment lengths. With rising levels of resistance, alternative treatment regimes are urgently needed to fight this disease. Ethionamide, a second-line drug is administered as a prodrug which is activated in vivo by the enzyme EthA, which is in turn regulated by EthR. The disruption of the action of EthR could lead to novel therapeutics which could enhance the efficacy of ethionamide, and raise it to a first-line treatment. The work reported in this thesis examines the elaboration of three chemical scaffolds using fragment-based approaches to develop novel inhibitors capable of disrupting the EthR-DNA interaction. The first scaffold, 5-(furan-2-yl)isoxazole was investigated by fragment-merging approaches and produced compounds with the best of these having a KD of 7.4 uM. The second scaffold, an aryl sulfone was elaborated using fragment-merging strategies. This led to several modifications of the fragment, leading to several variants with KDs around 20 uM. With both of these series the affinity could not be improved below 10 uM and due to the synthetic complexity a further scaffold was prioritised. The third scaffold was explored was a 4-(4-(trifluoromethyl)phenyl)piperazine using fragmentgrowing from the NH of the piperazine to probe deeper into the EthR binding pocket. In addition to this, SAR around the 4-(trifluoromethyl)phenyl group was assessed to explore the interactions with EthR. These modifications led to compounds with nanomolar IC50s. A range of compounds were then screened by REMAssay to determine the boosting effect on ethionamide, and this identified compounds with up to 30 times boosting in the ethionamide MIC. The final chapter examines a concept where compounds were designed to exploit the dimeric nature of EthR by linking two chemical warheads with a flexible linker. These compounds are examined using mass spectrometry to investigate the stoichiometry of the interaction to provide insight into the binding of these extended compounds and exploring an alternative strategy to inhibit EthR. The work in this thesis demonstrated the successful use of fragment-based approaches for development of novel EthR inhibitors which showed significant ethionamide boosting effects.

Avec plus d’un million et demi de morts chaque année, la tuberculose reste aujourd’hui la seconde cause de mortalité liée à un agent infectieux. De plus l’organisation mondiale de la santé (OMS) a estimé en 2011 qu’un tiers de la population mondiale était porteuse du bacille Mycobacterium tuberculosis responsable de la maladie. Depuis la fin des années 1980, une recrudescence du nombre de cas de tuberculose est observée à l’échelle mondiale. Cette recrudescence est due à la fois à l’apparition de souches résistantes, mais également à l’épidémie de VIH qui est un facteur de prédisposition au déclenchement de la maladie.En 2000, le répresseur transcriptionnel mycobactérien EthR a été identifié comme étant un régulateur clé dans la bioactivation de l’éthionamide (ETH), un antituberculeux utilisé pour le traitement de seconde intention. En 2009, l’inhibition de ce répresseur par le développement de molécules « drug-like » a permis de potentialiser l’activité de l’éthionamide d’un facteur 3 chez la souris infectée et a permis de valider cette cible pour une future approche thérapeutique.Ce travail repose sur la découverte et l’optimisation de nouveaux inhibiteurs de ce répresseur transcriptionnel mycobactérien, à partir d’une petite molécule appelée « fragment » qui a été cocristallisée avec la protéine. Par la combinaison d’un criblage in silico, d’un criblage in vitro des touches identifiées, de l’étude des structures radiocristallographiques des complexes ligands/protéines et de la chimie médicinale, le développement de trois approches complémentaires dites « fragmentgrowing », « fragment-merging » et « fragment-linking » a permis de développer des composés présentant de fortes activités. Ces résultats permettront très prochainement de sélectionner une nouvelle molécule issue de ce travail dans la perspective de nouveaux essais sur le modèle murin. / Tuberculosis (TB) remains the leading cause of death due to a single infective agent with more than 1.5 million people killed each year. In 2011, the world health organization (WHO) estimated that one third of the world’s population is infected with Mycobacterium tuberculosis, the pathogen responsible for the disease. This phenomenon may be due to an explosive escalation of TB incidence that occurred in the 1980s due to the emergence of both resistant strains and HIV epidemic.In 2000, EthR, a mycobacterial transcriptional repressor, was identified as a key modulator of ethionamide (ETH) bioactivation. ETH is one of the main second-line drugs used to treat drug resistant strains. In 2009, it was shown that co-administration of ETH and drug-like inhibitors of EthR was able to boost ETH activity threefold in a mouse-model of TB-infection, thus validating the target for a new therapeutic strategy.This work deals with the discovery and optimisation of new EthR inhibitors, based on a small molecule, called a “fragment”, co-crystallized with the protein. We combined in silico screening, in vitro evaluation of the hit compounds, study of co-crystal structures and medicinal chemistry to develop three complementary approaches called “fragment growing”, “fragment merging” and “fragment linking” that led to the discovery of very potent inhibitors. Based on these results, we are currently selecting a potential candidate for new in vivo experiments.