El objetivo central del presente trabajo de Tesis Doctoral fue restablecer in vitro la susceptibilidad antimicrobiana de cepas comensales de Escherichia coli (con fenotipo multirresistente-MDR-) aisladas de explotaciones pecuarias, mediante la asociación de diferentes antimicrobianos con el inhibidor de bombas de eflujo 1-(1-naphthylmethyl)-piperazine (NMP). De esta manera, se pretende contribuir al desarrollo de planes de dosificación de máxima eficacia antimicrobiana minimizando el riesgo de emergencia y diseminación de resistencia bacteriana; permitiendo así la obtención de productos de origen animal de excelencia sanitaria, en función de la correcta interpretación de los parámetros farmacocinéticos/farmacodinámicos (modelización PK/PD) para una correcta dosificación, del mecanismo de resistencia y del eventual bloqueo de éste último. Se obtuvieron muestras de materia fecal mediante hisopado rectal de vacas en ordeñe, terneros y animales de compañía, pertenecientes a tambos de la provincia de Buenos Aires; así como también de pozos sépticos, agua de consumo y bombas estercoleras. Se determinaron los perfiles de sensibilidad, mediante el método estandarizado de Kirby-Bauer de difusión en agar, frente a ocho antimicrobianos a todas las cepas de E.coli aisladas. Se hallaron diez cepas de E. coli multirresistentes a partir de los animales muestreados en el estudio de tipo transversal. Se emplearon cepas isogénicas de E. coli con diferentes grados de expresión de bombas de eflujo como control de calidad (AG100A con deleción total de bombas de eflujo, AG100 como cepa “normal” y AG112 con sobreexpresión de bombas). Se determinó la concentración inhibitoria mínima (CIM) y la concentración bactericida mínima (CBM) de florfenicol, ciprofloxacina, tetraciclina y ampicilina por el método de microdilución seriada en caldo Luria-Bertani (LB) con y sin NMP. Para la determinación de las interacciones entre los tres antimicrobianos seleccionados (florfenicol, ciprofloxacina y tetracilina) y el inhibidor de bombas se calculó el Índice de Concentración Inhibitoria Fraccionaria (CIF) a fin de evaluar la manifestación o no de efecto sinérgico. Para evaluar la cinética de muerte bacteriana se realizaron curvas de muerte bacteriana de las cepas de referencia y las cepas de campo MDR con y sin NMP. Con los datos obtenidos se realizó el análisis estadístico correspondiente. Por último, a partir de la información farmacodinámica obtenida se realizó una modelización farmacocinética/farmacodinámica (PK/PD), para lo cual se utilizaron datos obtenidos de estudios farmacocinéticos de florfenicol, danofloxacina y oxitetraciclina realizados previamente por el grupo de investigación de la Cátedra de Farmacología. Se aislaron cepas resistentes y multirresistentes con altos niveles de resistencia frente a tetraciclina y ampicilina. Todas las combinaciones de resistencia múltiple siempre incluyeron en su perfil a la tetraciclina. El NMP asociado a ampicilina tuvo un efecto nulo tanto en las cepas isogénicas como en las de campo. Sin embargo, ciprofloxacina, florfenicol y tetraciclina, demostraron ser claros sustratos de las bombas. Se evidenció la ocurrencia de sinergismo de potenciación ya que con una concentración de antimicrobiano varias veces inferior a la de su CIM, se logró un efecto antibacteriano mejorado con la incorporación de NMP. Se comprobó que es posible disminuir la concentración de los antimicrobianos -florfenicol, ciprofloxacina y tetraciclina- con la incorporación de NMP, sin modificar de manera importante la “cinética de muerte bacteriana”, tanto en las curvas de muerte de las cepas de referencia como en las cepas problema. En cuanto a la relación PK/PD, en la cepa AG112 se mejoraron notablemente los parámetros predictores de eficacia con la adición del inhibidor, con la consecuente disminución de la concentración de los antimicrobianos. Resulta prometedor el efecto de la combinación de un fármaco inhibidor de bombas de eflujo como coadyuvante de aquellos antimicrobianos sustratos de las bombas de eflujo sobreexpresadas como mecanismo inespecífico de resistenca bacteriana.

A signifficant obstacle facing the healthcare industry is the phenomenon of multidrug resistance (MDR) in which a cell acquires simultaneous resistance to many unrelated drugs that it has never been exposed to. At the molecular level, MDR can be characterised by a reduction of intracellular drug levels due to their active efflux by multidrug transporters such as P-glycoprotein (Pgp). Pgp is able to efflux a phenomenally wide variety of chemically unrelated drugs and causal relationships have been established between its expression and the acquisition of MDR to numerous anticancer and central nervous system (CNS) drugs. There has thus been much effort to understand the molecular biology of Pgp and how it functions. However, many aspects of its functioning remain unclear. From a drug discovery viewpoint, we have yet to fully understand what features make some drugs susceptible to Pgp-mediated efflux (substrates) and what makes others able to inhibit Pgp function (inhibitors). From a mechanistic viewpoint, it is still uncertain what the exact nature of Pgp's binding site is, the role of ATP binding and hydrolysis in transport and how both of these interplay with ligand binding. The work presented in this thesis attempts to answer these questions from two perspectives. Firstly the mouse Pgp crystal structure [PDB 3G60] was used as a unique starting point for molecular dynamics (MD) simulations to characterise the dynamics and conformational exibility of Pgp, properties believed to be integral to its function. The simulations revealed Pgp to be a highly dynamic molecule at both its transmembrane (TM) and nucleotide binding domains (NBDs). The latter exhibited a conformational asymmetry that supports the Constant Contact model of ATPase activity. In the presence of the Pgp substrate, daunorubicin, the NBDs exhibited tighter asymmetric dimerisation leading to increased affinity for ATP. In contrast, the presence of the Pgp inhibitor, QZ59-RRR led to NBD conformational changes that reduced their affinity for ATP. Thus providing an appealing mechanism for how QZ59-RRR inhibits Pgp ATPase activity. MD simulation was also used to provide atomic-detail interpretations of multiple binding stoichiometries of drug and lipid molecules observed by collaborator-led mass spectrometry experiments. This also provided opportunity to validate the Pgp simulations against novel experimental data. The second strand of the thesis explored the membrane permeation dynamics of CNS therapeutics in order to identify differences in protonation states, conformations, orientations and membrane localisation that might distinguish those that are Pgp substrates and from those that are not. These properties were studied using complementary MD simulation and nuclear magnetic resonance (NMR) techniques. The simulations revealed a novel set of criteria that in uence the likelihoodof a drug to 'flip-flop' across a membrane, a behaviour that may make drugs more susceptible to Pgp efflux. These observations were broadly consistent with the NMR experiments. However, the NMR data also highlighted limitations in the simulation approaches used in this thesis and emphasised the need to also consider the kinetics of permeation in addition to its thermodynamics.

P. aeruginosa e espécies de Acinetobacter são causas comuns de diversas infecções em pacientes hospitalizados, principalmente nos internados em centros de tratamento intensivo. Além disso, esses microrganismos se destacam por apresentarem resistência, intrínseca e adquirida, a várias classes de antibióticos, conferindo à bactéria fenótipos de multirresistência e panresistência. O objetivo deste estudo foi avaliar a participação de integrons (elementos genéticos que carreiam genes de resistência), de genes codificadores de metalo--lactamases, da perda de porinas (canais protéicos da membrana externa), e da atividade de efluxo aumentada, como determinantes do fenótipo de multirresistência e panresistência. Foram estudadas 147 P. aeruginosa e 57 Acinetobacter spp. isolados de pacientes hospitalizados no Hospital Universitário da Universidade Federal de Juiz de Fora, no período de 2003 a 2006. O perfil de sensibilidade destes isolados foi determinado por disco de difusão e utilizado para classificá-las como multirresistentes (MDR) e não multirresistentes (n-MDR). A variabilidade clonal dos isolados foi investigada por PFGE. Os isolados pertencentes aos grupos MDR e n-MDR foram investigados quanto a presença de integrons de classe 1, 2 e 3, por PCR e análise de RFLP. Os cassetes gênicos contidos nestes integrons, assim como genes codificadores de carbapenemases (ex. IMP, VIM e SPM), foram detectados por PCR e identificados por seqüenciamento. Avaliação da expressão gênica de bombas de efluxo (mexB, mexY, mexD e adeB) e de porina (OprD) foi conduzida por real-time RT-PCR. Os dados apresentados para os isolados do grupo MDR foram comparados àqueles do grupo n-MDR e a associação entre os determinantes de resistência e o fenótipo MDR foi calculada estatisticamente. Fenótipo de multiresistência foi observado em 42,2% e 84,2% das P. aeruginosa e Acinetobacter spp. estudadas. Nenhum isolado bacteriano apresentou fenótipo panresistente. Em 65 (44,2%) dos isolados de P. aeruginosa, foram detectados integrons de classe 1. Esses elementos apresentaram relação estatisticamente significativa com fenótipos MDR em P. aeruginosa. Entretanto, a maioria desses integrons não carreava nenhum cassete gênico (43/65) ou continham apenas cassetes gênicos de resistência a aminoglicosídeos (19/65). Entre os isolados de Acinetobacter spp., 11 (17,5%) apresentaram integrons de classe 1 e 30 (47,6%) integrons de classe 2. Apenas os últimos foram estatisticamente associados com fenótipos MDR. A pesquisa de metalo--lactamase (MBL) revelou a produção de enzimas SPM em 24 isolados de P. aeruginosa. Os estudos de expresão gênica demonstraram que, entre os sistemas de efluxo mais relatados para P. aeruginosa, MexXY-OprM foi o que mostrou maior diferença entre o nível de expressão dos grupos MDR e n-MDR, sugerindo que este sistema de efluxo desempenha importante papel no fenótipo MDR. Diminuição, em média de 66,4%, da produçãode OprD também foi um padrão encontrado nos isolados MDRem relação aos n-MDR. Dois grupos clonais de P. aeruginosa e dois de Acinetobacter spp. foram predominantes e tiveram relação com presença de integrons, produção de SPM-1 e com fenótipo MDR. Portanto, esse fenótipo pode ser consequência de acúmulo de determinantes de resistência em clones específicos. / The non-fermenting pathogenic bacteria Pseudomonas aeruginosa and Acinetobacter spp. are important causes of nosocomial infections. Theses species are often associated with a multidrug resistance (MDR) phenotype, due to intrinsic and acquired resistance genes. Some determinants of resistance, such as integrons, carbapenemases, overexpression of efflux systems and porins loss may be associated with the MDR phenotype. The aim of this study was to evaluate the association of non-MDR and MDR phenotypes in P. aeruginosa and Acinetobacter spp. to the presence of integrons and carbapenemases encoding genes, the overexpression of mexY, mexB, mexD and adeB genes and loss of the outer membrane protein, OprD. These resistance determinants were evaluated in 147 P. aeruginosa and 57 Acinetobacter spp., isolated from in-patients of University Hospital of UFJF. Isolates with different PFGE and non-susceptibility profiles were grouped according to MDR or non-MDR phenotypes. PCR and real-time RT-PCR were used to investigate the presence of class 1, 2 and 3 integrons and carbapenemase encoding genes and the expression of mexY, mexB, mexD and adeB efflux pumps and OprD porin, respectively. Class 1 integrons were one of the most common genetic elements present in MDR P. aeruginosa (44,2%), but the phenotype could not be attributed to these elements, since they showed empty (43/65) or only aminoglycoside gene cassettes (19/65). Class 2 integrons were the most common genetic elements in MDR Acinetobacter spp., and this association was statistically significant. SPM encoding gene was the only carbapenemase gene found in P. aeruginosa and, predominantly, in the PFGE cluster A. Expression of MexXY-OprM determined by real-time RT-PCR was the highest variable between MDR and non-MDR P. aeruginosa isolates (almost 10-fold). Reduction of 66.4% in OprD expression was observed in MDR P. aeruginosa, in comparison with non-MDR ones. It is concluded that the most important genetic determinants in the MDR phenotype of P. aeruginosa were SPM-1 production, followed by MexXY-OprM over expression and diminished production of OprD, while class 2 integrons was the most important genetic determinant of MDR phenotype in A. baumannii.

Blood-brain barrier (BBB) is a unique membranous barrier, which segregates brain from the circulating blood. It works as a physical and metabolic barrier between the central nervous system (CNS) and periphery. In mammals, endothelial cells were shown to be of BBB and are characterized by the tight junctions along with efflux system which are responsible for the restriction of movement of molecules within the cells. Efflux system consists of multidrug resistance proteins such as P-glycoprotein (P-gp). P-gp removes substances out back from the brain to the blood before they reach to the brain. So the barrier is impermeable to many compounds such as amino acids, ions, small peptides and proteins, making it the most challenging factor for the development of new drugs for targeting CNS. Curcumin is a bioactive compound that has a number of health promoting benefits such as anti-inflammatory, anticancer, anti-oxidant agent; as well as a role in neurodegenerative diseases, but low oral bioavailability is the major limiting factor. Low water solubility and rapid metabolism are the two important factors responsible for poor bioavailability of curcumin. Galaxolide is a musk compound and previously known for the bioaccumulation of toxic components in the aquatic animals by interference with the activity of multidrug/multixenobiotic resistance efflux transporters (MDR/MXR). The bioavailability of curcumin can be enhanced when administered with galaxolide. This study was carried out to investigate the effect of galaxolide on the permeation of curcumin through the epithelial cell monolayers. MDCKII-MDR1 cell monolayer is used an in vitro blood-brain barrier model while Caco-2 monolayer is used as an in vitro intestinal model, which also expresses the P-glycoprotein. The curcumin and galaxolide were separately solubilised in the DMSO and used in combination to perform permeation study, to determine the effect of galaxolide on curcumin permeation through epithelial cell monolayers. The galaxolide shows an efflux protein inhibition activity and this activity was used to enhance permeation of curcumin through the Caco-2 monolayer. In summary, galaxolide is a novel permeation enhancer molecule, which can be used for the improvement of drug delivery of other bioactive compounds in future.

Leung, Winnie. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 155-164). / Abstracts in English and Chinese. / Abstract --- p.i / 摘要 --- p.iii / Acknowledgements --- p.v / Table of Contents --- p.vi / List of Figures --- p.x / Abbreviations --- p.xii / Chapter Chapter 1 --- General Introduction --- p.1 / Chapter 1.1 --- Clinical management of Cancer --- p.2 / Chapter 1.2 --- Multidrug resistance --- p.8 / Chapter 1.3 --- Aim of study --- p.14 / Chapter Chapter 2 --- Identification of gene contributing to multidrug resistance in human uterine sarcoma cells --- p.16 / Chapter 2.1 --- Introduction --- p.17 / Chapter 2.2 --- Material and Methods / Chapter 2.2.1 --- Materials / Chapter 2.2.1.1 --- Cell lines --- p.20 / Chapter 2.2.1.2 --- "Cell culture medium, supplements and buffers" --- p.20 / Chapter 2.2.1.3 --- Gene expression assay reagents --- p.22 / Chapter 2.2.1.4 --- Western blotting reagents --- p.24 / Chapter 2.2.1.5 --- MTT assay reagents --- p.29 / Chapter 2.2.1.6 --- Apoptosis analysis by flow cytometry reagents --- p.29 / Chapter 2.2.2 --- Metho --- p.ds / Chapter 2.2.2.1 --- Cell Culture --- p.31 / Chapter 2.2.2.2 --- MTT assay --- p.32 / Chapter 2.2.2.3 --- Gene expression essay (RT-PCR) --- p.33 / Chapter 2.2.2.4 --- Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of protein lysate and Western blotting --- p.37 / Chapter 2.2.2.5 --- Quantification of doxorubicin uptake by flow cytometry --- p.40 / Chapter 2.2.2.6 --- Apoptosis analysis by flow cytometry --- p.41 / Chapter 2.3 --- Results --- p.4 / Chapter 2.3.1 --- Cytotoxicity of doxorubicin on SA and DX5 cells --- p.43 / Chapter 2.3.2 --- mRNA expression of multidrug resistance related genes in SA and DX5 cells --- p.46 / Chapter 2.3.3 --- P-glycoprotein expression in SA and DX5 cells --- p.49 / Chapter 2.3.4 --- Doxorubicin (Dox) uptake by SA and DX5 cells --- p.51 / Chapter 2.3.5 --- Doxorubicin induced Apoptosis in SA and DX5 cells --- p.54 / Chapter 2.4 --- Discussion --- p.61 / Chapter 2.5 --- Conclusion --- p.65 / Chapter Chapter 3 --- Alternation in P-glycoprotein expression in DX5_Ninjl cells --- p.66 / Chapter 3.1 --- Introduction --- p.67 / Chapter 3.2 --- Materials and Methods / Chapter 3.2.1 --- Materials / Chapter 3.2.1.1 --- Cell lines --- p.70 / Chapter 3.2.1.2 --- "Cell culture medium, supplements and buffers" --- p.70 / Chapter 3.2.1.3 --- Gene expression assay reagents --- p.70 / Chapter 3.2.1.4 --- Western blotting reagents --- p.72 / Chapter 3.2.1.5 --- Plasmid DNA extraction --- p.75 / Chapter 3.2.1.6 --- Transient transfection --- p.76 / Chapter 3.2.1.7 --- MTT reagents --- p.76 / Chapter 3.2.2 --- Methods / Chapter 3.2.2.1 --- Cell culture --- p.78 / Chapter 3.2.2.2 --- Gene expression essay (RT-PCR) --- p.79 / Chapter 3.2.2.3 --- Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of protein lysate and Western blotting --- p.81 / Chapter 3.2.2.4 --- DNA plasmid extraction --- p.83 / Chapter 3.2.2.5 --- Transient transfection --- p.84 / Chapter 3.2.2.6 --- MTT assay --- p.85 / Chapter 3.2.2.7 --- Quantification of doxorubicin (Dox) uptake by flow cytometry --- p.86 / Chapter 3.3 --- Results / Chapter 3.3.1 --- mRNA expression of Ninjurinl (Ninj1) in SA and DX5 cells --- p.87 / Chapter 3.3.2 --- The protein expression of Ninjurinl (Ninj1) in SA and DX5 cells --- p.89 / Chapter 3.3.3 --- Ninjurin1 (Ninj1) cDNA transfection in DX5 cells --- p.91 / Chapter 3.3.4 --- mRNA expression of MDR1 in Ninjurin1-transfected DX5 cells (DX5_Ninjl) --- p.93 / Chapter 3.3.5 --- P-glycoprotein expression in Ninjurin1-transfected DX5 cells --- p.95 / Chapter 3.3.6 --- "Cytotoxicity of doxorubicin (Dox) on DX5 control, DX5 vector control and DX5_Ninjl cells" --- p.97 / Chapter 3.3.7 --- "Doxorubicin (Dox) uptake by SA control, DX5 control and DX5_Ninjl cells" --- p.99 / Chapter 3.4 --- Discussion --- p.102 / Chapter 3.5 --- Conclusion --- p.105 / Chapter Chapter 4 --- Alternation in MDR1 expression in DX5一THBS1 cells --- p.106 / Chapter 4.1 --- Introduction --- p.107 / Chapter 4.2 --- Materials and Methods / Chapter 4.2.1 --- Materials / Chapter 4.2.1.1 --- Cell lines --- p.109 / Chapter 4.2.1.2 --- Cell culture medium； supplements and buffers --- p.109 / Chapter 4.2.1.3 --- Gene expression assay reagents --- p.109 / Chapter 4.2.1.4 --- Western blotting reagents --- p.111 / Chapter 4.2.1.5 --- Plasmid DNA extraction --- p.114 / Chapter 4.2.1.6 --- Transient transfection --- p.115 / Chapter 4.2.1.7 --- MTT reagents --- p.115 / Chapter 4.2.2 --- Methods / Chapter 4.2.2.1 --- Cell culture --- p.117 / Chapter 4.2.2.2 --- Gene expression essay (RT-PCR) --- p.118 / Chapter 4.2.2.3 --- Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of protein lysate and Western blotting --- p.120 / Chapter 4.2.2.4 --- DNA plasmid extraction --- p.123 / Chapter 4.2.2.5 --- Transient transfection --- p.123 / Chapter 4.2.2.6 --- MTT assay --- p.124 / Chapter 4.2.2.7 --- Quantification of doxorubicin (Dox) uptake by flow cytometry --- p.125 / Chapter 4.3 --- Results / Chapter 4.3.1 --- mRNA expression of Thrombospondinl (THBS1) in SA and DX5 cells --- p.126 / Chapter 4.3.2 --- The protein expression of Thrombospondinl (THBS1) in SA and DX5 cells --- p.128 / Chapter 4.3.3 --- Thrombospondinl (THBS1) cDNA transfection in DX5 cells --- p.130 / Chapter 4.3.4 --- mRNA expression of MDR1 in Thrombospondinl-transfected DX5 cells (DX5_THBS1) --- p.132 / Chapter 4.3.5 --- P-glycoprotein expression in Thrombospondinl-transfected DX5 cells --- p.134 / Chapter 4.3.6 --- "Cytotoxicity of doxorubicin (Dox) on DX5 control, DX5 vector control and DX5一THBS1 cells" --- p.136 / Chapter 4.3.7 --- "Doxorubicin (Dox) uptake by SA control, DX5 control and DX5_THBS1 cells" --- p.138 / Chapter 4.4 --- Discussion --- p.141 / Chapter 4.5 --- Conclusion --- p.145 / Chapter Chapter 5 --- General discussion --- p.146 / Chapter 5.1 --- Doxorubicin induced multidrug resistance in human uterin sarcoma cells via upregulation of P-glycoprotein --- p.147 / Chapter 5.2 --- The down-regulation of Ninjurin1 in human uterine sarcoma cells contributed to multidrug resistance --- p.148 / Chapter 5.3 --- The down-regulation of Thrombospondin1 in human uterine sarcoma cells contributed to multidrug resistance --- p.150 / Chapter 5.4 --- Conclusion and Future Perspective --- p.153 / Reference --- p.155

<p>U skladu sa postavljenim ciljevima rada formirana je kolekcija&nbsp;<br />fenotipski i genotipski okarakterisanih multiplo rezistentnih&nbsp;<br />kultura genomske vrste <em>Acinetobacter baumannii</em>. Za sojeve iz&nbsp;<br />kolekcije kultura utvrđen je anti-<em>A. baumannii</em> efekat etarskih&nbsp;<br />ulja, biljnih ekstrakata i njihovih bioaktivnih komponenti, kao&nbsp;<br />nekonvencionalnih antimikrobnih agensa. Takođe, osim njihovog&nbsp;<br />pojedinačnog efekta utvrđen je i kombinovani efekat&nbsp;<br />konvencionalnih i nekonvencionalnih antimikrobnih agenasa, koji&nbsp;<br />je dovedo do redukcije minimalnih ihnibitronih koncentracija oba&nbsp;<br />agensa u kombinaciji. Kombinacije etarskih ulja i njihovih&nbsp;<br />bioaktivnih komponenti sa trenutno dostupnim konvencionalnim&nbsp;<br />antibioticima, čija je efikasnost smanjena kada se primenjuju&nbsp;<br />pojedinačno, predstavljaju novu perspektivnu strategiju u terapiji&nbsp;<br />infekcija multiplo rezistentnim sojevima vrste <em>A. baumannii</em>.</p> / <p>In accordance to the aims of the work the collection of phenotypic and<br />genotypic characterized multidrug-resistant cultures of genomic species<br /><em>Acinetobacter baumannii</em> was formed. For the strains from the culture<br />collection an anti-<em>A. baumannii </em>effect of the essential oils, plant extracts<br />and their bioactive components, as non-conventional antimicrobial<br />agents, was determined. Also, in addition to their individual effect the<br />combined effect of conventional and non-conventional antimicrobial<br />agents was determined, which lead to a reduction of the minimal<br />inhibitroy cocnentrations of both agents in combination. Combinations<br />of the essential oils and their bioactive components with the currently<br />available conventional antibiotics, whose efficiency reduced when<br />administered individually, represent a promising new strategy for the<br />treatment of infections caused by multidrug-resistant <em>A. baumannii.</em></p>

Cancer cells that survive chemotherapy treatment often develop resistance to the administered chemotherapeutics, as well as to many other types of drugs, because the cancer cells increase their production of efflux pumps in the cell. This undesired phenomenon of resistance to cancer drugs is known as multidrug resistance. This work uses a novel drug carrier, called an eLiposome, to achieve cytosolic drug delivery to kill multidrug-resistant cancer cells. An eLiposome consists of a perfluoropentane (PFC5) emulsion droplet inside of a liposome. Folate attached to the eLiposome facilitates uptake into the cell. The PFC5 droplet is metastable at body temperature, but will rupture the liposome as the droplet expands during vaporization, and will release any drugs encapsulated inside of the liposome directly to the cell cytosol. Laser and ultrasound were examined as triggers to initiate the vaporization of the PFC5 droplet and actuate the release of doxorubicin (Dox) from folated eLiposomes containing Dox (feLD). Gold nanorods (GNRs) were synthesized and transferred to PFC5 droplets. Although GNRs are efficient at converting irradiated laser light to heat, no vaporization of the PFC5 droplets was observed when irradiated with laser light. Further investigation into the energy required for vaporization of PFC5 droplets revealed that there are currently no portable and wearable lasers available to provide enough energy to vaporize PFC5 droplets. Two seconds of ultrasound can release 78% of encapsulated Dox from feLD. Dox-sensitive KB-3-1 cells and Dox-resistant KB-V1 cells treated with feLD (without ultrasound) had cell viabilities of 33% and 60%, respectively. Ultrasound had negligible additional effect on the cell viability of KB-3-1 and KB-V1 cells treated with feLD (33% and 53%, respectively). We hypothesized that the Dox fiber formed during the loading of Dox into the eLiposome is a site for heterogeneous nucleation once the feLD is endocytosed by the cell, and vaporization and drug release occurs with or without ultrasound. Blocking the efflux pumps with verapamil decreases the rate at which Dox is exported from multidrug-resistant cells. When verapamil is co-delivered with feLD, the cell viability of KB-3-1 and KB-V1 cells decreases to 29% and 25%, respectively; thereby reversing the multidrug resistance possessed by KB-V1 cells. The delivery of doxorubicin inside of folated eLiposomes with an efflux pump blocker is a novel way to kill multidrug-resistant cancer cells as effectively as non-resistant cancer cells independent of lasers or ultrasound.

Burkholderia pseudomallei est l’agent causal de la mélioïdose, une maladie tropicale endémique dans le Nord de l’Australie et en Asie du Sud-Est. Nous avons analysé le système d’efflux, mécanisme majoritairement impliqué la multi-résistance aux antibiotiques. Nous avons chercher à identifier des mutations dans les pompes d’efflux et des modulation de l’expression de ces dernières afin d’expliquer ces phénotypes de résistance. Les techniques de séquençage de l’ADN et de transcriptomique par RT-qPCR nous ont permis d’identifier deux mécanismes chez des souches cliniques. Un mécanisme transitoire responsable d'une résistance croisée du Cotrimoxazole, avec les quinolones, et le chloramphénicol, pour lequel nous suspectons une modulation de l’expression de l’efflux. Le second, impliqué dans la résistance au méropénème, par surexpression de l'efflux suite à une mutation dans le régulateur de la pompe AmrAB-OprA.Dans un second axe de recherche, nous avons également criblé plusieurs molécules afin d'identifier des candidats inhibiteurs de l'efflux, dérivant de la famille des phénothiazines et capables de restaurer une sensibilité aux antibiotiques. Nous avons analysé l’impact de ces molécules sur des souches modèles de multi-résistance (Burkholderia thailandensis) et sur des souches cliniques et environnementales de B. pseudomallei. Ces molécules sont capables d’impacter l’expression de l’efflux, mais nous pensons que le mécanisme majeur d’inhibition de cette famille de molécules reste l’entrée en compétition avec les antibiotiques efflués. Nous avons identifié une molécule, AST17, capable de restaurer la sensibilité au Cotrimoxazole, ainsi qu'aux quinolones. / Burkholderia pseudomallei is thecausal agent of melioidosis, a tropical disease, endemic in Notrhern Australia and South-East Asia. We have analyzed efflux systeme, known to be one of the main mecanism implicated in antibiotic resistance phenotypes. We have looked for mutations in efflux pumps and for transient modulations of the efflux pumps expression, that could explain resistance phenotypes. Whole genome sequencing and a the targeted method of RT-qPCR allowed us to identified two mecanisms in clinical strains. A transient mecanism, responsible of a cross-resistance to Cotrimoxazole, quinolones and chloramphenicol, and we suspect an implication of modulation of efflux. The second one is implicated in meropenem resistance by an overexpression of the AmrAB-OprA efflux pumps, due to a mutation of its regulator. In a second time, we also have screened several compounds, all derivated from phenothiazines, in order to identify efflux pump inhibitors for a restoration of the antibiotic susceptibility. We have analyzed the impact of these molecules in multi-resistant strain models, and on several clinical and environnemental strains. These molecules are able to modulate efflux pumps expression, however, we think that the main inhibition mecanism of these derivatives is about a competition between the molecule and the antibiotics. We have identified one molecule, AST17, that is able to restore Cotrimoxazole and quinolones susceptibilities.

As one of the mechanisms of antibiotic resistance, bacteria use several families of membrane-embedded α-helical transporters to remove cytotoxic molecules from the cell. The small multidrug resistance protein family (SMR) is one such group of drug transporters that because of their relative small size [ca. 110 residues with four transmembrane (TM) helices] must form at the minimum dimers to efflux drugs. We have used the SMR homologue Hsmr from Halobacterium salinarum to investigate the oligomerization properties of the protein family at TM helix 4. We produced point mutations along the length of the TM4 helix in the full length Hsmr protein and assayed their dimerization and functional properties via SDS-PAGE and bacterial cell growth assays. We found that Hsmr forms functionally dependent dimers via an evolutionarily conserved 90GLxLIxxGV98 small residue heptad repeat. Upon investigation of the large hydrophobic residues in this motif by substituting each large residue to Ile, Leu, Met, Phe, and Val, we determined that Hsmr efflux function relies on an optimal level of dimerization. While some substitutions led to either decreased or increased dimer and substrate-binding strength, several Ile94 and Val98 mutants were equal to wild type dimerization levels but were nonfunctional, leading to the hypothesis of a mechanistic role at TM4 in addition to the locus of dimerization. The functionally sensitive TM4 dimer represents a potential target for SMR inhibition using a synthetic TM4 peptide mimetic. Using exponential decay measurements from a real-time cellular efflux assay, we observed the efflux decay constant was decreased by up to ~60% after treatment with the TM4 peptide inhibitor compared to control peptide treatments. Our results suggest that this approach could conceivably be used to design hydrophobic peptides for disruption of key TM-TM interactions of membrane proteins, and represent a valuable route to the discovery of new therapeutics.

ATP binding cassette (ABC) transporters constitute one of the largest families of transport proteins. The occurrence of multidrug resistance (MDR) in human cancer cells has been correlated with the over expression of human ABC, P-glycoprotein (Pgp). Streptomyces peucetius produces two anticancer agents, doxorubicin and daunorubicin, that belong to the anthracycline family of antibiotics. The organism is self-resistant to the potent effects of the antibiotics it produces due to the action of an efflux pump, DrrAB. Both Pgp and DrrAB carry out similar functions, but in two different cell types. An understanding of the bacterial drug transporter DrrAB is thus expected to help in obtaining a better understanding of the function and evolution of the multidrug transporter P-glycoprotein. In DrrAB, the catalytic and membrane domains are present on separate subunits, DrrA and DrrB respectively. How the catalytic ATP-binding domains and the membrane domains in transporters interact with each other, or how energy is transduced between them, is not well understood. We introduced several single cysteine substitutions in DrrB and then by using a cysteine to amine hetero-bifunctional cross-linker showed that DrrA interacts predominantly with the N-terminal cytoplasmic tail of DrrB. Within this region of DrrB, we also identified a sequence with similarities to the EAA motif found in importers of the ABC family of proteins, thus leading to the proposal that the EAA or the EAA-like motif may be involved in forming a generalized interface between the ABC and the TMD of both uptake and export systems. By using a combination of approaches, including point mutations and disulfide cross-linking analysis, we show here that the Q-loop region of DrrA plays an important role in dimerization of DrrA as well as in interactions with DrrB. Furthermore, we also show that the interaction of the Q-loop with the N-terminus of DrrB is involved in transmitting conformational changes between DrrA and DrrB. The scope of the present study further extends into identifying the factors involved in the biogenesis of the DrrAB pump. We have identified two accessory proteins namely, FtsH and GroEL that may be involved in proper folding and assembly of the transporter.