Efficacy of linezolid on Treponema pallidum, the syphilis agent : A preclinical study
Haynes, Austin M. (University of Washington. Department of Medicine)
Giacani, Lorenzo (University of Washington. Department of Global Health)
Mayans, Marti Vall (Institut Germans Trias i Pujol. Fundació de Lluita Contra la Sida)
Ubals, Maria (Institut Germans Trias i Pujol. Fundació de Lluita Contra la Sida)
Nieto, Carles (Laboratorio Reig Jofre)
Pérez-Mañá, Clara (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)
Quintó, Llorenç (Hospital Clínic i Provincial de Barcelona)
Romeis, Emily (University of Washington. Department of Medicine)
Mitjà, Oriol (Institut Germans Trias i Pujol. Fundació de Lluita Contra la Sida)

Fecha:	2021
Resumen:	Penicillin G, the current standard treatment for syphilis, has important drawbacks, but virtually no preclinical or clinical studies have been performed to identify viable alternatives. We tested, both in vitro and in vivo, three marketed antibiotics with adequate pharmacological properties to treat syphilis. We used an in vitro culturing system of T. pallidum to perform drug susceptibility testing and applied quantitative PCR targeting the tp0574 gene to measure bacterial growth. To confirm in vivo efficacy, fifteen rabbits were infected intradermally with T. pallidum at eight sites each and randomly allocated to an experimental treatment (linezolid, moxifloxacin, clofazimine) or a control arm (benzathine penicillin G [BPG], untreated). The primary outcome was treatment efficacy defined as the time to lesion healing measured from the date of treatment start. Secondary outcomes were absence of treponemes or treponemal mRNA in injection sites, absence of seroconversion, and cerebrospinal fluid (CSF) abnormalities and negative rabbit infectivity tests (RIT). Linezolid showed in vitro bactericidal activity at concentrations of 0. 5 µg/mL or higher. When administered orally to experimentally infected rabbits, it induced healing of early lesions at a time similar to BPG (hazard ratio 3. 84; 95% CI 2. 05-7. 17; p < 0. 0001 compared to untreated controls). In linezolid-treated animals, dark-field microscopy and qPCR assessment showed no presence of treponemes after day 3 post-treatment start, serologic test did not convert to positive, CSF had no abnormalities, and RIT was negative. Moxifloxacin and clofazimine failed to inhibit bacterial growth in vitro and could not cure the infection in the rabbit model. Linezolid, a low-cost oxazolidinone, has in vitro and in vivo activity against T. pallidum, with efficacy similar to BPG in treating treponemal lesions in the animal model. Our findings warrant further research to assess the efficacy of linezolid as an alternative to penicillin G to treat syphilis in human clinical trials.
Ayudas:	European Research Council 850450
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Treponema pallidum ; Syphilis ; Yaws ; Repurposing ; Linezolid ; Preclinical
Publicado en:	EBioMedicine, Vol. 65 (march 2021) , ISSN 2352-3964

DOI: 10.1016/j.ebiom.2021.103281
PMID: 33721817

8 p, 1.4 MB

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