Intracellular localisation of Mycobacterium tuberculosis affects efficacy of the antibiotic pyrazinamide

Pierre Santucci, Daniel J. Greenwood, Antony Fearns, Kai Chen, Haibo Jiang () and Maximiliano G. Gutierrez ()
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Pierre Santucci: The Francis Crick Institute
Daniel J. Greenwood: The Francis Crick Institute
Antony Fearns: The Francis Crick Institute
Kai Chen: University of Western Australia
Haibo Jiang: University of Western Australia
Maximiliano G. Gutierrez: The Francis Crick Institute

Nature Communications, 2021, vol. 12, issue 1, 1-15

Abstract: Abstract To be effective, chemotherapy against tuberculosis (TB) must kill the intracellular population of the pathogen, Mycobacterium tuberculosis. However, how host cell microenvironments affect antibiotic accumulation and efficacy remains unclear. Here, we use correlative light, electron, and ion microscopy to investigate how various microenvironments within human macrophages affect the activity of pyrazinamide (PZA), a key antibiotic against TB. We show that PZA accumulates heterogeneously among individual bacteria in multiple host cell environments. Crucially, PZA accumulation and efficacy is maximal within acidified phagosomes. Bedaquiline, another antibiotic commonly used in combined TB therapy, enhances PZA accumulation via a host cell-mediated mechanism. Thus, intracellular localisation and specific microenvironments affect PZA accumulation and efficacy. Our results may explain the potent in vivo efficacy of PZA, compared to its modest in vitro activity, and its critical contribution to TB combination chemotherapy.

Date: 2021
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DOI: 10.1038/s41467-021-24127-3

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