Bacterial type II fatty acid synthesis (FASII) is a target for the development of novel therapeutics. Bacteria incorporate extracellular fatty acids into membrane lipids, raising the question of whether pathogens use host fatty acids to bypass FASII and defeat FASII therapeutics. Some pathogens suppress FASII when exogenous fatty acids are present to bypass FASII therapeutics. FASII inhibition cannot be bypassed in many bacteria because essential fatty acids cannot be obtained from the host. FASII antibiotics may not be effective against all bacteria, but a broad spectrum of Gram-negative and -positive pathogens can be effectively treated with FASII inhibitors.
The Biological ProblemThe discovery of antibiotics for the treatment of infectious bacterial diseases has led to significant improvements in human health. The success of these broad-spectrum "miracle drugs" is reflected in the dearth of new antibiotic classes introduced in the last 30 years (1). However, the steady increase in bacterial antibiotic resistance to all antimicrobials in clinical use (2, 3) has caused infectious bacterial diseases to re-emerge as a serious threat to human health. These resistant bacteria are a clear and present danger that will require the discovery of new antibiotic targets and drugs to combat (4). Fatty acid synthesis is a vital facet of bacterial physiology, and its essentiality for membrane formation makes it an attractive target for drug discovery (5). Nature has exploited this dependence to produce a variety of natural products that target bacterial fatty acid synthesis (5-7). Selective targeting of the bacterial pathway is possible due to the significant differences in the structure of eukaryotic and bacterial fatty acid synthesis systems. Mammalian type I fatty acid synthase is a large, multifunctional peptide that elongates acetyl-CoA to produce a single product, palmitic acid (8).In the bacterial type II system (FASII), 2 each enzymatic step is carried out by a discrete, monofunctional enzyme ( Fig. 1)
(9).Many inhibitors targeting FASII enzymes have been made in the past two decades, and several of these inhibitors are effective antibiotics both in vitro and in animal models (10 -13). Two of these compounds, AFN-1252 and CG400549, have proven efficacy in human clinical trials, providing direct evidence that targeting FASII components can result in effective therapeutic agents (14,15).Most bacteria are able to incorporate extracellular fatty acids into their membrane phospholipids, leading to the important question of whether this property will allow them to circumvent FASII inhibitors by acquiring the fatty acids they need from the host. Brinster et al. (16) argued that FASII is not an antibacterial target in Gram-positive bacteria due to the ability of Streptococcus agalactiae to circumvent FASII inhibitors when supplied with exogenous host-derived fatty acids. However, the situation is more complex because not all Gram-positive bacteria have the same fatty acid structures as mammals, and the conclusion is not co...