Helicobacter pylori is
found in
the gut lining of more than half of the world’s population,
causes gastric ulcers, and contributes to stomach cancers. Menaquinone
synthesis in H. pylori relies on the
rare futalosine pathway, where H. pylori 5′-methylthioadenosine nucleosidase (MTAN) is proposed to
play an essential role. Transition state analogues of MTAN, including
BuT-DADMe-ImmA (BTDIA) and MeT-DADMe-ImmA (MTDIA), exhibit bacteriostatic
action against numerous diverse clinical isolates of H. pylori with minimum inhibitory concentrations
(MIC’s) of <2 ng/mL. Three H. pylori BTDIA-resistant clones were selected under increasing BTDIA pressure.
Whole genome sequencing showed no mutations in MTAN. Instead, resistant
clones had mutations in metK, methionine adenosyltransferase
(MAT), feoA, a regulator of the iron transport system,
and flhF, a flagellar synthesis regulator. The mutation
in metK causes expression of a MAT with increased
catalytic activity, leading to elevated cellular S-adenosylmethionine. Metabolite analysis and the mutations associated
with resistance suggest multiple inputs associated with BTDIA resistance.
Human gut microbiome exposed to MTDIA revealed no growth inhibition
under aerobic or anaerobic conditions. Transition state analogues
of H. pylori MTAN have potential as
agents for treating H. pylori infection
without disruption of the human gut microbiome or inducing resistance
in the MTAN target.