“…Since its introduction, pentamidine has been used for the treatment and prophylaxis of infections by Pneumocystis carinii (Ivády & Páldy, 1957;Hughes, 1991) and other eukaryotic microbial pathogens+ However, due to the inability to culture P. carinii from patients (Sloand et al+, 1993), the mechanism of action of pentamidine on this organism remains unknown (reviewed by Queener, 1995)+ In vitro, pentamidine has been shown to inhibit topoisomerases from P. carinii (Dykstra & Tidwell, 1991)+ In addition, pentamidine is known to bind in the minor groove of duplex DNA (Cory et al+, 1992;Nunn et al+, 1994)+ Because gene sequence analysis has shown P. carinii to be a fungus related to Saccharomyces cerevisiae (Edman et al+, 1988), this latter organism is a useful model for studying the mechanism of pentamidine antimicrobial activity (Ludewig et al+, 1994)+ Pentamidine appears to act on a mitochondrial target in S. cerevisiae, because growth inhibition was observed at 200-fold lower pentamidine concentrations on nonfermentable glycerol medium than on a fermentable carbon source+ However, the actual target of this inhibition was not mitochondrial DNA (mtDNA) maintenance, because petite mutants were generated only by much higher concentrations of pentamidine than are needed to inhibit growth on glycerol (Ludewig et al+, 1994)+ Furthermore, pentamidine inhibits the growth of yeast at much lower concentrations than are required to uncouple oxidative phosphorylation (Ludewig et al+, 1994)+ Such uncoupling has been noted in vitro in rat liver mitochondria, and may explain the toxicity of this drug to animals (Moreno, 1996)+ Pneumocystis carinii harbors group I introns in its rRNA genes (Edman et al+, 1988;Liu et al+, 1992;Liu & Leibowitz, 1993)+ Model transcripts containing these introns self-splice in vitro (Sogin & Edman, 1989;Lin et al+, 1992;Liu et al+, 1992;Liu & Leibowitz, 1993), and their splicing is inhibited by pentamidine (Liu & Leibowitz, 1993Liu et al+, 1994)+ Pentamidine inhibits the in vitro splicing catalyzed by these ribozymes noncompetitively relative to the guanosine cofactor, with total inhibition being achieved at concentrations of 250 mM (Liu et al+, 1994)+ However, the inability to grow clinical isolates of P. carinii in culture has precluded determination of whether this inhibition accounts for the anti-Pneumocystis activity...…”