In nearly all bacterial species examined so far, amino acid starvation triggers the rapid accumulation of the nucleotide second messenger (p)ppGpp, the effector of the stringent response. While for years the enzymes involved in (p)ppGpp metabolism and the significance of (p)ppGpp accumulation to stress survival were considered well defined, a recent surge of interest in the field has uncovered an unanticipated level of diversity in how bacteria metabolize and utilize (p)ppGpp to rapidly synchronize a variety of biological processes important for growth and stress survival. In addition to the classic activation of the stringent response, it has become evident that (p)ppGpp exerts differential effects on cell physiology in an incremental manner rather than simply acting as a biphasic switch that controls growth or stasis. Of particular interest is the intimate relationship of (p)ppGpp with persister cell formation and virulence, which has spurred the pursuit of (p)ppGpp inhibitors as a means to control recalcitrant infections. Here, we present an overview of the enzymes responsible for (p)ppGpp metabolism, elaborate on the intricacies that link basal production of (p)ppGpp to bacterial homeostasis, and discuss the implications of targeting (p)ppGpp synthesis as a means to disrupt long-term bacterial survival strategies.
While analyzing nucleotide extracts of Escherichia coli, Cashel and Gallant visualized two spots by thin-layer chromatography that could be implicated in the inhibition of stable RNA accumulation provoked by amino acid starvation, which they dubbed "magic spots" (1). These magic spots were later identified as the hyperphosphorylated guanosine derivatives ppGpp (GDP, 3=-diphosphate) and pppGpp (GTP, 3=-diphosphate), collectively referred to as (p)ppGpp, or alarmones (2, 3). Subsequent studies revealed that (p)ppGpp is responsible for activation of the stringent response (SR), a highly conserved stress response to nutrient starvation (4, 5). Generally speaking, accumulation of (p)ppGpp induces large-scale transcriptional alterations leading to general repression of genes required for rapid growth, such as rRNA genes, and concomitant activation of genes involved in amino acid biosynthesis, nutrient acquisition, and stress survival. In addition to transcriptional control, (p)ppGpp has been shown to directly inhibit the activity of several enzymes, including DNA primase, translation factors, and enzymes involved in GTP biosynthesis (6) (Fig. 1). Ultimately, the SR reallocates cellular resources toward adaptation to a semidormant state, facilitating survival under unfavorable conditions (5, 7). Although initially defined as a response to amino acid and carbon starvation, the term SR has since been expanded to include any regulatory effect exerted by cellular (p)ppGpp accumulation irrespective of the triggering mechanism (4).The broad physiological alterations induced by (p)ppGpp accumulation rely heavily upon transcriptional alterations. In Gammaproteobacteria, such as the Gram-negative paradigmatic orga...