Ian B. Seiple, Arthur A Tran, Justin T Biel, Dean L. Shinabarger, Beverly Murray, David Chow, Na Zhang, Kenneth W. Borrelli, Kaijie Ji, Gydo C. P. van Zundert, Jenna Pellegrino, D. John Lee, Cindy Wolfe, Jesslyn E Park, Ruoxi Wang, Qi Li, Olivier Chesneau, Estelle Mühle, Axel F. Brilot, Hector A Chaires, Matthew P. Jacobson, James S. Fraser, University of California [San Francisco] (UC San Francisco), University of California (UC), Beijing University of Technology, Schrödinger, Micromyx, Collection de l'Institut Pasteur (CIP), Institut Pasteur [Paris] (IP), A.A.T. and J.P. were supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. 1650113. D.J.L. was supported by a Postdoctoral Individual National Research Award NIH AI148120. H.A.C. was supported by a National Institute on Minority Health and Health Disparities (NIMHD) research diversity supplement under NIH GM123159. This project was funded by the UCSF Program for Breakthrough Biomedical Research, funded in part by the Sandler Foundation (J.S.F. and I.B.S.), a Sangvhi-Agarwal Innovation Award (J.S.F.), Packard Fellowships from the David and Lucile Packard Foundation (J.S.F. and I.B.S.), NIH GM123159 (J.S.F.), and NIH GM128656 (I.B.S.). We thank G. Meigs and J. Holton at Beamline 8.3.1 at the Advanced Light Source, which is operated by the University of California Office of the President, Multicampus Research Programs and Initiatives grant MR-15-328599, the National Institutes of Health (R01 GM124149 and P30 GM124169), Plexxikon Inc., and the Integrated Diffraction Analysis Technologies program of the US Department of Energy Office of Biological and Environmental Research. The Advanced Light Source (Berkeley, CA) is a national user facility operated by Lawrence Berkeley National Laboratory on behalf of the US Department of Energy under contract number DE-AC02-05CH11231, Office of Basic Energy Sciences. We thank M. Thompson for comments on the crystallography methods. We thank A. Myasnikov and D. Bulkley for technical support at the UCSF Center for Advanced CryoEM, which is supported by NIH grants S10OD020054 and S10OD021741 and the Howard Hughes Medical Institute (HHMI). We thank E. Eng and E. Kopylov for technical support at the National Center for CryoEM Access and Training (NCCAT) and the Simons Electron Microscopy Center located at the New York Structural Biology Center, which is supported by the NIH Common Fund Transformative High Resolution Cryo-Electron Microscopy program (U24 GM129539) and by grants from the Simons Foundation (SF349247) and NY State. We thank W. Weiss at the University of North Texas Health Science Center for conducting the animal study., University of California [San Francisco] (UCSF), University of California, and Institut Pasteur [Paris]
International audience; Natural products serve as chemical blueprints for most antibiotics in clinical use. The evolutionary process by which these molecules arise is inherently accompanied by the co-evolution of resistance mechanisms that shorten the clinical lifetime of any given class of antibiotics1. Virginiamycin acetyltransferase (Vat) enzymes are resistance proteins that provide protection against streptogramins2, potent antibiotics against Gram-positive bacteria that inhibit the bacterial ribosome3. Owing to the challenge of selectively modifying the chemically complex, 23-membered macrocyclic scaffold of group A streptogramins, analogues that overcome the resistance conferred by Vat enzymes have not been previously developed2. Here we report the design, synthesis, and antibacterial evaluation of group A streptogramin antibiotics with extensive structural variability. Using cryo-electron microscopy and forcefield-based refinement, we characterize the binding of eight analogues to the bacterial ribosome at high resolution, revealing binding interactions that extend into the peptidyl tRNA-binding site and towards synergistic binders that occupy the nascent peptide exit tunnel. One of these analogues has excellent activity against several streptogramin-resistant strains of Staphylococcus aureus, exhibits decreased rates of acetylation in vitro, and is effective at lowering bacterial load in a mouse model of infection. Our results demonstrate that the combination of rational design and modular chemical synthesis can revitalize classes of antibiotics that are limited by naturally arising resistance mechanisms.