Isoniazid Bactericidal Activity Involves Electron Transport Chain Perturbation

• Published in: Antimicrobial agents and chemotherapy 2019-03, Vol.63 (3)
• Main Authors: Zeng, Sheng, Soetaert, Karine, Ravon, Faustine, Vandeput, Marie, Bald, Dirk, Kauffmann, Jean-Michel, Mathys, Vanessa, Wattiez, Ruddy, Fontaine, Véronique
• Format: Article
• Language: English
• Subjects: Adenosine Triphosphate - metabolism; Antitubercular Agents; Antitubercular Agents - pharmacology; Cytochrome b Group - antagonists & inhibitors; Diarylquinolines - pharmacology; Electron Transport; Electron Transport - drug effects; Electron Transport Chain Complex Proteins; Electron Transport Chain Complex Proteins - antagonists & inhibitors; Electron Transport Complex IV - metabolism; Imidazoles - pharmacology; Isoniazid; Isoniazid - pharmacology; Mechanisms of Action: Physiological Effects; Membrane Potentials - drug effects; Mycobacterium bovis; Mycobacterium bovis - drug effects; Mycobacterium bovis - metabolism; Mycobacterium tuberculosis; Mycobacterium tuberculosis - drug effects; Mycobacterium tuberculosis - metabolism; Oxidation-Reduction - drug effects; Oxygen Consumption - drug effects; Piperidines - pharmacology; Pyridines - pharmacology
• ISSN: 0066-4804; 1098-6596
• DOI: 10.1128/AAC.01841-18

Accumulating evidence suggests that the bactericidal activity of some antibiotics may not be directly initiated by target inhibition. The activity of isoniazid (INH), a key first-line bactericidal antituberculosis drug currently known to inhibit mycolic acid synthesis, becomes extremely poor under stress conditions, such as hypoxia and starvation. This suggests that the target inhibition may not fully explain the bactericidal activity of the drug. Here, we report that INH rapidly increased BCG cellular ATP levels and enhanced oxygen consumption. The INH-triggered ATP increase and bactericidal activity were strongly compromised by Q203 and bedaquiline, which inhibit mycobacterial cytochrome and F F ATP synthase, respectively. Moreover, the antioxidant -acetylcysteine (NAC) but not 4-hydroxy-2,2,6,6-tetramethylpiperidin-1-oxyl (TEMPOL) abrogated the INH-triggered ATP increase and killing. These results reveal a link between the energetic (ATP) perturbation and INH's killing. Furthermore, the INH-induced energetic perturbation and killing were also abrogated by chemical inhibition of NADH dehydrogenases (NDHs) and succinate dehydrogenases (SDHs), linking INH's bactericidal activity further to the electron transport chain (ETC) perturbation. This notion was also supported by the observation that INH dissipated mycobacterial membrane potential. Importantly, inhibition of cytochrome oxidase significantly reduced cell recovery during INH challenge in a culture settling model, suggesting that the respiratory reprogramming to the cytochrome oxidase contributes to the escape of INH killing. This study implicates mycobacterial ETC perturbation through NDHs, SDHs, cytochrome , and F F ATP synthase in INH's bactericidal activity and pinpoints the participation of the cytochrome oxidase in protection against this drug under stress conditions.