Development of a gut microbe–targeted nonlethal therapeutic to inhibit thrombosis potential View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-09

AUTHORS

Adam B. Roberts, Xiaodong Gu, Jennifer A. Buffa, Alex G. Hurd, Zeneng Wang, Weifei Zhu, Nilaksh Gupta, Sarah M. Skye, David B. Cody, Bruce S. Levison, William T. Barrington, Matthew W. Russell, Jodie M. Reed, Ashraf Duzan, Jennifer M. Lang, Xiaoming Fu, Lin Li, Alex J. Myers, Suguna Rachakonda, Joseph A. DiDonato, J. Mark Brown, Valentin Gogonea, Aldons J. Lusis, Jose Carlos Garcia-Garcia, Stanley L. Hazen

ABSTRACT

Trimethylamine N-oxide (TMAO) is a gut microbiota-derived metabolite that enhances both platelet responsiveness and in vivo thrombosis potential in animal models, and TMAO plasma levels predict incident atherothrombotic event risks in human clinical studies. TMAO is formed by gut microbe-dependent metabolism of trimethylamine (TMA) moiety-containing nutrients, which are abundant in a Western diet. Here, using a mechanism-based inhibitor approach targeting a major microbial TMA-generating enzyme pair, CutC and CutD (CutC/D), we developed inhibitors that are potent, time-dependent, and irreversible and that do not affect commensal viability. In animal models, a single oral dose of a CutC/D inhibitor significantly reduced plasma TMAO levels for up to 3 d and rescued diet-induced enhanced platelet responsiveness and thrombus formation, without observable toxicity or increased bleeding risk. The inhibitor selectively accumulated within intestinal microbes to millimolar levels, a concentration over 1-million-fold higher than needed for a therapeutic effect. These studies reveal that mechanism-based inhibition of gut microbial TMA and TMAO production reduces thrombosis potential, a critical adverse complication in heart disease. They also offer a generalizable approach for the selective nonlethal targeting of gut microbial enzymes linked to host disease limiting systemic exposure of the inhibitor in the host. More... »

PAGES

1407-1417

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/s41591-018-0128-1

DOI

http://dx.doi.org/10.1038/s41591-018-0128-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1105858691

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30082863


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69 schema:description Trimethylamine N-oxide (TMAO) is a gut microbiota-derived metabolite that enhances both platelet responsiveness and in vivo thrombosis potential in animal models, and TMAO plasma levels predict incident atherothrombotic event risks in human clinical studies. TMAO is formed by gut microbe-dependent metabolism of trimethylamine (TMA) moiety-containing nutrients, which are abundant in a Western diet. Here, using a mechanism-based inhibitor approach targeting a major microbial TMA-generating enzyme pair, CutC and CutD (CutC/D), we developed inhibitors that are potent, time-dependent, and irreversible and that do not affect commensal viability. In animal models, a single oral dose of a CutC/D inhibitor significantly reduced plasma TMAO levels for up to 3 d and rescued diet-induced enhanced platelet responsiveness and thrombus formation, without observable toxicity or increased bleeding risk. The inhibitor selectively accumulated within intestinal microbes to millimolar levels, a concentration over 1-million-fold higher than needed for a therapeutic effect. These studies reveal that mechanism-based inhibition of gut microbial TMA and TMAO production reduces thrombosis potential, a critical adverse complication in heart disease. They also offer a generalizable approach for the selective nonlethal targeting of gut microbial enzymes linked to host disease limiting systemic exposure of the inhibitor in the host.
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