1. Academic Validation
  2. Indolcarboxamide is a preclinical candidate for treating multidrug-resistant tuberculosis

Indolcarboxamide is a preclinical candidate for treating multidrug-resistant tuberculosis

  • Sci Transl Med. 2013 Dec 4;5(214):214ra168. doi: 10.1126/scitranslmed.3007355.
Srinivasa P S Rao 1 Suresh B Lakshminarayana Ravinder R Kondreddi Maxime Herve Luis R Camacho Pablo Bifani Sarath K Kalapala Jan Jiricek Ng L Ma Bee H Tan Seow H Ng Mahesh Nanjundappa Sindhu Ravindran Peck G Seah Pamela Thayalan Siao H Lim Boon H Lee Anne Goh Whitney S Barnes Zhong Chen Kerstin Gagaring Arnab K Chatterjee Kevin Pethe Kelli Kuhen John Walker Gu Feng Sreehari Babu Lijun Zhang Francesca Blasco David Beer Margaret Weaver Veronique Dartois Richard Glynne Thomas Dick Paul W Smith Thierry T Diagana Ujjini H Manjunatha
Affiliations

Affiliation

  • 1 Novartis Institute for Tropical Diseases, Singapore 138670, Singapore.
Abstract

New chemotherapeutic compounds against multidrug-resistant Mycobacterium tuberculosis (Mtb) are urgently needed to combat drug resistance in tuberculosis (TB). We have identified and characterized the indolcarboxamides as a new class of antitubercular bactericidal agent. Genetic and lipid profiling studies identified the likely molecular target of indolcarboxamides as MmpL3, a transporter of trehalose monomycolate that is essential for mycobacterial cell wall biosynthesis. Two lead candidates, NITD-304 and NITD-349, showed potent activity against both drug-sensitive and multidrug-resistant clinical isolates of Mtb. Promising pharmacokinetic profiles of both compounds after oral dosing in several species enabled further evaluation for efficacy and safety. NITD-304 and NITD-349 were efficacious in treating both acute and chronic Mtb infections in mouse efficacy models. Furthermore, dosing of NITD-304 and NITD-349 for 2 weeks in exploratory rat toxicology studies revealed a promising safety margin. Finally, neither compound inhibited the activity of major cytochrome P-450 enzymes or the hERG (human ether-a-go-go related gene) channel. These results suggest that NITD-304 and NITD-349 should undergo further development as a potential treatment for multidrug-resistant TB.

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