Mediated Antibiotic Action

The chemical production of hydroxyl radical, either by metal-mediated redox reactions or as a result of radiolysis products, can induce strand breaks in DNA. An example of a chemotherapeutic agent whose chemical production of activated oxygen is believed to be the critical step in its action is bleomycin, a naturally occurring antibiotic. The binding of metals to this and other antibiotics has been summarized in detail [1—3] and the material presented here is based on these reviews. 

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A number of substances have been discovered in the last thirty years with a macrocyclic structure (i.e. with ten or more ring members), polar ring interior and non-polar exterior. These substances form complexes with univalent (sometimes divalent) cations, especially with alkali metal ions, with a stability that is very dependent on the individual ionic sort. They mediate transport of ions through the lipid membranes of cells and cell organelles, whence the origin of the term ion-carrier (ionophore). They ion-specifically uncouple oxidative phosphorylation in mitochondria, which led to their discovery in the 1950s. This property is also connected with their antibiotic action. Furthermore, they produce a membrane potential on both thin lipid and thick membranes. 

As schematically own in Fig. 30, the cell membranes of living organism (/ S6) are composed of a lipid bilayer and form the interface between the intracellular and the extracellular aqueous parts. Concentrations of metal ions and amino adds in the cell are thus kept constant and the biological functions in the cell are executed. Specifically, the concentration of metal ions is in a dynamic equilibrium between the inside and the outside of the cell membrane, and it has been suggested that the mass tran rt through the membrane is mediated by lipoproteins. For the metal-km tran rt through the membrane, the participation of a group of cyclic conqxrunds called lonophores is important, which is dosely related to the antibiotic actions of cyclic peptides and cyclic depsipeptides (iJ6). These cyclic compounds are compatibile... 

Murphy M, Ahn J, Walker KK (1999) Transcriptional repression by wild-type p53 utilizes histone deacetylases, mediated by interaction with mSin3a. Genes Dev 13 2490-2501 Nakajima H, Kim YB, Terano H, Yoshida M, Horinouchi S (1998) FR901228, a potent antitumor antibiotic, is a novel histone deacetylase inhibitor. Exp Cell Res 241(1) 126-133 Nebbioso A, Clarke N, Voltz E, Germain E, Ambrosino C, Bontempo P, Alvarez R, Schiavone EM, Eerrara F, Bresciani F, Weisz A, de Lera AR, Gronemeyer H, Altucci L (2005) Tumor-selective action of HDAC inhibitors involves TRAIL induction in acute myeloid leukemia cells. Nature Med 11 77-84... 

Rapamycin (sirolimus), a macrolide antibiotic, has been used recently in organ transplantation for its potent immunosuppressive actions by inhibiting both cytokine mediated and growth factor mediated proliferation of smooth muscle cells and lymphocytes [55, 56]. In the RAVEL trial of non-acute single vessel lesions, the Sirolimus-eluting stent was compared to bare metal stent (BMS) in a 1 1 fashion [57]. One-year major adverse cardiovascular events and 6 month neointimal proliferation as assessed by late luminal loss (-0.01 0.33 mm in Sirolimus stent versus 0.80 0.53 mm in BMS) were improved. The Sirolimus-eluting stent thus virtually eliminated in-stent restenosis with no evidence of edge effect, dissection, or in-stent thrombosis. 

B. Overproduction (A) of PABA is one of the resistance mechanisms of sulfonamides. Changes in the synthesis of DNA gyrases (B) is a well-described mechanism for quinolone resistance. Plasmid-mediated resistance (C) does not occur with quinolones. An active efflux system for transport of drug out of the cell has been described for quinolone resistance, but it is not plasmid mediated. Inhibition of structural blocks (D) in bacterial cell wall synthesis is a basic mechanism of action of p-lactam antibiotics. Inhibition of folic acid synthesis (E) by blocking different steps is the basic mechanism of action of sulfonamides. 

The lincosamides, lincomycin and clindamycin are active against Grampositive bacteria. Plasmid-mediated inactivation from enzymatic nucleo-tidylation occurs in some staphylococci. Plasmid-encoded enzymes can modify streptogramin A (O-acetyltransferase enzyme) and streptogramin B (hydrolase enzyme involved) in S. aureus [198, 199], There is no evidence that bacteria can circumvent the action of other antibiotics for example, mupirocin is not degraded [200]. 

Traditional medical therapies for Crohn s disease include sulfasalazine and corticosteroids. These are pluripotent, reducing the production of inflammatory mediators and cytokines, although the complex and multiple mechanisms remain incompletely understood. Novel therapies related to newer aminosalicylate preparations such as balsalazide (colazide) or olsalazine (dipentum) newer corticosteroids such as budesonide immunomodulators such as azathioprine, 6-mercaptopurine, or methotrexate and antibiotics such as metronidazole are aimed at more specific delivery of active compounds to the site of disease, reduction of systemic absorption and side effects, and modulation of more focal targets within the immune response and the action of specific proinflammatory cytokines. 

A number of drugs inhibit the antidiuretic actions of vasopressin. Lithium is of particular importance because of its use in the treatment of manic-depressive disorders. Lithium-induced polyuria is usually reversible. Acutely, lithium appears to reduce V -receptor-mediated stimulation of adeny-lyl cyclase. Also, hthium increases plasma levels of parathyroid hormone, a partial antagonist to vasopressin. In most patients, the antibiotic demeclocycline attenuates the antidiuretic effects of vasopressin, probably owing to decreased accumulation and action of cyclic AMP. 

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