Potent Inhibitors of Acetyltransferase Eis Overcome Kanamycin Resistance in Mycobacterium tuberculosis

ACS Chem Biol. 2016 Jun 17;11(6):1639-46. doi: 10.1021/acschembio.6b00110. Epub 2016 Apr 7.


A major cause of tuberculosis (TB) resistance to the aminoglycoside kanamycin (KAN) is the Mycobacterium tuberculosis (Mtb) acetyltransferase Eis. Upregulation of this enzyme is responsible for inactivation of KAN through acetylation of its amino groups. A 123 000-compound high-throughput screen (HTS) yielded several small-molecule Eis inhibitors that share an isothiazole S,S-dioxide heterocyclic core. These were investigated for their structure-activity relationships. Crystal structures of Eis in complex with two potent inhibitors show that these molecules are bound in the conformationally adaptable aminoglycoside binding site of the enzyme, thereby obstructing binding of KAN for acetylation. Importantly, we demonstrate that several Eis inhibitors, when used in combination with KAN against resistant Mtb, efficiently overcome KAN resistance. This approach paves the way toward development of novel combination therapies against aminoglycoside-resistant TB.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetyltransferases / antagonists & inhibitors*
  • Antitubercular Agents / chemistry
  • Antitubercular Agents / pharmacology*
  • Bacterial Proteins / antagonists & inhibitors*
  • Crystallography, X-Ray
  • Cyclic S-Oxides / chemistry
  • Cyclic S-Oxides / pharmacology*
  • Drug Design
  • High-Throughput Screening Assays
  • Kanamycin / metabolism
  • Kanamycin / pharmacology
  • Kanamycin Resistance / drug effects*
  • Mycobacterium tuberculosis / drug effects*
  • Mycobacterium tuberculosis / enzymology
  • Staphylococcus aureus / drug effects
  • Structure-Activity Relationship
  • Thiazoles / chemistry
  • Thiazoles / pharmacology*


  • Antitubercular Agents
  • Bacterial Proteins
  • Cyclic S-Oxides
  • Thiazoles
  • Kanamycin
  • Acetyltransferases
  • Eis protein, Mycobacterium tuberculosis