Loxapine, an antipsychotic drug, suppresses intracellular multiple-antibiotic-resistant Salmonella enterica serovar Typhimurium in macrophages

J Microbiol Immunol Infect. 2019 Aug;52(4):638-647. doi: 10.1016/j.jmii.2019.05.006. Epub 2019 Jun 8.

Abstract

Background: The emergence of multiple-antibiotic-resistant (MAR) Salmonella has been a serious threat worldwide. Salmonella can invade into host cells and evade the attacks of host humoral defenses and antibiotics. Thus, a new antibacterial agent capable of inhibiting intracellular Salmonella is highly needed.

Methods: The anti-intracellular activity and cytotoxicity of drugs on intracellular bacteria and macrophages were assayed using intracellular CFU assay and MTT cell viability assay, respectively. The uptake of gentamicin into macrophage and the effect of autophagy inhibitor on loxapine's anti-intracellular Salmonella activity were assessed by using image-based high-content system. The expression of bacterial genes was measured by real-time PCR. The efflux pump activity of bacteria was measured by Hoechst accumulation assays.

Results: With our efforts, an antipsychotic drug, loxapine, was identified to exhibit high potency in suppressing intracellular MAR S. Typhimurium, Staphylococcus aureus, Shigella flexneri or Yersinia enterocolitica. Subsequent investigations indicated that loxapine's anti-intracellular bacteria activity was not associated with increased penetration of gentamicin into bacteria and macrophages. Loxapine didn't inhibit bacterial growth in broth at concentration up to 500 μM and has no effect on Salmonella's type III secretion system genes' expression. Blockage of autophagy also didn't reverse loxapine's anti-intracellular activity. Lastly, loxapine suppressed bacterial efflux pump activity in all bacteria tested.

Conclusion: Altogether, our data suggested that loxapine might suppress intracellular bacteria through inhibiting of bacterial efflux pumps. In light of its unique activity, loxapine represents a promising lead compound with translational potential for the development of a new antibacterial agent against intracellular bacteria.

Keywords: Autophagy; Efflux pump; High-content assay; Phenothiazine; Type III secretion system.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / pharmacology*
  • Antipsychotic Agents / pharmacology*
  • Autophagy / drug effects
  • Bacterial Proteins / genetics
  • Cell Survival / drug effects
  • Colony Count, Microbial
  • Drug Resistance, Multiple, Bacterial / drug effects
  • Fluoroquinolones / pharmacology
  • Gene Expression Regulation, Bacterial / drug effects
  • Gentamicins / pharmacology
  • Loxapine / pharmacology*
  • Macrophages / microbiology*
  • Membrane Transport Proteins / drug effects
  • Membrane Transport Proteins / genetics
  • Mice
  • Microbial Sensitivity Tests
  • Phenothiazines / pharmacology
  • RAW 264.7 Cells
  • Salmonella typhimurium / drug effects*
  • Salmonella typhimurium / genetics
  • Salmonella typhimurium / growth & development
  • Serogroup
  • Shigella flexneri / drug effects
  • Staphylococcus aureus / drug effects
  • Type III Secretion Systems / drug effects
  • Type III Secretion Systems / genetics
  • Yersinia enterocolitica / drug effects

Substances

  • Anti-Bacterial Agents
  • Antipsychotic Agents
  • Bacterial Proteins
  • Fluoroquinolones
  • Gentamicins
  • Membrane Transport Proteins
  • Phenothiazines
  • Type III Secretion Systems
  • phenothiazine
  • Loxapine