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Biological Chemistry

Mannosides Fight Urinary Infections

Sugar-based antibiotics combat common infection and help beat back bacterial resistance

by Stu Borman
December 5, 2011 | A version of this story appeared in Volume 89, Issue 49

Mannosides, small-molecule drugs that contain a mannose sugar group, may be able to treat and prevent urinary tract infections (UTIs), without inducing antibiotic resistance. Bacteria that cause UTIs often develop resistance to antibiotics, making those medications less effective. James W. Janetka and Scott J. Hultgren of Washington University School of Medicine, in St. Louis, and coworkers synthesized orally available mannosides active against uropathogenic bacteria and are optimizing them to improve their drug properties (Sci. Transl. Med., DOI: 10.1126/scitranslmed.3003021). The mannosides block the bacterial cell-surface receptor FimH, which bacteria use to interact with bladder epithelial cells to cause infection. In mice with chronic UTIs, the mannosides eliminated uropathogenic bacteria more effectively than did standard antibiotic treatments. The mannosides also work effectively with traditional antibiotics, and healthy mice treated with them don’t get infections. Bacteria typically develop resistance by pumping drug molecules out of their cells and mutating target proteins. But the mannosides function extracellularly, and mutating FimH could eliminate bacterial infectivity, making the development of resistance less likely than with standard antibiotics.

Credit: Corinne Cusumano & Scott Hultgren
This bladder cell (red) is loaded with a bacterium (green) that causes urinary tract infections.
Image of a urinary tract infection. Bladder cell (red) engulfed with bacteria (green).
Credit: Corinne Cusumano & Scott Hultgren
This bladder cell (red) is loaded with a bacterium (green) that causes urinary tract infections.
Mannoside-Receptor Interaction
Credit: Bradley Ford & Scott Hultgren, Washington University School of Medicine
This x-ray crystal structure of a mannoside bound to a bacterial FimH receptor aided the rational design of orally active mannoside FimH inhibitors. Note: X-ray is from J. Med. Chem., DOI: 10.1021/jm100438s.


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