National Institutes of Health/National Cancer Institute (NIH/NCI)
CA231466
United States
Citation
Journal: bioRxiv / Year: 2025 Title: Butyrolactol A potentiates caspofungin efficacy against resistant fungi via phospholipid flippase inhibition. Authors: Xuefei Chen / H Diessel Duan / Michael J Hoy / Kalinka Koteva / Michaela Spitzer / Allison K Guitor / Emily Puumala / Aline A Fiebig / Guanggan Hu / Bonnie Yiu / Sommer Chou / Zhuyun Bian / ...Authors: Xuefei Chen / H Diessel Duan / Michael J Hoy / Kalinka Koteva / Michaela Spitzer / Allison K Guitor / Emily Puumala / Aline A Fiebig / Guanggan Hu / Bonnie Yiu / Sommer Chou / Zhuyun Bian / Yeseul Choi / Amelia Bing Ya Guo / Wenliang Wang / Sheng Sun / Nicole Robbins / Anna Floyd Averette / Michael A Cook / Ray Truant / Lesley T MacNeil / Eric D Brown / James W Kronstad / Brian K Coombes / Leah E Cowen / Joseph Heitman / Huilin Li / Gerard D Wright Abstract: Fungal infections cause millions of deaths annually and are challenging to treat due to limited therapeutic options and rising resistance. Cryptococci are intrinsically resistant to the latest ...Fungal infections cause millions of deaths annually and are challenging to treat due to limited therapeutic options and rising resistance. Cryptococci are intrinsically resistant to the latest generation of antifungals, echinocandins, while , a notorious global threat, is also increasingly resistant. We performed a natural product extract screen to rescue caspofungin fungicidal activity against H99 and identified butyrolactol A, which restores echinocandin efficacy against resistant fungal pathogens, including multidrug-resistant . Mode of action studies revealed that butyrolactol A inhibits the phospholipid flippase Apt1-Cdc50, blocking phospholipid transport. Cryo-electron microscopy analysis of the Apt1•butyrolactol A complex revealed that the flippase is trapped in a dead-end state. Apt1 inhibition disrupts membrane asymmetry, vesicular trafficking, and cytoskeletal organization, thereby enhancing echinocandin uptake and potency. This study identifies lipid flippases as promising antifungal targets and demonstrates the potential of revisiting natural products to expand the antifungal arsenal and combat resistance.
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