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Sacchettini, J.

Publications and source records attributed to Sacchettini, J..

5 recordsLinked to original sources

Improving Generalizability in Whole-Cell Antibiotic Discovery Through Active Learning

Machine learning (ML) has accelerated molecular discovery, yet training models to generalize to out-of-distribution (OOD) chemical spaces remains fundamentally constrained by the high cost of experimental validation. In antibiotic discovery, where whole-cell phenotypic high throughput screening (HTS) is resource-intensive, iterative ML-guided compound selection - or Active Learning (AL) - offers a pathway to efficiently navigate available chemical spaces. However, the algorithmic tradeoffs between prioritizing compound novelty (exploration), predicted bioactivity (exploitation), and their impact on OOD generalizability remain unresolved for noisy, whole-cell biological systems. In this work, we systematically evaluate three AL strategies for whole-cell bacterial bioactivity and benchmark their effects on model accuracy, hit rate, and OOD performance. Using retrospective simulations on Mycobacterium tuberculosis HTS data, we identify an optimal AL strategy that balances predicted hit/non-hit novelty with overall hit rate. We then integrate the strategy in a closed-loop Borrelia burgdorferi antibiotic discovery HTS campaign. The AL-guided approach successfully increased the experimental screening hit rate five-fold (from a 0.2% rate within investigator-selected plates to 1.0%). Further, when the trained model was applied in prospective in silico selection of highly diverse compounds across multiple bacterial species, the AL-trained whole-cell inhibition predictor demonstrates 53-fold enrichment over investigator-directed screening (11.0% experimental validation of predicted hits). Of these, 100% demonstrated the intended narrow spectrum activity for Borrelia burgdorferi. These results demonstrate that calibrated AL strategies can overcome data acquisition bottlenecks and train generalizable property predictors able to extrapolate to OOD molecules.

bioinformatics↗

Fleming: An AI Agent for Antibiotic Discovery in Mycobacterium Tuberculosis

Antibiotic development is challenged by high costs and failure rates. Artificial intelligence (AI) holds promise to overcome these challenges by predicting inhibitory properties of novel compounds, generating new candidates, and contextualizing property predictions in the biological background. Fleming is an integrative AI agent that explores novel chemical space to identify lead compounds meeting multiple criteria. The discriminative and generative AI models for Mycobacterium tuberculosis (Mtb) inhibition were trained on a set of 114,900 diverse compounds and fragments based on in vitro growth inhibition. We combined both models as well as molecular optimization, ADMET prediction and literature search functions to make Fleming an integrated agent for Mtb preclinical lead identification. Fleming has 17% higher discrimination between known Mtb leads and leads for other diseases than a generic LLM agent along with 13% higher discrimination than molecular property prediction alone on challenging ADMET tasks. Fleming demonstrates an 83% in vitro hit rate of predicted inhibition and a 100% hit rate of de novo generative design. Flemings generative designs also demonstrate an 83% rate of favorable ADMET profiles. Fleming is an integrative AI agent able to explore new regions of the chemical space to select lead compounds that simultaneously meet several desirable criteria.

bioinformatics↗

Mutations in Rv2983 as a novel determinant of resistance to nitroimidazole drugs in Mycobacterium tuberculosis

Delamanid represents one of two novel antimicrobial classes approved to treat tuberculosis in over 40 years. Pretomanid is another promising nitroimidazole pro-drug in clinical development. Characterization of the full spectrum of mutations conferring resistance to nitroimidazoles and their related phenotypes in Mycobacterium tuberculosis will inform development of suitable genotypic and phenotypic drug susceptibility tests. Here, we used a range of pretomanid doses to select pretomanid-resistant mutants in two pathologically distinct murine TB models. The frequency of spontaneous pretomanid resistance mutations was approximately 10-5 CFU. Pretomanid demonstrated dose-dependent bactericidal activity and selective amplification of resistant mutants. Whole genome sequencing of 161 resistant isolates from 47 mice revealed 99 unique mutations, 90% of which were found in 1 of 5 genes previously associated with nitroimidazole activation and resistance. The remaining 10% harbored isolated mutations in Rv2983. Complementing an Rv2983 mutant with a wild-type copy of Rv2983 restored wild-type susceptibility to pretomanid and delamanid, confirming that loss of Rv2983 function causes nitroimidazole resistance. By quantifying F420 and its precursor Fo in Mycobacterium smegmatis overexpressing Rv2983 and an M. tuberculosis Rv2983 mutant, we provide evidence that Rv2983 is necessary for F420 biosynthesis and nitroimidazole activation, perhaps as the guanylyltransferase CofC. F420H2-deficient mutants displayed hypersusceptibility to malachite green (MG), a selective decontaminant present in solid media used to isolate and propagate mycobacteria from clinical samples. The wide diversity of mutations causing high-level pretomanid resistance and MG hypersusceptibility of most mutants poses significant challenges to clinical detection of nitroimidazole resistance using either genotypic or phenotypic methods.\n\nSignificanceNitroimidazole pro-drugs represent a promising new class of anti-tuberculosis drugs. Reliable methods to assure nitroimidazole susceptibility are critical to assure their optimal use. Yet, the spectrum of nitroimidazole resistance mutations remains incompletely characterized. Using 161 pretomanid-resistant Mycobacterium tuberculosis isolates selected in pretomanid-treated mice, we discovered a novel resistance determinant, Rv2983, required for cofactor F420 biosynthesis and characterized the remarkable diversity of mutations in this and 5 other genes involved in nitroimidazole activation. We show that F420H2-deficient nitroimidazole-resistant mutants are hypersusceptible to the selective decontaminant malachite green used in solid media to isolate mycobacteria and may evade detection on such media. These results have important implications for development and clinical use of genotypic and phenotypic methods for nitroimidazole susceptibility testing.

microbiology↗

Genome wide association with quantitative resistance phenotypes in Mycobacterium tuberculosis reveals novel resistance genes and regulatory regions

Drug resistance is threatening attempts at tuberculosis epidemic control. Molecular diagnostics for drug resistance that rely on the detection of resistance-related mutations could expedite patient care and accelerate progress in TB eradication. We performed minimum inhibitory concentration testing for 12 anti-TB drugs together with Illumina whole genome sequencing on 1452 clinical Mycobacterium tuberculosis (MTB) isolates. We then used a linear mixed model to evaluate genome wide associations between mutations in MTB genes or noncoding regions and drug resistance, followed by validation of our findings in an independent dataset of 792 patient isolates. Novel associations at 13 genomic loci were confirmed in the validation set, with 2 involving noncoding regions. We found promoter mutations to have smaller average effects on resistance levels than gene body mutations in genes where both can contribute to resistance. Enabled by a quantitative measure of resistance, we estimated the heritability of the resistance phenotype to 11 anti-TB drugs and identify a lower than expected contribution from known resistance genes. We also report the proportion of variation in resistance levels explained by the novel loci identified here. This study highlights the complexity of the genomic mechanisms associated with the MTB resistance phenotype, including the relatively large number of potentially causative or compensatory loci, and emphasizes the contribution of the noncoding portion of the genome.

evolutionary biology↗

Genotypic clustering does not imply recent tuberculosis transmission in a high prevalence setting: A genomic epidemiology study in Lima, Peru

BackgroundWhole genome sequencing (WGS) can elucidate Mycobacterium tuberculosis (Mtb) transmission patterns but more data is needed to guide its use in high-burden settings. In a household-based transmissibility study of 4,000 TB patients in Lima, Peru, we identified a large MIRU-VNTR Mtb cluster with a range of resistance phenotypes and studied host and bacterial factors contributing to its spread.\n\nMethodsWGS was performed on 61 of 148 isolates in the cluster. We compared transmission link inference using epidemiological or genomic data with and without the inclusion of controversial variants, and estimated the dates of emergence of the cluster and antimicrobial drug resistance acquisition events by generating a time-calibrated phylogeny. We validated our findings in genomic data from an outbreak of 325 TB cases in London. Using a larger set of 12,032 public Mtb genomes, we determined bacterial factors characterizing this cluster and under positive selection in other Mtb lineages.\n\nFindingsFour isolates were distantly related and the remaining 57 isolates diverged ca. 1968 (95% HPD: 1945-1985). Isoniazid resistance arose once, whereas rifampicin resistance emerged subsequently at least three times. Amplification of other drug resistance occurred as recently as within the last year of sampling. High quality PE/PPE variants and indels added information for transmission inference. We identified five cluster-defining SNPs, including esxV S23L to be potentially contributing to transmissibility.\n\nInterpretationClusters defined by MIRU-VNTR typing, could be circulating for decades in a high-burden setting. WGS allows for an improved understanding of transmission, as well as bacterial resistance and fitness factors.\n\nFundingThe study was funded by the National Institutes of Health (Peru Epi study U19-AI076217 and K01-ES026835 to MRF). The funding sources had no role in any aspect of the study, manuscript or decision to submit it for publication.\n\nResearch in contextO_ST_ABSEvidence before this studyC_ST_ABSUse of whole genome sequencing (WGS) to study tuberculosis (TB) transmission has proven to have higher resolution that traditional typing methods in low-burden settings. The implications of its use in high-burden settings are not well understood.\n\nAdded value of this studyUsing WGS, we found that TB clusters defined by traditional typing methods may be circulating for several decades. Genomic regions typically excluded from WGS analysis contain large amount of genetic variation that may affect interpretation of transmission events. We also identified five bacterial mutations that may contribute to transmission fitness.\n\nImplications of all the available evidenceAdded value of WGS for understanding TB transmission may be even higher in high-burden vs. low-burden settings. Methods integrating variants found in polymorphic sites and insertions and deletions are likely to have higher resolution. Several host and bacterial factors may be responsible for higher transmissibility that can be targets of intervention to interrupt TB transmission in communities.

microbiology↗