Simonsson, U. S. | bioRxiv Science

bioRxiv2025

In vitro pharmacokinetics and pharmacodynamics of the diarylquinoline TBAJ-587 and its metabolites against Mycobacterium tuberculosis

The first-in-class diarylquinoline (DARQ) bedaquiline (BDQ) is in the medicines list for drug-resistant tuberculosis. TBAJ-587 is a next-generation DARQ with improved anti-Mycobacterium tuberculosis (Mtb) activity and reduced cardiac repolarization abnormalities. Methods. The in-vitro efficacy of TBAJ-587 and its main metabolites (M2, M3 and M12) was analyzed under standard (ST) growth conditions, with cholesterol (CHO), or fatty acids (FA) as alternative carbon sources. Minimal inhibitory concentration (MIC) assays and time-kill assays (TKA) linked to drug measurements in bacterial samples were performed to allow correlation of pharmacodynamics (PD) with actual pharmacokinetics (PK). The most active compounds, TBAJ-587 and its M3 metabolite, exhibited broth media and concentration dependent efficacy showing a bactericidal effect at [≥]5x MIC. Bacterial cultures treated with 1x MIC and 2x MIC of TBAJ-587 resumed growth after 28 days and displayed moderate increased MIC values compared to untreated conditions, which were linked to new variants of BDQ resistance mutations in the atpE, atpB, and Rv0678 genes. This study revealed TBAJ-587 and metabolites bind to polystyrene plastic-ware, the most commonly used material in antimicrobial research, being the effective unbound drug concentration dependent on the media composition. PKPD analyses determined that Mtb was killed with lower exposures of TBAJ-587 and M3 than expected in ST and FA broth, suggesting previously underestimated potency in these media. This is the first in-vitro study to precisely link compound activities (PD) to their effective concentration (PK) over time in Mtb cultures, providing improved longitudinal data to feed models for translational research.

pharmacology and toxicology↗

bioRxiv2023

A BCG Skin Challenge Model for Assessing TB Vaccines

Controlled Human infection models (CHIM) are valuable tools for assessing relevant biological activity in vaccine candidates, with the potential to accelerate Tuberculosis vaccine development into the clinic. Tuberculosis infection poses significant constraints on the design of a CHIM using the causative agent Mycobacterium tuberculosis. As a safer alternative, we propose a challenge model using the attenuated vaccine agent Mycobacterium bovis BCG as a surrogate for Mycobacterium tuberculosis, and intradermal (skin) challenge as an alternative to pulmonary infection. We have developed a unique non-invasive imaging system based on fluorescent reporters to quantitatively measure bacterial load over time, thereby determining a relevant biological vaccine effect. We assessed the utility of this model to measure the effectiveness of two TB vaccines: the currently licenced BCG and a novel subunit vaccine candidate. To assess the efficacy of the skin challenge model a pharmacometric model was built describing the decline of fluorescence over time. The results show that vaccination is a statistically significant factor which reduced the fluorescence readout of both fluorophores. The higher decline in vaccinated mice correlated with bacterial burden in the lungs. This supports the fluorescence output from the skin as a reflection of vaccine induced functional pulmonary immune responses. This novel non-invasive approach allows for repeated measurements from the challenge site, providing a dynamic readout of vaccine induced responses over time. This BCG skin challenge model represents an important contribution to the ongoing development of controlled challenge models for Tuberculosis.

microbiology↗