AUTHOR=Tseng Yen-Yu , Liou Jyh-Ming , Cheng Wei-Chieh , Hsu Jing-Ting , Hsu Tsui-Ling , Wu Ming-Shiang , Wong Chi-Huey 

TITLE=Combating multidrug-resistant Helicobacter pylori with moenomycin A in combination with clarithromycin or metronidazole

JOURNAL=Frontiers in Chemistry

VOLUME=10

YEAR=2022

URL=https://www.frontiersin.org/journals/chemistry/articles/10.3389/fchem.2022.897578

DOI=10.3389/fchem.2022.897578

ISSN=2296-2646

ABSTRACT=<p>Current treatment of <italic>Helicobacter pylori</italic> involves a triple therapy comprising one proton pump inhibitor and two other antibiotics; however, the outcomes are limited due to the existence of antibiotic resistant strains. We previously reported that moenomycin A, a cell-wall transglycosylase inhibitor, is highly active against multidrug-resistant <italic>Helicobacter pylori</italic>. Herein we show that combination of moenomycin A with the protein synthesis inhibitor clarithromycin or metronidazole can synergistically achieve almost 95% eradication of multidrug-resistant <italic>Helicobacter pylori</italic>. We also found that the moenomycin A-non-susceptible strains of <italic>Helicobacter pylori</italic> with deletion of transglycosylase exhibit moenomycin A hyposensitivity, faster growth and impaired biofilm formation compared to the parental strain. Overall, the combination of moenomycin A and clarithromycin or metronidazole to achieve a synergistic effect on different targets is a promising treatment for multidrug-resistant <italic>Helicobacter pylori</italic>.</p>