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Cryo-electron microscopy structural studies of a bacterial multi-drug efflux pump involved in antibiotic resistance

Abstract : The increasing appearance of multi-drug-resistant pathogenic bacteria to most available antibiotics is emerging as a global public health problem. Unfortunately, excessive use in both human and animal medicine has led to the emergence of multi-drug-resistant strains for most antibiotics available on the market. It is therefore urgent to better understand the underlying mechanisms by which bacteria resist to antibiotics to combat multi-resistance strains. In this context, this work aims at better understanding the molecular basis of active drug efflux in Pseudomonas aeruginosa, which is one of the most important mechanisms used by the bacterium to resist to several antibiotics. Efflux systems form protein complexes in the bacterial wall and actively expel antibiotics even before they reach their intracellular target, rendering them inactive. The structural study focuses on the MexA-MexB-OprM RND (Resistance-Nodulation and cell Division) system that is constitutively expressed in wild-type bacteria and is over-expressed in resistant strains. This tripartite complex is composed of a transporter inserted into the inner membrane, a channel protein inserted in the outer membrane and a periplasmic adapter protein that connects the other two proteins to form a sealed conduit through the periplasm. In the absence of knowledge of the structure of the tripartite complex, the aim of the thesis was to develop an original strategy to reconstitute the whole complex in vitro in a lipid environment from the three native components produced separately.The assembly of the tripartite complex is made by mixing MexA with MexB and OprM in Nanodisc mimicking the two lipid bilayers. The structure of this tripartite complex was obtained by combining cryo electron microscopy and the so-called 'isolated particles' approach. The three-dimensional structure of the complex, calculated at a resolution of less than 4 Å, was used to build an atomic model of the tripartite complex assembled between two Nanodiscs. The tripartite complex is composed of an OprM trimer, a MexB trimer and a MexA hexamer surrounding MexB and interacting with OprM. We solve the complete structure of MexA whose N-terminal part hitherto unknown because of a high flexibility and describe for the first time the anchoring of MexA in a lipid membrane. The conformational changes are observed on OprM and MexB when they are assembled in the complex with the opening of the periplasmic end of OprM and the spatial re-orientation of a MexB loop to establish additional contact with MexA.To integrate this tripartite structure into the antibiotic efflux cycle, it describes a state that is probably a resting state, knowing that no specific ligand was added during assembly. In addition, the complex forms an open channel at its extracellular end, providing the conduit to evacuate the drugs carried by MexB that uses the proton motive force as a source of energy. This work opens new perspective for structural studies of other conformational states of the efflux system in "energized" conditions to fulfill our understanding of the efflux cycle mechanism. Moreover, the knowledge of this first tripartite native complex structure constitutes the first step towards the development of molecules capable of blocking the assembly of the complex for therapeutic uses. Indeed, such molecules would inhibit active efflux and restore the lost efficiency of current antibiotics.
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Marie Glavier. Cryo-electron microscopy structural studies of a bacterial multi-drug efflux pump involved in antibiotic resistance. Human health and pathology. Université de Bordeaux, 2018. English. ⟨NNT : 2018BORD0239⟩. ⟨tel-01961910⟩

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