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Overview
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Pretomanid is a bicyclic nitroimidazole and small molecule pro-drug that is active against actively replicating and hypoxic non-replicating Mycobacterium tuberculosis, the causative agent of tuberculosis (TB). It is activated by deazaflavin-dependent nitroreductase. Other mono- and multidrug-resistant strains of M. tuberculosis exhibited comparable susceptibilities to Pretomanid, indicating no cross-resistance with current anti-TB drugs.
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Background
Pretomanid has a complex mechanism of action, with differing aerobic and anaerobic activity. Aerobic activity includes cell wall inhibition via mycolic acid biosynthesis. Anaerobic activity has Pretomanid acting as a nitric oxide donor, resulting in respiratory poisoning through nitric oxide release. The nitric oxide possibly reacts with cytochromes to interfere with electron flow and ATP homeostasis under hypoxic conditions. Nitric oxide has multiple targets including as many as 29 mycobacterial enzymes (Manjunatha et al, 2009).
Understanding the interaction between Pretomanid and the target bacterial metabolome is important to contribute to the discovery of new TB candidates.
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- Properties
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Overview