Amixicile: A Concept Therapeutic for Treatment of Chronic Anaerobic Infections.

Paul S Hoffman
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Abstract

Anaerobic microorganisms are often associated with chronic mucosal infections including periodontal disease, inflammatory bowel diseases, and recurrent colitis caused by Clostridioides difficile. Management of these diseases requires a long term strategy, but available antibiotics (e.g., metronidazole) can only be used short term. Conceptually, therapeutics that control chronic inflammation would lessen the risk of associated autoimmune diseases including atherosclerosis, arthritis, type II diabetes, Crohn's and ulcerative colitis and even Alzheimer's disease. To meet this need, an antibiotic must overcome inevitable antibiotic resistance, toxicity to humans or their mitochondria and limit collateral damage (dysbiosis) to gut microbiota. This review describes attributes of amixicile (AMIX), a novel systemic therapeutic, that shows efficacy in animal models for treatment of C. difficile colitis and gastric infections caused by Helicobacter pylori, while limiting collateral damage to gut microflora. Together with the apparent absence of drug resistance, toxicities, and drug metabolism, might qualify amixicile for consideration as a long term therapeutic for management of chronic and acute anaerobic infections.

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氨苄青霉素:治疗慢性厌氧性感染的概念疗法。
厌氧微生物通常与慢性粘膜感染有关,包括牙周病、炎症性肠病和由艰难梭菌引起的复发性结肠炎。这些疾病的管理需要长期战略,但现有的抗生素(如甲硝唑)只能短期使用。从概念上讲,控制慢性炎症的治疗方法将降低相关自身免疫性疾病的风险,包括动脉粥样硬化、关节炎、II型糖尿病、克罗恩病和溃疡性结肠炎,甚至阿尔茨海默病。为了满足这一需求,抗生素必须克服不可避免的抗生素耐药性,对人类或其线粒体的毒性,并限制对肠道微生物群的附带损害(生态失调)。这篇综述描述了一种新型全身治疗药物amixile (AMIX)的特性,该药物在动物模型中显示出治疗由幽门螺杆菌引起的艰难梭菌结肠炎和胃感染的有效性,同时限制了对肠道菌群的附带损伤。再加上明显没有耐药性、毒性和药物代谢,可能有资格考虑将阿米巴霉素作为慢性和急性厌氧感染的长期治疗药物。
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