Overview | bedaquiline, the chemical name is 1-(6-bromo-2-methoxyquinolin-3-yl) -4-dimethylamino-1-phenyl-2-(1-naphthyl)-2-butanol, the trade name is Sirturo, which is a new type of diarylquinoline anti-Mycobacterial Drug, which inhibits the activity of ATP synthase proton pump of Mycobacterium tuberculosis, to affect the ATP synthesis of Mycobacterium tuberculosis, so as to play an antibacterial and bactericidal effect. It is clinically used for the treatment of multi-drug resistant pulmonary tuberculosis in adults (MDR-PTB). |
pharmacological action | bedaquinoline has the same bactericidal activity against sensitive strains and drug-resistant strains of Mycobacterium tuberculosis, it also has a good sterilization effect on dormant bacteria. |
mechanism of action | unique and specific anti-tuberculosis (TB) the site is the proton pump of M. Tuberculosis ATP synthase. ATP synthase is a key enzyme in the synthesis of ATP in Mycobacterium tuberculosis. The oligomer of ATP synthase and the lipoprotein subunit c, when combined with bedaquine, can inhibit the synthesis of ATP, leading to the death of bacteria. Compared with the existing anti-TB drugs, bedacoline has a new anti-TB mechanism, and has no cross-resistance with the existing anti-TB drugs. The gene sequence of subunit c of ATP synthase is designated atpE. Its amino acid sequence is highly conserved. The mechanism by which Mycobacterium tuberculosis is resistant to bedquinoline is that the mutation of amino acid 63 or 66 of atpE reduces the binding ability of bedquinoline to ATP synthase c subunit. |
pharmacokinetics | , 5h to reach the peak blood concentration, and human plasma protein binding rate of more than 99.9%, plasma half-life of 173 hours, widely distributed in the tissue, steady-state distribution volume of more than 1000L, low clearance rate, terminal elimination half-life of 5.5 months. The metabolite 1-8 is formed mainly by CYP3A4 and partially by CYP2C8 and CYP2C19 demethylation, the most important of which is the demethylated product m2. M2 has only 1/3-1/6 of the biological activity of bedaquinoline, but is more cytotoxic and more susceptible to the development of drug-induced phospholipids. The vast majority of bedaquinoline and its metabolites are excreted by feces, and only 1% ~ 4% are excreted by urine. (2015-12-21)
preparation method | FIG. 1 is the synthetic route |
adverse reactions | the common adverse reactions were Nausea, Head Pain, Arthralgia, loss of appetite, Nausea and vomiting followed by rash, dizziness, elevated transaminase, elevated blood amylase, muscle pain, Diarrhea and TQ interval prolongation, etc. |
contraindications | 1. Allergic to this product; 2. Serious heart, liver, kidney and other functional insufficiency relative contraindications; 3. The safety and effectiveness of this product in pregnant women, lactating women, children, the elderly over 56 years old and HIV-infected patients have not been determined, and it is relatively contraindicated and is not recommended. |
toxic substance data | information provided by: pubchem.ncbi.nlm.nih.gov (external link) |