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Bionanotechnology III: from Biomolecular Assembly to Applications Nanomechanics of superbugs and superdrugs: new frontiers in nanomedicine Rachel A. McKendry1 London Centre for Nanotechnology and Division of Medicine, University College London, 17–19 Gordon Street, London WC1H 0AH, U.K. Abstract The alarming rise in drug-resistant hospital ‘superbugs’ and the associated increase in fatalities is driving the development of technologies to search for new antibiotics and improve disease diagnostics. One of the most successful drug targets is the bacterial cell wall, an evolutionary feature of virtually all prokaryotes and vital for their survival by providing mechanical strength. The recent discovery of bacterial cytoskeletal proteins analogous to the key force-bearing machinery in eukaryotes also provides new opportunities for drug discovery, but little is known about their mechanical role in bacteria. In the present short article, I review recent developments in the field of nanotechnology to investigate the mechanical mechanisms of action of potent antibiotics on cell wall and cytoskeletal targets with unprecedented spatial, temporal and force resolution and the development of a new generation of nanomechanical devices to detect pathogens for point-of-care diagnostics. Introduction Bacteria represent some of the most genetically diverse and mechanically robust organisms on the planet and are able to survive in a remarkable range of harsh physical environments. They play a vital role in the global ecosystem and offer a valuable source of new medicines. However, bacteria also pose some of the greatest threats to human health. New infections can emerge unexpectedly and spread rapidly, while old enemies, including tuberculosis, are a major source of morbidity and mortality across the world. Fleming’s serendipitous discovery of penicillin and its subsequent development into a ‘wonder drug’ by Florey, Chain and coworkers is rightly considered to be one of the most important breakthroughs of modern science and has contributed to the enormous gains in life expectancy over the last century. However, the widespread emergence of drug-resistance looks set to challenge these advances [1]. The alarming rise in drug-resistance has been fuelled by the indiscriminate use of these precious medicines which has forced bacteria to selectively evolve resistance via increasingly sophisticated mechanisms. Today, the emergence of new infections and the re-emergence of old enemies with acquired resistance, including MRSA (methicillin-resistant Staphylococcus aureus), VRE (vancomycin-resistant Enterococcus), NDM-1 (New Delhi metallo-β-lactamase-1) and Escherichia coli, extensively drug-resistant tuberculosis and, most recently, totally resistant Mycobacterium tuberculosis, is a major global healthcare problem, and the pipeline of potential drugs that might combat infections has dried to a trickle, with only a couple of new classes of antibiotics discovered over Key words: antibiotic-resistance, atomic force microscopy (AFM), drug-resistance, methicillinresistant Staphylococcus aureus (MRSA), nanomechanics, nanomedicine, superbug, superdrug. Abbreviations used: AFM, atomic force microscope; MRSA, methicillin-resistant Staphylococcus aureus; VRE, vancomycin-resistant Enterococcus. 1 email [email protected] Biochem. Soc. Trans. (2012) 40, 603–608; doi:10.1042/BST20120082 the last 40 years [2]. This has sparked renewed interest in understanding how drugs work on targets such as the bacterial cell wall, a vital evolutionarily conserved feature of virtually all bacteria, which confers mechanical strength and is key to their survival. The cell wall is a crosslinked peptidoglycan matrix that protects bacteria from harsh external forces and high internal osmotic pressures, and, importantly, it is not found in humans, making it an ideal drug target. However, there remains much to be learnt about its structure and mechanical properties and the mechanism of action of drugs on this complex surface. Several major antibiotics target the cell wall. Penicillin, the first known antibiotic, targets the final stage of cell wall cross-linking, transpeptidation, whereas vancomycin, currently the last line of treatment for MRSA, complexes to nascent cell wall peptides. Although the chemical basis of these interactions is well known, much less is known about the mechanics; essentially, these antibiotics, and others, work by engineering mechanical ‘defects’ in the cell wall. Yet the mechanism by which these local ‘surface defects’ collectively lead to the cell weakening and death is not understood [3]. This is important, since it is the mechanical failure induced by these drugs that actually kills the bacteria and combats the infection. Moreover, the recent astonishing discovery of bacterial cytoskeleton proteins [4] analogous to the key force-bearing machinery in eukaryotic cells highlights the need for an improved understanding of bacterial mechanics, work which could pave the way for new antibiotics. However, progress in our understanding of the mechanics of bacteria has been limited by the lack of physical tools to study their properties at submicron length scales. Indeed, the mechanics of bacteria are much less well understood than their eukaryotic counterparts [5]. Optical imaging is limited by the wavelength of light, and cryo-electron microscopy is powerful but requires specialized sample preparations and C The C 2012 Biochemical Society Authors Journal compilation 603 604 Biochemical Society Transactions (2012) Volume 40, part 4 fixing steps, but provides little information on mechanical properties. In the present short article, I review some of the recent advances in the field of nanotechnology that offer new capabilities to probe the structure and mechanics of bacteria and the molecular workings of antibiotics with unprecedented spatial, temporal and force resolution. Nanotechnology, the science of the small, is a rapidly advancing field that offers tremendous opportunities for revolutionalizing healthcare, energy and information technology. Although much of this trillion-dollar industry is driven by the miniaturization of microelectronic processing chips, the powerful impact of this technology in the field of medicine is particularly exciting. In the present article, I focus on advances in mechanical tools based on the AFM (atomic force microscope) to probe pathogens and antibiotics focusing on three key areas: (i) advanced imaging of pathogens at the nanoscale; (ii) nanomechanical mapping of single bacteria; and (iii) nanomechanical biosensors for diagnostics applications. It should be noted that the present article is not intended to be an exhaustive review of the field, but instead provides a snapshot of recent developments in the field and highlights important future challenges. Advanced imaging of pathogens at the nanoscale The AFM offers a unique tool to image the dynamics of live bacteria cells with nanometre-scale lateral resolution under ambient conditions (liquid or air). It works much like an old-fashioned record player by scanning a sharp tip across a surface, mapping three-dimensional topographical features and nanomechanical stiffness simultaneously [6]. AFM has been applied to study live cells and cell fragments [7], resolved nanoscale features in cell wall and membrane organization [8,9], and single spores [10]. Until recently, one of the bottlenecks has been the long acquisition time: AFM typically takes several minutes to capture a scan, which is slow compared with the life cycle of some bacteria. However, the recent breakthrough in the development of high-speed AFM using miniaturized cantilevers and multi-harmonic methods to image live bacteria with nanometre resolution and large enough scan sizes to image several cells simultaneously. In 2010, Belcher and co-workers demonstrated the first use of this technology to directly track the kinetics of drug action of antimicrobial peptides on E. coli [11]. These studies revealed drug activity within 1 min, but considerable heterogeneity even on cells cloned from single colony, and identified a two-step killing process: (i) a time-variable incubation phase (which takes seconds to minutes), and (ii) a more rapid execution phase. Multi-harmonic imaging methods recently developed by Contera and co-workers can probe local properties of cells using the zeroth, first and second harmonic components of the Fourier spectrum of the AFM cantilevers interacting with the cell surface, deriving local stiffness, stiffness gradient and the viscoelastic dissipation of live C The C 2012 Biochemical Society Authors Journal compilation bacteria with 1000-fold improvement in temporal resolution compared with quasi-static AFM [12]. The advantage of the latter approach over miniaturized cantilevers is that it is amenable to conventional AFMs and therefore likely to become more widely available in the near future. Nanomechanical mapping of single bacteria In the force-spectroscopy mode of the AFM, cantilever deflection is monitored as a function of the vertical displacement of the sample, i.e. the tip is pushed towards and away from the sample. The indentation part of the curve provides a direct measure of the local stiffness of the bacteria. Nanomechanical measurements of Myxococcus xanthus, for example, have shown that cell wall stiffness varies significantly across the cell and extracellular polymeric substances [13]. Another mode of force spectroscopy measures the characteristic adhesion between the AFM tip and the sample to map chemical groups and receptor sites on the surface of bacteria with single-molecule sensitivity. For example, Dufrene and co-workers used AFM tips functionalized with heparin-binding haemagglutinin adhesin to measure specific binding forces of individual adhesins and map their distribution on the surface of Mycobacterium smegmatis, and found that the adhesins are concentrated into nanodomains [14]. Dufrene and co-workers have also developed AFM tips coated with the antibiotic vancomycin to map individual receptor sites on the division septum of living Lactococcus lactis bacteria [15]. To date, most force-mapping studies have focused on the outer cell wall; exciting recent work by Shaevitz and co-workers revealed for the first time the mechanical role of internal cytoskeletal filaments [16]. Using force-sensing methods based on optical traps, they investigated the mechanical role of the actin analogue MreB using the inhibitor A22, and found that MreB contributes up to 50 % of a cell’s global stiffness [16], findings which are set to challenge the long-accepted view that the ‘rigid shell’ of the cell wall primarily determines bacterial mechanics. Nanomechanical biosensors In recent years, the key force-transducing element of the AFM, the cantilever, has evolved beyond the well-established realm of imaging to innovative point-of-care nanosensor applications for biomedical analysis and disease diagnosis (Figure 1). By tailoring the cantilever with a capture layer, it is possible to study reactions with different analytes in solution by measuring changes in surface stress and/or resonance [17–36]. The major advantage of cantilever sensors is that they are label-free sensors that do not require complex sample labelling or amplification steps, which are timeconsuming and costly, and can affect the conformation of biomolecules, thereby allowing rapid sensitive detection with high specificity using in situ reference cantilevers. Bionanotechnology III: from Biomolecular Assembly to Applications Figure 1 Nanomechanical detection of vancomycin–cell wall peptide interactions on multiple cantilevers (a) Schematic diagram of cantilevers coated with lysine-d-alanine-d-alanine, lysine-d-alanine-d-lactate or PEG [poly(ethylene glycol)] alkanethiol monolayers. Vancomycin is injected into solution and binds specifically to the cell wall analogues, causing the cantilever to bend downwards owing to a compressive stress. (b) The chemical interaction between vancomycin and the bacterial cell wall analogue. It is known from solution data [37] that the specificity of this complex arises due to (i) the interaction of the C-terminus free carboxy group of the peptide with the three amide bonds in the vancomycin backbone; (ii) the formation of two C=O···H-N hydrogen bonds; and (iii) hydrophobic interactions of alanine methyl groups with aromatic residues of vancomycin. The broken lines represent five intermolecular hydrogen bonds. The yellow broken line represents the hydrogen bond associated with bacterial resistance. (c) The deletion of a single hydrogen bond in mutated d-lactate cell wall peptides gives rise to drug-resistance. The binding pocket of vancomycin is represented schematically and the grey broken line represents the deleted hydrogen bond and electrostatic repulsion between oxygen lone pairs of electrons. Reprinted by permission from Macmillan Publishers Ltd: Nature Nanotechnology, Ndieyira, J.W., Watari, M., Barrera, A.D., Zhou, D., Vogtli, M., Batchelor, M., Cooper, M.A., Strunz, T., Horton, M.A., Abell, C., Rayment, T., Aeppli, G. and McKendry, R.A. (2008) Nanomechanical detection of antibiotic mucopeptide binding in a model for superbug drug resistance, 3, 691–696. c 2008. Cantilever fabrication is also immediately compatible with silicon-processing methods and device integration for lowcost nanosensor applications. Moreover, cantilever sensors are uniquely able to measure changes in the mechanics of adsorbed species, in contrast with competing technologies such as surface plasmon resonance, and are therefore uniquely suited to study the mechanics of bacteria and the workings of antibiotics [3]. There are essentially two main modes of operation: (i) the static mode which measures changes in bending due to surface stress (see below), and (ii) the dynamic mode where the cantilever is driven to oscillate close to its resonance frequency to serve as a microbalance. Early studies of bacteria on cantilevers were confined to a vacuum [23], but in 2005 Hegner and co-workers demonstrated the power of cantilever mass sensors to detect live bacteria using arrays C The C 2012 Biochemical Society Authors Journal compilation 605 606 Biochemical Society Transactions (2012) Volume 40, part 4 coated with selective-growth medium to test susceptibility to different antibiotics in real-time with the sensitivity to detect thousands of cells [26]. This approach offers major advantages in terms of speed and sensitivity compared with conventional microbiological methods that requires more than 24 h for sufficient colonies of bacteria to grow on Petri dishes in specialist laboratories with trained staff. Tamayo and co-workers later showed that the dynamic cantilever signal is convoluted by changes in added mass and stiffness of adsorbates [27], whereas Hoogenboom, together with my group at UCL, have shown that we can decouple these effects by nanopatterning the cantilever, which could provide future opportunities to study the mechanics of bacteria in response to different antibiotics [28]. Boisen and Thundat [24] and Roukes and co-workers [25] have shown that the sensitivity of these devices is dependent on the dimensions and material of the cantilever itself, but, in liquid, the dynamic signal is heavily damped, resulting in low quality factors. To overcome this limitation, Manalis and co-workers have developed novel types of hollow cantilever sensors where cantilevers have an embedded microfluidic channel inside the beam, allowing the device to be operated in a vacuum with high-quality factors [28]. Remarkably, they have shown the sensitivity to weigh individual E. coli cells (110 fg) and Bacillus subtilis (150 fg) bacteria in aqueous environments [29]. This approach shows enormous promise for both basic and applied research. The surface-stress mode of operation has been the most sensitive way to detect small-molecule interactions, and my team at UCL have exploited this inherent sensitivity to probe a range of biomolecular interactions, including DNA and RNA detection with Gerber and co-workers [18,30], plus molecular motors [31], self-assembled monolayers [32– 36], bacteria, HIV and cell detection. One of the key breakthroughs of our work has been the development of a unified multiscale multidimensional model to predict the direction and magnitude of surface-stress signals on cantilever sensors, work which spans across the traditionally distinct modelling areas of materials science, solid-state physics, organic chemistry and soft matter theory, and we find remarkably strong agreement between experiment and theory [33]. In the present paper, I highlight our work on vancomycin [3], one of the most powerful drugs in the battle against superbugs such as MRSA, where the deceptively simple alteration of the cell wall structure from an amide to an ester linkage confers vancomycin-resistance (Figure 1). Indeed, VRE is the second leading superbug in U.S. hospitals and is responsible for urinary tract, heart, wound and blood infections, underlining the urgent need for new antibiotics [37]. We are using multiple arrays of eight silicon cantilever ‘diving boards’ to examine the process which takes place in the body when vancomycin binds to the outer bacterial cell wall. Using cantilever arrays coated with mucopeptides that mimic the cell wall in VSE (vancomycin-susceptible Enterococcus) and VRE, we found that, as the antibiotic attaches itself to the cell wall mucopeptides, it generates C The C 2012 Biochemical Society Authors Journal compilation a surface stress which can be detected by a tiny bending movement of the levers (illustrated in Figure 1). By measuring the surface drug-target binding constants on the cantilever arrays, we see that even tiny changes in drug-resistant cell wall structures make it approximately 800-fold harder for the antibiotic to attach itself on to VRE analogues, leaving it much less able to disrupt the bacterial cell’s structure and thus therapeutically ineffective. The relationship between cantilever bending and the cell wall peptide surface density was also investigated, and from this, a new surface-stress model, based on percolation, was derived, which is dependent on two factors: a chemical factor, and a geometric factor. By varying the density of the underlying peptide film, a critical threshold at a peptide coverage of ∼10 %, below which there is no signal and above which surface stress increased as a function of peptide density, was found. This means is that the stress transduction is actually a collective phenomenon, requiring a relatively large fraction of surface to be covered, so as to establish chemical connectivity between different regions where there are peptides bound to the vancomycin. The surface stress build-up is therefore the product of the connectivity of the chemically transformed localized region and the interactions between nodes of the entire network (Figure 2). These findings are leading to a dramatically improved sensitivity of cantilever devices for applications in functional drug discovery. The study also led to the idea that this surface stress contributes to the disruption of bacterial cell wall and the eventual breakdown of the bacteria themselves [3]. Our current efforts focus on investigating the mechanical mechanism of action of some of the most promising new drugs in development with activity against clinically problematic pathogens. We are testing the hypothesis that vancomycin slowly weakens the cell over 24 h by forming point-defects, whereas dimeric drugs such as oritavancin self-assemble into dimers forming extended line-defects across bacteria, likened to a ‘San Andreas fault’, leading to rapid cell death within 2 h (Figure 2). Conclusions and future perspectives The nanotechnology ‘toolkit’ offers new capabilities to study the mechanical mechanism of action of antibiotics on pathogens with nanometre spatial, piconewton force and microsecond temporal resolution, and new frameworks based on percolation are emerging to understand how these drugs mechanically kill bacteria. The first mechanical investigations of the role of bacterial cytoskeletal proteins are revealing the major role of internal proteins on the global stiffness of cells, challenging the long accepted view that bacteria are simply ‘empty sacks’ where the cell wall alone imparts mechanical strength. More work is needed to study the spatiotemporal dynamic interplay of the cell wall and cytoskeleton and its role on local and global cell stiffness during the cell cycle. As this powerful technology becomes more amenable to microbiologists, research will move beyond proof-ofprinciple experiments on model bacteria and antibiotics to detailed understanding of the systems biology of clinically Bionanotechnology III: from Biomolecular Assembly to Applications Figure 2 The concept of percolation on (left) cantilevers and (right) bacteria Below the critical threshold, pc , bound complexes are isolated and no stress is detected. However, above pc , sites become connected, leading to large-scale stressed network connections on cantilevers. We speculate that this percolation concept may also aid our understanding of the mode of action of antibiotics on real bacteria where molecules ‘team up’ to mechanically weaken bacteria, forming point-defects or extended line-defects, leading to cell rupture and combating infections. Reprinted by permission from Macmillan Publishers Ltd: Nature Nanotechnology, Ndieyira, J.W., Watari, M., Barrera, A.D., Zhou, D., Vogtli, M., Batchelor, M., Cooper, M.A., Strunz, T., Horton, M.A., Abell, C., Rayment, T., Aeppli, G. and McKendry, R.A. (2008) c 2008. Nanomechanical detection of antibiotic mucopeptide binding in a model for superbug drug resistance, 3, 691–696. problematic pathogens, using well-established antibiotics as tools to unravel the complexity of bacteria and testing the mechanisms of action of new antibiotics currently in development. In turn, through a closer collaboration between the microbiology and physical science communities, new nanotools are likely to emerge; for example, the integration of high-speed AFM with fluorescence imaging will open exciting opportunities to track the spatiotemporal dynamics of cytoskeletal proteins, dynamic cell wall biosynthesis and local mechanics, and the development of mechanical devices and microfluidics to routinely study the effects of external mechanical stresses on bacteria and coherent X-ray diffraction to map three-dimensional strains [36]. Moreover, the development of low-cost devices to detect pathogens with such high sensitivity may lead to early-warning disease diagnosis, resulting in better stratified treatments, improving patient quality of life and preventing the spread of infection in our society. Funding This work was funded by the Engineering and Physical Sciences Research Council [grant numbers EP/G062064/1, EP/D505925/1 and EP/G068437/1], Biotechnology and Biological Sciences Research Council, Interdisciplinary Research Collaboration in Nanotechnology (Cambridge, Bristol and UCL) and the Royal Society. References 1 Hopwood, D.A. (2007) A call to arms. Nat. Rev. Drug Discovery 6, 8–12 2 Cooper, M.A. and Shlaes, D. (2011) Fix the antibiotics pipeline. Nature 472, 32 3 Ndieyira, J.W., Watari, M., Barrera, A.D., Zhou, D., Vogtli, M., Batchelor, M., Cooper, M.A., Strunz, T., Horton, M.A., Abell, C. et al. (2008) Nanomechanical detection of antibiotic mucopeptide binding in a model for superbug drug resistance. Nat. Nanotechnol. 3, 691–696 4 Jones, L.J.F., Carballido-Lopez, R. and Errington, J. (2001) Control of cell shape in bacteria: helical, actin-like filaments in Bacillus subtilis. Cell 104, 913–922 5 Fletcher, D.A. and Mullins, R.D. 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