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Macrolides: Mechanisms of Action and Resistance 

Mechanisms in Medicine
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Animation Description: The DNA is shown as a circular double strand within the bacterial cell. Like the DNA of all living organisms, it contains the unique genetic code for all of the proteins required for bacterial survival. These include the proteins required for reproduction, growth, repair and regulation of metabolism. It also codes for the 3 kinds of RNA that are essential for carrying out protein synthesis. These are known as ribosomal RNA (rRNA), messenger RNA (mRNA) and transfer RNA (tRNA).
In order for the bacteria to begin protein synthesis, the double-stranded DNA molecule must first unwind and separate in the region which codes for the specific protein that is to be made. Only one strand of the DNA serves as the template for this process known as transcription. Transcription results in the formation of messenger RNA (mRNA) which is a mirror copy of the DNA segment.
Once the strand of mRNA is complete, it will detach from the DNA template and in turn become attached to ribosomes. Bacterial ribosomes are made of a small (30S) and a large (50S) subunit.
After the 2 subunits join together around the strand of mRNA, synthesis of the polypeptide chain begins. This step involves the aligning of transfer RNA (tRNA) molecules in sequence along the mRNA. Each tRNA carries a unique amino acid (determined by the sequence of the tRNA) which, when aligned along the mRNA and ribosome, join together to form the polypeptide chain. This step is known as translation.
The ribosome will continue to add amino acids to the growing polypeptide chain until it reaches a point along the mRNA that signals it to stop. At this point it releases the finished protein molecule.
Macrolide antibiotics such as erythromycin, act as inhibitors of protein synthesis by attaching to the 50S ribosomal subunit.
By so doing, they block the ability of the ribosome to synthesize the polypeptide chain.
By inhibiting protein synthesis, macrolides are considered bacteriostatic antibiotics. However, at higher concentrations and with lower bacterial density or during rapid bacterial growth, macrolides may be bactericidal.
Changes or modifications to the 50S ribosomal subunit (i.e. the target binding site for macrolide antibiotics) will confer resistance to macrolides and sometimes other classes of antibiotics. This type of resistance may be of a high level. This mechanism of resistance is mediated by the erm (erythromycin ribosome methlylation) gene which is found on plasmids or transposons (i.e. small genetic elements which are capable of moving from one bacterium to another and integrating into the host chromosomal DNA). Copies of the erm gene are transported to other bacteria via plasmids or transposons through "pili-like" channels. The erm gene is incorporated into the new bacterial genome.
During the process of protein synthesis, this bacterium will transcribe and translate the genetic code of the erm gene resulting in the production of a protein enzyme capable of methylating the 50S ribosomal subunit at a specific position.
This altered 50S subunit results in decreased binding affinity for macrolides and other antibiotics such as lincosamides (e.g. clindamycin) and streptogramin type B. This pattern of resistance is referred to as the MLS phenotype.
Because the macrolide antibiotic is unable to bind to the 50S ribosomal subunit, it is unable to inhibit protein synthesis and thus the bacteria itself is not harmed, continuing to produce polypeptide chains of amino acids.
A second mechanism of bacterial resistance to macrolide antibiotics is mediated by efflux pumps.
These efflux pumps are encoded by the mef(A) gene which is a transposable element. Because they confer resistance to only macrolides and not lincosamides or streptogramin B they are referred to as the M phenotype.
The efflux pumps are energy-dependent and for S. pneuomoniae result in moderate levels of resistance. These pumps traverse the cell membrane of the bacteria and function to "pump out" the macrolide antibiotic after it has entered the bacterium. It should be noted that for other bacteria such as Staphylococcus aureus for example, a different efflux system which is plasmid-mediated and encoded by the msr(A) gene results in macrolide resistance as well as lincosamide and streptogramin resistance in some cases.
Despite the presence of these efflux pumps, macrolide antibiotics continue to enter the bacteria.
However, once inside the cytoplasm of the bacteria, these efflux pumps actively remove the macrolide antibiotics before they have a chance to reach their target, the 50S ribosomal subunit and bacterial protein synthesis is unaffected.

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28 мар 2011

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Комментарии : 40   
@maheshkale7387
@maheshkale7387 4 года назад
Your videos make learning very simple . Thank you sir🙏
@ghadah8070
@ghadah8070 10 лет назад
This is really amazing !
@Stickerie
@Stickerie 12 лет назад
YOU REALLY REALLY SAVED ME :) .. i really neeedd this video description for my synthesis .. thx
@dr.janpreetsingh5103
@dr.janpreetsingh5103 5 лет назад
excellent explanation!!! worth the time spent!!!😊
@piseth49
@piseth49 12 лет назад
i'm favourite for uploading any video to this website again.data that you embellish for machanism or animation to internet is very nice... i like all action that you prepare it and sharing miscellaneous document for medical department provide the knowledge to the humanbeing in which has always want to seek other datas that related to pharmacy.... good luck.....
@JA-zw6gr
@JA-zw6gr 11 лет назад
great videos, make things easier to understand!
@Rayyan36
@Rayyan36 12 лет назад
AMAAAAZING!
@kittisakchawawisit1910
@kittisakchawawisit1910 8 лет назад
Thank you very much
@Eastpak200730
@Eastpak200730 9 лет назад
Very very clear!
@gsueldo1
@gsueldo1 12 лет назад
Great videos! thank you for sharing, it makes studying fun! :)
@RgAmelie
@RgAmelie 13 лет назад
Hi I´m a Med student, thanks a lot for this videos, all this videos make learning much easier!
@mayankkesharwani8580
@mayankkesharwani8580 11 лет назад
superbb video!!!
@salvinnaaz27
@salvinnaaz27 12 лет назад
excellent video
@siminnasr7663
@siminnasr7663 9 лет назад
Thank you
@shreekantparanjape
@shreekantparanjape 8 лет назад
Good Video presentation
@muhammadshahzaib9370
@muhammadshahzaib9370 3 года назад
Well explained
@usdrag3n
@usdrag3n 12 лет назад
would love to see a new curriculum in medical school that incorporate new ways of interactive and visual learning like this. cant way when people actually push for online flash based books to append the traditional books.
@dr.catssicknotes7556
@dr.catssicknotes7556 8 лет назад
awesome
@ichaukan
@ichaukan 7 лет назад
Danke!
@galalmaatooq8592
@galalmaatooq8592 3 года назад
thank you
@omprakashyadav2220
@omprakashyadav2220 11 лет назад
easier to learn great videos.
@nokialover31
@nokialover31 10 лет назад
Thanks
@mahawee9363
@mahawee9363 5 лет назад
الف شكررر
@TheChickendiary
@TheChickendiary 8 лет назад
thanks a lot
@khuludalqahtani9248
@khuludalqahtani9248 8 лет назад
good 👏👏thank you
@stevengr4
@stevengr4 6 лет назад
It gets interesting at 3:02.
@Bhargav7771
@Bhargav7771 11 лет назад
You guys rock!! :)
@MrNani1983
@MrNani1983 12 лет назад
hi very good video please make physiology videos also..
@artisharma3462
@artisharma3462 5 лет назад
Thankuuu so much
@vishalrajsaxena9879
@vishalrajsaxena9879 10 лет назад
thnx for the help :)
@zakayombwaga2631
@zakayombwaga2631 8 лет назад
enx alot
@tahamalek4588
@tahamalek4588 6 лет назад
Good
@sarmad663
@sarmad663 12 лет назад
thanks alot for grt videoo,.......
@quyenvuvan5343
@quyenvuvan5343 4 года назад
GOOD
@imcrazyforwar
@imcrazyforwar 4 года назад
Is there a video showing bacteria being attacked by a bacteriophage? I been seeing it being used in experimental medicine against antibiotic resistant bacteria as a last resort with a varying degrees of success.
@lydiaglam92
@lydiaglam92 12 лет назад
OMG the bacteria's resistance is horrible !!! GREAT VIDEO
@khuludalqahtani9248
@khuludalqahtani9248 8 лет назад
من هو الفاضي إلي جلس يدرس البروتين والبكتيريا 😣
@user-kx6gr6ky4b
@user-kx6gr6ky4b 6 лет назад
Let's just take a moment of silence of how bacteria is so smart and created by Allah.....😍......THANK YOU for the clear cut explanation!!!☺
@eirikb9464
@eirikb9464 6 лет назад
So Allah is the one that makes bacteria resistant to antibiotics.. Thanks Allah, very nice of you!
@jfjauy123456
@jfjauy123456 10 лет назад
2fast
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